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A nurse and social worker co-lead a reminiscence group for eight adults aged 65 to 70. Which activity is most appropriate to include in the group?
- A. Singing a song from World War II
- B. Learning how to join an online social network
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: C
Rationale: Young-old adults (65?74 years) were attuned to conflicts in national leadership during the Vietnam War, making this activity appropriate for a reminiscence group.
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An older adult patient brings a bag of medication to the clinic. The nurse found one bottle labeled 'Ativan' and one labeled 'lorazepam,' and both are labeled 'Take two times daily.' Bottles of hydrochlorothiazide, Inderal, and rofecoxib, each labeled 'Take one daily,' are also included. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. The patient's blood pressure is likely to be very high.
- C. This patient should not self-administer any medication.
- D. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug, creating an accidental overdose situation.
A nurse wants to perform a preliminary assessment for suicidal ideation in an older adult patient. Which question would obtain the desired data?
- A. What thoughts do you have about a person's right to take his or her own life?'
- B. If you felt suicidal, would you communicate your feelings to anyone?'
- C. Do you have any risk factors that potentially contribute to suicide?'
- D. Do you think you are vulnerable to developing a depressed mood?'
Correct Answer: A
Rationale: The correct response is clear, direct, respectful, and open-ended, producing information relative to the acceptability of suicide as an option.
An advance directive gives valid direction to health care providers when a patient is demonstrating what characteristic?
- A. Aggression
- B. Dehydration
- C. Ineffective verbally communicate
- D. Unable to make health care decisions
Correct Answer: D
Rationale: Advance directives are invoked when patients are unable to make their own decisions.
Which is the best statement for a nurse to use when beginning an interview with an older adult patient?
- A. Hello, [call patient by first name]. I am going to ask you some questions to get to know you better.'
- B. Hello. My name is [nurse's name]. I am a nurse. Please tell me how you would like to be addressed by the staff.'
- C. I am going to ask you some questions about yourself. I would like to call you by your first name if you don't mind.'
- D. You look as though you are comfortable and ready to participate in an admission interview. Shall we get started?'
Correct Answer: B
Rationale: The correct response identifies the nurse's role and politely seeks direction for addressing the patient in a way that will make him or her comfortable. This is particularly important when a considerable age difference exists between the nurse and the patient.
When making a distinction as to whether a patient is experiencing confusion related to depression or dementia, what information would be most important for the nurse to consider?
- A. The patient with dementia is persistently angry and hostile.
- B. Early morning agitation and hyperactivity occur in dementia.
- C. Confusion seems to worsen at night when dementia is present.
- D. A patient who is depressed is preoccupied with somatic symptoms.
Correct Answer: C
Rationale: Noting whether the confusion seems to increase at night, which occurs more often with dementia than with depression, will help distinguish the cause of the confused behavior.