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A nurse assessing an older adult patient for depression should include questions about mood as well as which other symptoms?
- A. Increased appetite
- B. Sleep pattern changes
- C. Anhedonia and anergia
- D. Increased social isolation
- E. Increased concern with bodily functions
Correct Answer: B,C,D,E
Rationale: These symptoms are often noted in older adult patients experiencing depression. Somatic symptoms are often present but missed by nurses as being related to depression.
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A patient tells the nurse of the recent deaths of a spouse of 50 years as well as an adult child in an automobile accident. The patient has no other family and only a few friends in the community. What is the priority nursing diagnosis?
- A. Spiritual distress, related to being angry with God for taking the family
- B. Risk for suicide, related to recent deaths of significant others
- C. Anxiety, related to sudden and abrupt lifestyle changes
- D. Social isolation, related to loss of existing family
Correct Answer: B
Rationale: The patient appears to be experiencing normal grief, but due to age and social isolation, the risk for suicide is a high-priority nursing diagnosis.
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.
A nurse caring for an older adult patient population should be familiar with which legal and ethical issues that are common concerns for this group?
- A. Physical abuse
- B. Autonomous decision making
- C. Emotional abuse
- D. Financial abuse
- E. Need for medication therapy
Correct Answer: A,C
Rationale: Among the most important legal and ethical issues are decision-making about health care and various forms of elder abuse, including physical and emotional abuse.
An older patient reports drinking a six-pack of beer daily. The patient tells the community health nurse, 'I've been having trouble with my arthritis lately, so I take acetaminophen four times a day for pain.' What are the nurse's priority interventions?
- A. Inquiring about sleep disturbances caused by mixing alcohol and analgesic medications
- B. Determining the safety of the daily acetaminophen dose the patient is ingesting
- C. Advising the patient of harmful effects of alcohol and acetaminophen on the liver
- D. Suggesting an increase in the acetaminophen dose because alcohol produces faster excretion
- E. Assessing the patient for declining functional status associated with medication-induced dementia
Correct Answer: B,C
Rationale: The toxicity of acetaminophen is enhanced by alcohol and age-related decrease in clearance, requiring assessment of the dose and education on the dangers of combined use.
A patient asks the nurse, 'I already have a living will. Why should I have a durable power of attorney for health care also?' The nurse should provide what as the truth related to a durable power of attorney for health care?
- A. It gives your agent the authority to make decisions about your care if you are unable to during any illness.
- B. It can be given only to a relative, usually the next of kin, who has your best interests at heart.
- C. It authorizes your physician to make decisions about your care that are in your best interest.
- D. It can be used only if you have a terminal illness and become incapacitated.
Correct Answer: A
Rationale: A durable power of attorney for health care is an instrument that appoints a person other than a health care provider to act as an individual's agent in the event that he or she is unable to make medical decisions.