Nokea
A nurse is assessing an older adult client. Which of the following would the nurse interpret as most indicative of mental health and wellness?
- A. Keeping social contacts to a minimum
- B. Interacting with others in the environment
- C. Relying solely on family for assistance
- D. Experiencing bereavement
Correct Answer: B
Rationale: Interacting with others in the environment (option B) is most indicative of mental health and wellness, as it reflects social engagement, a key component of psychological well-being. Keeping social contacts to a minimum (A) or relying solely on family (C) suggests isolation or dependence, which are less healthy. Bereavement (D) is a normal response but not an indicator of wellness.
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Assessment of an older adult client reveals that the client is receiving psychiatric medications. The client states, 'I get dizzy periodically and have trouble walking.' Which of the following should the nurse do first?
- A. Compare the client?s baseline blood pressure with the client?s current blood pressure.
- B. Instruct the client to stop taking the psychiatric medications.
- C. Interview the client?s family about the client?s coping skills and current stress level.
- D. Suggest the client periodically use an alcohol-based mouthwash several times a day.
Correct Answer: A
Rationale: Dizziness and walking difficulties in an older adult on psychiatric medications may indicate orthostatic hypotension, a common side effect. Comparing baseline and current blood pressure (option A) is the first step to assess this. Stopping medications (option B) is premature without evidence. Interviewing family (option C) is secondary to physical assessment. Mouthwash (option D) is irrelevant to the symptoms.
The nurse is assessing a 78-year-old client who lives alone in his own home. To assess the client?s instrumental activities of daily living, which question would be most appropriate to ask?
- A. How often do you bathe or shower?
- B. How many times do you change clothes during the day?
- C. How often do you cook meals for yourself?
- D. How often do you go to the store to buy groceries?
Correct Answer: C
Rationale: Instrumental activities of daily living (IADLs) include complex tasks like cooking, shopping, and managing finances. Asking about cooking meals (option C) directly assesses an IADL. Bathing (option A) and changing clothes (option B) are basic activities of daily living (ADLs). Grocery shopping (option D) is an IADL but is less specific than cooking for assessing daily functioning.
A couple is concerned that the husband?s father may be developing depression. In questioning the couple, which of the following statements would support their concern?
- A. Dad has been crying off and on now for over 2 weeks since Mom died. He?s also still having trouble sleeping.
- B. Dad is agitated and anxious; he?s been that way for a month now since Mom died.
- C. It?s been over 2 months now since Mom died, and Dad keeps crying; he can?t eat or sleep.
- D. Mom?s funeral was last week, and Dad hasn?t been able to eat or sleep since then.
Correct Answer: C
Rationale: Persistent crying, inability to eat, and sleep difficulties for over 2 months (option C) strongly suggest depression, as these symptoms exceed normal grief duration (typically lessening within 2 months). Option A (2 weeks) and option D (1 week) reflect acute grief, which is more expected. Option B (agitation and anxiety) is less specific to depression and could indicate other conditions.
A nurse is caring for a 76-year-old patient with a hearing deficit caused by presbycusis. Which of the following would be most appropriate for the nurse to do when communicating with the patient?
- A. Use a higher volume of speech.
- B. Address the client?s family members.
- C. Ask if the client can use sign language.
- D. Use lower pitched tones.
Correct Answer: D
Rationale: Presbycusis, age-related hearing loss, primarily affects high-frequency sounds, making lower-pitched tones easier to hear. Using lower-pitched tones (option D) is most appropriate, as it accommodates the patient?s hearing deficit. Higher volume (option A) may help but can distort sound if too loud. Addressing family members (option B) excludes the patient and is inappropriate. Sign language (option C) is irrelevant unless the patient is trained in it, which is not indicated.
A group of nursing students is reviewing information about age-related changes occurring in cognition and intellectual performance. The students demonstrate understanding of the information when they identify which of the following as a normal cognitive change?
- A. Disorientation to time
- B. Slowed information processing
- C. Diminished executive functioning
- D. Restricted judgment
Correct Answer: B
Rationale: Slowed information processing (option B) is a normal age-related cognitive change, as processing speed declines with aging but does not impair overall function significantly. Disorientation to time (A), diminished executive functioning (C), and restricted judgment (D) are more indicative of pathological conditions like dementia, not normal aging.