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A nurse is developing a plan for establishing appropriate supportive community care services for older adults to promote independence. Which services would the nurse be most likely to include? Select all that apply.
- A. Transportation
- B. Homemakers
- C. Legal
- D. Housing
- E. Child care
Correct Answer: A,B,C,D
Rationale: Supportive services for older adults to promote independence include transportation (A), homemakers (B), legal services (C), and housing (D), addressing mobility, daily tasks, legal needs, and living arrangements. Child care (E) is irrelevant for most older adults.
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The nurse is working with a patient whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the patient, who has diabetes, is developing problems with vision and hearing. The patient seems increasingly withdrawn and depressed. The nurse determines that the patient is at risk for spiritual distress. Which intervention would be most appropriate?
- A. Encourage the patient to talk about significant childhood religious experiences.
- B. Offer to take the patient to a revival the nurse?s church is holding in the community.
- C. Read to the patient Bible passages that seem particularly relevant to the patient?s case.
- D. Explore what the mobility, sight, and hearing changes mean to the patient.
Correct Answer: D
Rationale: Exploring the meaning of the patient?s losses addresses spiritual distress by focusing on their personal values and coping, which is patient-centered. Religious interventions (A, B, C) may not align with the patient?s beliefs and could be inappropriate.
The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate?
- A. Older adults who have multiple prescriptions from a variety of different pharmacies.
- B. Older adults who are experiencing a deep and profound depression.
- C. Older adult women who are divorced or widowed.
- D. Men over the age of 75 years who are divorced or widowed.
Correct Answer: D
Rationale: Men over 75 who are divorced or widowed have the highest suicide risk in older adults due to social isolation, loss, and gender-specific tendencies. Depression is a risk factor, but men in this demographic are particularly vulnerable. Women and polypharmacy are less specific.
While assessing an older adult patient for mental health issues, the nurse pays special attention to the patient?s sensory function based on the understanding of which of the following?
- A. Most older adults follow a specific pattern of decline in functioning leading to gradual onset of problems.
- B. Sensory decline may affect the individual?s ability to process information, possibly influencing the findings of the mental status examination.
- C. Diminished sensory function can lead to changes in other body systems that may affect the individual?s reaction to prescribed medications.
- D. Changes in the senses can result in changes in cognitive abilities that mimic the manifestations of mental disorders.
Correct Answer: B
Rationale: Sensory decline (e.g., hearing, vision) can impair information processing, affecting mental status examination results. Patterns of decline vary, sensory changes don?t directly alter other systems for medication reactions, and cognitive mimicry is possible but less primary.
A nurse is reviewing the medical records of several older adult patients. The nurse determines that which individual would have the least chance of developing mental health problems with aging?
- A. A man who is single, has an eighth grade education, and walks to the mailbox and back every day
- B. A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day
- C. A man who is married, has a high school education, eats mostly fast food, and walks a mile each day
- D. A woman who is single, has a college degree and watches what she eats but really does not exercise
Correct Answer: B
Rationale: The married woman with graduate education, balanced diet, and regular exercise has protective factors (education, social support, healthy lifestyle) reducing mental health risks. The others have risk factors like lower education, poor diet, or minimal exercise.
The nurse is presenting a community educational program focusing on older adults and mental health protective factors. One of the participants asks what the influence of co-parenting one?s grandchild has on the mental health of the grandparent. Which response by the nurse would be most appropriate?
- A. The well-being of grandmothers is statistically more significant when they co-parent their grandchildren.
- B. Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives.
- C. White grandmothers experience less well-being when they co-parent their grandchildren.
- D. The perceived well-being of grandfathers who co-parent their grandchildren significantly changes in a positive direction.
Correct Answer: B
Rationale: Co-parenting grandchildren can enhance well-being through purpose and connection, though it involves stress; benefits generally outweigh negatives. Gender-specific or racial claims (A, C, D) lack broad evidence and are less accurate.