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A nurse is preparing to conduct an assessment of a 79-year-old woman who has come to the clinic for evaluation. When performing this assessment, which of the following would be most appropriate for the nurse to do? Select all that apply.
- A. Dim any lights that appear too bright.
- B. Face the patient from the side.
- C. Use short, simple sentences.
- D. Focus on one topic at a time.
- E. Speak slowly in a shouting tone.
Correct Answer: A,C,D
Rationale: Appropriate assessment techniques for older adults include dimming bright lights (A) to reduce glare, using short, simple sentences (C), and focusing on one topic (D) to accommodate sensory and cognitive changes. Facing from the side (B) is less effective than facing directly, and shouting (E) may be inappropriate or distressing.
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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.
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.
An older patient tells the nurse that she is becoming more forgetful. The nurse explains to the patient that this is most likely related to which of the following?
- A. Anxiety
- B. Organic brain syndrome
- C. Plaques in the brain tissue
- D. Medications
Correct Answer: D
Rationale: Medications, especially those with anticholinergic or sedative effects, are a common cause of forgetfulness in older adults. Anxiety may contribute, but medications are more likely. Organic brain syndrome and plaques suggest more severe conditions like dementia, not initially assumed.
A nursing student is reading an article about protective factors for mental illness with older adults. The article mentions the individual?s ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which of the following?
- A. Functional status
- B. Gerotransendence
- C. Resilience
- D. Empty nest
Correct Answer: C
Rationale: Resilience is the ability to adapt to stress, trauma, or adversity, a key protective factor for mental health. Functional status refers to physical capabilities, gerotranscendence to spiritual aging, and empty nest to a life stage, not adaptation.
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.