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A nurse is using the Neuropsychiatric Inventory to assess an older adult client who is exhibiting behavior problems related to dementia. When using this tool, which of the following would the nurse assess? Select all that apply.
- A. Dysphoria
- B. Inhibition
- C. Apathy
- D. Level of orientation
- E. Memory
- F. Anxiety
Correct Answer: A,C,F
Rationale: The Neuropsychiatric Inventory assesses behavioral and psychological symptoms in dementia, including dysphoria (A), apathy (C), and anxiety (F). Inhibition (B) is not a standard domain, though disinhibition is. Level of orientation (D) and memory (E) are cognitive functions assessed by other tools, not the Neuropsychiatric Inventory, which focuses on behavioral symptoms.
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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.
While caring for an 88-year-old client suspected of having dementia, the nurse assesses the client for a common delusional thought. Which of the following would the nurse interpret as a common delusion?
- A. I am the king of the universe.
- B. Creatures are living in my closet.
- C. The government has people following me.
- D. My roommate keeps stealing my clothes.
Correct Answer: D
Rationale: In dementia, a common delusion is the belief that personal belongings are being stolen, often by familiar people like roommates or caregivers, as in option D. Grandiose delusions (option A) or paranoid delusions about the government (option C) are less common in dementia and more associated with other disorders like schizophrenia. Option B is less typical and more fantastical.
A nurse is preparing a presentation for a group of colleagues about suicide and the older adult population. Which of the following would the nurse include in this presentation? Select all that apply.
- A. Suicide is less of a risk in this population as compared with middle-aged adults.
- B. Married African American men are at the greatest risk for suicide in this group.
- C. Depression is the greatest risk factor for suicide in this population group.
- D. White women account for the highest number of suicide deaths in this age group.
- E. Recent behavior changes and loss of support are important assessment areas for suicide risk.
Correct Answer: C,E
Rationale: Depression (C) is the greatest risk factor for suicide in older adults, as it significantly increases vulnerability. Recent behavior changes and loss of support (E) are critical to assess, as they signal increased risk. Option A is incorrect, as older adults have higher suicide rates than middle-aged adults. Option B is false, as White men, not African American men, are at higher risk. Option D is incorrect, as White men, not women, have the highest suicide rates in this group.
An 80-year-old client visits the mental health clinic with her daughter. During the assessment process, the client tells the nurse that she is taking an antidepressant, an antibiotic, and an occasional aspirin. Which question would be most important for the nurse to ask?
- A. How much grapefruit juice do you drink on a daily basis?
- B. How much orange juice do you drink on a daily basis?
- C. How much tomato juice do you drink on a daily basis?
- D. How much grape juice do you drink on a daily basis?
Correct Answer: A
Rationale: Grapefruit juice can interact with many medications, including some antidepressants and antibiotics, by inhibiting the cytochrome P450 enzyme system, potentially leading to increased drug levels and toxicity. Orange, tomato, and grape juices (options B, C, D) do not have significant interactions with these medications, making grapefruit juice the most critical to assess.
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.