Nokea
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.
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A community mental health nurse plans an educational program for staff members at a home health agency that specializes in the care of older adults. What topic is of high priority?
- A. Identifying depression in older adults
- B. Providing cost-effective foot care for older adults
- C. Identifying nutritional deficiencies in older adults
- D. Psychosocial stimulation for those who live alone
Correct Answer: A
Rationale: Depression is the most common, most debilitating, and also most treatable psychiatric disorder in the older adult. Home health staff are often better versed in the physical aspects of care and less knowledgeable about mental health topics. Statistics show that older adult patients with mental health problems are less likely than young adults to be diagnosed accurately.
What is the highest priority for assessment by nurses caring for older adults who self-administer medications?
- A. Use of multiple drugs with anticholinergic effects
- B. Overuse of medications for erectile dysfunction
- C. Misuse of antihypertensive medications
- D. Trading medications with others
Correct Answer: A
Rationale: Anticholinergic effects are cumulative in older adults and often have adverse consequences related to accidents and injuries.
An 80-year-old patient has difficulty walking because of arthritis and says, 'It's awful to be old. Every day is a struggle. No one cares about old people.' Which is the nurse's most therapeutic response?
- A. Everyone here cares about old people. That's why we work here.'
- B. It sounds like you're having a difficult time. Tell me about it.'
- C. Let's not focus on the negative. Tell me something good.'
- D. You are still able to get around, and your mind is alert.'
Correct Answer: B
Rationale: The nurse uses therapeutic communication and empathic understanding to encourage the patient to express frustration and clarify the 'struggle' for the nurse.
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 asks the following questions while assessing an older adult. The nurse will add the Geriatric Depression Scale as part of the assessment if the patient answers 'yes' to which question?
- A. Would you say your mood is often sad?'
- B. Are you having any trouble with your memory?'
- C. Have you noticed an increase in your alcohol use?'
- D. Do you often experience moderate-to-severe pain?'
Correct Answer: A
Rationale: Sadness may be a symptom of depression. Sad moods occurring with regularity should signal the need to assess further for other symptoms of depression.