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A patient is admitted to the acute care medical center with change in mental status, dehydration, and electrolyte imbalances. Which of these reflects a reversible cause of the changes in mental status?
- A. Alzheimer's disease
- B. Delirium
- C. Dementia
- D. Delirium superimposed on dementia
Correct Answer: B
Rationale: Delirium is a reversible cause of changes in mental status, often triggered by factors like dehydration or electrolyte imbalances, which can be treated. Alzheimer's disease and dementia are progressive and irreversible, while delirium superimposed on dementia includes a reversible component (delirium) but is complicated by underlying irreversible dementia.
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A nurse researcher interviews adults to validate Erikson's theory that middle-aged adults who do not achieve their developmental tasks may be in the stage of stagnation. Which patient statement will the nurse correlate to this theory?
- A. I am helping my parents move into an assisted-living facility.
- B. I spend all of my time going to the doctor to be sure I am not sick.
- C. I have enough money to help my son and his wife when they need it.
- D. I earned this gray hair and I like it!
Correct Answer: B
Rationale: According to Erikson, middle adulthood involves generativity versus stagnation. The tasks include guiding the next generation and adjusting to aging parents. A statement indicating excessive concern about personal health, such as spending all time at the doctor, reflects stagnation, where the individual becomes self-absorbed rather than generative.
A nurse caring for older adults in a provider's office researches aging theories to help determine why some people age more rapidly than others. Which statements describe the immunity theory of the aging process? Select all that apply.
- A. Immunosenescence likely promotes the increase in infections in the older adult.
- B. Free radicals have adverse effects on adjacent molecules.
- C. Decreases in size and function of the thymus result in more infections.
- D. Nutrition likely plays an important role in maintaining the immune response.
- E. Lifespan depends to a great extent on genetic factors.
- F. Organisms wear out from increased metabolic functioning.
Correct Answer: A,C,D
Rationale: The immunity theory of aging focuses on the functions of the immune system and states that the immune response declines steadily after younger adulthood as the thymus loses size and function, resulting in more infections. Vitamin supplements (such as vitamin E) may improve immune function. Free radicals are part of the free radical theory, not the immunity theory. The genetic theory of aging holds that lifespan depends on genetic factors. The wear-and-tear theory suggests organisms wear out from increased metabolic functioning.
A nurse is helping to prepare a calendar for an older adult patient with cognitive impairment. Which type of cognitive impairment is non-reversible?
- A. Post-stroke speech issues
- B. Malnutrition
- C. Alzheimer's disease
- D. Loss of cardiac reserve
Correct Answer: C
Rationale: Alzheimer's disease causes progressive, irreversible cognitive impairment and is the most common degenerative neurologic illness. Post-stroke speech issues, malnutrition, and loss of cardiac reserve can often be managed or improved with therapeutic interventions.
A nurse providing health services for a community setting for people age 55 years and older considers health problems for these residents. Which of the following problems is most appropriate for many middle-aged adults?
- A. Adequate nutrition
- B. Mental health problems
- C. Abuse
- D. Caregiver role strain
Correct Answer: D
Rationale: Many middle-aged adults help care for aging parents, leading to caregiver role strain due to 24-hour care responsibilities over extended periods. Nutritional issues are more common in childhood or older adulthood, while mental health problems and abuse can occur across age groups but are less specific to middle-aged adults.
Following a fall that left an older adult temporarily bedridden, the nurse is using the SPICES assessment tool to evaluate for cascade iatrogenesis. Which are correct aspects of this tool? Select all that apply.
- A. Senility
- B. Problems with feeding
- C. Irritability
- D. Confusion
- E. Edema of the legs
- F. Skin breakdown
Correct Answer: B,D,F
Rationale: The SPICES acronym identifies common problems in older adults: S-Sleep disorders, P-Problems with eating or feeding, I-Incontinence, C-Confusion, E-Evidence of falls, S-Skin breakdown. Senility is not a specific term used in the SPICES tool, and irritability is not part of the acronym.