Nokea
A tricyclic antidepressant is prescribed for an older adult patient diagnosed with major depressive disorder. Nursing assessment should include careful collection of information regarding what focus?
- A. Use of other prescribed medications and over-the-counter products
- B. Evidence of pseudoparkinsonism or tardive dyskinesia
- C. A history of psoriasis and any other skin disorders
- D. A current immunization status
Correct Answer: A
Rationale: Drug interactions, with both prescription and over-the-counter products, can be problematic for the geriatric patient taking tricyclic antidepressant medications.
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A health care provider writes these new prescriptions for a resident in a skilled care facility: '2 g sodium diet; restraint as needed; limit fluids to 2000 mL daily; 1 dose milk of magnesia 30 mL orally if no bowel movement occurs for 3 days.' Which prescription should the nurse question?
- A. Restraint
- B. Fluid restriction
- C. Milk of magnesia
- D. Sodium restriction
Correct Answer: A
Rationale: Restraints may be applied only on the written order of the health care provider that specifies the duration during which the restraints can be used. The Joint Commission guidelines and Omnibus Budget Reconciliation Act regulations also mandate a number of other conditions that must be considered and documented before restraints are used.
A student nurse visiting a senior center tells the instructor, 'It's so depressing to see all these old people. They are so weak and frail. They are probably all confused.' The student is expressing what attitude?
- A. Reality
- B. Ageism
- C. Empathy
- D. Distrust
Correct Answer: B
Rationale: Ageism is defined as a bias against older people because of their age. None of the other options can be identified from the ideas expressed by the student.
Which statement about aging provides the best rationale for focused assessment of older adult patients?
- A. Older adults are often socially isolated and lonely.
- B. As people age, they become more rigid in their thinking.
- C. The majority of older adults sleep more than 12 hours per day.
- D. The senses of vision, hearing, touch, taste, and smell decline with age.
Correct Answer: D
Rationale: Only the correct answer is true and cues the nurse to assess carefully the sensory functions of the older adult patient. The incorrect options are myths about aging.
An advance directive gives valid direction to health care providers when a patient is demonstrating what characteristic?
- A. Aggression
- B. Dehydration
- C. Ineffective verbally communicate
- D. Unable to make health care decisions
Correct Answer: D
Rationale: Advance directives are invoked when patients are unable to make their own decisions.
An older adult with a history of major depressive disorder has taken an antidepressant daily for 3 years. The patient tells the nurse, 'I want to stop taking this medication. I don't think I need it anymore.' What is the nurse's best response to assure the patient's safety?
- A. Why do you think you don't need this medication anymore?'
- B. Have you talked with your family members about this decision?'
- C. If you stop the medication, your depression will return worse than ever.'
- D. This medication should be gradually stopped. Let's talk to your health care provider about a plan.'
Correct Answer: D
Rationale: A gradual discontinuation is needed to avoid discontinuation symptoms, ensuring patient safety.