Nokea
An elderly client tells the nurse that she had been constipated for the last few days and decided to use an over-the-counter fiber laxative that is dissolved in water. When reviewing the use of this laxative with the client, which of the following would the nurse include as a possible side effect?
- A. Diarrhea
- B. Nausea
- C. Flatus
- D. Stomach pain
Correct Answer: C
Rationale: Fiber laxatives, such as psyllium, increase bulk in the stool and can cause flatus (gas) as a common side effect due to fermentation in the gut. Diarrhea (option A) may occur with overuse but is less common. Nausea (option B) and stomach pain (option D) are less directly associated with fiber laxatives compared to flatus.
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Assessment of an older adult client reveals that the client is receiving psychiatric medications. The client states, 'I get dizzy periodically and have trouble walking.' Which of the following should the nurse do first?
- A. Compare the client?s baseline blood pressure with the client?s current blood pressure.
- B. Instruct the client to stop taking the psychiatric medications.
- C. Interview the client?s family about the client?s coping skills and current stress level.
- D. Suggest the client periodically use an alcohol-based mouthwash several times a day.
Correct Answer: A
Rationale: Dizziness and walking difficulties in an older adult on psychiatric medications may indicate orthostatic hypotension, a common side effect. Comparing baseline and current blood pressure (option A) is the first step to assess this. Stopping medications (option B) is premature without evidence. Interviewing family (option C) is secondary to physical assessment. Mouthwash (option D) is irrelevant to the symptoms.
The nurse is planning to assess a client?s anxiety level using the Rating Anxiety in Dementia Scale because the client also has dementia. When using this scale which of the following areas would the nurse assess? Select all that apply.
- A. Apprehension
- B. Motor tension
- C. Life satisfaction
- D. Boredom
- E. Autonomic hyperactivity
- F. Worry
Correct Answer: A,B,E,F
Rationale: The Rating Anxiety in Dementia Scale assesses anxiety symptoms in dementia patients, including apprehension (A), motor tension (B), autonomic hyperactivity (E), and worry (F). Life satisfaction (C) and boredom (D) are not specific components of this scale, which focuses on anxiety-related behaviors and physiological signs.
A nurse has used the Geriatric Depression Scale (short form) to assess an older adult client for depression. Which score would lead the nurse to suspect that the client is mildly depressed?
- A. 3
- B. 5
- C. 8
- D. 13
Correct Answer: C
Rationale: The Geriatric Depression Scale (short form) has 15 questions, with scores of 5?8 indicating mild depression and 9?15 indicating moderate to severe depression. A score of 8 (option C) falls within the mild depression range. Scores of 3 and 5 (options A and B) are below the threshold, and 13 (option D) indicates moderate to severe depression.
A nurse is providing an in-service educational program for beginning nurses regarding mental health assessment needs of the older adult. One of the topics addressed is the importance of interviewing family members in addition to the older adult client. The nurse tells the audience that family members are sometimes able to give a more accurate history if the client has memory impairment. The nurse also emphasizes that interviewing family members provides which of the following?
- A. A more accurate picture of the social support resources available
- B. Evaluation of the family?s ability to effectively care for the older client
- C. Determination of the extent of the client?s memory impairment
- D. A much needed period of respite and support for the family members
Correct Answer: A
Rationale: Interviewing family members provides a clearer picture of the client?s social support resources (option A), which is critical for assessing the older adult?s ability to manage mental health challenges. Option B focuses on caregiver ability, which is secondary. Option C is partially correct but less comprehensive, as memory impairment is only one aspect. Option D is incorrect, as interviews are not primarily for family respite.
A couple is concerned that the husband?s father may be developing depression. In questioning the couple, which of the following statements would support their concern?
- A. Dad has been crying off and on now for over 2 weeks since Mom died. He?s also still having trouble sleeping.
- B. Dad is agitated and anxious; he?s been that way for a month now since Mom died.
- C. It?s been over 2 months now since Mom died, and Dad keeps crying; he can?t eat or sleep.
- D. Mom?s funeral was last week, and Dad hasn?t been able to eat or sleep since then.
Correct Answer: C
Rationale: Persistent crying, inability to eat, and sleep difficulties for over 2 months (option C) strongly suggest depression, as these symptoms exceed normal grief duration (typically lessening within 2 months). Option A (2 weeks) and option D (1 week) reflect acute grief, which is more expected. Option B (agitation and anxiety) is less specific to depression and could indicate other conditions.