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An older adult is given the diagnosis of depression and is started on medication. Which group of medications would be appropriate for the depressed older adult?
- A. Selective serotonin reuptake inhibitors (SSRIs)
- B. Benzodiazepines
- C. Hypnotics
- D. Monoamine oxidase inhibitors
Correct Answer: A
Rationale: SSRIs are often the first-line treatment for depression in older adults due to their favorable side effect profile, including lower risk of sedation and falls compared to other options. Benzodiazepines are not typically used for depression as they treat anxiety and can increase the risk of falls and confusion in older adults. Hypnotics are used for sleep issues, not as antidepressants, and don’t address the core symptoms of depression. Monoamine oxidase inhibitors are effective but often reserved for cases where other treatments fail due to their dietary restrictions and potential for serious side effects.
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A nurse is reviewing the plan of care for a client who has depression. Which of the following actions should the nurse plan to take?
- A. Reinforce how to use assertive communication techniques.
- B. Schedule the client's daily self-care activities.
- C. Discourage the client from expressing anger.
- D. Set short-term and long-term goals for the client.
Correct Answer: D
Rationale: Assertiveness is secondary to overall planning. Scheduling self-care helps but isn’t comprehensive. Suppressing anger hinders emotional health. Goal setting provides direction and motivation, key to depression management.
In developing a nursing care plan for an adult with a mental health disorder, the nurse knows the goals that are set must be:
- A. Important to the client
- B. Evaluated on a weekly basis
- C. Achievable by client discharge
- D. Approved by the physician
Correct Answer: A
Rationale: Client-important goals boost engagement. Weekly evaluation is useful but not mandatory. Discharge-tied goals may not fit long-term needs. Physician approval is secondary to client-centered planning.
A nurse is caring for a group of older adult clients. Which of the following client findings indicates delirium?
- A. A client expresses dislike of orange juice after reporting earlier that it was a favorite juice.
- B. A client wants to know what type of poison the nurse placed in her medication.
- C. A client asks when family members will be arriving after visiting 1 hr earlier.
- D. A client requests extra blankets when the thermostat in the room indicates 80°F.
Correct Answer: C
Rationale: Changing preferences isn’t delirium-specific. Suspecting poison suggests delusion, not necessarily delirium. Confusion about recent events, like family visits, indicates delirium’s hallmark disorientation. Requesting blankets in a warm room may reflect sensory issues, not delirium directly.
A nurse is caring for a client who has an anxiety disorder and who has begun to hyperventilate, wring her hands, and is pacing the floor continually. Which of the following actions should the nurse take first?
- A. Tell the client you will remain with her.
- B. Take the client to a quiet room.
- C. Ask the client what precipitated this anxiety
- D. Offer the client a prescribed anxiety medication
Correct Answer: A
Rationale: Reassuring presence stabilizes the client emotionally, addressing immediate distress. A quiet room helps but follows reassurance. Asking about triggers is secondary to calming the client. Medication may be needed, but support comes first.
A nurse is conducting a home health visit for an older adult client who lives with family members. The nurse notices that the client has multiple unusual bruises, and, based on several other factors, the nurse suspects that the client has been physically abused. Which of the following actions should the nurse take first?
- A. Check the bruises at the next visit to the client's home.
- B. Institute more frequent visits to the client's home.
- C. Follow the agency's guidelines for reporting suspected abuse.
- D. Arrange referral for family therapy to deal with home stressors.
Correct Answer: C
Rationale: Delaying action by checking bruises later doesn’t address immediate safety. More frequent visits monitor but don’t act on the suspicion promptly. Following agency guidelines for reporting suspected abuse ensures the client’s safety first, as it’s the nurse’s legal and ethical duty. Therapy may help later but isn’t the first step without ensuring safety.