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An older adult patient brings a bag of medication to the clinic. The nurse found one bottle labeled 'Ativan' and one labeled 'lorazepam,' and both are labeled 'Take two times daily.' Bottles of hydrochlorothiazide, Inderal, and rofecoxib, each labeled 'Take one daily,' are also included. Which conclusion is accurate?
- A. Rofecoxib should not be taken with Ativan.
- B. The patient's blood pressure is likely to be very high.
- C. This patient should not self-administer any medication.
- D. Lorazepam and Ativan are the same drug; consequently, the dose is excessive.
Correct Answer: D
Rationale: Lorazepam and Ativan are generic and trade names for the same drug, creating an accidental overdose situation.
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A 79-year-old white man tells a visiting nurse, 'I've been feeling sad lately. My family and friends are all dead. My money is running out, and my health is failing.' How should the nurse analyze this comment?
- A. Normal negativity of older adults
- B. Evidence of suicide risk
- C. A cry for sympathy
- D. Normal grieving
Correct Answer: B
Rationale: The patient describes the loss of significant others, economic insecurity, and declining health, which are risk factors for suicide, especially in older adult white men.
A nurse wants to perform a preliminary assessment for suicidal ideation in an older adult patient. Which question would obtain the desired data?
- A. What thoughts do you have about a person's right to take his or her own life?'
- B. If you felt suicidal, would you communicate your feelings to anyone?'
- C. Do you have any risk factors that potentially contribute to suicide?'
- D. Do you think you are vulnerable to developing a depressed mood?'
Correct Answer: A
Rationale: The correct response is clear, direct, respectful, and open-ended, producing information relative to the acceptability of suicide as an option.
If an older adult patient must be physically restrained, who is responsible for the patient's safety?
- A. Nurse assigned to care for the patient.
- B. Nursing assistant who applies the restraint.
- C. Health care provider who ordered the application of the restraint.
- D. Family member who agrees to the application of the restraint.
Correct Answer: A
Rationale: The nurse caring for the patient is responsible for the safe application of restraining devices and for providing safe care while the patient is restrained.
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.
Recognizing the risk for acquired immunodeficiency syndrome (AIDS) among older adults, nurses should provide health teaching focused on what?
- A. Discouraging sexual expression
- B. Using birth control measures
- C. Avoiding blood transfusions
- D. Encouraging condom use
Correct Answer: D
Rationale: Safe sex continues to be important and should be taught to the older adult population. Condom use is diminished in postmenopausal women, which places older adults at risk for AIDS and other sexually transmitted diseases.