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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.
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A nurse assessing an older adult patient for depression should include questions about mood as well as which other symptoms?
- A. Increased appetite
- B. Sleep pattern changes
- C. Anhedonia and anergia
- D. Increased social isolation
- E. Increased concern with bodily functions
Correct Answer: B,C,D,E
Rationale: These symptoms are often noted in older adult patients experiencing depression. Somatic symptoms are often present but missed by nurses as being related to depression.
A patient asks the nurse, 'I already have a living will. Why should I have a durable power of attorney for health care also?' The nurse should provide what as the truth related to a durable power of attorney for health care?
- A. It gives your agent the authority to make decisions about your care if you are unable to during any illness.
- B. It can be given only to a relative, usually the next of kin, who has your best interests at heart.
- C. It authorizes your physician to make decisions about your care that are in your best interest.
- D. It can be used only if you have a terminal illness and become incapacitated.
Correct Answer: A
Rationale: A durable power of attorney for health care is an instrument that appoints a person other than a health care provider to act as an individual's agent in the event that he or she is unable to make medical decisions.
An 80-year-old patient has difficulty walking because of arthritis and says, 'It's awful to be old. Every day is a struggle. No one cares about old people.' Which is the nurse's most therapeutic response?
- A. Everyone here cares about old people. That's why we work here.'
- B. It sounds like you're having a difficult time. Tell me about it.'
- C. Let's not focus on the negative. Tell me something good.'
- D. You are still able to get around, and your mind is alert.'
Correct Answer: B
Rationale: The nurse uses therapeutic communication and empathic understanding to encourage the patient to express frustration and clarify the 'struggle' for the nurse.
A nurse and social worker co-lead a reminiscence group for six 'baby boomer' adults. Which activity is appropriate to include in the group?
- A. Post-World War II music
- B. Learning to send and receive email
- C. Discussing national leadership during the Vietnam War
- D. Identifying the most troubling story in today's newspaper
Correct Answer: A
Rationale: The baby boomer generation (born 1946?1964) would be familiar with post-World War II culture, making this activity appropriate for a reminiscence group.
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.