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The nurse is working with a patient whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the patient, who has diabetes, is developing problems with vision and hearing. The patient seems increasingly withdrawn and depressed. The nurse determines that the patient is at risk for spiritual distress. Which intervention would be most appropriate?
- A. Encourage the patient to talk about significant childhood religious experiences.
- B. Offer to take the patient to a revival the nurse?s church is holding in the community.
- C. Read to the patient Bible passages that seem particularly relevant to the patient?s case.
- D. Explore what the mobility, sight, and hearing changes mean to the patient.
Correct Answer: D
Rationale: Exploring the meaning of the patient?s losses addresses spiritual distress by focusing on their personal values and coping, which is patient-centered. Religious interventions (A, B, C) may not align with the patient?s beliefs and could be inappropriate.
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A nursing student is reading an article about protective factors for mental illness with older adults. The article mentions the individual?s ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which of the following?
- A. Functional status
- B. Gerotransendence
- C. Resilience
- D. Empty nest
Correct Answer: C
Rationale: Resilience is the ability to adapt to stress, trauma, or adversity, a key protective factor for mental health. Functional status refers to physical capabilities, gerotranscendence to spiritual aging, and empty nest to a life stage, not adaptation.
A nurse is reviewing the medical records of several older adult patients. The nurse determines that which individual would have the least chance of developing mental health problems with aging?
- A. A man who is single, has an eighth grade education, and walks to the mailbox and back every day
- B. A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day
- C. A man who is married, has a high school education, eats mostly fast food, and walks a mile each day
- D. A woman who is single, has a college degree and watches what she eats but really does not exercise
Correct Answer: B
Rationale: The married woman with graduate education, balanced diet, and regular exercise has protective factors (education, social support, healthy lifestyle) reducing mental health risks. The others have risk factors like lower education, poor diet, or minimal exercise.
The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate?
- A. Older adults who have multiple prescriptions from a variety of different pharmacies.
- B. Older adults who are experiencing a deep and profound depression.
- C. Older adult women who are divorced or widowed.
- D. Men over the age of 75 years who are divorced or widowed.
Correct Answer: D
Rationale: Men over 75 who are divorced or widowed have the highest suicide risk in older adults due to social isolation, loss, and gender-specific tendencies. Depression is a risk factor, but men in this demographic are particularly vulnerable. Women and polypharmacy are less specific.
A nursing instructor is preparing for a class discussion on polypharmacy and older adults. Which of the following would the instructor expect to include?
- A. The risk for drug abuse, although present, is fairly rare in this population.
- B. Older adults often experience a greater risk for adverse reactions.
- C. Medications are usually prescribed in higher doses initially and then gradually reduced.
- D. Age-related pharmacokinetic changes enhance the drug?s therapeutic effectiveness.
Correct Answer: B
Rationale: Older adults face a greater risk for adverse drug reactions due to age-related changes in metabolism and excretion. Drug abuse is rare, doses are typically lower, not higher, and pharmacokinetic changes often reduce, not enhance, effectiveness.
A group of nursing students is reviewing information about the course of aging in future older adults and qualities that contribute to successful aging. The students demonstrate understanding of this information when they identify which of the following as least important?
- A. Capacity to adapt to change
- B. Engagement in life
- C. Stability with reliable social support
- D. Physical health
Correct Answer: D
Rationale: While physical health is important, successful aging relies more on adaptability, engagement, and social support, as these psychosocial factors often outweigh physical limitations in promoting well-being. Physical health is less critical in defining successful aging.