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When making a distinction as to whether a patient is experiencing confusion related to depression or dementia, what information would be most important for the nurse to consider?
- A. The patient with dementia is persistently angry and hostile.
- B. Early morning agitation and hyperactivity occur in dementia.
- C. Confusion seems to worsen at night when dementia is present.
- D. A patient who is depressed is preoccupied with somatic symptoms.
Correct Answer: C
Rationale: Noting whether the confusion seems to increase at night, which occurs more often with dementia than with depression, will help distinguish the cause of the confused behavior.
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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.
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.
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 75-year-old patient comes to the clinic reporting frequent headaches. After an introduction at the beginning of the interview, what should the nurse address?
- A. Initiate a neurological assessment.
- B. Assess if the patient can hear the spoken word clearly.
- C. Suggest that the patient lie down in a darkened room to rest.
- D. Administer medication to relieve the patient's pain prior to the assessment.
Correct Answer: B
Rationale: Before proceeding, the nurse should assess the patient's ability to hear questions. Hearing ability often declines with age. Impaired hearing could lead to inaccurate answers.
A 74-year-old patient is regressed and apathetic. This patient responds to others only when they initiate the interaction. Which therapy would be most useful to promote resocialization?
- A. Medication
- B. Re-motivation
- C. Group psychotherapy
- D. Individual psychotherapy
Correct Answer: B
Rationale: Re-motivation therapy is designed to re-socialize patients who are regressed and apathetic by focusing on a single topic, creating a bridge to reality.