Chapter 31 Older
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 1 of 24
1. A nurse leads a staff development session about ageism among health care workers. What
information should the nurse include about the consequences of ageism? Select all that apply.
a. Failure of older adults to receive necessary medical information
b. Development of public policy that favors programs for older adults
c. Staff shortages because caregivers prefer working with younger adults
d. Perception that older adults consume a small share of medical resources
e. More ancillary than professional personnel discriminate with regard to age ANS: A, C
Because of society's negative stereotyping of older adults as having little to offer, some staff members
avoid working with older patients. Staff shortages in long-term care facilities are often greater than
those for acute care settings. Older adult patients often receive less information about their conditions
and are offered fewer treatment options than younger patients; some health care staff members
perceive them as less able to understand. This problem exists among professional and ancillary
personnel. Public policy discriminates against programs for older adults. Societal anger exists because
older adults are perceived to consume a disproportionately large share of the medical resources.
1. A student nurse visiting a senior center tells the instructor, "It's so depressing to see all these old
people. They are so weak and frail. They are probably all senile." The student is expressing:
a. reality.
b. ageism.
c. empathy.
d. advocacy. ANS: B
Ageism is defined as a bias against older people because of their age. None of the other options can be
identified from the ideas expressed by the student.
1 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
,Chapter 31 Older
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 2 of 24
1. During an interview with a patient, which question asked of an older adult is associated with the
Patient Self-Determination Act?
a. "Who besides yourself may have access to your medical information?"
b. "Have you discussed your end-of-life choices with your family or designated surrogate?"
c. "Do you have the information you need to make an informed decision about your treatment?"
d. "How can I help you feel comfortable about this interview and any decisions you need to make?"
b. "Have you discussed your end-of-life choices with your family or designated surrogate?"
10. A health care provider decided that the emotional distress of an older adult patient who experiences
threatening auditory hallucinations warrants the use of risperidone (Risperdal). Which intervention
should the nurse add to the patient's plan of care?
a. Use disposable briefs for incontinence.
b. Monitor for psychomotor changes.
c. Implement a tyramine-free diet.
d. Monitor for dehydration. ANS: B
Use of atypical antipsychotic medications increases the risk of cerebrovascular events in the older adult
population; therefore the nurse should carefully monitor the patient for psychomotor changes. This
medication does not place the patient at great risk for the other options.
10. You are caring for Ellie, age 91, whose provider has written a "DNR-CCO" order. Which nursing action
would be appropriate if Ellie were to go into cardiac arrest?
a. Immediately call for the code team
b. Notify the attending physician and family of the change in status
c. Administer prescribed medication morphine for pain control
d. Initiate cardiopulmonary resuscitation b. Notify the attending physician and family of the
change in status
2 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
, Chapter 31 Older
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 3 of 24
11. An older adult patient brings a bag of medication to the clinic. The nurse finds 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. ANS: D
Lorazepam and Ativan are generic and trade names for the same drug, creating an accidental misuse
situation. The patient needs medication education and help with proper, consistent labeling of bottles;
no evidence suggests that the patient cannot self-administer medication. The distracters are not factual
statements.
12. An advance directive gives valid direction to health care providers when a patient is:
a. aggressive
b. dehydrated
c. unable to verbally communicate
d. unable to make decisions for him- or herself ANS: D
Advance directives are invoked when patients are unable to make their own decisions. Aggression,
dehydration, or an inability to speak does not mean the patient is unable to make a decision.
13. A patient with whom the nurse is discussing advance directives asks, "What advantage does a
durable power of attorney for health care have over a living will?" The nurse should reply that a durable
power of attorney for health care:
a. "Gives your agent the authority to make decisions about your care if you are unable to during any
illness."
b. "Can be given only to a relative, usually the next of kin, who has your best interests at heart."
c. "Authorizes your physician to make decisions about your care that are in your best interest."
d. "Can be used only if you have a terminal illness and become incapacitated." ANS: A
3 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 1 of 24
1. A nurse leads a staff development session about ageism among health care workers. What
information should the nurse include about the consequences of ageism? Select all that apply.
a. Failure of older adults to receive necessary medical information
b. Development of public policy that favors programs for older adults
c. Staff shortages because caregivers prefer working with younger adults
d. Perception that older adults consume a small share of medical resources
e. More ancillary than professional personnel discriminate with regard to age ANS: A, C
Because of society's negative stereotyping of older adults as having little to offer, some staff members
avoid working with older patients. Staff shortages in long-term care facilities are often greater than
those for acute care settings. Older adult patients often receive less information about their conditions
and are offered fewer treatment options than younger patients; some health care staff members
perceive them as less able to understand. This problem exists among professional and ancillary
personnel. Public policy discriminates against programs for older adults. Societal anger exists because
older adults are perceived to consume a disproportionately large share of the medical resources.
1. A student nurse visiting a senior center tells the instructor, "It's so depressing to see all these old
people. They are so weak and frail. They are probably all senile." The student is expressing:
a. reality.
b. ageism.
c. empathy.
d. advocacy. ANS: B
Ageism is defined as a bias against older people because of their age. None of the other options can be
identified from the ideas expressed by the student.
1 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
,Chapter 31 Older
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 2 of 24
1. During an interview with a patient, which question asked of an older adult is associated with the
Patient Self-Determination Act?
a. "Who besides yourself may have access to your medical information?"
b. "Have you discussed your end-of-life choices with your family or designated surrogate?"
c. "Do you have the information you need to make an informed decision about your treatment?"
d. "How can I help you feel comfortable about this interview and any decisions you need to make?"
b. "Have you discussed your end-of-life choices with your family or designated surrogate?"
10. A health care provider decided that the emotional distress of an older adult patient who experiences
threatening auditory hallucinations warrants the use of risperidone (Risperdal). Which intervention
should the nurse add to the patient's plan of care?
a. Use disposable briefs for incontinence.
b. Monitor for psychomotor changes.
c. Implement a tyramine-free diet.
d. Monitor for dehydration. ANS: B
Use of atypical antipsychotic medications increases the risk of cerebrovascular events in the older adult
population; therefore the nurse should carefully monitor the patient for psychomotor changes. This
medication does not place the patient at great risk for the other options.
10. You are caring for Ellie, age 91, whose provider has written a "DNR-CCO" order. Which nursing action
would be appropriate if Ellie were to go into cardiac arrest?
a. Immediately call for the code team
b. Notify the attending physician and family of the change in status
c. Administer prescribed medication morphine for pain control
d. Initiate cardiopulmonary resuscitation b. Notify the attending physician and family of the
change in status
2 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
, Chapter 31 Older
Chapter
Adults31Halter
OlderVarcarolis'
Adults Halter
Foundations
Varcarolis'ofFoundations
Psychiatric Mental
of Psychiatric
Health Nursing
Mental Health
A Clinical
Nursing
Approach,
A Clinical
10thApproach,
Edition 10th Edition Page 3 of 24
11. An older adult patient brings a bag of medication to the clinic. The nurse finds 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. ANS: D
Lorazepam and Ativan are generic and trade names for the same drug, creating an accidental misuse
situation. The patient needs medication education and help with proper, consistent labeling of bottles;
no evidence suggests that the patient cannot self-administer medication. The distracters are not factual
statements.
12. An advance directive gives valid direction to health care providers when a patient is:
a. aggressive
b. dehydrated
c. unable to verbally communicate
d. unable to make decisions for him- or herself ANS: D
Advance directives are invoked when patients are unable to make their own decisions. Aggression,
dehydration, or an inability to speak does not mean the patient is unable to make a decision.
13. A patient with whom the nurse is discussing advance directives asks, "What advantage does a
durable power of attorney for health care have over a living will?" The nurse should reply that a durable
power of attorney for health care:
a. "Gives your agent the authority to make decisions about your care if you are unable to during any
illness."
b. "Can be given only to a relative, usually the next of kin, who has your best interests at heart."
c. "Authorizes your physician to make decisions about your care that are in your best interest."
d. "Can be used only if you have a terminal illness and become incapacitated." ANS: A
3 VARCAROLI’S CHAPTER 22 SUBSTANCE RELATED AND ADDICTIVE DISORDERS!@!!
2/4/2026 Chapter 31 OlderChapter
Adults Halter
31 Older
Varcarolis'
Adults Halter
Foundations
Varcarolis'
of Psychiatric
FoundationsMental
of Psychiatric
Health Nursing
MentalAHealth
Clinical
Nursing
Approach,
A Clinical
10th Edition.pdf
Approach, 10th Edition
