, NURS 3325 Holistic Care Older Adult
Test #3
1. A nurse discusses recent issues with an older adult client. The client is distraught stating,
“I forgot to pay a bill, and I lost my wallet.” How should the nurse best interpret these
recent deficits in memory?
The older adult may be experiencing mild cognitive impairment
The older adult is likely experiencing a temporary state of delirium that will self-
resolve
The older adult is likely experiencing the early stages of Alzheimer’s disease
The older adult may be experiencing age-related changes in personality
Rationale: Healthy older adults will not experience any significant cognitive
impairment that interferes with daily life, but they will notice minor deficits in
some aspects of cognitive function and improvements in other aspects.
Longitudinal studies have identified patterns of cognitive change that are likely to
occur even in the absence of any pathologic processes. This does not rule out the
possibility of dementia or delirium, but a fundamental change in personality is
unlikely.
2. A nurse plans activities each month at an assisted living facility. Which activity is most
cognitively stimulating?
Movie night
Book discussions
Exercise
Reminiscence therapy
Rationale: The cognitive reserve model suggests that improving cognitive abilities
occurs through participation in creative and intellectual stimulating activities.
Reminiscence may provide some social interaction, and movies serve as a
distraction. Exercise does increase the blood flow; however, the brain and neural
circuits develop in response to environmental stimuli.
3. An older adult arrives at the community clinic accompanies by an adult child. Which
assessment question is most likely to identify potential risk factors for impaired cognitive
functioning?
“What did your mother and father die of”?
“Where are you currently living?”
“What medications are you currently taking?”
Rationale: Adverse medication effects can have a profound influence on the
cognitive functioning of older adults. Genetic, environmental, and occupation
factors are potential risk factors, but medications are more commonly
implicated.
, 4. An older adult client tells a nurse, “I am worried that I’m losing my mind; I have difficulty
remembering names as well as I used to, and I missed two health care appointments in
the past month because I forgot about them.” Which question is the best approach to
evaluating the effectiveness of a memory training program?
“How have the memory training techniques helped you?”
“Are you using the memory training techniques now?”
“Are you less worried about your memory now?”
“Have you seen an improvement in your memory?”
Rationale: The question about how the memory training techniques have helped
the client allows the older adult to tell the nurse how memory training has helped
and is more open-ended than other options. It also communicates positive
expectation. The question helps identify the techniques that are most effective for
the individual.
5. A nurse assesses an older adult Hispanic client. The client states that “my spouse was
punished by God.” To which illness is the client most likely referring?
Posttraumatic stress disorder (PTSD)
Voodoo
Fainting
Alcohol abuse
Rationale: For some Hispanics, views of mental illness are a punishment by a
supreme being for past transgressions; Hispanic older adults define mental
health problems as alcohol and other drug abuse. PTSD is relatively common in
immigrants. Hallucinations are not related to Hispanic culture. Those of
Caribbean descent may attribute the cause of mental illness to voodoo.
6. A nurse manager develops policies to promote a sense of control for older adults in the
assisted living facility. Which policies should be included?
Post a metal menu every Sunday and tell the residents that they must notify the
kitchen in advance if they want a menu change
Design all the emergency pull cords so they blend in with the wallpaper and are
inconspicuous
Hold resident council meetings twice monthly and invite all residents to attend
Teach the nurses’ aides to use the passkey to do spot checks on every resident at
least twice during the night to ensure that the residents are safe
Rationale: Resident meetings allow older adults to address personal preferences
and to make choices. Posting the meals and later allowing choices is giving the
older residents a limited chance to make a choice. Safety should be an ongoing
concern.
7. An older adult client, saddened by a recent diagnosis of type 2 diabetes, is concerned
about the future. Which action demonstrates a problem-focused approach to this
stressor?
Test #3
1. A nurse discusses recent issues with an older adult client. The client is distraught stating,
“I forgot to pay a bill, and I lost my wallet.” How should the nurse best interpret these
recent deficits in memory?
The older adult may be experiencing mild cognitive impairment
The older adult is likely experiencing a temporary state of delirium that will self-
resolve
The older adult is likely experiencing the early stages of Alzheimer’s disease
The older adult may be experiencing age-related changes in personality
Rationale: Healthy older adults will not experience any significant cognitive
impairment that interferes with daily life, but they will notice minor deficits in
some aspects of cognitive function and improvements in other aspects.
Longitudinal studies have identified patterns of cognitive change that are likely to
occur even in the absence of any pathologic processes. This does not rule out the
possibility of dementia or delirium, but a fundamental change in personality is
unlikely.
2. A nurse plans activities each month at an assisted living facility. Which activity is most
cognitively stimulating?
Movie night
Book discussions
Exercise
Reminiscence therapy
Rationale: The cognitive reserve model suggests that improving cognitive abilities
occurs through participation in creative and intellectual stimulating activities.
Reminiscence may provide some social interaction, and movies serve as a
distraction. Exercise does increase the blood flow; however, the brain and neural
circuits develop in response to environmental stimuli.
3. An older adult arrives at the community clinic accompanies by an adult child. Which
assessment question is most likely to identify potential risk factors for impaired cognitive
functioning?
“What did your mother and father die of”?
“Where are you currently living?”
“What medications are you currently taking?”
Rationale: Adverse medication effects can have a profound influence on the
cognitive functioning of older adults. Genetic, environmental, and occupation
factors are potential risk factors, but medications are more commonly
implicated.
, 4. An older adult client tells a nurse, “I am worried that I’m losing my mind; I have difficulty
remembering names as well as I used to, and I missed two health care appointments in
the past month because I forgot about them.” Which question is the best approach to
evaluating the effectiveness of a memory training program?
“How have the memory training techniques helped you?”
“Are you using the memory training techniques now?”
“Are you less worried about your memory now?”
“Have you seen an improvement in your memory?”
Rationale: The question about how the memory training techniques have helped
the client allows the older adult to tell the nurse how memory training has helped
and is more open-ended than other options. It also communicates positive
expectation. The question helps identify the techniques that are most effective for
the individual.
5. A nurse assesses an older adult Hispanic client. The client states that “my spouse was
punished by God.” To which illness is the client most likely referring?
Posttraumatic stress disorder (PTSD)
Voodoo
Fainting
Alcohol abuse
Rationale: For some Hispanics, views of mental illness are a punishment by a
supreme being for past transgressions; Hispanic older adults define mental
health problems as alcohol and other drug abuse. PTSD is relatively common in
immigrants. Hallucinations are not related to Hispanic culture. Those of
Caribbean descent may attribute the cause of mental illness to voodoo.
6. A nurse manager develops policies to promote a sense of control for older adults in the
assisted living facility. Which policies should be included?
Post a metal menu every Sunday and tell the residents that they must notify the
kitchen in advance if they want a menu change
Design all the emergency pull cords so they blend in with the wallpaper and are
inconspicuous
Hold resident council meetings twice monthly and invite all residents to attend
Teach the nurses’ aides to use the passkey to do spot checks on every resident at
least twice during the night to ensure that the residents are safe
Rationale: Resident meetings allow older adults to address personal preferences
and to make choices. Posting the meals and later allowing choices is giving the
older residents a limited chance to make a choice. Safety should be an ongoing
concern.
7. An older adult client, saddened by a recent diagnosis of type 2 diabetes, is concerned
about the future. Which action demonstrates a problem-focused approach to this
stressor?
