C HAPTER 41: C OMMON P SYCHOSOCIAL C ARE
P ROBLEMS OF O LDER A DULTS
Williams: deWit's Fundamental Concepts and Skil ls for Nursing, 5th
Edition
MULTIPLE CHOICE
1. The nurse adds to the plan of care for a cognitiv el y impaired resident who
has begun to wander night and day throughout the long -term care facilit y.
An appropriate intervention to add to the plan of care for the resident with
wandering behavior would be to:
a. place the resident on a locked unit to prevent long-range wandering.
b. obtain an order for wrist restraints or a vest restraint.
c. appl y a bracelet that alarms as the resident approaches an outside
door.
d. discuss with the health care provider the need for stronger
medication.
ANS: C
Wanderers may be findin g a means to combat boredom. Placing a door
alarm bracelet will alert the staff if the resident is near an outside
door. Frequent checks on the resident’s location can also help keep
such a resident safe.
DIF: Cognitive Level: Application REF: p. 835 OBJ:
Theory #5 TOP: Interventions for Wandering KEY: Nursing
, Process Step: Implementation MSC: NC LEX: Safe,
Effective Care Environment: Safet y and Infection Control
2. The 64-year-old resident newl y admitted to a long -term care facilit y
refuses to sit down and eat, preferring to wander aimlessl y through the
facilit y. The initial intervention by the nursing staff should be to:
a. appl y an alarm bracelet to monitor wandering.
b. offer high protein malts to drink on the go.
c. feed the resident in his room away from ot her residents.
d. feed the patient rapidl y before he begins to wander.
ANS: B
The offering of high protein drinks or nutritious snacks to eat on the go
may be an initial approach to the problem.
DIF: Cognitive Level: Anal ysis REF: p. 837 OBJ:
Theory #5 TOP: Sundown S yndrome KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Physiological Integrity: Basic Care and Comfort
3. In order to minimize the risk of aspiration in a resident with advanced
Alzheimer disease, the person feeding the patient should:
a. keep a suction machine available.
b. have the patient consume onl y liquids.
c. remind the patient to chew and swallow.
d. offer large amounts of water after each bite.
ANS: C
, Reminding the demented patient to chew and swallow will help prevent
the resident from holding food in his mouth.
DIF: Cognitive Level: Application REF: p. 837 OBJ:
Theory #5 TOP: Strategies to Prevent Aspiration KEY:
Nursing Process Step: Implementation MSC: NC LEX:
Psychosocial Integrity: Reduction of Risk
4. A depressed older adult patie nt was started on antidepressant drug therapy
3 weeks ago. The highest nursing priorit y when working with this patient
at this time would be:
a. stimulating appetite.
b. providing realit y orientation.
c. encouraging socialization.
d. protecting the patient from self -injury.
ANS: D
The primary nursing responsibilit y for a depressed patient is to protect
him from self-injury, especiall y after the patient has been started on
antidepressant therapy. Before that time, the patient may not have had
the energy to commit self -injury.
DIF: Cognitive Level: Anal ysis REF: p. 838 OBJ:
Clinical Practice #2 TOP: Depression KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Psychosocial Integrity: Coping and Adaptation
P ROBLEMS OF O LDER A DULTS
Williams: deWit's Fundamental Concepts and Skil ls for Nursing, 5th
Edition
MULTIPLE CHOICE
1. The nurse adds to the plan of care for a cognitiv el y impaired resident who
has begun to wander night and day throughout the long -term care facilit y.
An appropriate intervention to add to the plan of care for the resident with
wandering behavior would be to:
a. place the resident on a locked unit to prevent long-range wandering.
b. obtain an order for wrist restraints or a vest restraint.
c. appl y a bracelet that alarms as the resident approaches an outside
door.
d. discuss with the health care provider the need for stronger
medication.
ANS: C
Wanderers may be findin g a means to combat boredom. Placing a door
alarm bracelet will alert the staff if the resident is near an outside
door. Frequent checks on the resident’s location can also help keep
such a resident safe.
DIF: Cognitive Level: Application REF: p. 835 OBJ:
Theory #5 TOP: Interventions for Wandering KEY: Nursing
, Process Step: Implementation MSC: NC LEX: Safe,
Effective Care Environment: Safet y and Infection Control
2. The 64-year-old resident newl y admitted to a long -term care facilit y
refuses to sit down and eat, preferring to wander aimlessl y through the
facilit y. The initial intervention by the nursing staff should be to:
a. appl y an alarm bracelet to monitor wandering.
b. offer high protein malts to drink on the go.
c. feed the resident in his room away from ot her residents.
d. feed the patient rapidl y before he begins to wander.
ANS: B
The offering of high protein drinks or nutritious snacks to eat on the go
may be an initial approach to the problem.
DIF: Cognitive Level: Anal ysis REF: p. 837 OBJ:
Theory #5 TOP: Sundown S yndrome KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Physiological Integrity: Basic Care and Comfort
3. In order to minimize the risk of aspiration in a resident with advanced
Alzheimer disease, the person feeding the patient should:
a. keep a suction machine available.
b. have the patient consume onl y liquids.
c. remind the patient to chew and swallow.
d. offer large amounts of water after each bite.
ANS: C
, Reminding the demented patient to chew and swallow will help prevent
the resident from holding food in his mouth.
DIF: Cognitive Level: Application REF: p. 837 OBJ:
Theory #5 TOP: Strategies to Prevent Aspiration KEY:
Nursing Process Step: Implementation MSC: NC LEX:
Psychosocial Integrity: Reduction of Risk
4. A depressed older adult patie nt was started on antidepressant drug therapy
3 weeks ago. The highest nursing priorit y when working with this patient
at this time would be:
a. stimulating appetite.
b. providing realit y orientation.
c. encouraging socialization.
d. protecting the patient from self -injury.
ANS: D
The primary nursing responsibilit y for a depressed patient is to protect
him from self-injury, especiall y after the patient has been started on
antidepressant therapy. Before that time, the patient may not have had
the energy to commit self -injury.
DIF: Cognitive Level: Anal ysis REF: p. 838 OBJ:
Clinical Practice #2 TOP: Depression KEY: Nursing
Process Step: Implementation MSC: NC LEX:
Psychosocial Integrity: Coping and Adaptation
