Chapter 31: Older Adults Halter: Varcarolis’ Foundations of Psychiatric Mental Health Nursing: A Clinical Approach, 8th Edition

MULTIPLE CHOICE 1. A student nurse visiting a senior center says, ―It‘s depressing to see these old people. They are weak and frail. I doubt any of them can engage in a discussion.‖ The student is expressing a. reality. b. ageism. c. empathy. d. vulnerability. ANS: B Ageism is a bias against older people because of their age. None of the other options applies to the ideas expressed by the student. PTS: 1 DIF: Cognitive Level: Understand (Comprehension) REF: Page 31-14 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 2. A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include? a. Pain assessment techniques for older adults b. Psychosocial stimulation for those who live alone c. Preparation of psychiatric advance directives in the elderly d. Ways to manage disinhibition in elderly persons with dementia ANS: A The topic of greatest immediacy is the assessment of pain in older adults. Unmanaged pain can precipitate other problems, such as substance abuse and depression. Elderly patients are less likely to be accurately diagnosed and adequately treated for pain. The distracters are unrelated or of lesser importance. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 31-9, 10 TOP: Nursing Process: Planning MSC: Client Needs: Physiological Integrity 3. Select the best comment for a nurse to begin an interview with an elderly patient. a. I am a nurse. Are you familiar with what nurses do?‖ b. Hello. I am going to ask you some questions to get to know you better.‖ c. You look comfortable and ready to participate in an admission interview. Shall we get started?‖ d. Hello. My name is and I am a nurse. How you would like to be addressed by staff?‖ ANS: D The correct opening identifies the nurse‘s role and politely seeks direction for addressing the patient in a way that will make him or her comfortable. This is particularly important when a considerable age difference exists between the nurse and the patient. The nurse should address patients by name and not assume patients want to be called by a first name. The nurse should always introduce self. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 31-17, 18, 21, 45 (Box 31-8) TOP: Nursing Process: Implementation MSC: Client Needs: Psychosocial Integrity 4. Which information is most important to obtain during assessment of an older adult diagnosed with health problems? a. Functional ability and emotional status b. Chronological age and sexual function c. Economic status and sources of income d. Developmental history, interests, and activities ANS: A Information related to functional ability and emotional status provides an overview of a patient‘s problems and abilities. It guides selection of interventions and services to meet identified needs. The distracters reflect information of relevance, but are not of highest priority. PTS: 1 DIF: Cognitive Level: Apply (Application) REF: Pages 31-12, 20 TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 5. A 75-year-old patient comes to the clinic reporting frequent headaches. As the nurse begins the interaction, which action is most important? a. Complete a neurological assessment. b. Determine whether the patient can hear as the nurse speaks. c. Suggest that the patient lie down in a darkened room for a few minutes. d. Administer medication to relieve the patient‘s pain before continuing the assessment. ANS: B Before proceeding with any further assessment, the nurse should assess the patient‘s ability to hear questions. Impaired hearing could lead to inaccurate answers. PTS: 1 DIF: Cognitive Level: Analyze (Analysis) REF: Pages 31-3, 18, 43 (Box 31-6) TOP: Nursing Process: Assessment MSC: Client Needs: Health Promotion and Maintenance 6. Which statement about aging provides the best rationale for focused assessment of elderly patients? a. The elderly are usually socially isolated and lonely. b. Vision, hearing, touch, taste, and smell decline with age. c. The majority of elderly patients have some form of early dementia. d. As people age, thinking becomes more rigid and learning is impaired.