Deck 14: Mental Health

Question 1

The nurse is preparing a health promotion program for a group of adults in their late 60s.When considering the mental health of this cohort, the nurse includes local information regarding which of the following? Select all that apply.

A)Volunteering opportunities
B)Healthy cooking classes
C)Community college course lists
D)Wellness programs
E)Free health clinics

Answer 1

Volunteering opportunities
Healthy cooking classes
Community college course lists
Wellness programs

Question 2

An older adult is hospitalized for treatment of a mental health disorder and is prescribed clomipramine (Anafranil).The nurse documents that the medication is having the desired effect when the client:

A)begins sleeping 8 hours per night.
B)engages in fewer ritualistic behaviors.
C)reports fewer episodes of nervousness.
D)exhibits no delusionary thinking.

Answer 2

engages in fewer ritualistic behaviors.

Question 3

The nurse is caring for a severely depressed older client.To best effect change in the client's emotional state, the nurse's initial goal is to:

A)plan interventions that will enhance client self-esteem.
B)introduce the client to new coping skills.
C)assess the client's potential to self-harm.
D)develop a therapeutic nurse-client relationship.

Answer 3

develop a therapeutic nurse-client relationship.

Question 4

An older client is anxious about an upcoming diagnostic test and requests something to calm his nerves.To best address the client's need, the nurse prepares to administer a PRN dose of:

A)clonazepam (Klonopin).
B)diazepam (Valium).
C)chlordiazepoxide (Librium).
D)lorazepam (Ativan).

Question 5

To best advocate for an older adult client being prescribed medication to control newly observed signs of confusion and aggressive behavior, the nurse:

A)initiates an assessment to determine possible underlying causes of the behavior.
B)contacts family to inform them of the new medication therapy being planned.
C)discusses possible nonpharmaceutical treatments with the physician.
D)documents a detailed description of the behaviors before administering the drugs.

Question 6

A 72-year-old is prescribed lithium.The nurse educates the client on the importance of biannual evaluation of which of the following? Select all that apply.

A)Renal function
B)Serum glucose level
C)Liver function
D)Thyroid function
E)Red blood cell count

Question 7

The geriatric nurse is caring for an older widowed client who is legally blind and who is hospitalized for hip replacement surgery.The nurse recognizes that the greatest risk factor for mental health illness is the client's:

A)lack of spousal support.
B)visual limitations.
C)prolonged recovery period.
D)impaired mobility.

Question 8

To help manage the potential side effects of prescribed antipsychotic medications, amantadine (Symmetrel) may be prescribed.Which statement best indicates that the nurse understands the appropriateness of this medication for the older adult client?

A)"This medication produces few anticholinergic effects."
B)"Symmetrel is an effective dopamine agonist."
C)"Extrapyramidal symptoms are best controlled by Symmetrel."
D)"Older clients seem to have the fewest side effects on this medication."

Question 9

A 65-year-old adult who recently lost his spouse is admitted to the hospital after a failed suicide attempt.He presents with a sad affect and is reluctant to interact within the milieu.The nursing diagnosis with priority is:

A)Ineffective coping related to recent loss.
B)Hopelessness related to death of spouse.
C)Risk for loneliness related to loss of spouse.
D)Risk for self-directed violence related to depression.

Question 10

An older adult has been recently diagnosed with type 2 diabetes and mild retinal deterioration.To best address the client's potential for developing situation depression, the nurse:

A)assesses the client's coping skills.
B)encourages the client's participation in a depression support group.
C)assesses the client's ability to manage his symptoms.
D)educates the family regarding the early signs of depression.

Question 11

An 80-year-old client who is experiencing symptoms of depression and anxiety is reluctant to comply with the prescribed treatment plan.The nurse initially addresses the issue with the client by asking:

A)"Are you concerned about how others view you having a mental health problem?"
B)"Are you concerned about paying for your psychiatric medications?"
C)"Did you know that depression is common among people your age?"
D)"Do you have any questions about your the mental health treatment plan?"

Question 12

When planning care for the older adult being treated for depression, the nurse addresses the client's tertiary intervention needs by:

A)assisting the client to identify the early symptoms of depression.
B)helping the client deal with the physical symptoms of depression.
C)discussing with the client how to implement new coping skills.
D)educating the client to the importance of being drug compliant.

Question 13

While collecting a health history for an older adult client, the nurse learns that he had been prescribed Elavil 3 weeks ago and wants to stop taking it because, "It didn't make me feel any better." In response to this information, the nurse shares with the client that:

A)sudden withdrawal is likely to cause a hypertensive crisis.
B)depression seldom improves without medication.
C)realistically it will take longer for improvement to be felt.
D)in time, people adjust to the side effects.

Question 14

An older adult client being treated for chronic obstructive pulmonary disease ( COPD ) is exhibiting signs of memory loss and confusion.In planning his care, the nurse should give priority to:

A)obtaining an order for a pulmonary function test.
B)determining the potential of a possible adverse drug reaction.
C)reorienting the client to time, place, and person frequently.
D)assessing for a family history of dementia.

Question 15

The nurse familiar with the old adult population will recognize that the client who has the greatest potential for successfully committing suicide is the:

A)63-year-old Asian female who has been diagnosed with advanced breast cancer.
B)86-year-old Caucasian male who recently lost his wife of 62 years.
C)76-year-old Hispanic female who is divorced after 40 years of marriage.
D)67-year-old African-American male who has lost his entire retirement savings.

Question 16

An older adult has a medical condition that has required hospitalization at a facility far from home and family.To best minimize the client's risk for depression, the nurse:

A)keeps the client informed of the expected discharge date.
B)offers to help the client telephone family members each evening.
C)reassures the client that early discharge is a nursing goal.
D)encourages the client to place family photographs around his room.

Question 17

The nurse caring for an older adult client recovering from cardiac surgery recognizes that it is most appropriate to assess this client for mental health problems because:

A)cardiac surgery often results in anxiety-related issues.
B)untreated depression can contribute to the client's morbidity risks.
C)many in this age cohort have undiagnosed depression.
D)hospitalization is both anxiety and depression inducing.