Deck 24: Mental Health and Wellness in Later Life

Question 1

Which of the following statements made by an older adult should a nurse consider as a signal for a gambling addiction?

A) "I have an overwhelming sense of being out of control of my life and destiny."
B) "Someone is stealing my things."
C) "I cannot account for blocks of time in my day."
D) "My wife died six months ago and I have nothing left to live for."

Answer 1

"I cannot account for blocks of time in my day."

Question 2

An older adult female resident lowers her voice and tells the nurse that another female resident is looking at her behind her back and is going to make her move tonight with a male staff member. Which of the following ideas should the nurse include in a response to this individual?

A) Tell her that the staff receives training in ethics and will not act against another resident's interests.
B) Validate her impression and add additional information about the other resident.
C) Advise her to avoid suspicious, paranoid thinking because the staff and residents are trustworthy individuals.
D) Tell her that the nurse will look in on her and to use the call bell if she becomes frightened.

Answer 2

Tell her that the nurse will look in on her and to use the call bell if she becomes frightened.

Question 3

An older female adult fell at home while trying to get to the bathroom in time to prevent urinary leakage. What is the priority nursing intervention to prevent patient injury at home in the future?

A) Discharge the patient to home while she is attending an alcohol prevention program.
B) Perform a home safety inspection to identify modifiable safety hazards.
C) Instruct the patient on pelvic floor exercises and other incontinence strategies.
D) Explore and assess for depression, alcohol abuse, and physiological contributors to falls.

Answer 3

Explore and assess for depression, alcohol abuse, and physiological contributors to falls.

Question 4

An older female adult lost her brother recently, provides care for her husband who has health needs, and must move to a new location after having lived for 35 years in the same house. When she arrives for primary care with clinical indicators of influenza, which of the following does the nurse recognize about this older adult?

A) She is exhibiting attention-seeking behaviours.
B) Crises and stressors can impair physical health.
C) Her greatest need is respite care for her husband.
D) Crisis leads to a lower functional status for the person.

Question 5

Although an older male adult who was forced to retire from law enforcement has multiple physical complaints, the primary care health care provider finds nothing abnormal. After the man tells the nurse that his girlfriend just left him, what is the priority nursing intervention to complete before this older adult leaves?

A) Ask him how he plans to cope with his loss.
B) Use direct questions about access to firearms.
C) Collaborate with the provider for antidepressants.
D) Allow him to express himself by intent listening.

Question 6

Which statement is true about the mental health of older adults?

A) Nurses should discourage denial and regression so older adults can face underlying causes of anxiety directly.
B) Anxiety is easily distinguished from depression, dementia, and the effects of disease or medication.
C) Compulsive rituals surrounding toileting and sleep are signs of a serious mental disorder.
D) The nurse avoids anti-anxiety medications without an assessment for factors associated with anxiety.

Question 7

You are evaluating the plan of care for an older adult who is alcohol-dependent. Which patient documentation indicates a need for follow-up nursing interventions by the nurse?

A) The patient states that he intends to decrease his alcohol consumption.
B) The patient arrives at his group session on time and well groomed.
C) The patient states, "I am an alcoholic because I drink ten beers a day."
D) The patient states that he understands that he needs continued treatment.

Question 8

An older female adult with dementia exhibits new behaviours, including crying and verbalizing the same phrase repeatedly; furthermore, the behaviour has increased over two days. Which intervention should the nurse implement in response to this behaviour?

A) The nurse tells the older adult that he will remember what she says if she stops crying.
B) The nurse attributes these findings to deterioration in cognitive function.
C) The nurse checks the medication administration record for missed doses or drug interactions.
D) The nurse presents probing questions to the patient about her behaviour.

Question 9

An older male adult who has activity intolerance due to pulmonary fibrosis barks orders and commands at the nursing staff when he cannot help himself. What is the nurse's priority patient outcome for planning care to resolve these problems?

A) The patient verbalizes requests in a calm, respectful, and appreciative manner.
B) The patient identifies potential triggers of anger and redirects energy positively.
C) The patient expresses an understanding of the need to balance rest and exercise.
D) Resolve the pulmonary fibrosis to restore baseline activity tolerance.

Question 10

An older male adult who had radical surgery for oral cancer is refusing to see visitors and is losing weight, despite aggressive nutrition therapy. The nurse assesses this older adult and recognizes that he is not coping well and appears to be grieving. What is the most important patient outcome, in light of this nursing assessment?

A) The patient discusses how his coping mechanisms are overwhelmed.
B) The patient performs self-feedings through gastrostomy tube daily.
C) The patient uses nonverbal forms of communication effectively.
D) The patient exhibits self-confidence in regaining a sense of control.

Question 11

Which of the following statements about suicide among older adults is true?

A) Older adults and young adults manifest suicidal intent in similar ways.
B) Older female adults have the highest risk of suicide.
C) Ethics require that the nurse respect a person's intent to terminate his or her own life.
D) Depression and other mental health problems contribute to the risk of suicide.

Question 12

Which of the following statements about psychotic behaviour in older adults is true?

A) Usually, hallucinations in older patients are the result of psychological conflicts.
B) Illusion, delusion, and hallucination are different terms for the same phenomenon.
C) An older adult with psychotic behaviour should be assessed for a variety of causes.
D) Regardless of the cause, dissimilar hallucinations are treated with similar therapies.

Question 13

Which assessment finding of an older adult living in an assisted-living facility indicate the highest risk for suicide?

A) The older adult has liver failure due to alcohol abuse but enjoys socializing.
B) The older adult declines company, and is preoccupied with lethal weapons.
C) The older adult refuses to allow a large extended family to help him.
D) The older adult experienced an acetaminophen overdose 20 years ago.