Deck 7: Psychological and Cognitive Function

Question 1

The nurse is admitting an older patient who requires a cane for ambulation, bilateral hearing aids, and monthly vitamin B12 injections. The daughter of the patient tells the nurse that the patient no longer remembers how to use a toothbrush or turn on the television set. Which information requires further assessment?
1) Vitamin deficiency
2) Loss of hearing
3) Assistive device for ambulation
4) Cognitive change

Answer 1

4

Question 2

An elderly patient is admitted for abdominal pain. The nurse assesses withdrawal, somatic complaints, and continued, unrelieved pain. What nursing action is indicated?
1) Request an anti-anxiety medication
2) Contact the family to intervene
3) Assess for signs and symptoms of depression
4) Obtain an order for stronger pain medication

Answer 2

3

Question 3

An elderly, Asian patient is admitted for suicide precautions. After performing an assessment, the nurse identifies a history of multiple, unsuccessful suicide attempts in the past three years. Which factor(s) may have contributed to the delay in treatment? Select all that apply.
1) Ageism
2) Poverty
3) Cultural bias
4) Discrimination
5) Birth order

Answer 3

1, 2, 3, 4

Question 4

The nurse is assessing an older patient exhibiting signs of paranoia. Which is known to increase the risk of developing of this disorder? Select all that apply.
1) Food allergies
2) Hearing loss
3) Dementia
4) Social isolation
5) Cognitive impairment

Question 5

The son of an older patient is concerned about the patient's ongoing forgetfulness and asks the nurse to explain what could be wrong with the patient. How should the nurse respond to the son?
1) "Memory difficulties are hard for family members to deal with."
2) "My parents are the same age as yours, and they can't remember anything."
3) "Forgetfulness is common in older adults. It's nothing you need to worry about."
4) "Memory difficulties can be due to underlying issues including anxiety, chronic pain, or depression."

Question 6

What should the nurse instruct an older patient to do to cope with age-associated cognitive changes? Select all that apply.
1) Read daily
2) Write "notes to self"
3) Play computer games
4) Learn memory enhancement techniques
5) Avoid group conversations

Question 7

An older patient with cardiac disease has frequent sleep problems and insomnia. How would the nurse describe these manifestations?
1) Abnormal sleep disturbances due to chest pain
2) Predictive signs of respiratory disease
3) Negative symptoms of stress and anxiety
4) Expected manifestations of cardiac disease

Question 8

An older patient is concerned about remembering to take prescribed medications. What strategies should the nurse recommend to this patient? Select all that apply.
1) Rely on habit to take the medication.
2) Use an assistive device such as a pillbox.
3) Suggest a family member provide the medication.
4) Discuss moving to an assisted living facility for safety.
5) Discuss reducing the number of medications with the physician.

Question 9

The discharge nurse is teaching insulin administration to an older patient. Which teaching strategy would be best?
1) Provide written materials to reinforce the verbal instructions.
2) Encourage repetitive exercises to review new information until it is understood.
3) Allow longer teaching times to compensate for a slower learning pace.
4) Provide instruction to relatives so the patient will not be overwhelmed with new information.

Question 10

During an interview, the nurse notes that an older patient is having mild difficulty with some words and forgets the names of people. The patient is alert, oriented to time, person, and place, and makes appropriate responses. What does the nurse determine this patient's cognitive changes to mean?
1) Normal signs of aging
2) Early symptoms of dementia
3) Indicators of depression in the elderly
4) Memory impairment that may be related to cerebral ischemia

Question 11

During an assessment, the nurse learns that an older patient feels his heart race during times of stress. How would the nurse best describe this event?
1) "Your body is reacting with a fight-or-flight response which is normal."
2) "Your body is releasing a chemical to make your heart stronger because it is weak."
3) "This is not a normal response, and further testing will be required."
4) "This is an emergency and will require immediate hospitalization."

Question 12

While organizing a walking program at an assisted living facility, one resident asks why older people should exercise. Which is the nurse's best response?
1) "You aren't too old to exercise."
2) "Older people often forget to exercise."
3) "Your doctor has ordered it."
4) "Exercise can reduce stress and improve physical health."

Question 13

An older patient admits to feeling worthless and depressed since the death of their spouse. Which health risk is most concerning to the nurse?
1) Suicide
2) Situational depression
3) Dementia
4) Self-harm

Question 14

The nurse is concerned that an older patient has a problem related to regular alcohol consumption. What did the nurse assess in this patient? Select all that apply.
1) Anxiety
2) Malnutrition
3) Social isolation
4) Bruises from falling
5) Dependence on family members

Question 15

The daughter of an elderly patient expresses concern about a change in the patient's mental health. Which is most likely due to normal cognitive changes? Select all that apply.
1) Decline in the ability to draw
2) Decrease in size of vocabulary
3) Difficulty filtering out irrelevant information
4) Difficulty switching attention from one person to another
5) Increased need to repeat information to the patient

Question 16

The nurse is preparing a presentation on grief. What information should be included regarding factors that can affect duration and the course of grieving? Select all that apply.
1) Centrality of loss
2) Suicide of an adult child
3) Death of a child who lived next door
4) Cultural and ethnic influences
5) Survivor's religious or spiritual belief system

Question 17

The nurse working in a long-term care facility is coordinating a screening for depression. Which is the primary benefit of this event?
1) Educates family about signs of depression
2) Allows family to lower their expectations of their loved one
3) Identifies symptoms of depression often associated with chronic illness and pain
4) Allows early intervention with antidepressant medication

Question 18

An older patient wakes up from sleep, confused, and insists a family member is in the other room. What information within the patient's medical record should the nurse consider as a source of the patient's confusion?
1) The patient is elderly.
2) The patient's spouse recently died.
3) The patient received pain medication.
4) The patient has a history of cardiac disease.

Question 19

An older patient's spouse passed away 4 years ago; however, the patient still sets a place at the dinner table for the spouse and has never removed any clothing or other personal items from the home. What does the nurse suspect the patient is experiencing?
1) Normal grief
2) Hopelessness
3) Survivor guilt
4) Pathological grief

Question 20

The nurse educator is preparing an educational program about psychiatric issues in older patients. Which symptoms should be included in instruction? Select all that apply.
1) Flat affect
2) Thoughts of suicide
3) Social withdrawal and isolation
4) Delusions and hallucinations
5) Difficulty in performing ADLs

Question 21

An older patient is prescribed a monoamine oxidase inhibitor (MAOI) medication. Which meal choice requires the nurse to intervene immediately?
1) Smoked salmon with salad and bleu cheese dressing
2) Grilled chicken salad on whole wheat with fresh fruit
3) Turkey sandwich with American cheese and coleslaw
4) Chicken salad on a croissant, carrot sticks, and fresh apple

Question 22

The nurse is planning care for an older patient diagnosed with major depression who states that voices are telling the patient to kill himself. Which nursing diagnosis would be a priority for this patient?
1) Social isolation
2) Risk for suicide
3) Disturbed sleep pattern
4) Altered sensory perception

Question 23

Which statement made by an older patient best indicates to the nurse that the patient might be contemplating suicide?
1) "I wish I could stop all of this pain."
2) "I'll beat this cancer even if it kills me."
3) "I'll get through this one day at a time."
4) "I'm no use to anyone. I might as well be dead."

Question 24

The nurse is assessing an older patient in a long-term care facility. Which observation best indicates the need for depression screening?
1) Slight decline in memory
2) Increase in socialization
3) Increased energy and participation
4) Persistent sadness

Question 25

The nurse is planning an educational session on suicide in the older patient population. What information should the nurse include in this presentation? Select all that apply.
1) An older patient does not have the physical strength to commit suicide.
2) A patient should never be questioned about suicide intent.
3) Suicide rates are the highest in people age 65 and older.
4) An older person who contemplates suicide is more likely to complete the act than a younger person.
5) Many older adults who commit suicide had visited their primary care physician within the previous month.