Question 1

The highest suicide rate in the elderly population in the United States is in which of the following groups?&#10;A) Black men&#10;B) White men&#10;C) White women&#10;D) Black women

Accepted Answer

White men older than age 85 have the highest rate of suicide in the United States; they commit suicide at approximately six times the national rate.

Question 2

A 77-year-old woman recently moved to an assisted living facility.She expresses concern that her apartment is not close to the emergency exit stairs and that she could not get out in the event of an emergency.During a routine fire drill,she becomes very agitated and pushes another resident over as she quickly runs to the exit stairs.She was recently discharged from the hospital after an admission for smoke inhalation after a fire destroyed her home.What would be least helpful for her?

A) Instructing her on safe procedures during a fire drill
B) Establishing a supportive relationship with her
C) Moving her to an apartment close to the exist stairs
D) Allowing her to discuss her fears related to her fire experience

Accepted Answer

Based on the scenario,she is likely experiencing posttraumatic stress disorder.Effective coping with extremely traumatic events that create intense fear and helplessness is associated with secure and supportive relationships and the ability to freely express or fully suppress the distressing experience.Recognizing the precipitating event and making efforts to remove it or change the environment is also helpful.Education on proper technique will not assist her with dealing with the intensely emotional response.Options B and D are directed toward the provision of a safe and supportive relationship.Option C is directed at removing the precipitating factor.

Question 3

The most prevalent mental health disorder in older adults is:&#10;A) anxiety disorder.&#10;B) depression.&#10;C) schizophrenia.&#10;D) alcoholism.

Accepted Answer

Depression is the most common mental health disorder of later life,affecting up to 15% of adults older than age 65.Options A,C,and D are all incorrect; although these disorders are present in older adults,they occur in far fewer numbers than depression.

Question 4

An 88-year-old resident of a nursing home reports to the nurse that there was a problem during the night and that someone entered her room and stood by the window watching her.She expresses fear of going to sleep.What action is most appropriate for the nurse to take initially?

A) Reassure her that there was no one in her room and that she must have been dreaming.
B) Request a psychiatric consult to evaluate her.
C) Assess the environment in her room to see if there is anything that could be confusing for her.
D) Suggest to her that she request sleeping medication every night.

Accepted Answer

She is likely experiencing delusions,which are frightening for her.The first step is assessment of the truth of the delusion.The nurse assesses the environment to see if there is anything that could have been misinterpreted by the resident.Concluding that someone is delusional is never safe unless the claim has been thoroughly investigated.Consulting a psychiatrist is not the first option; if symptoms interfere with function,than a psychiatric evaluation and medication management might be indicated.Medicating for sleep will not help with the delusions.

Question 5

You are assigned to the care of an 80-year-old schizophrenic client who has been admitted to your acute care facility.As you develop a plan of care for this client,you are taking into consideration what reality about being an older adult with schizophrenia?

A) The majority of mental health care for older adults is provided in long-term psychiatric facilities.
B) Mental health services for older adults are readily reimbursed by Medicare.
C) Popular managed care programs usually include in-depth assessment involving specialized expertise in mental health.
D) The mental health needs of older adults are not easily recognized or accurately reported.

Accepted Answer

Nursing homes provide the majority of care given to older adults with mental health problems.There is limited coverage of mental health services under Medicare and Medicaid,with only approximately 50% of mental health services being covered.Most managed care plans cover mental health counseling and treatment for addictions,not the full spectrum of services needed by older adults.Mental health disorders in older adults are not well recognized; they are frequently confused with age-related changes and thus are not accurately reported.

Question 6

The goals of treatment for a depressed elderly client include the following except:&#10;A) decreasing symptoms&#10;B) reducing risk of relapse.&#10;C) increasing quality of life.&#10;D) increasing medication use.

Accepted Answer

Goals of treatment for a depressed client include decreasing symptoms,decreasing the risk of a relapse,increasing quality of life,improving medical health status,decreasing health care costs,and decreasing mortality.Increasing medication use is not one of the goals.

Question 7

Your elderly client is being discharged to a nursing home.In the past she has lived independently and is now expressing displeasure at her inability to be discharged home.What intervention would best serve to help her avoid experiencing an adjustment disorder?

A) Carefully review any options and alternatives available to her.
B) Make the move quickly.
C) Convince her why this is really the best way.
D) Talk to the physician regarding prescribing her an antianxiety agent.

Accepted Answer

In adjustment disorders,the individual develops a significant emotional response to a stressor.The most therapeutic way to deal with an individual with an adjustment disorder is to have an anticipatory rehearsal of the event and to look at all options and alternatives as well as have a reliable support system available.Rushing an individual will only increase the emotional response and worsen the adjustment."Convincing" the individual will also add to the emotional response.An antianxiety agent will not prevent this individual from having an adjustment disorder reaction.

Question 8

Your elderly neighbor has played the piano at the local nursing home for 15 years.This past year her volunteerism has dropped off.She complains about the "old senile folks" there.In listening to her complaints about the facility,you understand that she is exhibiting signs of:

A) positive identification.
B) denial.
C) projection.
D) delusions.

Accepted Answer

Projection is a defense mechanism wherein an individual attributes her own unacceptable feelings,impulses,or thoughts to someone else.In positive identification,the individual in poor health identifies with older adults who are more physically able and in this way appraises herself in a more manageable way.The neighbor is not exhibiting denial.Delusions are conceivable ideas without foundation.

Question 9

One goal of reminiscence is to:&#10;A) provide cognitive stimulation.&#10;B) divert the individual's attention from the problem.&#10;C) eliminate painful memories.&#10;D) educate the individual on proper communication strategies.

Accepted Answer

Goals of reminiscence include cognitive stimulation,improved communication,as well as a pleasurable experience that improves quality of life.Reminiscence does not divert attention from the problem,does not eliminate painful memories,and is not an education strategy.

Question 10

The following are true statements about bipolar disorders in older adults except:&#10;A) bipolar disorders often level out in later life.&#10;B) relapses in bipolar disorder tend to be precipitated by medical problems.&#10;C) older adults with bipolar disorder tend to cycle more quickly between mania and depression than younger adults.&#10;D) bipolar disorder is the most common psychiatric disorder in older adults.

Accepted Answer

Depression is the most common psychiatric disorder in older adults.Bipolar disorders tend to level out in later life,and individuals tend to have longer periods of depression.Relapses in older adults are usually precipitated by medical problems.Older adults tend to be "rapid cyclers," cycling from mania to deep depression in a much shorter period of time than they did when they were younger.

Question 11

Your older adult client has admitted himself for treatment of alcohol dependency.In implementing care,you draw upon your knowledge about alcohol and aging that:&#10;A) substance abuse often arises in old age as a coping mechanism to deal with loss,anxiety,or depression.&#10;B) treatment programs for older adults have low rates of success.&#10;C) health care providers readily detect drinking problems with older adults.&#10;D) women older than age 65 have the highest rate of alcoholism of any population.

Accepted Answer

The answer of Your older adult client has admitted himself...

Question 12

Your elderly client has just suffered a myocardial infarction.Upon discharge,he says to you,"I watched all those heart videos and stuff,but I still insist it was just indigestion." In formulating a response,you recognize that he is showing signs of:

A) denial.
B) projection.
C) altruism.
D) deficient knowledge.

Accepted Answer

The answer of Your elderly client has just suffered a...

Question 13

An 88-year-old woman is seen in the geriatric clinic for a routine physical examination.She reports being more tired,eating less,and having less desire to participate in activities,all of which she attributes to aging.The gerontological clinical nurse specialist suspects that she is depressed and asks her to complete the Geriatric Depression Scale.The woman becomes visibly upset and states,"What,you think I am crazy? Shame on you." Her response is:

A) typical of older adults due to a stigma associated with depression.
B) atypical and requires investigation by a psychiatrist.
C) related to an inability to complete the Geriatric Depression Scale.
D) evidence of cognitive deficits.

Accepted Answer

The answer of An 88-year-old woman is seen in the...

Question 14

Electroconvulsive therapy (ECT)in older adults:&#10;A) has been found to be effective in individuals with psychotic depression and those who do not respond to antidepressant medications.&#10;B) has been found not to be as effective in older adults as in younger adults.&#10;C) has been found to be safe for older adults with increased intracranial pressure.&#10;D) has been found to improve symptoms of dementia in older adults.

Accepted Answer

The answer of Electroconvulsive therapy (ECT)in older adults:&#10;A) has been...

Question 15

A 77-year-old man is brought to the emergency department after falling and sustaining a laceration on his forehead that required suturing.He has an elevated blood alcohol level and says to the nurse,"I don't know why I can't handle booze like I used to when I was younger.I only had two beers; I used to have five when I was young." The nurse knows that:

A) older adults develop higher blood alcohol levels due to age-related changes in the neurological system.
B) older adults develop higher blood alcohol levels due to age-related changes that alter absorption and filtration of alcohol.
C) older adults develop higher blood alcohol levels due to slowed reaction times.
D) older adults develop higher blood alcohol levels due to cognitive changes.

Accepted Answer

The answer of A 77-year-old man is brought to the...

Deck 25: Emotional Health in Late Life