Ch16 Psychosocial Disorders Test Questions & Answers

Chapter 16 Psychosocial Disorders

Multiple Choice

1. Mrs. James is 78 years old and comes to the clinic for an annual checkup. The nurse practitioner addresses the psychosocial needs of older adults and specifically the need for which of the following?

1. Dependence.

2. Dignity, credibility, and respect.

3. Being alone.

4. Not being touched.

2. Mr. Slobinsky, 80 years old, is unable to leave his home due to mobility problems. The nurse practitioner conducts a social support assessment because Mr. Slobinsky:

1. May not want to see anyone.

2. Is not missing the cultural traditions of community activities.

3. Has made frequent appointments for consultation with the practitioner.

4. Looks forward to sharing his loneliness with the nurse practitioner.

3. Mrs. Khan is 89 years old and is reported to have bouts of agitation. The nurse practitioner is counseling her family that these periods of agitation can be triggered by which of the following?

1. Silence and soft music.

2. Dim lights.

3. Approaches from other people.

4. A feeling of appetite satiety.

4. The nurse practitioner is considering ordering medications to help control an older patient’s agitation. She chooses which of the following?

1. Psychotropic medications

2. Seizure medications

3. Stimulants

4. Depressants

5. The nurse practitioner is conducting an admitting assessment of a 69-year-old man. He has diminished ability to ambulate and has difficulty with activities of daily living (ADLs). In the interview, the nurse practitioner asks him if he drinks alcohol. He says, “Yes.” The practitioner follows up with a psycho-social evaluation because:

1. Physiological dynamics need to be ruled out as a possible contribution.

2. His drinking may be a function of the environment where he lives.

3. Criteria from the DSM-V is the same for people of any age.

4. His condition could be related to a long-term usage of alcohol or a new occurrence.

6. The daughter of a 70-year-old woman asks the nurse practitioner why her mother has had a change in functional ability recently. The mother has regularly been drinking for 40 years, however, her behavior is changing. The nurse practitioner replies that:

1. The concentration of alcohol in her body remains the same as she ages.

2. Her change in behavior has nothing to do with any drugs she is taking.

3. There are different types of alcoholism in older adults, and the change in behavior is related to the specific type.

4. Physical changes due to aging affect the body’s metabolism of alcohol differently.

7. The son of a 72-year-old man brings his father into the practitioner to plan for treatment of the patient’s alcoholism. The nurse practitioner has several options available. Which is the first choice?

1. Treat for anxiety.

2. Begin with higher doses of anti-anxiety medications.

3. The last choice for medication is serotonin uptake inhibitors.

4. Buspirone and gabapentin are used as first-line choices.

Multiple Response

8. Elisabeth, 67 years old, comes to the practitioner with her daughter, who is her caregiver. The nurse practitioner notices that Elizabeth is very busy and always moving and placing things in order within the waiting room. Along with this increase in energy, which of the following suggest bipolar with mania or hypomania? Select all that apply.

1. Ability to focus on a task

2. Flight of ideas

3. Rapid speech

4. Impulsivity

5. Thoughtfulness

9. The nurse practitioner is assessing a 69-year-old man for possible bipolar disorder. Which of the following will contribute to diagnosing this patient? Select all that apply.

1. Complete blood count (CBC) and comprehensive metabolic panel, toxicology screen, urinalysis, thyroid function tests.

2. Electroencephalogram (EEG) and magnetic resonance imaging (MRI).

3. Mini-Mental State Examination.

4. Saint Louis University Mental Status (SLUMS).

5. Total body computed tomography (CT) scan.

10. Mark, 82 years old, is in a rehabilitation center for therapy post-knee replacement. The nurse practitioner is visiting Mark and finds him confused, disoriented, and with speech difficulty. The staff nurse says that his condition changed quickly over the last few hours. The nurse practitioner orders which of the following? Select all that apply.

1. Pulse oximetry

2. Evaluation for infections

3. Assessment of change in medications

4. Brain scan

5. Radiology

11. Larry is 69 years old and beginning to experience a cognitive decline. His son brings him to the practitioner asking for an evaluation. The nurse practitioner assesses for which of the following signs or symptoms? Select all that apply.

1. Cognitive decline in complex attention, executive function, learning, and memory.

2. Gradual onset and the course of illness and progression are typically slow.

3. Impaired ability to care for oneself.

4. Total or partial loss of the ability to recognize familiar people.

5. Improvement in symptoms in time.

12. Mr. Dan is 75 years old and suffering from depression. He tells the nurse practitioner that he is tired of feeling so low. He asks if depression is a normal part of aging. The nurse practitioner tells him that depression is which of the following? Select all that apply.

1. Not a normal part of aging.

2. Related to nutritional deficiencies, especially vitamin B₁₂ and vitamin D.

3. Triggered by one life event.

4. Learned helplessness, loss, and bereavement

5. A state of balanced neurotransmitters in the brain.

13. Ms. Smith, 70 years old, is being treated for geriatric depression. What choices does the nurse practitioner have to order? Select all that apply.

1. Evaluate the present medication regimen.

2. Treat any comorbidity.

3. Maintain basic daily needs.

4. Order a selective serotonin reuptake inhibitor (SSRI).

5. Order Abilify.

14. Mrs. Smith is 90 years old and has a daytime caregiver. Her daughter stays with her during the evening and nighttime. The daughter suspects her mother is being abused. Which of the following statements would confirm this for the nurse practitioner? Select all that apply.

1. My mother complains of physical pain and has bruises on her arm.

2. My mother is losing weight and is always hungry in the evening.

3. My mother has lost her wallet and funds are going out of her bank account.

4. My mother has been withdrawing from others.

5. My mother has burn marks on her body in the shape of a cigarette.

15. Mr. Hupp, 84 years old, lost his wife 2 months ago. He goes to his nurse practitioner and complains of the same symptoms that his wife had before she died. Possible treatment options available to the nurse practitioner include which of the following? Select all that apply.

1. Educate him on normal signs of grieving.

2. Take time to remember his wife and discuss memories.

3. Provide emotional support.

4. Monitor current chronic medical conditions.

5. Encourage him to stay quiet at home and decrease his physical activity.

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