Chapter 18: Mental Health Promotion for Older Adults

Format: Multiple Choice

Client Needs: Health Promotion and Maintenance

Cognitive Level: Understand

Integrated Process: Nursing Process

Objective: 2

Page and Header: 269, Sensory Changes

1. The nurse is preparing to assess a 78-year-old client who has been diagnosed with major depression. Which would the nurse expect to assess as a normal finding?

A) Decrease in body fat

B) Increased muscle mass

C) Dulled taste sensation

D) Enhanced visual acuity

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2. A group of nursing students is reviewing the physical changes that occur in older adults. The students demonstrate understanding of the information when they identify what as contributing to the client’s risk for drug toxicity?

A) Reduced liver function

B) Reduced brain gray matter volume

C) Lower metabolic rate at rest

D) Decreased body water

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3. An older client tells the nurse about being more forgetful. The nurse explains to the client that this is most likely related to what cause?

A) Increased related anxiety

B) Undiagnosed organic brain syndrome

C) Accumulated plaques in the brain tissue

D) Current medications

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4. While assessing an older adult, the nurse allows ample time for the client to respond based on what understanding of the aging process?

A) Allowing ample time ensures that the correct answer is given.

B) The client is most likely experiencing irreversible memory impairment.

C) The client is experiencing decreased cerebral oxygen flow from reduced activity.

D) Ample time is needed to weigh the pros and cons of the perceived risk for answering.

Page and Header: 275, Lack of Social Support, and Suicide, Box 18.4

5. The nurse is planning a presentation to a group of older adults on the topic of suicide in the population. One of the group participants asks who has the highest risk of suicide. Which response by the nurse would be most appropriate?

A) Older adults who have multiple prescriptions from a variety of different pharmacies

B) Older adults who are experiencing a deep and profound depression

C) Older adult women who are divorced or widowed

D) Men over the age of 75 years who are divorced or widowed

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6. The nurse is working with a client whose mobility is impaired secondary to a fall that resulted in a broken hip. In addition, the client, who has diabetes, is developing problems with vision and hearing. The client seems increasingly withdrawn and depressed. The nurse determines that the client is at risk for spiritual distress. Which intervention would be most appropriate?

A) Encourage the client to talk about significant childhood religious experiences.

B) Offer to take the client to a revival that the nurse’s church is holding in the community.

C) Read to the client Bible passages that seem particularly relevant to his or her case.

D) Explore what the mobility, sight, and hearing changes mean to the client.

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7. After having blood pressure taken, the client asks the nurse what changes should be expected when growing older. Which response by the nurse would be most appropriate?

A) “You don’t have anything to worry about; you will basically stay the same.”

B) “Your personality will stay the same, but your intelligence level will lessen somewhat.”

C) “Usually, you can anticipate that you will begin to react to things more slowly.”

D) “You will become increasingly childlike, and your personality will change.”

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8. A nurse reviewing the medical records of several older adult clients determines that which individual would have the least chance of developing mental health problems with aging?

A) A man who is single, has an eighth-grade education, and walks to the mailbox and back every day

B) A woman who is married with graduate education, eats nutritionally balanced meals, and exercises for 20 minutes each day

C) A man who is married, has a high school education, eats mostly fast food, and walks a mile each day

D) A woman who is single, has a college degree, watches what she eats, but really does not exercise

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9. The nurse is presenting a community educational program focusing on older adults and mental health protective factors. One of the participants asks what the influence of co-parenting one’s grandchild has on the mental health of the grandparent. Which response by the nurse would be most appropriate?

A) “The well-being of grandmothers is statistically more significant when they co-parent their grandchildren.”

B) “Although there are stresses involved with grandparenting, the positive benefits appear to outweigh the negatives.”

C) “White grandmothers experience less well-being when they co-parent their grandchildren.”

D) “The perceived well-being of grandfathers who co-parent their grandchildren significantly changes in a positive direction.”

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10. A nursing student is reading an article about protective factors for older adults with mental illness. The article mentions the individual’s ability to adapt successfully to stress, trauma, or chronic adversity. The student identifies this as which process?

A) Functional status

B) Gerotransendence

C) Resilience

D) Empty nesting

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11. A nurse is reviewing the medical records of several older adult clients who have come to the clinic for evaluation. The nurse would classify a client of which age as being in the middle-old stage?

A) Adult 66 years of age

B) Adult 70 years of age

C) Adult 78 years of age

D) Adult 86 years of age

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12. While assessing an older adult client for mental health issues, the nurse pays special attention to the client’s sensory function based on what understanding?

A) Most older adults follow a specific pattern of decline in functioning, leading to gradual onset of problems.

B) Sensory decline may affect the individual’s ability to process information, possibly influencing the findings of the mental status examination.

C) Diminished sensory function can lead to changes in other body systems that may affect the individual’s reaction to prescribed medications.

D) Changes in the senses can result in changes in cognitive abilities, which mimic the manifestations of mental disorders.

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13. A group of nurses is reviewing information about the course of aging in future older adults, and qualities that contribute to successful mental aging. The nurses demonstrate the need for additional review when they identify which aspect as most important?

A) Capacity to adapt to change

B) Engagement in life

C) Stability with reliable social support

D) Physical health

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14. A nursing instructor is preparing for a class discussion on polypharmacy and older adults. What would the instructor expect to include?

A) The risk for drug abuse, although present, is fairly rare in this population.

B) Older adults often experience a greater risk for adverse reactions.

C) Medications are usually prescribed in higher doses initially, and then gradually reduced.

D) Age-related pharmacokinetic changes enhance the drug’s therapeutic effectiveness.

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15. A group of nursing students is reviewing risk and protective factors associated with mental disorders in the older adult population. The students demonstrate understanding of the information when they identify what as a protective factor?

A) Poverty

B) Education

C) Loss

D) Chronic illness

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16. The nurse is working as part of a team to help reduce the stigma attached to mental health treatment for the older adult population. Which would be most appropriate to do to achieve this outcome?

A) Provide education about mental health and mental disorders.

B) Initiate screening programs for symptoms.

C) Ensure older adults receive integrated community care.

D) Institute a wide range of social support services.

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17. A nurse is explaining the concept of cognitive aging to a group of seniors at the senior center when one asks, “So when does this type of aging begin?” Which response by the nurse would be most appropriate?

A) “It usually starts sometime during your forties.”

B) “Researchers have yet to identify exactly when it starts.”

C) “It’s a life-long process that starts before you were born.”

D) “Each person begins this type of aging at different times.”

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18. A nurse is preparing to conduct an assessment of a 79-year-old woman who has come to the clinic for evaluation. When performing this assessment, what would be most appropriate for the nurse to do? Select all that apply.

A) Dim any lights that appear too bright.

B) Face the client from the side.

C) Use short, simple sentences.

D) Focus on one topic at a time.

E) Speak slowly in a shouting tone.

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19. A nurse is developing a plan for establishing appropriate supportive community care services for older adults to promote independence. Which services would the nurse be most likely to include? Select all that apply.

A) Transportation

B) Homemakers

C) Legal

D) Housing

E) Child care

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20. Assessment of an older adult reveals problems with the adult’s working memory. When developing the adult’s plan of care, which interventions would be most appropriate for the nurse to include? Select all that apply.

A) Establishing written reminders for the adult to take medications

B) Having a caregiver reorient the adult to person, place, and time

C) Speaking slowly and clearly when engaged in conversations with the adult

D) Demonstrating different but simple ways the adult can solve problems

E) Not allowing the adult to engage in any situations that require decision-making