C HAPTER 31: O LDER A DULTS
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. In a sad voice, an elderl y patient tells the nurse of the recent deaths of a
spouse and close friend. The patient has no other famil y and onl y a few
acquaintances in the commun it y. The nurses priorit y is to determine
whether which nursing diagnosis applies to this patient?
a. Risk for suicide related to recent deaths of significant others
b. Anxiet y related to sudden and abrupt lifestyle changes
c. Social isolation related to loss of exi sting famil y
d. Spiritual distress related to anger with God
ANS: A
The patient appears to be experiencing normal grief related to the loss
of her famil y, but because of age and social isolation, the risk for
suicide should be determined and has high priori t y. No defining
characteristics exist for the diagnoses of anxiet y or spiritual distress.
The patients social isolation is important, but the risk for suicide has
higher priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 567
TOP: Nursing Process: Anal ysis/Diagnosis MSC: Client
Needs: Psychosocial Integrit y
,2. When making a distinction as to whether an elderl y patient has confusion
related to delirium or another problem, what information would be of
particular value?
a. Evidence of spasticity or flaccidit y
b. The patients level of motor activit y
c. Medications the patient has recentl y taken
d. Level of preoccupation with somatic sym ptoms
ANS: C
Delirium in the elderly produces symptoms of confusion. Medication
interactions or adverse reactions are often a cause. The distracters do
not give information important for delirium.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 568 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
3. An 85-year-old has difficult y walkin g after a knee replacement. The
patient tells the nurse, Its awful to be old. Every day is a struggle. No one
cares about old people. Select the nurses best response.
a. Everyone here cares about old people. Thats why we work here.
b. It sounds like youre having a difficult time. Tell me about it.
c. Lets not focus on the negative. Tell me something good.
d. You are still able to get around, and your mind is alert.
ANS: B
, The nurse uses empathetic understanding to permit the patient to
express frustration and clarify her struggle for the nurse. The
distracters block communication.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 575 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A 76-year-old is regressed, indifferent, and re sponds to others onl y when
they initiate an interaction. What form of group therapy would be most
useful to promote resocialization?
a. Remotivation
b. Activit y group
c. Psychotherapy
d. Reminiscence (life review)
ANS: A
Remotivation therapy helps to resocialize regressed and apathetic
patients by focusing on a single topic, creating a bridge to realit y as
group members talk about the world in which they live and work and
hobbies related to the topic. Group leaders give members acceptance
and appreciation. Group psychotherapy would not be effective for this
patient. An activit y group does not address the patients problem.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 581 TOP: Nursing Process: Planning MSC:
Client Needs: Psychosocial Integrit y
Varcarolis’ Foundations of Psychiatric -Mental Health Nursing: 8th Edition
MULTIPLE CHOICE
1. In a sad voice, an elderl y patient tells the nurse of the recent deaths of a
spouse and close friend. The patient has no other famil y and onl y a few
acquaintances in the commun it y. The nurses priorit y is to determine
whether which nursing diagnosis applies to this patient?
a. Risk for suicide related to recent deaths of significant others
b. Anxiet y related to sudden and abrupt lifestyle changes
c. Social isolation related to loss of exi sting famil y
d. Spiritual distress related to anger with God
ANS: A
The patient appears to be experiencing normal grief related to the loss
of her famil y, but because of age and social isolation, the risk for
suicide should be determined and has high priori t y. No defining
characteristics exist for the diagnoses of anxiet y or spiritual distress.
The patients social isolation is important, but the risk for suicide has
higher priorit y.
PTS: 1 DIF: Cognitive Level: Anal yze (Anal ysis) REF: 567
TOP: Nursing Process: Anal ysis/Diagnosis MSC: Client
Needs: Psychosocial Integrit y
,2. When making a distinction as to whether an elderl y patient has confusion
related to delirium or another problem, what information would be of
particular value?
a. Evidence of spasticity or flaccidit y
b. The patients level of motor activit y
c. Medications the patient has recentl y taken
d. Level of preoccupation with somatic sym ptoms
ANS: C
Delirium in the elderly produces symptoms of confusion. Medication
interactions or adverse reactions are often a cause. The distracters do
not give information important for delirium.
PTS: 1 DIF: Cognitive Level: Understand (Comprehension)
REF: 568 TOP: Nursing Process: Assessment MSC:
Client Needs: Physiological Integrit y
3. An 85-year-old has difficult y walkin g after a knee replacement. The
patient tells the nurse, Its awful to be old. Every day is a struggle. No one
cares about old people. Select the nurses best response.
a. Everyone here cares about old people. Thats why we work here.
b. It sounds like youre having a difficult time. Tell me about it.
c. Lets not focus on the negative. Tell me something good.
d. You are still able to get around, and your mind is alert.
ANS: B
, The nurse uses empathetic understanding to permit the patient to
express frustration and clarify her struggle for the nurse. The
distracters block communication.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 575 TOP: Nursing Process: Implementation
MSC: Client Needs: Psychosocial Integrity
4. A 76-year-old is regressed, indifferent, and re sponds to others onl y when
they initiate an interaction. What form of group therapy would be most
useful to promote resocialization?
a. Remotivation
b. Activit y group
c. Psychotherapy
d. Reminiscence (life review)
ANS: A
Remotivation therapy helps to resocialize regressed and apathetic
patients by focusing on a single topic, creating a bridge to realit y as
group members talk about the world in which they live and work and
hobbies related to the topic. Group leaders give members acceptance
and appreciation. Group psychotherapy would not be effective for this
patient. An activit y group does not address the patients problem.
PTS: 1 DIF: Cognitive Level: Appl y (Application)
REF: 581 TOP: Nursing Process: Planning MSC:
Client Needs: Psychosocial Integrit y
