ATI LPN
Test Bank for Psychiatric Nursing: Contemporary Practice
Chapter 37 : Mental Health Assessment of Older Adults Questions
Question 1 of 5
A nurse is assessing an older adult client. Which of the following would the nurse interpret as most indicative of mental health and wellness?
Correct Answer: B
Rationale: Interacting with others in the environment (option
B) is most indicative of mental health and wellness, as it reflects social engagement, a key component of psychological well-being. Keeping social contacts to a minimum (
A) or relying solely on family (
C) suggests isolation or dependence, which are less healthy. Bereavement (
D) is a normal response but not an indicator of wellness.
Question 2 of 5
A nurse is using the Neuropsychiatric Inventory to assess an older adult client who is exhibiting behavior problems related to dementia. When using this tool, which of the following would the nurse assess? Select all that apply.
Correct Answer: A,C,F
Rationale: The Neuropsychiatric Inventory assesses behavioral and psychological symptoms in dementia, including dysphoria (
A), apathy (
C), and anxiety (F). Inhibition (
B) is not a standard domain, though disinhibition is. Level of orientation (
D) and memory (E) are cognitive functions assessed by other tools, not the Neuropsychiatric Inventory, which focuses on behavioral symptoms.
Question 3 of 5
A nurse has used the Geriatric Depression Scale (short form) to assess an older adult client for depression. Which score would lead the nurse to suspect that the client is mildly depressed?
Correct Answer: C
Rationale: The Geriatric Depression Scale (short form) has 15 questions, with scores of 5?8 indicating mild depression and 9?15 indicating moderate to severe depression. A score of 8 (option
C) falls within the mild depression range. Scores of 3 and 5 (options A and
B) are below the threshold, and 13 (option
D) indicates moderate to severe depression.
Question 4 of 5
A nurse is caring for a 76-year-old patient with a hearing deficit caused by presbycusis. Which of the following would be most appropriate for the nurse to do when communicating with the patient?
Correct Answer: D
Rationale: Presbycusis, age-related hearing loss, primarily affects high-frequency sounds, making lower-pitched tones easier to hear. Using lower-pitched tones (option
D) is most appropriate, as it accommodates the patient?s hearing deficit. Higher volume (option
A) may help but can distort sound if too loud. Addressing family members (option
B) excludes the patient and is inappropriate. Sign language (option
C) is irrelevant unless the patient is trained in it, which is not indicated.
Question 5 of 5
The nurse is caring for a 78-year-old client who is taking an anticholinergic medication and complains of dry mouth. Which of the following would be most appropriate for the nurse to suggest?
Correct Answer: A
Rationale: Chewing hard candies, especially sugar-free ones, stimulates saliva production, which helps alleviate dry mouth caused by anticholinergic medications. Mouthwash (option
B) may not address dryness and could irritate the mouth if alcohol-based. Seasonings (option
C) do not relieve dry mouth. Decaffeinated beverages (option
D) may help with hydration but are less effective than stimulating saliva.