ATI LPN
Psychiatric Nursing: Contemporary Practice 6th Edition
Chapter 37 : Mental Health Assessment of Older Adults Questions
Question 1 of 5
An elderly client tells the nurse that she had been constipated for the last few days and decided to use an over-the-counter fiber laxative that is dissolved in water. When reviewing the use of this laxative with the client, which of the following would the nurse include as a possible side effect?
Correct Answer: C
Rationale: Fiber laxatives, such as psyllium, increase bulk in the stool and can cause flatus (gas) as a common side effect due to fermentation in the gut. Diarrhea (option
A) may occur with overuse but is less common. Nausea (option
B) and stomach pain (option
D) are less directly associated with fiber laxatives compared to flatus.
Question 2 of 5
An 80-year-old client visits the mental health clinic with her daughter. During the assessment process, the client tells the nurse that she is taking an antidepressant, an antibiotic, and an occasional aspirin. Which question would be most important for the nurse to ask?
Correct Answer: A
Rationale: Grapefruit juice can interact with many medications, including some antidepressants and antibiotics, by inhibiting the cytochrome P450 enzyme system, potentially leading to increased drug levels and toxicity. Orange, tomato, and grape juices (options B, C,
D) do not have significant interactions with these medications, making grapefruit juice the most critical to assess.
Question 3 of 5
While caring for an 88-year-old client suspected of having dementia, the nurse assesses the client for a common delusional thought. Which of the following would the nurse interpret as a common delusion?
Correct Answer: D
Rationale: In dementia, a common delusion is the belief that personal belongings are being stolen, often by familiar people like roommates or caregivers, as in option D. Grandiose delusions (option
A) or paranoid delusions about the government (option
C) are less common in dementia and more associated with other disorders like schizophrenia. Option B is less typical and more fantastical.
Question 4 of 5
The nurse is assessing a 78-year-old client who lives alone in his own home. To assess the client?s instrumental activities of daily living, which question would be most appropriate to ask?
Correct Answer: C
Rationale: Instrumental activities of daily living (IADLs) include complex tasks like cooking, shopping, and managing finances. Asking about cooking meals (option
C) directly assesses an IADL. Bathing (option
A) and changing clothes (option
B) are basic activities of daily living (ADLs). Grocery shopping (option
D) is an IADL but is less specific than cooking for assessing daily functioning.
Question 5 of 5
The nurse is assessing a client who has a history of heavy drinking and who lost his wife to cancer during the previous year. He reports that he isn?t getting as much sleep as he used to when he was younger. Which question would be most appropriate to ask the client to determine if the change in his sleep pattern is related to normal aging or depression?
Correct Answer: B
Rationale: Difficulty falling or staying asleep (option
B) is a key symptom of depression, especially in the context of recent loss and heavy drinking, which can exacerbate depressive symptoms. Normal aging may reduce sleep duration slightly, but insomnia is more indicative of depression. Options A, C, and D provide background but do not directly differentiate between aging and depression.