The highest priority for assessment by nurses caring for older adults who self-administer medications is:

Questions 29

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Kaplan and Sadocks Synopsis of Psychiatry 12th Edition Test Bank Questions

Question 1 of 9

The highest priority for assessment by nurses caring for older adults who self-administer medications is:

Correct Answer: A

Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications. Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects. Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications. Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.

Question 2 of 9

A nurse and patient are entering the termination phase in the group experience. An important nursing intervention will be to:

Correct Answer: D

Rationale: The correct answer is D because discussing feelings about leaving the group and the support found within the group is crucial during the termination phase. This allows for processing emotions, reflecting on progress, and providing closure. Choice A focuses on future goals, not on the current phase. Choice B addresses time constraints, not emotional support. Choice C is about coping strategies, which may not be the priority during termination. Thus, D is the most appropriate intervention for this phase.

Question 3 of 9

The spouse of a patient recently diagnosed with early-stage Alzheimer's disease asks, "Is there anything I can do to help delay the progression of this disease?" Which strategy has the greatest potential for preserving the protective abilities of immune cells related to the disease?

Correct Answer: B

Rationale: The correct answer is B: Enroll the patient in an exercise program that meets regularly. Regular exercise has been shown to have numerous benefits for brain health, including improving cognitive function and reducing the risk of cognitive decline. Exercise also helps in maintaining a healthy immune system by promoting the circulation of immune cells throughout the body. This can help support the protective abilities of immune cells related to Alzheimer's disease. Minimizing contact with the public during cold and flu season (Choice A) may reduce the risk of infections but does not directly address immune cell function. Providing supplements to enhance the patient's immune system (Choice C) may not be supported by scientific evidence and can potentially have adverse effects. Identifying creative ways to keep the patient mentally challenged (Choice D) is beneficial for cognitive health but does not directly target immune cell function as effectively as regular exercise.

Question 4 of 9

Which assessment observation supports a patient’s diagnosis of disorganized schizophrenia?

Correct Answer: C

Rationale: The correct answer is C because consistent inappropriate laughing is a characteristic symptom of disorganized schizophrenia. This observation aligns with the disorganized behavior and affect commonly seen in this subtype of schizophrenia. Option A is not specific to disorganized schizophrenia. Option B does not directly relate to disorganized symptoms. Option D suggests paranoia, which is more indicative of paranoid schizophrenia rather than disorganized schizophrenia.

Question 5 of 9

A patient presents to the emergency department with mixed psychiatric symptoms. The admission nurse suspects the symptoms may be the result of a medical problem. Lab results show elevated BUN (blood urea nitrogen) and creatinine. What is the nurse’s next best action?

Correct Answer: A

Rationale: Rationale for Correct Answer (A): Reporting the findings to the health care provider is the next best action because elevated BUN and creatinine levels indicate possible renal dysfunction, which could be causing the psychiatric symptoms. The health care provider needs this information to determine appropriate treatment and further evaluation. Summary of Incorrect Choices: B: Assessing the patient for a history of renal problems is not the next best action because the lab results already indicate potential renal issues. C: Assessing the patient’s family history for cardiac problems is irrelevant to the elevated BUN and creatinine levels and the psychiatric symptoms. D: Arranging for the patient’s hospitalization on the psychiatric unit is premature without addressing the underlying medical issue indicated by the lab results.

Question 6 of 9

A nursing instructor is teaching about electroconvulsive therapy (ECT). Which student statement indicates that learning has occurred?

Correct Answer: B

Rationale: The correct answer is B: ECT induces a grand mal seizure. This indicates learning has occurred because ECT does indeed induce a controlled grand mal seizure to treat severe depression. Euphoria (A) and catatonia (C) are not accurate states induced by ECT. A petit mal seizure (D) is a mild form of seizure not associated with ECT.

Question 7 of 9

The highest priority for assessment by nurses caring for older adults who self-administer medications is:

Correct Answer: A

Rationale: The correct answer is A: Use of multiple drugs with anticholinergic effects. This is the highest priority as anticholinergic medications can have severe side effects in older adults, including confusion, constipation, and increased risk of falls. Nurses need to assess for potential harm caused by these medications. Choice B (Overuse of medications for erectile dysfunction) is not the highest priority as it may not pose an immediate threat to the health and safety of older adults compared to anticholinergic effects. Choice C (Missed doses of medications for arthritis) is important but not as critical as assessing for the potential harm caused by anticholinergic medications. Choice D (Trading medications with acquaintances) is concerning but not as urgent as assessing for the harmful effects of anticholinergic medications, which can lead to serious health complications.

Question 8 of 9

A 79-year-old white male tells a nurse, “I have felt very sad lately. I do not have much to live for. My family and friends are all dead, and my own health is failing.” The nurse should analyze this comment as:

Correct Answer: C

Rationale: The correct answer is C: Evidence of risks for suicide. The statement contains indicators such as feeling very sad, lack of purpose, isolation, and declining health, which are red flags for suicide risk in older adults. It is crucial for healthcare providers to assess and intervene promptly in such cases to prevent harm. Choices A, B, and D are incorrect because they do not address the seriousness of the situation or the potential risk for self-harm.

Question 9 of 9

A health care provider writes these new prescriptions for a resident in a skilled nursing facility: 2 G sodium diet, Restraint as needed, Limit fluids to 1800 mL daily, Continue antihypertensive medication, Milk of magnesia 30 mL PO once if no bowel movement for 3 days. The nurse should:

Correct Answer: A

Rationale: Step 1: Fluid restriction of 1800 mL may not be appropriate for all residents in a skilled nursing facility. Step 2: Excessive fluid restriction can lead to dehydration, especially in elderly residents. Step 3: It is crucial for the nurse to question the fluid restriction to ensure it is safe for the resident. Therefore, the correct answer is A. Summary: - Option A is correct as questioning the fluid restriction is essential for the resident's safety. - Option B is incorrect as restraining a resident should only be used as a last resort and should be questioned if not necessary. - Option C is incorrect as blindly transcribing without assessing appropriateness can be harmful. - Option D is incorrect as assessing bowel elimination is important but addressing the fluid restriction is more urgent in this scenario.

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