What is the greatest threat

to the mental well-being of

the elderly?


Anxiety
Alcoholism
Depression
Pain










The primary goal of treatment of
depression in the elderly is:



Prompt prescription of appropriate
antidepressants.

Improving their quality of life.

Improving their affect.

Helping them cope with life stressors.










Which of the following interventions
might the nurse use to prevent
loneliness in a newly admitted
resident of a nursing home?



Provide one-to-one contact with the
resident.


Allow residents to wander the halls to
get acquainted.

Share a daily listing of activities and
invite the resident to participate.

Provide group learning activities.









Which of the following might cause
the nurse to suspect elder abuse
when making a home visit?



There is a bruise on the clients right leg
that she says she got from bumping
into a table.

There are only peanut butter and jelly
in the refrigerator.

The client is wrapped in a large wool
shawl.

The temperature in the house is 78F.










When the nurse suspects that a
medication an elderly client is
taking is causing signs of
depression, the nurse should:


Consult with the physician about a


possible change in medication.

Discuss the reasons for the depression
with the client.

Suggest that the client taper the dose
or frequency of the medication to see if
symptoms subside.

Ask the client for suggestions about
activities that would lift the depression.









One of the most common reasons
that depression is misunderstood in
the elderly is the belief that:



The elderly have come to terms with
the inevitability of their death.

The elderly have relatively stable
mental health due to their maturity.

Depression is to be expected as part of
aging and declining health.

The elderly have less need for
companionship as they age.










When providing care for an elderly
alcoholic client, the nurse
recognizes that:




Alcoholism often arises as a coping
mechanism to deal with loss,
depression, or anxiety.

Physicians are more likely to detect this
problem than is any other group of
healthcare providers.

Elderly females are the group least
likely to respond to treatment.

Treatment programs are relatively
successful with the elderly.









The elderly spouse who provides
home care for a loved one with
accelerating Alzheimers disease
has begun to say that the stress is
getting overwhelming and it might
be hard to keep going. What
intervention might the nurse
suggest to deal with this problem?



A low dose of an anti-depressant
medication might help lift mood.

Begin to visit care centers that
specialize in the care of residents with
Alzheimers disease.

A support group might help with coping

strategies and to relieve some tension.

Keep a journal to record thoughts and
feelings to help sort them out later.









The most commonly used
classification of medications used to
treat depression in the elderly is:



Tricyclic antidepressants.

Selective serotonin reuptake inhibitors
(SSRIs).

Thiazides.

Monoamine oxidase inhibitors (MAOIs).










When an elderly resident of a
nursing home is flat of affect, the
nurse is likely to observe:


Erratic behavior.
Dull eyes and no smile.
Slurred speech and many gestures.
4Decreased appetite.






1. A nurse is caring for a terminally ill client. In
which order is she likely to observe the following
five stages of death and dying, as described by
Elisabeth Kubler-Ross?
1. bargaining
2. denial and isolation
3. acceptance
4. anger
5. depression
What is the
greatest threat to
the mental well-
being of the
elderly?
Your
Answer:
Anxiet
y

Correct
Answer:
Depres
sion



Rationale: Depressive
symptoms among the
elderly are widespread,
with estimates ranging
from 8 to 27% of the
elderly population. It is
the mental health
problem with the
greatest frequency and
magnitude. Anxiety,
alcoholism, and pain
occur in the elderly,
but not as frequently
as depression does.
Nursing Process:
Evaluation
Cognitive Level:
Comprehension
NCLEX-RN Test Plan:
Psychosocial Integrity

2.

The primary goal of
treatment of
depression in the
elderly is:
Your
Answer:
Prompt
prescriptio
n of
appropriat
e

antidepres
sants.
Correct
Answer:
Improving
their
quality of
life.



Rationale: The elderly
are less likely to seek
and get treatment for
depression than are
other age groups, but
their quality of life can
be significantly
improved with
appropriate diagnosis
and treatment. They
need to be encouraged
to understand that
depression is common
and not associated with
the social stigma it
once was. Treatment
will improve affect and
their ability to cope
with stress.
Prescription of
antidepressants is not
a goal.
Nursing Process:
Implementation
Cognitive Level:
Analysis
NCLEX-RN Test Plan:
Psychosocial Integrity

3.

Which of the following
interventions might the
nurse use to prevent
loneliness in a newly
admitted resident of a
nursing home?
Your Answer: (blank)

4.

Which of the following
might cause the nurse
to suspect elder abuse
when making a home
visit?
Your
Answer:
There is
a bruise
on the
clients

right leg
that she
says she
got from
bumping
into a
table.
Correct
Answer:
There
are only
peanut
butter
and jelly
in the
refrigera
tor.



Rationale: A single
bruise usually is not
cause for concern, but
a client who clearly has
inadequate food might
be suffering from
abuse by family or
caregivers. Sensitivity
to hot or cold might
dictate the methods
the elderly use to feel
comfortable.
Nursing Process:
Evaluation
Cognitive Level:
Analysis
NCLEX-RN Test Plan:
Psychosocial Integrity

5.

When the nurse
suspects that a
medication an elderly
client is taking is
causing signs of
depression, the nurse
should:
Your
Answer:
Consult
with the
physician
about a
possible
change in
medicatio
n.

Rationale: For the
nurse to suspect a
medication is
contributing to
depression in the
elderly client, it would
have been important to
have eliminated other
causes first, so in this
case, the nurse would
consult with the
physician to determine
a course of action with
respect to medication.
Psychosocial changes
should be assessed
routinely by the nurse.
It is not appropriate for
the nurse to suggest
the client change the
medication dosage or
frequency.
Nursing Process:
Implementation
Cognitive Level:
Application
NCLEX-RN Test Plan:
Psychosocial Integrity

6.

One of the most
common reasons that
depression is
misunderstood in the
elderly is the belief
that:
Your
Answer:
The
elderly
have
come to
terms
with the
inevitabi
lity of
their
death.

Correct
Answer:
The
elderly
have
relativel
y stable
mental
health
due to
their
maturity
.



Rationale: Aging
requires many
adjustments to life
circumstances (living
arrangements, health,
finances, and social
circle), and the elderly
might experience
depression due to the
rapidity of the changes
and adjustment
required. The elderly
are no less likely to
need companionship
than are other age
groups. Depression is
not part of normal
aging, and many
elderly are very
content with their lives.
Nursing Process:
Evaluation
Cognitive Level:
Analysis
NCLEX-RN Test Plan:
Psychosocial Integrity

7.

When providing care
for an elderly alcoholic
client, the nurse
recognizes that:
Your
Answer:
Alcoholis
m often
arises as
a coping
mechanis
m to deal
with loss,
depressio
n, or
anxiety.

Rationale: The elderly
will turn to alcohol to
deal with losses and
use it as an escape
mechanism more often
than other age groups
will. They also are
more likely to drink
alone, so the problem
often goes undetected.
Treatment is no more
likely to be successful
with the elderly than
with other age groups.
Nursing Process:
Planning
Cognitive Level:
Analysis
NCLEX-RN Test Plan:
Psychosocial Integrity

8.

The elderly spouse who
provides home care for
a loved one with
accelerating
Alzheimers disease
has begun to say that
the stress is getting
overwhelming and it
might be hard to keep
going. What
intervention might the
nurse suggest to deal
with this problem?
Your
Answer:
A low
dose of
an anti-
depress
ant
medicati

on
might
help lift
mood.
Correct
Answer:
A
support
group
might
help
with
coping
strategi
es and
to
relieve
some
tension.



Rationale: Coping with
the stress of care
giving can be
overwhelming. Many
elderly people benefit
from group interaction
and support, and are
willing to use that kind
of resource when it is
presented in a positive
manner by the nurse.
The caregiver, with
support, might come to
realize that care
outside of the home
can be beneficial.
Medications are
considered only after
discussion with the
healthcare provider.
Journaling might help
relieve stress, but it is
not the most helpful
intervention the nurse
could suggest.
Nursing Process:
Implementation
Cognitive Level:
Application
NCLEX-RN Test Plan:
Psychosocial Integrity

9.

The most commonly
used classification of
medications used to
treat depression in the
elderly is:
Your
Answer:
Tricyclic
antidepres
sants.

Correct
Answer:
Selective
serotonin
reuptake
inhibitors
(SSRIs).



Rationale: This
classification of
medications usually is
well tolerated by the
elderly because of the
few side effects and
adverse effects. Tizzies
are diuretics.
Nursing Process:
Implementation
Cognitive Level:
Comprehension
NCLEX-RN Test Plan:
Psychosocial Integrity

10.

When an elderly
resident of a nursing
home is flat of affect,
the nurse is likely to
observe:
Your
Answer:
Erratic
behavi
or.

Correct
Answer:
Dull
eyes
and no
smile.



Rationale: An
individual who exhibits
a flat affect has a face
devoid of emotion, and
tends to be quiet and
withdrawn. The other
observations listed are
not associated with a
flat affect.
Nursing Process:
Assessment
Cognitive Level:
Analysis
NCLEX-RN Test Plan:
Psychosocial Integrity

















2. 2,4,1,5,3 Rationale: According to Kubler-Ross, the five
stages of death and dying are denial and isolation,
anger, bargaining, depression, and acceptance.