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NSG 4067 FINAL EXAM STUDY GUIDE
A nurse monitors older adults in a long-
term care facility. Which of the following
1. symptoms would require follow-up by the
nurse to assess for depression in the older
adult?
A) Anorexia
B) Weakness
C) Labile affect
D) Impaired perceptions
Ans: A
Feedback:
Appetite disturbances, particularly
anorexia, are among the most common
physical complaints of depressed older
adults. Individuals with dementia have the
following symptoms: vague fatigue, labile
affect, and physical complaints that are
easily forgotten.
Origin: Chapter 15- Impaired Affective F
unction- Depression, 2
A nurse is reviewing the side effects of
antidepressants with a group of older
2. adults. Which of the following statements
by a member of the group indicates that
the nurse's teaching has been effective?
"I will start on the dose that I will take for
A)
life."
"Fluoxetine should be given in the
B)
evening because it may help me sleep."
"I need to maintain my fluid intake while
C)
on antidepressant medication."
"The length of antidepressant treatment is
D) usually 3 months for a first-time
depression."
Ans: C
, Feedback:
An increase in fluid intake helps prevent
the risk of postural hypotension. Dosages
can be increased gradually until maximal
therapeutic levels are reached, while
observing for adverse effects. Fluoxetine
should be given in the afternoon because
of agitation. The length of treatment is
usually 6 months for a first-time
depression.
Origin: Chapter 15- Impaired Affective F
unction- Depression, 3
A nurse monitors for depression in the
older adult population. Which of the
3. following are a risk factor and a functional
consequence of depression in the older
adult? (Select all that apply.)
A) Chronic pain
B) Functional impairment
C) Hypernatremia
D) Nutritional deficiencies
E) Renal impairment
Ans: A, B, D
Feedback:
Chronic pain, functional impairment, and
nutritional deficiencies are both
contributing factors and consequences of
depression in the older adult. Renal
impairment and hypernatremia are not
specifically related to depression.
Origin: Chapter 15- Impaired Affective F
unction- Depression, 4
A nurse educator teaches about theories of
late-life depression. Which of the
4.
following statements by a student shows
that the material is understood?
, "Adverse events impair your ability to
A)
evaluate yourself."
"Depression is caused by decreased
B) activity in the hypothalamic–pituitary–
adrenal axis."
"Older adults with depression and chronic
C) illness have more serious negative
functional consequences."
"Researchers have identified a cause-and-
D) effect relationship between depression and
dementia."
Ans: C
Feedback:
Studies consistently find that the co-
occurrence of depression with chronic
conditions in older adults is associated
with more serious negative functional
consequences. Cognitive theory says that
distorted perceptions, not adverse
(unfavorable) events, impair one's ability
to appraise oneself and the event
constructively. Increased plasma cortisol
levels and increased activity of the
hypothalamic–pituitary–adrenal axis can
lead to depression. Researchers have
identified neuropathologic changes but
have not identified a specific cause-and-
effect relationship between dementia and
depression.
Origin: Chapter 15- Impaired Affective F
unction- Depression, 5
When risk factors to potential suicide have
been identified, a nurse must further
assess the actual risk for a suicide attempt.
Which of the following questions would
5.
be appropriate for initial assessment to
determine the presence or absence of
suicidal thoughts in an older adult with
risk factors?
A) "Under what circumstances would you
, take your life? Have you ever started to
act on a plan to harm yourself?"
"Do you have a plan for taking your life?
B) What action would you take if you were to
harm yourself?"
"Does your life feel worthless? Do you
C) ever think about escaping from your
problems?"
"Do you think about harming yourself?
D) Do you ever think about committing
suicide?"
Ans: C
Feedback:
Suicide assessment is multilevel, and each
level of questions depends on the response
the client gives to the previous level's
questions. Level 1 questions determine the
presence or absence of suicidal thoughts.
Level 1 questions are indirect; at level 2,
they become more direct. Level 2
determines the presence or absence of
thoughts about self-harm. Level 3
questions determine whether the client has
a realistic suicide plan.
Origin: Chapter 15- Impaired Affective F
unction- Depression, 6
A gerontological nurse conducts an
assessment of an older adult who has a
history of depression. Assessment reveals
that the client has been drinking up to two
6.
bottles of wine each day for the last
several months. What should the nurse
teach the client about alcohol use and
depression?
"If you choose to use alcohol to address
A) your depression, it's best to limit it to four
to five drinks each day."
"We recommend that everyone over the
B)
age of 70 abstain from drinking alcohol."
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