Which intervention best demonstrates the nurse's understanding of safe medication administration of rivastigmine (Exelon) to the older client experiencing symptoms of Alzheimer's disease?
a. The client's cognitive status is evaluated weekly against baseline abilities
b. Rivastigmine route of administration will affect the presence of side effects
c. The client is carefully monitored for side effects before the medication dose is increased
d. The use of a patch delivery system is discussed with the physician and phar-macist
Question 2An older client admitted to the hospital after having sustained a fall at home is diag-nosed with a right hip fracture and experienced a surgical reduction of the fracture. At 2:30 AM, she awakens from sleep insisting that her daughter is in the other roo
room and wants to see her. Attempts to reorient her to the surroundings are unsuccessful. In reviewing the client's record, what data would be considered a primary risk factor for the delirium?
a. History of dementia
b. Death of the client's husband last month
c. The client's age
d. History of cardiac disease
Question 3Which intervention best addresses the principle that is the basis for communicating with a client experiencing post-surgical delirium?
a. Reminding the client that delirium is generally acute and reversible
b. Assuming that the client's statements are an attempt to express needs
c. Allowing the client sufficient time to formulate an answer to questions
d. Using non-verbal communication techniques to communicate with the client
Question 4When assessing the intellectual abilities of an older adult, the nurse demonstrates an understanding of a major barrier to reliable testing of this population when:
a. sharing with the client that the test can be scheduled at whatever time is good for you.
b. providing the client with frequent rest periods
c. stating, Just take your time and try to relax; there are no wrong answers to this test.
d. assuring that the area is well-lit and quiet
Question 5The nurse is caring for an older client who experienced a hip replacement surgery 10 hours ago. Which intervention will help minimize this client's risk of developing deliri-um?
a. Requesting that staff offer fluids each time they interact with the client.
b. Medicating the client to best facilitate restorative sleep.
c. Encouraging the client to remain still and thus minimize pain.
d. Suggesting that visitors is limited to family members only.
Question 6While the older African-American is at the highest risk for developing Alzheimer's disease, the nurse demonstrates an understanding of this disease process's risk factors when assessing this population's:
a. Weight and elimination patterns
b. Heart rate and capillary refill status
c. Blood pressure and glucose serum levels
d. Muscle strength and reflex times
Question 7The following are true statements about bipolar disorders in older adults except:
a. Bipolar disorder often results in 'a leveling out' of symptoms as one ages.
b. Relapses in bipolar disorder tend to be precipitated by medical problems.
c. Older adults with bipolar disorder tend to be 'rapid cyclers'.
d. Bipolar disorder is the most commonly diagnosed psychiatric disorder in older adults.
e. Antidepressant medication can cause an increase in manic behavior.
Question 8An older client in an adult day care program tells the nurse that, I'm very stressed because another neighbor passed away. The most therapeutic response by the nurse is:
a. What do you mean by 'stressed'?
b. Tell me what you did when your other neighbor passed away.
c. Are you worrying about your own death?
d. Let's get involved in some activities and not think about sad things.
Question 9An older client was recently admitted to a nursing home after being transferred directly from the hospital after a hospitalization for a fall and subsequent hip replacement. The client is not eating well, refuses to take medications, and prefers to sit al
sit alone. Which suggestion will the nurse make when the client's daughter visits?
a. When visiting bring familiar objects from the patient's home to decorate the room.
b. Do not visit for a few weeks in order to give the patient time to get used to the facility.
c. Speak with the primary physician and request a psychiatric evaluation to rule out dementia.
d. Consider transferring the patient to a different facility since adjusting to this one seems problematic
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