The son of an older adult couple ends his life suddenly and violently. The husband proceeds with ...

Answer to #1

C

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A Incorrect. Encouraging fluids can be a reasonable nursing intervention for this woman; however, encouraging social activity without a complete assessment and without being in the environment of a trusting relationship is unlikely to help improve functioning.
B Incorrect. The husband can be displaying disenfranchised grief and be unable to help until his grief is managed.
C Correct. This couple is at high risk for chronic grief because of the nature of their son's death. The nurse can help this older female adult work toward better mental health by establishing a trusting and caring relationship with her to en-courage expressions about her son. Afterward, the nurse can pose probing ques-tions to determine the best plan of care to help this older adult resolve or reframe enough grief to allow improved functioning.
D Incorrect. A survivor's support group can be helpful to survivors of a loved one's suicide; however, expecting this older adult to attend such a group is unrealistic until the nurse establishes a trusting relationship with her.

Answer to #2

D
Good health is always a desirable state; however, if an older adult in poor health plans for re-tirement, then the transition to the changes of retirement can be smoother if the planning ac-counts for health challenges. With preretirement planning, private pensions are not obligatory. With preretirement planning, 401k retirement plans are not obligatory; however, these plans are effective saving plans for retirement; they allow employees to save pretax dollars. Preretirement planning is the most important aspect of a smooth transition into retirement because it affords the individual a chance to prepare for losses associated with retirement such as income, interpersonal communication, health insurance, status, influence, and other issues. Health, social, and financial planning help the older adult adapt to expected or sudden retirement.

Answer to #3

B
Healthy bladder behavior skills include scheduling voiding at 2- to 4-hour intervals for residents either independently or with prompting. Beginning a low-calorie diet can be a reasonable ap-proach to urinary incontinence, but the nurse first applies low-cost behavioral techniques. Pelvic floor exercises will help control urinary incontinence. Bladder training involves increasing the time between the urge to void and voiding.

Answer to #4

A
The compromised immune system of an older individual makes him or her more susceptible to HIV or AIDS than a younger person. AIDS in older adults has been called the great imitator; many of the symptoms, such as fatigue, weakness, weight loss, and anorexia, are common to other disease conditions and may be attributed to normal aging. Alzheimer disease and schi-zophrenia are not known as the great imitator.

Answer to #5

A

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A Correct. The nurse is alert for rough, dry, flaky skin when an older adult com-plains of pruritus, to be able to prevent linear excoriation leading to skin breaks, excoriation, inflammation, and infection.
B Incorrect. A brown macule is a freckle or a liver spot, an indication of sun ex-posure.
C Incorrect. Brownish skin is a clinical indicator of venous insufficiency.
D Incorrect. Regional edema is a sign of fluid overload and venous insufficiency; localized edema is a sign of infection.

Answer to #6

C

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A Incorrect. Preoccupation with a death is acute grief, but since the death has not occurred, this cannot describe the patient.
B Incorrect. The patient might have unresolved issues with the family, but this is an unusual way to express it.
C Correct. Anticipatory grief occurs before the death and can be experienced by the patient or the potential survivors. When the patient who is dying experiences anticipatory grief, the individual detaches from the environment into a state sometimes described as psychological death. The person is no longer involved in day-to-day activities and enacts a premature death.
D Incorrect. The body prepares for death through the deterioration of organ system functioning; for example, the kidneys stop producing urine, the patient stops drinking and eating, the extremities become cold, and so forth.