Question

A 79-year-old man is admitted to a long-term care facility after a stroke that has left him paralyzed on one side and unable to talk. A daughter visiting from out of town approaches the gerontological nurse and expresses concern about how to communicate with her father.

1. The gerontological nurse explains to the daughter that when communicating with her father, she should

A.   use word boards and picture charts.

B.   face her father; speak loudly and clearly.

C.   explain procedures in detail.

D.   face her father with adequate light on her face.

2. The gerontological nurse identifies the nursing diagnosis of altered verbal communication for a client with expressive aphasia. An appropriate nursing intervention to assist the client to communicate is to

A.   ask simple questions that can be answered with “yes” or “no.”

B.   develop a list of simple words that the client can read and practice reciting.

C.   have the client practice facial and tongue exercises to improve motor control necessary for speech.

D.   prevent embarrassing the client by changing the subject if he or she does not respond in a timely manner.

3. Describe the gerontological nurse’s role in caring for persons with Parkinson’s disease (PD).

Chapter 24

An 80-year-old Caucasian white client recently lost her husband of 58 years to cancer. Although he was a chronic alcoholic, he provided for his family and did everything for his wife. While visiting with the client in a long-term care facility, she laments about “the loss of her husband and losing additional friends all the time.” She sighs and questions whether her life has any meaning.

1. The gerontological nurse’s best response is to

A.   ignore the client’s comment, assuming that “she is just a little depressed today.”

B.   suggest that the client develop some new interests.

C.   ask the client to describe her past experiences.

D.   refer the client for counseling to avoid worsening her depression.

2. Depression is the most common mental health problem in later life and among the most treatable, but it can be life threatening if left unrecognized and untreated.

A.   True

B.   False

3. The treatment of mental illness in nursing homes and in residential care/assisted living (RC/AL) facilities is substandard. Identify the obstacles to mental health care in nursing homes and RC/AL facilities.

4. The gerontological nurse is evaluating the plan of care for an alcoholic-dependent older adult client. Which of the following entries in his chart indicates a need for further client monitoring, exploration, or education?

A.   The client states that he understands the need for continued treatment.

B.   The client states that he intends to decrease his alcohol consumption.

C.   The client showered and shaved and attended group session.

D.   The client stated, “I am an alcoholic.”

Answer 1

The gerontological nurse’s role in caring for persons with Parkinson’s disease.

assess the neurological status.

assess the ability to swallow and chew

provide a high-calorie diet.

provide a high protein, high fiber, and a soft diet.

increase fluid intake 2000ml/day

monitor for constipation.

instruct the client to wear low heeled shoes.

promote independence along with safety.assist with ambulation and provide assistive devices.

encourage the client to lift the feet when walking.

advice to keep proper posture.

promote rehabilitation and other physical therapies.

administer anti parkinsonism medicines. (Amantadine, Bromocriptine)

avoid food high in vitamin B₆

instruct the client to avoid monoamine oxidase inhibitors.

The gerontological nurse’s best response is

Option: C. ask the client to describe her past experiences. since her husband gave everything to her during his lifetime, these memories can improve her mood. so asking this can ventilate her feelings. (Reminiscence therapy)

remaining options are inappropriate:

option A; is wrong because we should not neglect depressed clients.

Option B & Option D: these are not the best options because it takes time to achieve its objectives.

The statement is true; chronic depression is life-threatening. depression increases the risk of suicide and other illnesses.

The obstacles to mental health care in nursing homes and RC/AL facilities:

• long-stay residents
• provider norms
• facility finance
• non-professional staff and non trained staffs
• inadequate insurance coverage
• lack of mental health professionals

Option D: The client stated, “I am an alcoholic.” this statement indicates a need for further client monitoring, exploration, or education. because this statement shows the client non changing attitude regarding treatment.

the remaining options A, B, C shows a positive client attitude regarding the treatment.