Chapter 22 Mental Health

Chapter 22  Mental Health

Complete Chapter Questions And Answers
 

Sample Questions

MULTIPLE CHOICE

1. The nurse prepares to discharge an older man who has heart failure and is in stable condition, when his wife states that she will avoid sexual activities with him because of his heart disease. Which of the following factors should the nurse use in patient teaching about sexual activity for an older adult with heart failure?
a.
An older adult with heart failure should avoid sexual relations because of the demand it places on the heart.
b.
Sexual relations and climbing six flights of stairs expend the same amount of energy.
c.
Fear and lack of knowledge can cause older people to reduce their sexual activity unnecessarily.
d.
Sexuality is a private matter between the older man and his wife.

ANS: C
Sex is not restricted to young and healthy individuals; therefore the nurse provides the patient and his wife with information about safely resuming sexual intimacy. With appropriate cardiac rehabilitation, much of his capacity for exertion, such as sexual activity, can be restored. The energy expenditure for sexual activity varies; but, typically, it takes less energy than climbing six flights of stairs. The nurse must be prepared to discuss sexual issues with patients and seeks opportunities for discussion about sexual health.

PTS: 1 DIF: Apply REF: 3| 7-11| 20 TOP: Nursing Process: Planning
MSC: Psychosocial Integrity

2. An older woman recently lost her brother, provides care for her husband who has health needs, and must move to a new location after 35 years in the same home. When she comes to the primary care facility with clinical indicators of influenza, the nurse recognizes which of the following?
a.
She is exhibiting attention-seeking behaviors.
b.
Crises and stressors can impair physical health.
c.
Her greatest need is respite care for her husband.
d.
Crisis leads to a lower functional status for the victim.

ANS: B
Her resistance to disease is likely to be lower as a result of the effects of heavy stresses acting simultaneously. She may be seeking attention, but that does not make the stress and illness any less real. Her greatest need at this moment is to be treated for influenza. Respite care may be necessary, but it is not sufficient. Successful coping with a crisis may lead to a higher level of functioning.

PTS: 1 DIF: Understand REF: 2-9| 17-22
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity

3. Which of the following statements is true about the mental health of older adults?
a.
Nurses should discourage denial and regression so older adults can directly face underlying causes of anxiety.
b.
Anxiety is easily distinguished from depression, dementia, and the effects of disease or medication.
c.
Compulsive rituals surrounding toileting and sleep are signs of a serious mental disorder.
d.
The nurse avoids antianxiety medications without an assessment for factors associated with anxiety.

ANS: D
Without an adequate assessment, medications can exacerbate a problem. Denial and regression may be necessary to enable an older person to cope with underlying stressors. Depression, dementia, disease, and medications can produce anxious behavior, and the resultant anxiety can be manifested in a similar manner, regardless of the cause. Compulsive rituals can be a way of coping with challenges leading to anxiety.

PTS: 1 DIF: Understand REF: 6-9
TOP: Nursing Process: Assessment MSC: Psychosocial Integrity

4. An older female resident lowers her voice and tells the nurse that another female resident is looking at her behind her back and is going to make her move tonight with a male staff member. Which ideas should the nurse include in the response to this individual?
a.
The staff receives training in ethics.
b.
Validate the woman’s impression.
c.
Avoid suspicious, paranoid thinking.
d.
Use the call bell if she becomes frightened.

ANS: D
Telling the resident to use the call bell if she becomes frightened offers assurances to the patient that she will be protected, but it neither confirms her suspicions nor makes a promise that cannot be kept. Replying that the staff receives training in ethics sounds as if the nurse is arguing in defense of the male staff member and does not help alleviate the resident’s fear, which can lead her to suspect that the nurse is also a part of the plot. Validating the woman’s impression contributes to the resident’s suspicions; in addition, the nurse increases professional liability risks by speaking about another resident in a negative manner. Telling the resident to avoid suspicious, paranoid thinking only aggravates the struggle for control.

PTS: 1 DIF: Apply REF: 11-15 TOP: Nursing Process: Planning
MSC: Psychosocial Integrity