ATI PN

MENTAL

HEALTH

PROCTOR

ED EXAM.

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ATI PN MENTAL HEALTH PROCTORED EXAM

13. A nurse’s goal for an older adult is to reduce the risk of adverse

medication effects. Which action will the nurse take?

a. Review the patient’s list of medications at each visit.

b. Teach that polypharmacy is to be avoided at all cost.

c. Avoid information about adverse effects.

d. Focus only on prescribed medications.

ANS: A

Strategies for reducing the risk for adverse medication effects include

reviewing the medications with older adults at each visit; examining for

potential interactions with food or other medications; simplifying and

individualizing medication regimens; taking every opportunity to inform older

adults and their families about all aspects of medication use; and encouraging

older adults to question their health care providers about all prescribed and

over-the-counter medications. Although polypharmacy often reflects

inappropriate prescribing, the concurrent use of multiple medications is often

necessary when an older adult has multiple acute and chronic conditions.

Older adults are at risk for adverse drug effects because of age-related

changes in the absorption, distribution, metabolism, and excretion of drugs.

Work collaboratively with the older adult to ensure safe and appropriate use of

all medications—both prescribed medications and over-the-counter

medications and herbal options.

14. An older-adult patient has developed acute confusion. The patient

has been on tranquilizers for the past week. The patient’s vital signs are

normal. What should the nurse do?

Take into account age-related changes in body systems that affect

a. pharmacokinetic activity.

Increase the dose of tranquilizer if the cause of the confusion is an

b. infection.

c. Note when the confusion occurs and medicate before that time.

d. Restrict phone calls to prevent further confusion.

ANS: A

Some sedatives and tranquilizers prescribed for acutely confused older adults

sometimes cause or exacerbate confusion. Carefully administer drugs used to

manage confused behaviors, taking into account age-related changes in body

systems that affect pharmacokinetic activity. When confusion has a

physiological cause (such as an infection), specifically treat that cause, rather

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than the confused behavior. When confusion varies by time of day or is related

to environmental factors, nonpharmacological measures such as making the

environment more meaningful, providing adequate light, etc., should be used.

Making phone calls to friends or family members allows older adults to hear

reassuring voices, which may be beneficial.

15. Which assessment finding of an older adult, who has a urinary

tract infection, requires an immediate nursing intervention?

a. Confusion

b. Presbycusis

c. Temperature of 97.9° F

d. Death of a spouse 2 months ago

ANS: A

Confusion is a common manifestation in older adults with urinary tract

infection; however, the cause requires further assessment. There may be

another reason for the confusion. Confusion is not a normal finding in the

older adult, even though it is commonly seen with concurrent infections.

Difficulty hearing, presbycusis, is an expected finding in an older adult. Older

adults tend to have lower core temperatures. Coping with the death of a

spouse is a psychosocial concern to be addressed after the acute physiological

concern in this case.

16. Which patient statement is the most reliable indicator that an older

adult has the correct understanding of health promotion activities?

a. “I need to increase my fat intake and limit protein.”

“I still keep my dentist appointments even though I have partials

b. now.”

c. “I should discontinue my fitness club

membership for safety reasons.” “I’m

up-to-date on my immunizations, but at

my age, I don’t need the

d. influenza vaccine.”

ANS: B

General preventive measures for the nurse to recommend to older adults

include keeping regular dental appointments to promote good oral hygiene,

eating a low-fat, well-balanced diet, exercising regularly, and maintaining

immunizations for seasonal influenza, tetanus, diphtheria and pertussis,

shingles, and pneumococcal disease.

17. A 72-year-old woman was recently widowed. She worked as a teller at

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