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Mr. Greene is an 85-year-old male placed on a 5150 by the crisis team after his nurse called them. He has taken a fall in his driveway after his dialysis. He has end-stage kidney disease, diabetes, and a history of myocardial infarction 4 years ago. He was living alone until his home health nurse found him crying out in pain, clutching onto his leg in the kitchen. “I’m so tired,” he says.Some yes or no questions on the geriatric depression scale may include (select all that apply):

A.

Do you feel your life is empty?

B.

Are you on a low cholesterol diet?

C.

Have you dropped your activities or interests?

D.

Do you feel happy most of the time?

Question Solution

Correct Answer : A,C,D

Choice A reason:

“Do you feel your life is empty?” is a relevant question on the geriatric depression scale. Feelings of emptiness can indicate depression, especially in older adults who may experience significant life changes and losses.

 

Choice B reason:

“Are you on a low cholesterol diet?” is not a relevant question for assessing depression. This question pertains to dietary habits and cardiovascular health rather than mental health.

 

Choice C reason:

“Have you dropped your activities or interests?” is a pertinent question on the geriatric depression scale. A loss of interest in activities that were once enjoyable is a common symptom of depression.

 

Choice D reason:

“Do you feel happy most of the time?” is a relevant question on the geriatric depression scale. Assessing overall happiness helps identify depressive symptoms, as individuals with depression often report feeling unhappy or sad most of the time.


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Correct Answer is B

Explanation

Choice A reason:

While some may consider tricyclic antidepressants outdated, they are still used for certain conditions, including neuropathic pain. The primary concern with their use in elderly clients is not their age but their side effect profile.

Choice B reason:

Tricyclic antidepressants, including nortriptyline, can increase cardiac side effects and urinary retention, which are significant concerns in elderly clients. These medications can cause orthostatic hypotension, arrhythmias, and exacerbate urinary retention, making them less suitable for older adults with pre-existing health conditions.

Choice C reason:

The timing of medication administration (e.g., only taken at night) is not the primary issue with tricyclic antidepressants. The concern lies in their side effects, which can be particularly problematic for elderly clients.

Choice D reason:

While the cost of medication can be a factor in treatment decisions, it is not the primary reason tricyclic antidepressants are contraindicated in elderly clients. The main concern is their potential to cause serious side effects.

Correct Answer is D

Explanation

Choice A reason:

The statement “The stress of nursing school will cause depression” is not accurate according to the Diathesis-Stress Model. While stress can contribute to the development of depression, the model emphasizes the interaction between genetic vulnerabilities and environmental stressors, not a direct cause-and-effect relationship.

Choice B reason:

“Depression is a result of cultural and religious perspectives” is not a statement supported by the Diathesis-Stress Model. This model focuses on the interplay between genetic predispositions and environmental stressors, rather than cultural or religious factors alone.

Choice C reason:

“The stress of parenting often causes depression” is an oversimplification. While parenting can be stressful and may contribute to depression in some individuals, the Diathesis-Stress Model highlights the importance of genetic vulnerabilities interacting with life stressors to trigger depression.

Choice D reason:

“People with genetic vulnerabilities can develop depression with added stress of life events” accurately reflects the Diathesis-Stress Model. This model posits that individuals with a genetic predisposition to depression are more likely to develop the condition when exposed to significant stressors, such as life events or environmental challenges.

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