Geriatrics: Psychiatric Care for Older Adults

Question 1

When assessing psychiatric disorders in older adults, which factor poses a unique challenge?

Accepted Answer

Difficulty distinguishing age-related changes from psychiatric symptoms

Answer

Higher prevalence of cognitive impairment

Answer

Limited availability of mental health services

Answer

Stigma surrounding mental illness in the elderly

Question 2

In treating depression among older adults, which medication class is commonly prescribed?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

Tricyclic antidepressants

Answer

Lithium

Answer

Electroconvulsive therapy (ECT)

Question 3

In managing agitation in older adults, which non-pharmacological intervention can be effective?

Accepted Answer

Music therapy

Answer

Cognitive-behavioral therapy

Answer

Electroconvulsive therapy

Answer

Antipsychotic medications

Question 4

Which of the following is NOT a common psychiatric disorder in older adults?

Accepted Answer

Schizophrenia

Answer

Depression

Answer

Anxiety

Answer

Delirium

Question 5

Which neurotransmitter is primarily linked to cognitive impairment in older adults?

Accepted Answer

Acetylcholine

Answer

Dopamine

Answer

Serotonin

Answer

Norepinephrine

Question 6

Which assessment tool is most commonly used to evaluate cognitive impairment in older adults?

Accepted Answer

Mini-Mental State Examination (MMSE)

Answer

Hamilton Depression Rating Scale

Answer

Beck Anxiety Inventory

Answer

Positive and Negative Syndrome Scale

Question 7

A common psychiatric disorder in older adults that can often be misdiagnosed as dementia is:

Accepted Answer

Major depressive disorder

Answer

Generalized anxiety disorder

Answer

Schizophrenia

Answer

Bipolar disorder

Question 8

The primary intended use of antipsychotics in older adults with dementia is to:

Accepted Answer

Manage hallucinations

Answer

Reduce cognitive impairment

Answer

Enhance mood

Answer

Prevent delusions

Question 9

What are the main difficulties in treating depression with medications in older adults?

Accepted Answer

Physiological changes related to age that affect how the body processes and responds to medications

Answer

Antidepressants not working well in older adults

Answer

Lower risk of side effects from medications in older adults

Question 10

For an older adult diagnosed with major depressive disorder, which combination of interventions is typically recommended?

Accepted Answer

Cognitive Behavioral Therapy (CBT) and antidepressants

Answer

Electroconvulsive therapy (ECT) and antidepressants

Answer

Transcranial Magnetic Stimulation (TMS) and antipsychotics

Question 11

Which intervention is specifically designed to address cognitive impairment commonly seen in older adults with psychiatric disorders?

Accepted Answer

Cognitive rehabilitation therapy

Answer

Electroconvulsive therapy (ECT)

Answer

Mood stabilizers

Answer

Antipsychotics

Question 12

Which nursing intervention is most appropriate for managing agitation in older adults with dementia?

Accepted Answer

Redirection and distraction techniques

Answer

Physical restraints

Answer

Administering sedatives

Answer

Increased staff supervision

Question 13

Which nursing diagnosis is most relevant for an older adult experiencing hallucinations?

Accepted Answer

Disturbed sensory perception

Answer

Risk for injury

Answer

Impaired thought processes

Answer

Altered body image

Question 14

When caring for an older adult patient with depression, which intervention is most appropriate?

Accepted Answer

Cognitive behavioral therapy

Answer

Electroconvulsive therapy

Answer

Antipsychotic medication

Answer

Group therapy

Question 15

Which of the following is not a typical symptom of anxiety in older adults?

Accepted Answer

Cognitive impairment

Answer

Somatic complaints

Answer

Restlessness

Answer

Sleep disturbances

Question 16

How do cultural factors impact the evaluation and diagnosis of mental health conditions in older adults?

Accepted Answer

Cultural factors can affect how symptoms are expressed and how individuals seek care.

Answer

Cultural factors do not influence the interpretation of symptoms.

Answer

Cultural considerations only apply to non-Western cultures.

Question 17

To prevent falls in older adults with psychiatric disorders, which intervention is most effective?

Accepted Answer

Installing grab bars in high-risk areas

Answer

Restricting fluids

Answer

Prescribing antipsychotic medications

Answer

Using physical restraints

Question 18

Which of the following is a common age-related physiological change that can influence the manifestation of psychiatric disorders in older adults?

Accepted Answer

Reduced brain volume

Answer

Increased cerebral blood flow

Answer

Enhanced neurogenesis

Answer

Improved synaptic plasticity

Question 19

Which of the following assessment tools is specifically designed to detect cognitive impairment in older adults?

Accepted Answer

Mini-Mental State Examination

Answer

Hamilton Depression Rating Scale

Answer

Beck Anxiety Inventory

Answer

Structured Clinical Interview for DSM-5

Question 20

When performing the Mini-Mental State Examination (MMSE) on older adults, which factor requires the most adjustment in administration?

Accepted Answer

Sensory impairments

Answer

Cultural background

Answer

Educational level

Answer

Physical fatigue

Question 21

In selecting medication for depression in older adults, which class of drugs is generally considered first-line treatment?

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

Dopamine agonists

Answer

Antipsychotics

Answer

Tricyclic antidepressants (TCAs)

Question 22

When providing psychotherapy to older adults with psychiatric disorders, the most recommended approach to focus on is:

Accepted Answer

Life review and reminiscence therapy

Answer

Exposure and response prevention (ERP)

Answer

Cognitive restructuring

Answer

Electroconvulsive therapy (ECT)

Question 23

Which of the following is considered a major risk factor for developing dementia in older adults?

Accepted Answer

Mild cognitive impairment (MCI)

Answer

Smoking

Answer

Hypertension

Answer

Obesity

Question 24

The primary goal of environmental modifications for older adults with dementia is to:

Accepted Answer

Enhance safety and promote independence

Answer

Reduce behavioral symptoms

Answer

Improve cognitive function

Question 25

Which of the following behavioral symptoms is frequently observed in older adults with dementia?

Accepted Answer

Wandering

Answer

Hallucinations

Answer

Delusions

Question 26

When communicating with older adults with dementia, which strategy is most effective?

Accepted Answer

Using clear and concise language, and repeating information as needed

Answer

Confronting them about their disorientation

Answer

Speaking loudly and slowly

Answer

Ignoring repetitive questions

Question 27

A fundamental ethical consideration in the care of older adults with psychiatric disorders is:

Accepted Answer

Respecting their autonomy and decision-making capacity to the extent possible

Answer

Coercing treatment even without consent

Answer

Preventing harm by over-medicating

Question 28

Which of the following is a common age-related physiological change in the brain associated with a decline in cognitive function?

Accepted Answer

Decline in dopamine production

Answer

Increase in serotonin production

Answer

Enhanced norepinephrine sensitivity

Answer

Increased GABA activity

Question 29

Which of the following therapeutic approaches has been shown to be effective in treating anxiety disorders in older adults, reducing symptoms and improving quality of life?

Accepted Answer

Cognitive Behavioral Therapy (CBT)

Answer

Art Therapy

Answer

Dialectical Behavior Therapy (DBT)

Answer

Psychodynamic Therapy

Question 30

In older adults, what is an appropriate indication for the use of antipsychotic medications, considering the potential risks and benefits?

Accepted Answer

Severe agitation or psychosis

Answer

Insomnia

Answer

Mild anxiety

Answer

Depression

Question 31

When providing culturally competent care to older adults, it is essential to:

Accepted Answer

Respect traditional beliefs, values, and practices, recognizing their influence on health and well-being.

Answer

Impose Western values and beliefs on the patient, disregarding their cultural background.

Answer

Ignore cultural differences, assuming that Western approaches are universally applicable.

Question 32

For older adults experiencing sleep disturbances, which of the following interventions is recommended to improve sleep quality and duration?

Accepted Answer

Establishing regular sleep-wake cycles, creating a consistent sleep-wake pattern.

Answer

Using alcohol as a sleep aid, despite its potential negative effects on sleep architecture and overall health.

Answer

Taking multiple naps throughout the day, which can disrupt the natural sleep-wake cycle and worsen sleep disturbances.

Answer

None of the above, as sleep disturbances are an inevitable part of aging and cannot be effectively addressed.

Question 33

To reduce the risk of falls in older adults, which of the following is an effective preventive strategy, promoting mobility and independence?

Accepted Answer

Regular exercise, including activities that improve balance, coordination, and muscle strength.

Answer

Use of walking canes only when needed, as relying on assistive devices can weaken muscles and increase dependency.

Answer

Limiting outdoor activities, which can lead to social isolation, reduced physical activity, and increased risk of falls.

Question 34

Which of the following is a common age-related brain change in the structure of older adults?

Accepted Answer

Progressive decrease in white matter volume

Answer

Thickening of cerebral cortex

Answer

Increased gray matter volume

Answer

Enlargement of ventricles

Question 35

An appropriate first-line medication for depression in older adults is:

Accepted Answer

Selective serotonin reuptake inhibitors (SSRIs)

Answer

Lithium

Answer

Antipsychotics

Answer

Benzodiazepines

Question 36

Which of the following is a key principle of effective communication with older adults?

Accepted Answer

Speaking slowly and clearly, allowing ample time for response and clarification.

Answer

Avoiding eye contact to reduce anxiety.

Answer

Interrupting frequently to maintain engagement.

Answer

Using technical jargon to ensure comprehension.

Question 37

A multidisciplinary team approach to mental health care for older adults typically includes:

Accepted Answer

Psychiatrist, psychiatric nurse, social worker, and occupational therapist.

Answer

Nurse and social worker only.

Answer

Psychiatrist solely.

Answer

Family members only.

Question 38

Which of the following is a major risk factor for developing dementia in older adults?

Accepted Answer

Advanced age (over 65 years).

Answer

Regular physical activity.

Answer

High socioeconomic status.

Answer

Strong social connections.

Question 39

A common symptom of delirium in older adults is:

Accepted Answer

Sudden onset of confusion and changes in thinking and behavior that fluctuate.

Answer

Emotional instability.

Answer

Persistent hallucinations.

Answer

Progressive memory loss over months or years.

Question 40

Which of the following is a protective factor against mental health disorders in older adults?

Accepted Answer

Strong social networks and meaningful relationships.

Answer

Retirement from work.

Answer

Chronic physical health conditions.

Answer

Financial security.

Question 41

A unique ethical consideration in psychiatric care of older adults is:

Accepted Answer

Balancing respect for autonomy with ensuring safety, considering cognitive impairments and potential risks.

Answer

Prioritizing physical health over mental health concerns.

Answer

Withholding treatment options to avoid potential side effects.

Answer

Obtaining informed consent from family members only.

Question 42

Which of the following is a common physical symptom that may accompany depression in older adults?

Accepted Answer

Fatigue

Answer

Delusions of grandeur

Answer

Bipolar mood swings

Answer

Hallucinations

Question 43

When conducting a psychiatric evaluation of an older adult, it is important to:

Accepted Answer

Establish rapport by actively listening with a gentle, respectful approach.

Answer

Use confrontational questions to obtain information.

Answer

Focus exclusively on their medical history and current medications.

Question 44

Which of the following medications is commonly used to manage agitation and aggression in older adults with dementia?

Accepted Answer

Atypical antipsychotics

Answer

Benzodiazepines

Answer

Antidepressants

Answer

Mood stabilizers

Question 45

When developing a treatment strategy for an older adult with anxiety, it is essential to consider:

Accepted Answer

Co-occurring medical conditions, cognitive abilities, and potential adverse effects of medications.

Answer

Only the most severe symptoms.

Answer

Solely the patient's own preferences.

Question 46

Which of the following is a well-known risk factor for developing delirium in older adults?

Accepted Answer

Polypharmacy (using multiple medications)

Answer

Exceptional physical health

Answer

High level of education

Answer

Young age

Question 47

When providing care to an older adult with a psychiatric disorder, it is imperative to:

Accepted Answer

Respect their autonomy and decision-making capacity to the extent possible.

Answer

Dismiss or ignore their concerns.

Answer

Treat them as if they were children.

Question 48

Which of the following is a non-pharmacological intervention that may enhance sleep quality in older adults?

Accepted Answer

Cognitive-behavioral therapy for insomnia (CBT-I)

Answer

Consuming alcohol before bedtime

Answer

Taking sleeping pills on a nightly basis

Question 49

When assessing an older adult for depression, it is important to:

Accepted Answer

Utilize a geriatric depression screening tool.

Answer

Presume that depression is an inevitable part of aging.

Answer

Rely exclusively on self-reporting.

Answer

Disregard physical symptoms.

Question 50

Which of the following is a potential indicator of elder abuse?

Accepted Answer

Unexplained bruises or injuries.

Answer

Frequent medical checkups

Answer

Good personal hygiene

Answer

Regular social engagement

Question 51

When providing care to an older adult with dementia, it is important to:

Accepted Answer

Use clear and concise language, avoiding condescension.

Answer

Engage in arguments about their perceived reality.

Answer

Treat them as if they were infants

Answer

Ignore their attempts to communicate.