A nurse is caring for an older adult. Which sensory change will the nurse identify as normal during the assessment?

Difficulty hearing low pitch

Increased taste discrimination

Impaired night vision

Heightened sense of smell

Answer and Explanation

The Correct Answer is C

Choice A reason: Difficulty hearing low pitch is not a typical age-related change. Presbycusis, common in older adults, primarily affects high-frequency hearing, making it hard to discern high-pitched sounds like consonants. Low-pitch hearing is generally preserved. This choice does not reflect a normal sensory change, as it misaligns with the expected auditory decline in aging.

Choice B reason: Increased taste discrimination is incorrect, as aging typically reduces taste sensitivity due to fewer taste buds and altered salivary function. Older adults often report diminished flavor perception, impacting appetite. This choice is not a normal sensory change, as it contradicts the expected decline in gustatory function associated with aging.

Choice C reason: Impaired night vision is a normal age-related change due to presbyopia and reduced pupil dilation, decreasing retinal light sensitivity. Older adults struggle with low-light conditions, increasing fall risk. This change, linked to lens yellowing and slower dark adaptation, is expected and aligns with typical visual decline in aging populations.

Choice D reason: Heightened sense of smell is not typical in older adults. Aging reduces olfactory sensitivity due to fewer olfactory neurons and mucosal changes, impairing smell detection. This can affect safety, like detecting gas leaks. This choice is incorrect, as it opposes the normal decline in olfactory function seen in aging.

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Correct Answer is D

Explanation

Choice A reason: Depression in Kübler-Ross’s stages involves sadness and withdrawal due to loss. Marital discord suggests conflict, not introspective grief. The patient’s relational tension with her terminally ill spouse aligns with anger, not depression, which would manifest as despair or hopelessness rather than active discord.

Choice B reason: Denial involves refusing to accept the reality of death, often early in the dying process. Marital discord indicates engagement with the situation, not avoidance. The patient’s conflict suggests emotional reaction, aligning with anger, not denial, making this an incorrect stage for her behavior.

Choice C reason: Bargaining involves seeking to delay death through promises or deals, often privately. Marital discord reflects externalized emotion, not negotiation. The patient’s conflict with her spouse points to anger, not bargaining, which is less likely to manifest as relational tension, making this incorrect.

Choice D reason: Anger, per Kübler-Ross, involves frustration and resentment, often directed at loved ones, as the patient grapples with mortality. New marital discord with her terminally ill spouse suggests the patient is expressing anger, a common reaction to the unfairness of death, making this the correct stage.

A. Ask the patient’s family if the patient is behaving normally. B. Ask the patient to state name, location, and what month it is. C. Administer the Hearing Handicap Inventory for the Elderly (HHIE-S). D. Administer a Mini-Mental State Examination (MMSE).

Correct Answer is D

Explanation

Choice A reason: Asking the family about normal behavior provides subjective context but lacks standardized cognitive assessment. Cognitive function requires objective tools like the MMSE to evaluate memory, orientation, and attention. Relying solely on family input risks missing subtle deficits, delaying diagnosis of conditions like dementia or delirium critical for patient management.

Choice B reason: Asking for name, location, and month tests orientation, a component of cognitive assessment, but is too limited. The MMSE offers a comprehensive evaluation of memory, language, and visuospatial skills. This narrow approach risks overlooking broader cognitive impairments, potentially missing early dementia or other neurological conditions requiring targeted interventions.

Choice C reason: The HHIE-S assesses hearing impairment, not cognitive function. Hearing loss may affect communication but isn’t a direct cognitive measure. Using this tool for cognition misdirects assessment, risking failure to identify cognitive deficits like memory loss, delaying diagnosis and management of conditions such as Alzheimer’s disease or acute confusional states.

Choice D reason: Administering the MMSE is a standardized, comprehensive tool to assess cognitive function, evaluating orientation, memory, attention, language, and visuospatial skills. It detects impairments in conditions like dementia or delirium, guiding diagnosis and treatment. Its structured approach ensures reliable identification of cognitive deficits, critical for planning care and interventions in clinical settings.

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A nurse is caring for an older adult. Which sensory change will the nurse identify as normal during the assessment?

Nursing Test Bank

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Explanation

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Explanation

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