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. Acute stress disorder B. General adaptation syndrome (GAS) C. Posttraumatic stress disorder (PTSD) D. Alarm reaction

Correct Answer is C

Explanation

Choice A reason: Acute stress disorder occurs within one month of trauma, with symptoms like nightmares and dissociation. However, symptoms persisting beyond one month, as in this case, indicate PTSD. The patient’s presentation aligns with chronic trauma effects, making PTSD the more likely diagnosis over acute stress disorder.

Choice B reason: General adaptation syndrome describes the body’s physiological response to stress (alarm, resistance, exhaustion). It is not a psychiatric diagnosis and does not account for trauma-specific symptoms like nightmares or emotional numbing. This is unrelated to the patient’s psychological response, making it incorrect.

Choice C reason: PTSD is characterized by persistent symptoms beyond one month post-trauma, including nightmares, intrusive memories, avoidance, and emotional numbing, matching the patient’s presentation. Sexual assault is a common trigger, and the nurse would expect this diagnosis documented due to the chronicity and specificity of symptoms.

Choice D reason: Alarm reaction is the initial phase of general adaptation syndrome, involving acute stress response like fight-or-flight. It is not a diagnosis and does not explain chronic psychological symptoms like recurrent memories or emotional detachment, making it irrelevant to the patient’s trauma-related condition.

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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

Naxlex Comprehensive Predictor Exams

During a follow-up visit, a female patient is describing new onset of marital discord with her terminally ill spouse to the hospice nurse. Which Kübler-Ross stage of dying is the patient experiencing?

Correct Answer is D

Explanation

Correct Answer is C

Explanation

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