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):
Do you feel your life is empty?
Are you on a low cholesterol diet?
Have you dropped your activities or interests?
Do you feel happy most of the time?
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["A","B","D"]
Explanation
Choice A reason:
Improvement in activities of daily living (ADLs) and displaying hopefulness in interactions with others are positive nonverbal cues indicating that therapy and medication are effective. These improvements suggest that Edward is regaining interest in daily activities and looking forward to the future.
Choice B reason:
Being less tearful and able to discuss openly the loss of his grandfather with friends and in group settings are signs that Edward is processing his grief and benefiting from therapy. Open communication about his loss indicates emotional progress and acceptance.
Choice C reason:
Continuing to isolate is not a positive nonverbal cue. Isolation suggests that Edward is still struggling with his depressive symptoms and not fully engaging with his support system. This behavior indicates that further intervention may be needed.
Choice D reason:
Smiling appropriately and interacting with peers are positive nonverbal cues that therapy and medication are working. These behaviors show that Edward is beginning to re-engage socially and experience moments of joy and connection.
Correct Answer is D
Explanation
Stress can increase the basal metabolic rate (BMR) due to the release of stress hormones like adrenaline and cortisol, which can increase the body's energy expenditure.
Stress Response Mechanism
- Brain and Pituitary Gland:
- The stress response begins in the brain, specifically the hypothalamus, which signals the pituitary gland to release adrenocorticotropic hormone (ACTH).
- Adrenal Glands:
- ACTH travels through the bloodstream to the adrenal glands, located above the kidneys. The adrenal glands then release cortisol and adrenaline into the bloodstream.
- Cortisol and Adrenaline Effects:
- Cortisol:
- Cortisol increases glucose production in the liver by converting glycogen (the stored form of glucose) to glucose, making more energy available to the body.
- It also promotes protein breakdown into amino acids, which can be converted to glucose, further increasing energy availability.
- Adrenaline (Epinephrine):
- Adrenaline increases heart rate and blood pressure, enhancing the delivery of oxygen and nutrients to tissues.
- It stimulates glycogenolysis (the breakdown of glycogen to glucose) and lipolysis (the breakdown of fat into fatty acids), providing additional energy sources.
- Cortisol:
- Physiological Changes:
- Liver: Converts glycogen to glucose, increasing blood glucose levels.
- Heart: Accelerated heart rate and increased blood pressure improve oxygen and nutrient delivery.
- Lungs: Increased breathing rate (fast breathing) ensures more oxygen enters the bloodstream.
- Sweat Glands: Increased sweating helps cool the body.
- Digestive System: Digestion slows down, conserving energy for more immediate demands.
- Vision: Tunnel vision may occur as the body focuses on immediate threats.
Impact on Basal Metabolic Rate (BMR)
The combined effects of cortisol and adrenaline lead to an increase in BMR. The body’s energy expenditure rises due to:
- Increased Glucose and Fat Availability: Enhanced breakdown of glycogen and fats provides more fuel for cellular metabolism.
- Heightened Cardiovascular Activity: Increased heart rate and blood pressure raise energy demands.
- Enhanced Cellular Activity: The overall increase in cellular processes, including metabolism and energy production, results in higher energy expenditure.
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