The nurse is assessing an older adult client for the second time this week. The client reports a decreased energy level, insomnia, and anorexia. Diagnostic tests are within the expected reference ranges. For which of the following conditions should the nurse screen the client?
Dementia
Sarcopenia
Depression
Diabetes
The Correct Answer is C
A. Dementia: Usually presents with memory loss and cognitive decline, not primarily with low energy, insomnia, or anorexia.
B. Sarcopenia: This is muscle mass loss, which may cause weakness but is not associated with insomnia or anorexia.
C. Depression: In older adults, depression often presents with physical complaints like low energy, sleep disturbances, and appetite loss, even when labs are normal.
D. Diabetes: May cause fatigue, but typically includes additional findings like polyuria, polydipsia, and abnormal labs.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. 24-hour dietary intake of 75% of meals
This indicates adequate intake and is generally not concerning.
B. 24-hour urinary output of 1450 mL
This is within the normal range for urinary output and does not indicate GI dysfunction.
C. Weight loss of 2 lb since admission 2 months ago
While unintended weight loss in older adults is important, 2 pounds over 2 months is mild and not the most urgent finding.
D. Last bowel movement 4 days ago
Constipation is common but potentially serious in older adults. Not having a bowel movement for 4 days increases the risk for fecal impaction, discomfort, or bowel obstruction, and warrants intervention.
Correct Answer is C
Explanation
A. Constipation
Not part of SPICES. While bowel patterns are important, they are not included in this acronym.
B. Caregiver
SPICES is a patient-centered assessment tool, not focused on the caregiver.
C. Confusion
SPICES stands for: Sleep disorders, Problems with eating or feeding, Incontinence, Confusion, Evidence of falls, Skin breakdown.
D. Continence
"I" in SPICES stands for Incontinence, not "C".
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