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Older Adults and Mental Health

Chapter Introduction and Overview

1. The average lifespan in the United States has increased from 47 years in 1900 to more than 75 years in the mid-1990’s.  

A. True

B. False


2. What percentage of the population aged 55 and over experience specific mental disorders that are not part of "normal" aging?

A. 10 percent

B. 20 percent

C. 30 percent

D. 40 percent


3.   In the United States, the rate of suicide, which is frequently a consequence of depression, is lowest among older adults relative to all other age groups.

A. True

B. False


4.   When diagnosing and treating mental disorders in older people, which of the following is a risk factor that may complicate the course or outcome of treatment?

A. Coexisting general medical conditions

B. The high number of medications many older individuals take

C. Psychological stressors such as bereavement or isolation

D. All of the above


5.   Which of the following is NOT a common occurrence in the normal aging process?

A. Stable intellectual functioning

B. Capacity for change

C. Extreme disability in mental functioning

D. Productive engagement with life


6. According to several studies, memory complaints in older people are thought to be more a product of depression than of decline in memory performance.

A. True

B. False


Overview of Mental Disorders in Older Adults

7.   Primary care providers carry much of the burden for diagnosis of mental disorders in older adults, and unfortunately, the rates at which they recognize and properly identify disorders are often low.

A. True

B. False


8. Which of the following is a true statement regarding the importance of avoiding premature institutionalization for older adults?

A. Providing counseling services and support for caregivers of Alzheimer’s patients has not only delayed nursing home admission but has also decreased depression in the caregivers

B. Delaying institutionalization has not shown any significant public health impact in terms of reducing costs

C. Patients and family caregivers usually prefer institutionalization at the first sign of instability rather than waiting until the situation is grave

D. None of the above


9. Treatment of mental disorders in older adults encompasses which of the following

A. Electroconvulsive therapy

B. Psychosocial interventions.

C. Pharmacological interventions

D. All of the above


10. When taking medication, older people generally encounter an increased risk of side effects, usually because of taking multiple drugs or having higher blood levels of a given drug.

A. True

B. False


11. Many older adults are embarrassed to seek treatment for mental health issues so they prefer to pursue treatment options away from their primary care physicians

A. True

B. False


Depression in Older Adults

12. With increased information and training being provided to primary care physicians, depression in the aging population rarely goes undiagnosed and untreated.

A. True

B. False


13. __________ of older adults in the community and up to _________in primary care settings suffer from depressive symptoms.

A. 8-20 percent; 37 percent

B. 21-32 percent; 47 percent

C. 33-45 percent; 57 percent

D. 46-58 percent; 67 percent


14. Late onset depression includes which of the following unique characteristics

A. Patients with late-onset depression display less apathy than those with early onset depression

B. Late onset patients show greater lifetime personality dysfunction than early onset patients

C. The risk of recurrence of depression is relatively high among patients with onset of depression after the age of 60

D. None of the above


15. The most serious consequence of depression in later life is increased mortality from either suicide or somatic illness.

A. True

B. False


16. Late-life depression is particularly costly because of the excess disability that it causes as well as:

A. Older primary care patients with depression use more medication

B. They visit the doctor and emergency rooms more often

C. They incur higher outpatient charges

D. All of the above


17. There is consistent evidence that about 40 to 50 percent of depressed older patients respond to treatment with antidepressant medication while the placebo response rate is about 15 to 25 percent.

A. True

B. False


18. Problemsolving therapy has been found to be effective in the treatment of depression in older patients by giving them the tools to enable them to cope with stressors and thereby experience fewer symptoms of psychopathology.

A. True

B. False


Alzheimer’s Disease

19. Which of the following is an NOT an accurate statement about Alzheimer’s Disease?

A. The disease strikes 18 to 25 percent of people over the age of 65

B. Alzheimer’s Disease is one of the most feared mental disorders because of its gradual, yet relentless, attack on memory

C. Diagnosis is challenging because of the lack of biological markers and the need to exclude other causes of dementia

D. Both A and B above


20. Although genetic risk factors give some indication of the relative risk of Alzheimer’s Disease, they are as yet rarely useful for diagnosis on an individual basis.

A. True

B. False


21. In relationship to behavioral symptoms associated with Alzheimer’s Disease, which of the following is true:

A. Fortunately behavioral symptoms occur at some point during the disease with low frequencies

B. Behavioral symptoms are required as part of the diagnosis

C. Behavioral symptoms have generally received greater attention than cognitive symptoms

D. Behavioral symptoms include insomnia, incontinence, verbal, emotional, or physical outbursts, sexual disorders and weight loss


22. Approximately 50 percent of individuals with a family history of Alzheimer’s Disease, if followed into their 80’s and 90’s, will develop the disorder.

A. True

B. False


23. Protective factors that delay the onset of Alzheimer’s Disease include:

A. Higher education levels in older adults

B. The use of some medications, such as nonsteroidal anti-inflammatory drugs and estrogen replacement therapy

C. Greater socioeconomic status

D. Both A and B above


24. Individual and respite programs were found to be only marginally effective at reducing caregiver burden for Alzheimer’s patients while group interventions were moderately effective.

A. True

B. False


Other Mental Disorders in Older Adults

25. Community-based prevalence estimates indicate that about __________ of adults aged 55 years and older meet criteria for an anxiety disorder in 1 year.

A. 11.4 percent

B. 18.3 percent

C. 26.8 percent

D. 32.1 percent


26. Although schizophrenia is commonly thought of as an illness of young adulthood, it can both extend into and first appear in later life AND:

A. Symptoms of schizophrenia must be accompanied by prominent mood symptoms

B. One-year prevalence of schizophrenia among those 65 years or older is reportedly around 8.3 percent

C. Patients with late-onset schizophrenia were more likely to be women in whom paranoia was a predominant feature of the illness

D. One-fourth of older schizophrenics significantly improve or recover with treatment and psychosocial rehabilitation


27. Which of the following is NOT an accurate statement about older individuals and substance abuse:

A. Misuse of alcohol and prescription medications appears to be a more common problem among older adults than abuse of illicit drugs

B. The rate of substance abuse and dependence among older adults tends to be underestimated

C. The prevalence of heavy drinking (12 to 21 drinks per week) in older adults is estimated at 10 to 15 percent

D. One study found that being female is the greatest risk factor for abuse of prescription medication among older adults


28. The treatment of substance abuse and dependence in older adults is similar to that for other adults and generally involves a combination of pharmacological and psychosocial interventions, supplemented by family support and participation in self-help groups.

A. True

B. False


Service Delivery

29. In delivering services to aging populations, far greater emphasis is now being placed on community-based care, which entails care provided in homes, in outpatient settings, and through community organizations.

A. True

B. False


30. One new concept in service delivery, known as the landscape for aging:

A. Strives to tailor the environment to the needs of the person through a combined focus on health and residential requirements

B. Takes a different approach than nursing homes and hospitals who tend to be more focused on what individuals cannot do, as opposed to what they can do.

C. Offers a design for dealing with mental health problems as well as with health promotion to harness human potential

D. All of the above


Other Services and Support

31. Social networks established through support and self-help groups have not shown any significant results in preventing isolation and promoting health among aging populations.

A. True

B. False


32. There is a great need to better educate families about what they can do to help promote mental health and to prevent and treat mental health problems in their older family members because:

A. Families can fall prey to negative stereotypes that little can be done for late-life mental health problems

B. They need to understand how to better recognize symptoms or signals of impending mental health problems among older adults so that they can help their loved ones receive early interventions

C. They need to know what services are available, where they can be found, and how to help their older relatives access such help when necessary

D. All of the above


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