A nurse is caring for an older adult client. Exhibits Click to highlight the findings that require immediate follow-up. To deselect a finding, click on the finding again. System Findings General Adult child accompanying parent reports decline in client, expressing concern over memory and thought process, appetite, and self-care. Adult child states, "My sibling and I hired help at home for my parent. We thought that would help but it has not. I found the title to the car today, signed over to me." Physical Client makes poor eye contact, speaks in a monotone voice, and has a lack of facial expression. Client reports sleeping 7 hr a night and getting up "once or twice per night to go to the bathroom." Client reports not wanting to eat anymore. Client's child reports their parent has lost about 8 lb in the past month. Heart rate 68/min Affect Client says, "Why don't you just leave me? I am of no use."

Rationale for correct choices • The statement "Why don't you just leave me? I am of no use" reflects hopelessness, a high‑risk indicator for self‑harm in older adults. Expressions of worthlessness or being a burden require immediate follow‑up because they signal severe depression or suicidal ideation. The priority is ensuring safety and initiating urgent mental health evaluation. • The report of cognitive decline accompanied by worsening memory, disordered thought process, and impaired self‑care indicates a significant functional deterioration. These symptoms can reflect rapidly progressing depression, delirium, or early dementia. Any acute decline in cognition or functional ability in an older adult warrants prompt assessment to identify reversible causes. • Loss of appetite with an 8‑lb weight loss in one month suggests clinically significant unintentional weight loss. Combined with decreased interest in eating, this is a red flag for major depressive disorder, frailty progression, or underlying illness. Sudden nutritional decline increases morbidity risk and requires timely intervention. • Poor eye contact, monotone speech, and flat facial expression are key affective indicators of depression. These signs, when combined with statements of worthlessness, suggest severe depressive symptoms that require urgent assessment and intervention to prevent further decline. Rationale for incorrect choices • Sleeping 7 hours per night with 1–2 awakenings to urinate can be normal for older adults. This finding does not indicate acute risk and is not a priority compared with weight loss, cognitive decline, or suicidal statements. It can be evaluated during routine assessment rather than requiring urgent follow‑up. • Heart rate 68/min is within normal limits for an older adult and does not signal instability or deterioration. It does not require immediate intervention and can be monitored routinely while priority concerns related to mood, cognition, and safety are addressed.