A nurse is assessing the risk factors for sexually transmitted infections (STIs) in older adult clients.

Which of the following factors should the nurse consider?

(Select all that apply.).

The correct answer is C.

Living arrangements and social support.

This is because living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.Psychosocial changes refer to the changes in mental and emotional well-being, social relationships, and roles that occur as people age.Environmental factors are the external conditions or circumstances that affect a person’s life.

Choice A is wrong because physical health and functional status are not environmental factors, but rather biological factors that affect the aging process.Physical health and functional status can influence the psychosocial changes in older adults, but they are not part of the environment.

Choice B is wrong because cognitive conditions and memory loss are also not environmental factors, but rather neurological factors that affect the brain function of older adults.Cognitive conditions and memory loss can also influence the psychosocial changes in older adults, but they are not part of the environment.

Choice D is wrong because hormonal changes and sensory impairments are also not environmental factors, but rather physiological factors that affect the body function of older adults.Hormonal changes and sensory impairments can also influence the psychosocial changes in older adults, but they are not part of the environment.

Living arrangements and social support are environmental factors because they depend on the availability, accessibility, and quality of housing, transportation, community services, family networks, and social interactions that older adults have in their surroundings.Living arrangements and social support can influence the psychosocial changes in older adults by affecting their sense of independence, identity, belonging, security, and satisfaction.

Therefore, living arrangements and social support are some of the environmental factors that can influence the psychosocial changes in older adults.

The correct answer is D.

Digit Span Test (DST).

The DST is a tool that can be used to assess the client’s attention span and concentration by asking them to repeat a series of digits forward and backward (Martin, 1990).

The DST is part of the Mini-Mental State Examination (MMSE), which is a broader tool that covers other domains of cognitive functioning, such as orientation, memory, language, and visuospatial skills (Folstein et al., 1975).

Choice A is wrong because the MMSE is not a specific tool for attention span and concentration, but rather a general screening tool for cognitive impairment.

Choice B is wrong because the Confusion Assessment Method (CAM) is a tool that can be used to diagnose delirium, but not to assess attention span and concentration.

The CAM focuses on four features of delirium: acute onset and fluctuating course, inattention, disorganized thinking, and altered level of consciousness (Inouye et al., 1990).

Choice C is wrong because the Clock Drawing Test (CDT) is a tool that can be used to assess visuospatial skills and executive function, but not attention span and concentration.

The CDT requires the client to draw a clock face with numbers and hands indicating a specific time (Shulman et al., 1986).

Normal ranges for the DST vary depending on the age and education level of the client, but generally a score of 5 or more digits forward and 4 or more digits backward is considered normal (Martin, 1990).