An 80-Year-Old Woman Is Brought to the Office for Follow-Up

question 26

Multiple Choice

An 80-year-old woman is brought to the office for follow-up of hypertension.  The patient is prescribed lisinopril but has not taken any in the past 2 weeks because she ran out of medication.  She has tried to contact her son to pick up a refill but has been unable to reach him.  The patient moved in with her son 2 months ago after he arranged for her house to be sold.  She says he stays at his girlfriend's house during the week, so she must find neighbors who are able to drive her places.  Medical history includes a cerebrovascular accident with mild residual weakness on the left side.  Temperature is 37 C (98.6 F) , blood pressure is 156/88 mm Hg, and pulse is 80/min.  The patient is fully oriented.  Cardiopulmonary examination shows no abnormalities.  Gait and voluntary movements are normal.  On mental status examination, she appears tired and is wearing tattered clothing.  Which of the following is the most appropriate next step in management of this patient?

• A)Arrange for home healthcare services
• B)Contact the patient's son to review treatment recommendations
• C)Notify Adult Protective Services
• D)Recommend an in-home social work assessment
• E)Suggest moving into an assisted living facility

---

Definitions:

Homeostasis

The process by which biological systems tend to maintain stability while adjusting to conditions that are optimal for survival.

Internal State

Refers to an individual's psychological or emotional condition at a given moment, often invisible to outsiders.

Tension

A psychological state or physical condition resulting from the conflict between internal needs and external forces, often leading to stress.

Drive Theory

A psychological concept suggesting that motivation arises from biological drives that propel an organism to satisfy its needs.