You adjust care for older adults: polypharmacy, skin, confusion, and what family can safely do. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five geriatric questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which statement would indicate the use and abuse of power in a violent family situation?
A. I admit I was mad and yelling and swinging my fists in the air, but I wasn't trying to hit our child. I was letting off some steam. My spouse just overreacted.'
B. When she found out I watched television instead of taking the kids to the park, she starting yelling about how I don't care about the kids. She has no right to get mad at me. I should have some time to myself.'
C. I thought he would like this new recipe. I should have known better. I will not do that again. He was right. He works all day and should come home to a good meal that he can enjoy. It's not too much to ask of a wife.'
D. All I did was tell him I need some money. I can't understand why he can't just give me what I need. I stay home and take care of his house and kids, and I have to almost beg before he gives me money to spend on myself.'
Show answer and rationale
Correct answer: C — I thought he would like this new recipe. I should have known better. I will not do that again. He was right. He works all day and should come home to a good meal that he can enjoy. It's not too much to ask of a wife.'
The correct answer is C because it reflects an imbalance of power within the family dynamic. The statement indicates an acceptance of blame and a submissive attitude, suggesting a power dynamic where one person feels the need to please and appease the other. This behavior can indicate an abuse of power by the dominant individual, leading to a controlling and potentially manipulative relationship.
In contrast, the other choices do not clearly demonstrate an abuse of power. Choice A shows anger management issues but does not necessarily indicate a power dynamic. Choice B focuses on a disagreement over parenting responsibilities rather than a power struggle. Choice D highlights financial disagreements but does not explicitly show an abuse of power.
Therefore, Choice C is the most indicative of power abuse in a family situation.
Question 2
An 11-year-old boy stays home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. During the community mental health nurse's visit, he reveals that he thinks his father does not like him because he calls him 'stupid' all the time. He states he is too dumb to learn much and has no friends at school because he does not deserve them. Which nursing diagnosis should be the priority for the child?
A. Helplessness
B. Knowledge deficit
C. Ineffective coping
D. Chronic low self-esteem
Show answer and rationale
Correct answer: D — Chronic low self-esteem
The correct answer is D: Chronic low self-esteem. This diagnosis is appropriate because the child displays a negative self-concept, feeling unworthy, lacking confidence, and believing he is "stupid" and undeserving of friends. This impacts his self-worth and psychological well-being. Chronic low self-esteem is the priority to address as it affects various aspects of his life.
Choice A: Helplessness may seem relevant due to the family situation, but the child's core issue is more about self-worth than feeling helpless in his situation.
Choice B: Knowledge deficit is not the priority as the child's issue lies more in his emotional well-being rather than lack of information.
Choice C: Ineffective coping might be a concern, but the root of his struggles is his self-esteem, making chronic low self-esteem the primary focus.
Question 3
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
A. medication nonadherence.
B. a need for psychoeducation.
C. the chronic nature of his illness.
D. relapse of his schizophrenia.
Show answer and rationale
Correct answer: D — relapse of his schizophrenia.
The correct answer is D: relapse of his schizophrenia. The patient is displaying symptoms such as feeling tense, difficulty concentrating, disturbed sleep, and delusional thoughts about creatures hiding in his workplace. These symptoms indicate a return of psychotic features characteristic of schizophrenia, suggesting a relapse. This is supported by the patient's history of schizophrenia and the sudden onset of symptoms after a period of stability. Medication nonadherence (choice A) could be a possible cause, but the patient's symptoms are more indicative of a relapse. While psychoeducation (choice B) is important, the patient's current symptoms require immediate attention for relapse management. The chronic nature of his illness (choice C) is a general characteristic of schizophrenia and does not explain the current symptoms.
Question 4
A child, aged 11 years, has to stay home from school to care for his siblings while his mother works, because the family cannot afford a babysitter. The father appears to be emotionally abusive. Which intervention could be used for the primary prevention of problems such as these?
A. Involve the parents in a parenting support group, and help them find affordable childcare.
B. Meet with elected officials to lobby for subsidized childcare and increasing the minimum wage.
C. Screen for signs of abuse and neglect in all children so that it can be discovered and treated early.
D. Provide supportive counseling services for those who have survived neglect or abuse.
Show answer and rationale
Correct answer: B — Meet with elected officials to lobby for subsidized childcare and increasing the minimum wage.
The correct answer is B because lobbying for subsidized childcare and increasing the minimum wage addresses the root causes of the family's situation, such as financial insecurity and lack of affordable childcare. This intervention aims to prevent similar situations from occurring by advocating for systemic changes that can support families in need.
Choice A focuses on providing support to the parents, which may not address the underlying issues of financial instability and emotional abuse. Choice C addresses detection and treatment after the abuse has occurred, rather than preventing it from happening in the first place. Choice D focuses on providing counseling services after abuse or neglect has already taken place, rather than preventing it through systemic changes like subsidized childcare and increased minimum wage.
Question 5
Many persons brought before a criminal court have mental illness, have committed minor offenses, and are off medications. The judge consults the nurse at the local community mental health center for guidance about how to respond when handling such cases. Which advice from the nurse would be most appropriate?
A. Sometimes a little time in jail makes a person rethink what theyve been doing and puts them back on the right track.'
B. Sentencing such persons to participate in treatment instead of incarcerating them has been shown to reduce repeat offenses.'
C. Arresting these people helps them in the long run. Sometimes we cannot hospitalize them, but in jail they will get their medication.'
D. Research suggests that special mental health courts do not make much difference so far, but outpatient commitment does seem to help.'
Show answer and rationale
Correct answer: B — Sentencing such persons to participate in treatment instead of incarcerating them has been shown to reduce repeat offenses.'
Research supports the use of special mental health courts that can sentence mentally ill persons to treatment instead of jail. Jail exposes vulnerable mentally ill persons to criminals, victimization, and high levels of stimulation and stress. Incarceration can also interrupt eligibility for benefits or lead to the loss of housing and often provides lower-quality mental health treatment in other settings. Recidivism rates for both mentally ill and non-mentally ill offenders are relatively high, so it does not appear that incarceration necessarily leads people to behave more appropriately. In addition, a criminal record can leave them more desperate and with fewer options after release. Research indicates that outpatient commitment is less effective at improving the mental health of mentally ill persons than was expected.
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Question 6
A nurse plans an educational program for staff of a home health agency specializing in care of the elderly. Which topic is the highest priority to include?
A. Pain assessment techniques for older adults
B. Psychosocial stimulation for those who live alone
C. Preparation of psychiatric advance directives in the elderly
D. Ways to manage disinhibition in elderly persons with dementia
Correct answer:
The correct answer is A: Pain assessment techniques for older adults. This is the highest priority as pain management is crucial in the care of the elderly to ensure their comfort and well-being. By assessing pain accurately, appropriate interventions can be implemented.
- Choice B (Psychosocial stimulation): While important, it is not as critical as addressing pain, which directly impacts the individual's physical comfort.
- Choice C (Psychiatric advance directives): Important for mental health planning but not as immediately essential as pain assessment in day-to-day care.
- Choice D (Managing disinhibition in dementia): Important but secondary to addressing pain, which has a more immediate impact on the individual's quality of life.
Prioritizing pain assessment ensures holistic care for elderly patients.
The client has been taking lithium and fluoxetine (Prozac) for almost a week. During today's assessment, the nurse notes a temperature of 39°C, muscle rigidity, and confusion. The client's signs and symptoms suggest:
A. Dystonic reactions
B. Bradykinesic side effects
C. Extrapyramidal side effects
D. Neuroleptic malignant syndrome
Correct answer:
The correct answer is D: Neuroleptic malignant syndrome (NMS). This is indicated by the client's elevated temperature, muscle rigidity, and confusion, which are classic symptoms of NMS. NMS is a serious, potentially life-threatening condition associated with the use of antipsychotic medications like lithium and fluoxetine. The onset of NMS is often rapid and can lead to severe complications if not treated promptly. Dystonic reactions (choice A) involve sudden and involuntary muscle contractions, which are not consistent with the client's symptoms. Bradykinesic side effects (choice B) refer to slowed movements, which are not present in this case. Extrapyramidal side effects (choice C) typically include symptoms like tremors, stiffness, and restlessness, but do not encompass the combination of symptoms seen in NMS.
The family of a patient with schizophrenia who has been stable for a year reports to the community mental health nurse that the patient reports feeling tense and having difficulty concentrating. He sleeps only 3 to 4 hours nightly and has begun to talk about creatures called 'volmers' hiding in the warehouse where he works and undoing his work each night. This information most likely suggests:
A. medication nonadherence.
B. a need for psychoeducation.
C. the chronic nature of his illness.
D. relapse of his schizophrenia.
Correct answer:
The correct answer is D: relapse of his schizophrenia. The patient's symptoms of feeling tense, difficulty concentrating, poor sleep, and delusional beliefs about creatures at work indicate a worsening of his psychotic symptoms. This suggests a relapse of schizophrenia, a chronic mental illness characterized by periods of stability and exacerbation of symptoms. The patient's previous stability for a year makes medication nonadherence less likely. While psychoeducation may be beneficial, the patient's current symptoms require more immediate intervention for relapse management. The information provided does not directly indicate the chronic nature of his illness, but rather an acute exacerbation. Therefore, D is the most appropriate choice based on the presented symptoms and clinical understanding of schizophrenia.
A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. Which nursing approach or response would be most therapeutic?
A. Remain professional and a bit detached so as not to arouse suspiciousness on her part.
B. Reassure her that many others have fallen at work and not ever been criticized or fired.
C. Acknowledge her concerns in a matter-of-fact manner and provide first aid as needed.
D. Explain that an incident report about her fall will go to a manager who will contact her.
Correct answer:
The correct answer is B because it focuses on reassurance and empathy, which are important in therapeutic communication. By reassuring the worker that others have fallen without facing negative consequences, the nurse is validating her feelings and reducing her anxiety. This approach helps build trust and rapport, essential for effective communication and support.
Choices A, C, and D are incorrect because they do not address the worker's emotional needs or provide the reassurance she requires. Option A suggests remaining detached, which may come across as uncaring. Option C focuses solely on providing first aid and does not acknowledge the worker's concerns. Option D introduces the fear of potential consequences without providing any reassurance or emotional support, which could increase the worker's anxiety.
Which information should the nurse include when teaching a client with a personality disorder?
A. Journal writing will help you recognize feeling states.'
B. Try problem solving independently to help with difficult relationships.'
C. Identify people and circumstances that create conflict; then avoid them.'
D. Try to alleviate behaviors that cause problems relating with others.'
Correct answer:
The correct answer is A because journal writing can help individuals with personality disorders recognize and better understand their emotions, leading to improved self-awareness and emotional regulation. This can be a useful tool in therapy and self-management.
Choice B is incorrect because individuals with personality disorders often struggle with interpersonal relationships and might benefit from seeking support or guidance rather than attempting to solve problems independently.
Choice C is incorrect because avoidance does not address the underlying issues and can lead to isolation and maladaptive coping mechanisms.
Choice D is incorrect because simply trying to alleviate problematic behaviors without addressing the underlying emotional issues may not lead to long-term improvement in relationships.
A person diagnosed with serious mental illness has frequent relapses, usually precipitated by situational stressors such as running out of money or the absence of key staff at the mental health center. Which interventions would the nurse suggest to reduce the risk of stressors to cause relapse? Select one tha does not apply.
A. Discourage potentially stressful activities such as groups or volunteer work
B. Develop written plans that will help the patient remember what to do in a crisis
C. Help the patient identify and anticipate events that are likely to be overwhelming
D. Encourage health-promoting activities such as exercise and getting adequate rest
Correct answer:
Basic interventions for coping with crises involve anticipating crises where possible and then developing a plan with specific actions to take when faced with an overwhelming stressor. Written plans are helpful; it can be difficult for anyone, especially a person with cognitive or memory impairments, to develop or remember steps to take when under overwhelming stress. Health-promoting activities enhance a persons ability to cope with stress. As the name suggests, support groups help a person develop a support system, and they provide practical guidance from peers who learned from experience how to deal with issues the patient may be facing. Groups and volunteer work may involve a measure of stress but also provide benefits that help persons cope and should not be discouraged unless they are being done to excess.
A nurse is caring for a patient with bulimia nervosa. Which intervention should the nurse prioritize?
A. Assist the patient in identifying triggers for binge-purge cycles.
B. Focus solely on achieving a normal weight.
C. Provide daily exercise routines to increase physical fitness.
D. Discourage discussions about food to avoid increasing anxiety.
Correct answer:
The correct answer is A. Assisting the patient in identifying triggers for binge-purge cycles is crucial in the treatment of bulimia nervosa. By understanding the triggers, the patient can learn to recognize and manage them effectively, leading to a reduction in the frequency of binge-purge episodes. This intervention helps address the root cause of the disorder and promotes long-term recovery.
Choice B is incorrect because solely focusing on achieving a normal weight overlooks the complex psychological factors involved in bulimia nervosa. Choice C is incorrect as providing daily exercise routines may exacerbate the patient's obsession with weight and body image. Choice D is incorrect as discouraging discussions about food can hinder the patient's ability to address their relationship with food and emotions.
Which of the following is an appropriate nursing intervention for a patient with anorexia nervosa?
A. Promote gradual weight gain through a structured meal plan.
B. Encourage the patient to restrict calorie intake to avoid weight gain.
C. Offer emotional support without addressing food-related behaviors.
D. Focus on daily exercise to improve physical fitness.
Correct answer:
The correct answer is A because promoting gradual weight gain through a structured meal plan is essential in treating anorexia nervosa. This intervention helps the patient restore their nutritional status and physical health. By providing a structured meal plan, the patient can slowly increase their caloric intake, leading to healthy weight gain. This approach also helps address the underlying psychological and emotional issues associated with the eating disorder. Encouraging the patient to restrict calorie intake (B) is harmful as it perpetuates the cycle of malnutrition. Offering emotional support without addressing food-related behaviors (C) neglects the crucial aspect of nutritional rehabilitation. Focusing on daily exercise (D) may exacerbate the patient's physical health and reinforce unhealthy behaviors.
A nurse would evaluate that a family education plan for preventing childhood eating problems has met the stated objectives if which outcome is evident?
A. Parents serve three meals per day plus midmorning, midafternoon, and bedtime snacks.
B. Parents indicate an interest in learning about healthier eating patterns for their children.
C. Parents use food to reward their children for only especially good behavior or outstanding achievements.
D. Parents keep a diary to record both physical and psychological signs of hunger.
Correct answer:
The correct answer is B because it demonstrates that parents are actively engaged and interested in learning about healthier eating patterns for their children, aligning with the objective of preventing childhood eating problems. This outcome indicates a willingness to make positive changes in the family's approach to nutrition.
A: While providing structured meal times and snacks is important, this choice does not necessarily reflect an understanding of healthier eating patterns or prevention of eating problems.
C: Using food as a reward can actually contribute to unhealthy eating habits and does not align with the goal of preventing childhood eating problems.
D: Keeping a diary to record signs of hunger is useful, but it does not directly address the objective of learning about healthier eating patterns.
A victim of spousal abuse comes to the emergency department for treatment of a broken arm. She appears hypervigilant and anxious and admits to sleep disturbance when the nurse questions the dark circles under her eyes. She reluctantly tells the nurse the abuse usually occurs when the husband has been drinking, although she concedes he is always jealous and controlling. She is a stay-at-home mother of two preschool children. The family has lived in this town for 1 month. The patient states she has fleetingly considered suicide but must stay alive to care for her children and work her way out of the abusive relationship. She denies any further suicidal thoughts. The nurse should document in the medical record that: (Select all that apply.)
A. Signs of high anxiety and chronic stress are present.
B. The patient relies on the perpetrator for basic needs.
C. The patient has a history of suicidal ideation.
D. None of the above.
Correct answer:
The correct answer is A: Signs of high anxiety and chronic stress are present.
Rationale:
1. The patient displaying hypervigilance, anxiety, sleep disturbances, and dark circles under her eyes are indicators of high anxiety and chronic stress, common in victims of abuse.
2. Mentioning abuse occurring when the husband drinks, his jealousy, and control further support the presence of chronic stress and anxiety.
3. The patient's fleeting suicidal thoughts are a response to the abusive situation, not indicative of a history of suicidal ideation.
Summary:
B: The patient relying on the perpetrator for basic needs is not supported by the information provided.
C: There is no indication of a history of suicidal ideation, as the patient's thoughts are tied to her children and escaping the abusive relationship.
LPN exams geriatric practice questions, set 11 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the LPN exams exam guide.
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