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
A patient with swelling and a laceration above the right eye states, 'I don't know what caused me to fall and cut my head on the door frame in my bedroom. I'm lucky my spouse was home to take me to the hospital.' The patient's spouse appears nervous but smiles when mentioning that the patient is 'so clumsy at times.' Which nursing intervention should the nurse give priority attention to when addressing this patient's needs?
A. Provide a thorough assessment that includes a focus on signs of old injuries.
B. Interview the patient regarding the circumstances surrounding this suspicious fall.
C. Directly ask the patient if spousal abuse is occurring or has ever occurred.
D. Notify security that there is a possibility that this patient is a victim of physical abuse.
Show answer and rationale
Correct answer: A — Provide a thorough assessment that includes a focus on signs of old injuries.
The correct answer is A: Provide a thorough assessment that includes a focus on signs of old injuries. This is the priority intervention because the patient's statement, combined with the spouse's behavior, raises suspicion of potential domestic abuse. By assessing for signs of old injuries, the nurse can gather crucial information to determine if the patient is a victim of abuse.
Choice B: Interview the patient regarding the circumstances surrounding this suspicious fall may be important, but assessing for signs of old injuries takes priority as it provides concrete evidence of potential abuse.
Choice C: Directly ask the patient if spousal abuse is occurring or has ever occurred is necessary, but the patient may not feel comfortable disclosing abuse directly. Assessing for old injuries can provide objective evidence.
Choice D: Notify security that there is a possibility that this patient is a victim of physical abuse is premature without concrete evidence. Assessing for old injuries should be done first to gather information before taking further action.
Question 2
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
A. Explain that others eat the food and are not harmed
B. Allow client to select food from vending machines
C. Assist client with personal hygiene and grooming
D. Not allow client to verbalize delusional thoughts
Show answer and rationale
Correct answer: B — Allow client to select food from vending machines
The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his specific delusion of food being poisoned. By allowing the client to select food from vending machines, he can choose items he believes are safe, which can help alleviate his paranoia and increase his trust in the care being provided. This approach promotes a therapeutic relationship and empowers the client in making choices about his care.
Explanation of why other choices are incorrect:
A: Explaining that others eat the food and are not harmed may not be effective as the client's delusion is strong, and rational arguments may not be helpful in this case.
C: Assisting with personal hygiene and grooming is important but does not directly address the client's delusion about food being poisoned.
D: Not allowing the client to verbalize delusional thoughts can escalate the client's distress and hinder the therapeutic relationship. It is essential to acknowledge the client's experiences and work towards building trust and rapport
Question 3
A nurse planning teaching for a parent group concerned with preventing family violence can discuss the fact that exposure to violence in the media:
A. Has no effect on the increase of violence in society
B. Assists individuals to distinguish appropriate behaviors from inappropriate behaviors
C. Desensitizes people to the violence around them
D. Broadens the viewer's knowledge about world happenings
Show answer and rationale
Correct answer: C — Desensitizes people to the violence around them
The correct answer is C: Desensitizes people to the violence around them. Exposure to violence in the media can desensitize individuals, leading them to become less sensitive or responsive to violent acts in real life. This desensitization can contribute to a normalization of violence and reduce the perceived severity of violent behaviors. This can potentially lead to an increase in tolerance for violence in society.
Incorrect choices:
A: Has no effect on the increase of violence in society - This is incorrect because research has shown that exposure to media violence can have an impact on behavior.
B: Assists individuals to distinguish appropriate behaviors from inappropriate behaviors - This is incorrect as exposure to violence in the media may blur the lines between appropriate and inappropriate behaviors.
D: Broadens the viewer's knowledge about world happenings - This is incorrect as exposure to violence in the media may not necessarily lead to a broader understanding of world events, especially if the focus is on sensationalized or graphic content.
Question 4
A 63-year-old female has been admitted to the hospital for cholecystitis. She is accompanied by her sister, who provides all the assessment data while the client sits and stares somewhat vacantly. You determine that the client is single, lives alone, and lost her job as a secretary last year when she was unable to learn a new computer system. The sister states she has recently had to manage the client's shopping, meal preparation, and finances. Which of the following are appropriate nursing diagnoses?
A. Pain, self-care deficits, situational low self-esteem
B. Anxiety, self-care deficits, disturbed thought processes
C. Impaired home maintenance, disturbed thought process, impaired verbal communication
D. Disturbed body image, anxiety, pain
Show answer and rationale
Correct answer: C — Impaired home maintenance, disturbed thought process, impaired verbal communication
The correct answer is C: Impaired home maintenance, disturbed thought process, impaired verbal communication.
Rationale:
1. Impaired home maintenance: The client is unable to take care of herself and her living environment due to the need for assistance in shopping, meal preparation, and finances.
2. Disturbed thought process: The client's vacant stare and inability to learn new tasks suggest cognitive impairment or confusion.
3. Impaired verbal communication: The client's lack of verbal interaction and reliance on her sister for assessment data indicate difficulties in expressing herself.
Summary:
A: Pain, self-care deficits, situational low self-esteem - Pain is not mentioned in the scenario, and the client's issues go beyond self-care deficits and low self-esteem.
B: Anxiety, self-care deficits, disturbed thought processes - While anxiety and disturbed thought processes may be present, impaired home maintenance and impaired verbal communication are more appropriate diagnoses based on the scenario.
D: Disturbed body image, anxiety, pain - Disturbed
Question 5
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
A. Splitting
B. Projective identification
C. Isolation of affect
D. Dissociation
Show answer and rationale
Correct answer: A — Splitting
The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things in extremes of either all good or all bad. In this scenario, the client initially idealizes the psychiatrist as the best doctor, then suddenly devalues and hates him for taking a vacation, indicating a shift from all good to all bad. This extreme change in perception is characteristic of splitting.
B: Projective identification involves projecting one's own feelings onto another person and then identifying with those projected feelings. This choice does not fit the scenario as the client is not projecting their feelings onto the psychiatrist.
C: Isolation of affect refers to the separation of feelings from ideas and events. The client's strong emotions towards the psychiatrist do not demonstrate a lack of emotional expression or detachment from feelings.
D: Dissociation is a defense mechanism where thoughts, feelings, and experiences are separated from conscious awareness. The client's reaction does not suggest a disconnection from reality or consciousness.
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Question 6
A short-term goal for a patient with anorexia nervosa is 'Patient will select and eat a balanced diet.' The nurse writes which of the following nursing interventions into the care plan that will foster attainment of this goal?
A. Allow patient to weigh self every time a meal is completely eaten.
B. Assist the patient to fill out the dietary menus to ensure a balanced diet.
C. Encourage the patient to engage in only appropriate compensatory exercise.
D. Implement contracted consequences 50% of the time if a meal is not completed.
Correct answer:
The correct answer is B: Assist the patient to fill out the dietary menus to ensure a balanced diet. This intervention is appropriate because it directly supports the goal of the patient selecting and eating a balanced diet. By assisting the patient in filling out dietary menus, the nurse can help the patient make informed choices about their food intake, ensuring they are consuming a variety of nutrients necessary for a balanced diet. This intervention promotes patient autonomy and education, empowering the patient to make healthier choices.
Choice A is incorrect because allowing the patient to weigh themselves every time a meal is eaten does not directly address the goal of selecting and eating a balanced diet.
Choice C is incorrect because encouraging compensatory exercise may lead to unhealthy behaviors and does not focus on achieving a balanced diet.
Choice D is incorrect because implementing contracted consequences for incomplete meals may create a negative environment and does not promote a positive approach to achieving a balanced diet.
When analyzing the behaviors of a 23-year-old who meets the criteria for antisocial personality disorder, the nurse recognizes that the following nursing diagnosis would be pertinent to his care:
A. Risk for self-mutilation
B. Disturbed personal identity
C. Impaired social interaction
D. Social isolation
Correct answer:
Step-by-step rationale for choice C (Impaired social interaction) being the correct answer:
1. Antisocial personality disorder is characterized by a lack of regard for others and a pattern of violating their rights.
2. Individuals with this disorder often have difficulty forming and maintaining healthy relationships.
3. Impaired social interaction reflects the challenges the individual faces in relating to others.
4. This nursing diagnosis would address the core issue of social dysfunction in individuals with antisocial personality disorder.
Summary of why the other choices are incorrect:
A. Risk for self-mutilation - Not typically associated with antisocial personality disorder, more common in other mental health conditions.
B. Disturbed personal identity - Not a primary concern in antisocial personality disorder, which is more about behavior than identity.
D. Social isolation - While individuals with antisocial personality disorder may isolate themselves, impaired social interaction is a more direct and specific issue to address in their care.
What is the most important aspect of nursing care for patients with anorexia nervosa during refeeding?
A. Refeed the patient with high-calorie foods quickly to gain weight.
B. Start with small, manageable portions and gradually increase caloric intake.
C. Restrict food choices to healthy foods only.
D. Encourage the patient to take food supplements in addition to meals.
Correct answer:
The correct answer is B: Start with small, manageable portions and gradually increase caloric intake. This approach is essential because refeeding syndrome can occur in patients with anorexia nervosa, where rapid refeeding can lead to severe electrolyte imbalances and potentially life-threatening complications. Starting with small portions helps to prevent this syndrome by allowing the body to gradually adjust to increased caloric intake. Additionally, it helps in preventing overwhelming the patient with large amounts of food, which can trigger anxiety and resistance to eating.
Incorrect choices:
A: Refeed the patient with high-calorie foods quickly to gain weight - This can lead to refeeding syndrome and is not a safe approach.
C: Restrict food choices to healthy foods only - Restricting food choices can exacerbate disordered eating behaviors and does not address the need for gradual refeeding.
D: Encourage the patient to take food supplements in addition to meals - While supplements can be helpful, they should not be a primary focus over balanced
Which nursing diagnosis is most appropriate for a patient with bulimia nervosa who engages in frequent purging behaviors?
A. Ineffective coping related to inability to control impulses.
B. Risk for injury related to electrolyte imbalances.
C. Imbalanced nutrition: less than body requirements related to food refusal.
D. Disturbed body image related to fear of weight gain.
Correct answer:
The correct answer is B: Risk for injury related to electrolyte imbalances. Patients with bulimia nervosa who engage in frequent purging behaviors are at risk for electrolyte imbalances due to loss of potassium, sodium, and other essential minerals. This can lead to serious complications such as cardiac arrhythmias and organ damage. Monitoring and addressing electrolyte imbalances is crucial in the care of these patients to prevent potential harm.
A: Ineffective coping related to inability to control impulses is not the most appropriate diagnosis as it does not directly address the immediate risk of electrolyte imbalances in this scenario.
C: Imbalanced nutrition: less than body requirements related to food refusal is not the most appropriate diagnosis as the primary concern in bulimia nervosa with purging behaviors is the risk of electrolyte imbalances, not necessarily inadequate food intake.
D: Disturbed body image related to fear of weight gain is not the most appropriate diagnosis as it does not address the immediate physical health risks
What is the most accurate description of a migrant farmworker?
A. A person who does farmwork as the primary means of employment, although other work may be done when the seasonal work ends
B. A person who immigrates to the United States to "follow the crops" in performing seasonal farmwork
C. A person who moves from place to place to earn money performing seasonal agricultural work
D. A person who specializes in the development of rural land for the purpose of farming
Correct answer:
The correct answer is C because a migrant farmworker is defined as someone who moves from place to place to earn money by performing seasonal agricultural work. This definition accurately captures the essence of a migrant farmworker's lifestyle, which involves traveling to different locations to work in farming during specific seasons.
Choice A is incorrect because it focuses on the primary means of employment, whereas migrant farmworkers typically engage in seasonal agricultural work for income regardless of other employment opportunities.
Choice B is incorrect as it specifically mentions immigration to the United States, which is not a universal characteristic of migrant farmworkers.
Choice D is incorrect because it describes a person specializing in rural land development for farming purposes, which is not synonymous with the transient nature of a migrant farmworker's job.
In summary, choice C best encapsulates the defining feature of a migrant farmworker as someone who moves around to perform seasonal agricultural work for income.
A nursing diagnosis for a patient with bulimia nervosa is Ineffective coping related to feelings of loneliness and isolation, as evidenced by use of overeating and self-induced vomiting to comfort self. Select the best outcome related to this diagnosis. Within 2 weeks, the patient will:
A. Appropriately express angry feelings.
B. Verbalize two positive things about self.
C. Verbalize the importance of eating a balanced diet.
D. Identify two alternative methods of coping with loneliness and isolation.
Correct answer:
The correct answer is D: Identify two alternative methods of coping with loneliness and isolation.
Rationale:
1. The nursing diagnosis is Ineffective coping related to feelings of loneliness and isolation, indicating the patient struggles with coping mechanisms.
2. The desired outcome is for the patient to identify alternative coping methods, which directly addresses the ineffective coping issue.
3. By identifying two alternative methods, the patient demonstrates an understanding of healthier coping strategies.
4. This outcome focuses on addressing the root cause of the behavior (loneliness and isolation) rather than just surface-level expressions or behaviors.
Summary:
A: Appropriately expressing angry feelings does not directly address coping mechanisms related to loneliness and isolation.
B: Verbalizing positive things about oneself is beneficial but does not address the core issue of ineffective coping.
C: Verbalizing the importance of a balanced diet is important but does not directly address coping with loneliness and isolation.
A client with borderline disorder tells the nurse, 'It's hard to figure out who I am. Sometimes I'm sexually attracted to women and sometimes to men.' The nurse using Freudian concepts can analyze this as a developmental problem related to:
A. Lack of separation-individuation
B. Isolation of affect during latency
C. Impaired development of sexual identity during the phallic stage
D. Overdevelopment of latency stage traits related to control issues
Correct answer:
The correct answer is C: Impaired development of sexual identity during the phallic stage. According to Freudian theory, the phallic stage occurs around ages 3 to 6 and is when children become aware of their genitals. This stage is crucial for the development of sexual identity. In this case, the client's confusion about their sexual attraction to both men and women suggests a difficulty in establishing a clear sexual identity during this stage. This can lead to ongoing struggles with sexual orientation and identity.
Choice A (Lack of separation-individuation) is incorrect because this concept is related to the development of individuality and autonomy, not sexual identity.
Choice B (Isolation of affect during latency) is incorrect as it refers to a defense mechanism where emotions are separated from their associated ideas or events during the latency stage, not related to sexual identity development.
Choice D (Overdevelopment of latency stage traits related to control issues) is incorrect because it focuses on traits related to the
In planning aftercare for a client with schizophrenia and whose insurance benefits have been exhausted, the nurse who is concerned about overcoming negative symptoms will make provisions for the client to have stimulation, structure, socialization, and support. Which option would best incorporate these factors?
A. Day hospitalization
B. Attending a psychosocial club
C. Living with his elderly mother
D. Spending free time in the mall
Correct answer:
The correct answer is B: Attending a psychosocial club. This option best incorporates the necessary factors of stimulation, structure, socialization, and support for the client with schizophrenia.
- Stimulation: Psychosocial clubs offer various activities to engage the client's mind and keep them occupied.
- Structure: These clubs usually have regular schedules and routines, providing the client with a sense of order and predictability.
- Socialization: Interacting with others in the club can help the client improve social skills and combat feelings of isolation.
- Support: Being part of a community in the club can provide emotional support and encouragement for the client.
Incorrect Choices:
- A: Day hospitalization may offer structure and support but may lack the socialization and stimulation provided by a psychosocial club.
- C: Living with his elderly mother may provide support but may not offer the necessary stimulation, structure, and socialization outside of the home environment.
- D: Spending free time in the mall may offer
A nurse interviews a patient abducted and raped at gunpoint by an unknown assailant. The patient says, "I can't talk about it. Nothing happened. I have to forget."Â What is the patient's present coping strategy?
A. Somatization
B. Repression
C. Projection
D. Denial
Correct answer:
The correct answer is D: Denial. The patient's statement of "I can't talk about it. Nothing happened. I have to forget" indicates a denial coping strategy. Denial is a defense mechanism where individuals refuse to acknowledge a stressful situation or event. In this case, the patient is attempting to block out the traumatic experience of being abducted and raped by denying its existence. This coping mechanism helps the individual temporarily avoid the emotional distress associated with the event.
A: Somatization involves expressing emotional distress through physical symptoms, which is not evident in the patient's statement.
B: Repression is the unconscious blocking of unpleasant memories, whereas the patient is consciously trying to forget the event.
C: Projection involves attributing one's own thoughts or feelings to others, which is not demonstrated in the patient's statement.
In summary, the patient's use of denial as a coping strategy is evident in their attempt to minimize the traumatic experience by refusing to acknowledge it.
A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
A. Losses
B. Sleep patterns
C. School activities
D. Menstrual flow
Correct answer:
The correct answer, Losses (choice A), should be the priority issue for the nurse to address during the initial interview with the student. The rationale is as follows:
1. **Emotional Impact of Breakup**: The student's recent breakup is a significant loss that can trigger emotional distress.
2. **Social Isolation**: Slow to make friends at the university could indicate feelings of loneliness and isolation, further exacerbating the impact of the breakup.
3. **Eating Disorder Behaviors**: Eating large quantities and inducing vomiting are maladaptive coping mechanisms linked to emotional distress and loss.
4. **Academic Decline**: The decline in schoolwork could be a manifestation of the student's emotional struggles related to loss.
5. **Relationship with Family**: Close relationship with her mother and sister may also influence how she copes with losses and seeks support.
Summary:
- **Sleep Patterns (choice B)**: While important, sleep patterns are secondary to addressing the student's emotional distress and coping mechanisms related
LPN exams geriatric practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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