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, aged 77 years, has Alzheimer's disease. She goes to day care during the week and is otherwise cared for by her daughter and grandchildren. The nurse at the day care center noticed multiple bruises on the patient's palms, elbows, and buttocks. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes she cannot recognize me and accuses me of trying to poison her. I can't concentrate at work, and it's wrecking the family. Sometimes I just cannot bear it."Â Which nursing diagnosis would be most important to address for this family?
A. Knowledge deficit pertaining to dementia
B. Grieving related to mother's deterioration
C. Risk for injury related to cognitive impairment
D. Caregiver role strain related to increased care needs
Show answer and rationale
Correct answer: D — Caregiver role strain related to increased care needs
The correct nursing diagnosis to address in this scenario is D: Caregiver role strain related to increased care needs. This is the most important as it focuses on the daughter's challenges and emotional burden due to her mother's condition. The daughter's statements reveal feelings of overwhelm, guilt, and exhaustion, which are key indicators of caregiver role strain. By addressing this nursing diagnosis, the healthcare team can provide support and resources to help the daughter cope with the demands of caring for her mother.
Choice A (Knowledge deficit pertaining to dementia) is not the most important in this situation as the daughter's issue is not lack of knowledge but rather emotional stress. Choice B (Grieving related to mother's deterioration) is not the priority as addressing the daughter's emotional strain is more urgent than addressing grief. Choice C (Risk for injury related to cognitive impairment) is also important but not as immediate as addressing the caregiver's emotional well-being.
Question 2
What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?
A. Monitor for signs of electrolyte imbalances and dehydration.
B. Assess for any weight gain and increase exercise habits.
C. Encourage the patient to express feelings about food and body image.
D. Monitor for compulsive eating behaviors and binge episodes.
Show answer and rationale
Correct answer: A — Monitor for signs of electrolyte imbalances and dehydration.
The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.
Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.
Question 3
The mother of a 2-year-old tells the nurse at the well-child clinic that her child likes to take a blanket wherever he goes. The mother asks if she should take the blanket away from the child. The nurse counsels the mother to allow the child to have the blanket because it reminds him of his mother and comforts him. The basis for this counseling is:
A. Mahler's theory of object relations
B. Freud's developmental theory
C. Kernberg's conceptualization object constancy
D. Sullivan's theory of 'good me'
Show answer and rationale
Correct answer: A — Mahler's theory of object relations
The correct answer is A: Mahler's theory of object relations. Mahler's theory focuses on the development of a child's sense of self and relationships. In the scenario provided, the child's attachment to the blanket can be seen as a transitional object, which is a source of comfort and security, similar to the mother. This concept aligns with Mahler's theory that objects like blankets can serve as symbols of the mother and aid in the child's emotional development.
Incorrect choices:
B: Freud's developmental theory primarily focuses on psychosexual stages of development, which do not directly address the use of transitional objects.
C: Kernberg's conceptualization of object constancy pertains to personality disorders and the ability to maintain stable relationships, not the use of transitional objects.
D: Sullivan's theory of 'good me' is centered around interpersonal relationships and self-esteem, which are not directly related to the use of transitional objects in early childhood development.
Question 4
What is the most effective strategy for preventing relapse in a patient with anorexia nervosa?
A. Providing a rigid, inflexible meal plan with strict weight goals.
B. Offering therapy to address both physical and emotional factors.
C. Encouraging the patient to lose weight to maintain control.
D. Focusing on body image improvement before addressing nutrition.
Show answer and rationale
Correct answer: B — Offering therapy to address both physical and emotional factors.
The correct answer is B because offering therapy to address both physical and emotional factors is the most effective strategy for preventing relapse in a patient with anorexia nervosa. This approach helps the patient develop coping skills, explore underlying issues, and learn healthier ways to manage emotions and stress. By addressing both physical and emotional factors, the patient can build a strong support system, improve self-esteem, and work towards a sustainable recovery.
Choice A is incorrect because providing a rigid, inflexible meal plan with strict weight goals may increase anxiety and reinforce harmful behaviors associated with anorexia nervosa. Choice C is incorrect as encouraging the patient to lose weight to maintain control can perpetuate the disorder and increase the risk of relapse. Choice D is incorrect because focusing on body image improvement before addressing nutrition neglects the essential aspect of nutrition in recovery and may lead to distorted perceptions of health.
Question 5
Research demonstrates that exercise is important for general wellness and weight control. How might the school nurse use this information to implement primary prevention?
A. Developing individualized exercise programs for overweight children
B. Drafting policy for increases in noncompetitive physical activity programs
C. Monitoring body mass index in children to identify elevations before they become difficult to manage
D. Notifying parents and/or guardians of their child's height-weight scale in comparison with national norms
Show answer and rationale
Correct answer: B — Drafting policy for increases in noncompetitive physical activity programs
The correct answer is B because increasing noncompetitive physical activity programs in schools aligns with primary prevention efforts. By implementing policies that promote regular exercise for all students, the school nurse can proactively address wellness and weight control issues. This approach targets the entire student population, not just overweight children, and encourages healthy habits for all.
A: Developing individualized exercise programs for overweight children is more focused on secondary prevention rather than primary prevention. It addresses existing weight issues rather than preventing them.
C: Monitoring body mass index in children focuses on early detection rather than primary prevention. It does not address the broader population or promote general wellness.
D: Notifying parents about their child's weight in comparison to national norms is important but does not actively promote primary prevention through school-wide initiatives like increased physical activity programs.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
Stems and choices stay public so you can still reason. Correct answers and full rationales unlock with the rest of the bank.
Question 6
A parent who is very concerned about a 3-year-old son says, 'He likes to play with girls' toys. Do you think he is homosexual or mentally ill?' Which response by the nurse most professionally describes the current understanding of gender identity?
A. A child's interest in the activities of the opposite gender is not unusual or related to sexuality. Most children do not carry cross-gender interests into adulthood.
B. It's difficult to say for sure because the research is incomplete so far, but chances are that he will grow up to be a normal adult.
C. The research is incomplete, but many boys play with girls' toys and turn out normal as adults.
D. I am sure that whatever happens, he will be a loving son, and you will be a proud parent.
Correct answer:
The correct answer is A because it accurately reflects the current understanding of gender identity. Children's interests in activities typically associated with the opposite gender are not unusual and are not indicative of sexual orientation or mental illness. Most children who exhibit cross-gender interests do not carry these into adulthood. This response emphasizes the normalcy of such behavior and provides reassurance to the parent.
Choice B is incorrect because it implies uncertainty based on incomplete research, which goes against the established understanding that cross-gender interests in childhood are common and not predictive of future outcomes.
Choice C is incorrect because it focuses on incomplete research and uses the term "normal as adults," which can perpetuate stigmas surrounding gender expression.
Choice D is incorrect because it does not address the parent's concerns about the child's behavior and does not provide accurate information about gender identity development.
A nurse established an ongoing group meeting of teenagers with diabetes. In the early stages, the nurse was very directive in arranging location, providing low-carbohydrate drinks and snacks, steering the discussion, and trying to meet all the teenagers' needs. After the group had been meeting for about 3 months, the nurse noticed that the group members no longer simply accepted everything the nurse suggested. Instead, the teenagers began making decisions themselves, and eventually, the nurse no longer controlled the group. What most likely happened to cause this shift?
A. The group became cohesive enough to share leadership tasks.
B. Teenagers don't like feeling dependent on adults with power.
C. Teenagers often rebel against adult authority.
Correct answer:
The correct answer is A: The group became cohesive enough to share leadership tasks. This shift in group dynamics is indicative of the development of group cohesion and maturity. As the teenagers with diabetes continued to meet regularly, they likely built trust and rapport with each other and the nurse. This increased cohesion allowed for a more collaborative approach to decision-making, with members feeling empowered to take on leadership responsibilities. This shift demonstrates a positive progression in group dynamics towards shared leadership and mutual respect.
Summary:
B: Teenagers don't like feeling dependent on adults with power - This choice is not the best answer as it focuses on individual feelings of dependence rather than the group dynamics and cohesion that likely led to the shift.
C: Teenagers often rebel against adult authority - While rebellion against authority is common in adolescence, it does not fully explain the shift in the group dynamics towards shared leadership.
A patient was admitted in a semistuporous catatonic state. Family states that the patient has neither left the apartment nor attended to personal hygiene for several weeks. The patient's last 48 hours have been spent lying in bed, mute and motionless. The nursing diagnosis that should be considered the priority is:
A. self-care deficit.
B. situational low self-esteem.
C. disturbed thought processes.
D. impaired verbal communication.
Correct answer:
The correct answer is A: self-care deficit. This nursing diagnosis should be considered the priority because the patient is unable to attend to personal hygiene and has been lying in bed motionless and mute for 48 hours, indicating a significant impairment in self-care abilities. This is a critical issue that needs immediate attention to prevent further deterioration in the patient's physical and mental health.
Choice B: situational low self-esteem is not the priority as the patient's current state is more indicative of physical neglect rather than a self-esteem issue.
Choice C: disturbed thought processes may be a contributing factor to the patient's presentation, but the priority at this moment is addressing the self-care deficit to ensure the patient's safety and well-being.
Choice D: impaired verbal communication, while important, is not the priority in this scenario as the patient's inability to communicate verbally is secondary to the urgent need for assistance with self-care.
Therapeutic nutrition begins for a patient with anorexia nervosa who is 70% of ideal body weight. Which nursing intervention is most important to add to the plan of care?
A. Communicate empathy for the patient's feelings.
B. Observe for adverse effects associated with refeeding.
C. Teach patient about psychological origins of the disorder.
D. Direct the patient to balance energy expenditure and caloric intake.
Correct answer:
The correct answer is B: Observe for adverse effects associated with refeeding. This is important because refeeding syndrome can occur when a severely malnourished individual is reintroduced to nutrition too quickly, leading to potentially life-threatening electrolyte imbalances. Monitoring for signs such as fluid retention, electrolyte abnormalities, and changes in vital signs is crucial in preventing these complications.
Choice A: Communicating empathy is important in building trust and rapport with the patient, but it is not the most critical intervention in this scenario.
Choice C: Teaching the patient about the psychological origins of the disorder is important for long-term treatment, but it is not the most immediate concern when starting therapeutic nutrition.
Choice D: Directing the patient to balance energy expenditure and caloric intake is important for overall health, but it is not the priority when the patient is severely malnourished and at risk for refeeding syndrome.
A patient has not come out of her room for breakfast. The nurse finds the patient moving restlessly about her room in a disorganized manner. The patient is talking to herself, and her verbal responses to the nurse are nonsensical and suggest disorientation. The nurse notices that the patient's skin is hot and dry, and her pupils are somewhat dilated. All these symptoms are significant departures from the patient's recent presentation. The patient is likely experiencing _____, and the nurse should _____.
A. Anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
B. Relapse of her psychosis"¦administer PRN antipsychotic drugs and notify her physician
C. Neuroleptic malignant syndrome"¦contact her physician for a transfer to intensive care
D. Agranulocytosis"¦hold her antipsychotic and draw blood for a complete blood count
Correct answer:
The correct answer is A: Anticholinergic toxicity. The patient's symptoms of restlessness, disorganized behavior, nonsensical speech, disorientation, hot and dry skin, dilated pupils, and significant departure from recent presentation are classic signs of anticholinergic toxicity. Anticholinergic medications can lead to central nervous system and peripheral anticholinergic effects, causing confusion, delirium, hyperthermia, and dilated pupils. Checking vital signs and preparing to use a cooling blanket are appropriate initial interventions to address the symptoms.
Choices B, C, and D are incorrect because they do not align with the patient's symptoms and presentation. Choice B (Relapse of her psychosis) does not fully explain the physical symptoms such as hot and dry skin, dilated pupils, and disorientation. Choice C (Neuroleptic malignant syndrome) typically presents with muscle rigidity, hyperthermia, autonomic instability, and altered mental status, which are not completely consistent
A patient has recently been under significant stress and worked long hours. At home, the patient watches television and eats until going to bed. The patient is too tired to exercise and has gained 25 pounds in 1 month. A desired outcome for the patient is to recognize anxiety that precedes binge eating and reduce it. Which intervention addresses the outcome
A. Teach stress-reduction techniques such as relaxation and imagery.
B. Encourage the patient to design and implement an exercise program.
C. Explore ways in which the patient may feel more in control of the environment.
D. Encourage the patient to attend a support group such as Overeaters Anonymous.
Correct answer:
The correct answer is A: Teach stress-reduction techniques such as relaxation and imagery. This intervention directly addresses the desired outcome of recognizing anxiety that precedes binge eating and reducing it. By teaching stress-reduction techniques, the patient can learn to identify triggers, manage stress, and reduce the likelihood of turning to binge eating. Relaxation and imagery can help the patient relax and focus on positive thoughts, thus breaking the cycle of stress-induced binge eating.
Option B is incorrect because while exercise is beneficial for overall health, it does not directly address recognizing and reducing anxiety that leads to binge eating. Option C is incorrect as feeling more in control of the environment may help, but it does not specifically target anxiety reduction related to binge eating. Option D is incorrect as attending a support group may be helpful for some aspects of recovery, but it does not focus on recognizing and reducing anxiety specifically.
A 75-year-old male client is brought to the clinic by his son. The son states, 'Ever since Mom died, Dad hasn't been the same. At first he just seemed sad, but now he seems to get mixed up about everything.' The nurse is aware that based on the client's history, the source of confusion is most likely:
A. Dementia
B. Depression from the loss of his wife
C. Hypoxia of the brain
D. Delirium from medications
Correct answer:
Correct Answer: B - Depression from the loss of his wife
Rationale: Given the client's recent loss of his wife and subsequent changes in behavior, the most likely cause of his confusion is depression. Depression can manifest as cognitive impairment in older adults, leading to symptoms such as confusion and memory problems. Additionally, grief and loss can exacerbate depressive symptoms in elderly individuals, further contributing to cognitive difficulties.
Summary of other choices:
A: Dementia - Dementia typically presents with gradual cognitive decline over time, not a sudden onset following a specific event like the loss of a loved one.
C: Hypoxia of the brain - Hypoxia would likely present with more acute symptoms and physical signs, such as shortness of breath or cyanosis.
D: Delirium from medications - Delirium is characterized by acute onset and fluctuating course, often related to medication changes or other medical conditions, rather than an emotional trigger like grief.
A 72-year-old widow has just returned home after 2 weeks in the hospital after a fall. She lives alone and is visited weekly by her son. She takes digoxin, hydrochlorothiazide, and an antihypertensive drug. She also has a prescription for diazepam (Valium) as needed for moderate to severe anxiety. When the visiting nurse stopped by 2 days after discharge, he found the woman confused and disoriented, with an unsteady gait. The patient asks him who he is and why he is there. The nurse correctly deduces that the most likely cause for the changes seen in the patient is:
A. Delirium.
B. Dementia.
C. Drug toxicity.
D. None of the above.
Correct answer:
The correct answer is A: Delirium. The patient's sudden onset of confusion, disorientation, and unsteady gait after discharge from the hospital suggests delirium. Delirium is an acute change in mental status with fluctuating symptoms, often caused by underlying medical conditions, medications (such as diazepam), or environmental factors. In this case, the recent hospitalization, multiple medications, and potential stressors like living alone and recent fall increase the risk for delirium.
Incorrect choices:
B: Dementia is a chronic, progressive condition characterized by memory loss and cognitive decline. The sudden onset of symptoms in this case is not consistent with dementia.
C: Drug toxicity could be a possibility given the patient's medication list, but delirium is a more likely explanation due to the acute onset of symptoms post-hospitalization.
D: None of the above is incorrect because delirium is the most likely cause based on the patient's presentation and risk factors.
A 17-year-old client who has anorexia nervosa states she believes she will have fewer problems in college and will be more popular if she continues to lose weight. What nursing intervention would be useful at this time?
A. Assisting the client to identify the problems causing her concern.
B. Determining what she hopes to gain from the behavior.
C. Explaining that her chances for becoming ill from losing weight are high.
D. Having a physical report sent to college officials indicating her condition.
Correct answer:
The correct answer is A because it focuses on assisting the client to identify the problems causing her concern. By helping the client explore the underlying issues driving her desire to lose weight, the nurse can address the root cause of her behavior. This intervention promotes self-awareness and insight, enabling the client to better understand her motivations and make informed choices.
Option B is incorrect because while determining what the client hopes to gain from the behavior is important, it does not directly address the immediate concern of identifying underlying problems.
Option C is incorrect because simply explaining the risks of becoming ill may not effectively address the client's belief that losing weight will lead to fewer problems and increased popularity.
Option D is incorrect because sending a physical report to college officials without the client's consent may violate confidentiality and trust, and it does not address the client's psychological needs.
A patient receiving risperidone (Risperdal) reports severe muscle stiffness midmorning. During lunch he has difficulty swallowing food and speaking, and when vital signs are taken 30 minutes later, he is noted to be stuporous and diaphoretic, with a temperature of 38.8° C, pulse of 110 beats/min, and blood pressure of 150/90 mm Hg. The nurse should suspect _____ and should _____.
A. Neuroleptic malignant syndrome"¦place him in a cooling blanket and transfer to ICU
B. Anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
C. Relapse of his psychosis"¦administer PRN antipsychotic drugs and notify his physician
D. Agranulocytosis"¦hold his antipsychotic and draw blood for a complete blood count
Correct answer:
The correct answer is A: Neuroleptic malignant syndrome. The patient is exhibiting symptoms consistent with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, elevated temperature, and vital sign changes are classic signs of NMS. Treatment includes immediate cooling to lower the body temperature and transfer to the intensive care unit for close monitoring and supportive care.
Choice B: Anticholinergic toxicity does not fit the patient's presentation as there are no specific signs of anticholinergic toxicity such as dry mucous membranes, dilated pupils, or tachycardia.
Choice C: Relapse of psychosis is unlikely to present with the same constellation of symptoms, including altered mental status, fever, and vital sign changes.
Choice D: Agranulocytosis is characterized by a severe drop in white blood cells, leading to increased risk of infection, but it does
LPN exams geriatric practice questions, set 4 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.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
