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 nurse is planning care for a patient with anorexia nervosa. What is the priority intervention?
A. Encourage the patient to verbalize concerns about body image.
B. Monitor the patient's weight and nutritional intake closely.
C. Provide education on healthy eating and exercise.
D. Offer emotional support to the patient regarding self-esteem.
Show answer and rationale
Correct answer: B — Monitor the patient's weight and nutritional intake closely.
The correct answer is B. Monitoring the patient's weight and nutritional intake closely is the priority intervention for a patient with anorexia nervosa as it directly addresses the immediate health risks associated with the disorder, such as malnutrition and weight loss. By closely monitoring these parameters, healthcare providers can assess the patient's progress and make necessary adjustments to prevent further complications.
Choice A is incorrect because while addressing body image concerns is important in the long term, it is not the priority intervention when the patient's physical health is at risk.
Choice C is incorrect as providing education on healthy eating and exercise may not be effective if the patient is not yet in a stable physical condition to absorb and apply the information.
Choice D is incorrect as offering emotional support is valuable, but it is not the priority intervention in this case where the patient's physical health needs immediate attention.
Question 2
A woman tells the nurse that her husband abuses her most often when he is intoxicated, just as his father had beaten him and his mother. The woman is aware of the location of a safe house and has considered leaving home with her two children, but she cites being brought up to believe 'you keep quiet and stay together, no matter what happens.' She states the husband is always apologetic and remorseful after an incident. What evidence exists that the husband is at risk of becoming a perpetrator of physical abuse? He:
A. is unable to make lasting behavioral changes.
B. was an abused child.
C. is without a job.
D. experiences remorse.
Show answer and rationale
Correct answer: B — was an abused child.
The correct answer is B because the husband's history of being abused as a child increases his risk of becoming a perpetrator of physical abuse. Research shows that individuals who have been abused are more likely to perpetrate abuse themselves. This is due to a cycle of violence where behaviors learned in childhood are repeated in adulthood. In this case, the husband's abusive behavior towards his wife mirrors his own upbringing where his father abused his mother. This pattern suggests that the husband may continue the cycle of abuse.
Choice A (is unable to make lasting behavioral changes) is incorrect because it does not directly correlate with the risk of becoming a perpetrator of physical abuse. Choice C (is without a job) is also incorrect as employment status does not necessarily indicate a propensity for abuse. Choice D (experiences remorse) is incorrect as feeling remorse after abusive incidents does not negate the risk of becoming a perpetrator of physical abuse.
Question 3
An adolescent claims to have been physically abused by a parent. The adolescent's other parent angrily tells the nurse, 'It's ridiculous for our child to accuse my spouse, who's a prominent doctor and is respected by the community.' Which of these nursing communications would be most effective for the parent?
A. You believe that abuse does not exist in well-respected, professional families?'
B. Your spouse seems to have a very stressful, demanding practice. That can be a risk factor for losing your temper when angry.'
C. I know that it is difficult to believe what your child is saying about your spouse, but abuse has occurred.'
D. I know your spouse from working in the emergency room. Your spouse is always kind to patients, but that can be misleading.'
Show answer and rationale
Correct answer: A — You believe that abuse does not exist in well-respected, professional families?'
Correct Answer: A
Rationale:
1. This response challenges the parent's belief that abuse does not exist in respected families, highlighting the misconception that abuse can happen in any family.
2. It addresses the parent's disbelief directly, encouraging them to reconsider their assumptions and beliefs about abuse.
3. It promotes critical thinking and reflection on the parent's part, fostering a more open-minded and empathetic approach towards the adolescent's disclosure.
Summary of Other Choices:
B: This choice focuses on the stress of the accused parent, deflecting from the issue of abuse and potentially excusing their behavior.
C: This choice acknowledges the difficulty of the situation but does not effectively challenge the parent's disbelief or misconceptions about abuse.
D: This choice uses a positive characteristic of the accused parent to deflect from the allegations of abuse, which does not address the parent's denial or the seriousness of the situation.
Question 4
A man is diagnosed with prostate cancer. What does the nurse need to know to be able to answer the man when he asks, "What are the chances I'll survive this thing?"
A. Attack rate
B. Case fatality rate
C. Cause-specific morbidity rate
D. Crude mortality rate
Show answer and rationale
Correct answer: B — Case fatality rate
The correct answer is B: Case fatality rate. Case fatality rate indicates the proportion of individuals diagnosed with a specific condition who die from that condition within a specified time frame. In the context of prostate cancer, the case fatality rate will provide the man with an estimation of the likelihood of survival post-diagnosis.
Rationale:
1. Attack rate (Choice A) is the proportion of individuals who develop a specific disease among those exposed to the disease within a defined time period. This does not provide information on survival chances.
2. Cause-specific morbidity rate (Choice C) refers to the prevalence of a specific disease in a population but does not indicate the likelihood of survival for an individual with the disease.
3. Crude mortality rate (Choice D) is the total number of deaths in a population due to any cause, not specific to prostate cancer. It does not provide insight into the survival chances of an individual with prostate cancer.
Question 5
A child, age 5, was admitted to the children's unit, having been sexually abused by an acquaintance of her family. The child refuses to talk and participate in unit activities, choosing to stay in her room with her stuffed animals. Which therapeutic intervention will best help the child release pent-up feelings about the abuse?
A. Individual communication with the nurse
B. Play therapy
C. Family therapy
D. Role-play with other children on the unit
Show answer and rationale
Correct answer: B — Play therapy
The correct answer is B: Play therapy. Play therapy is the most suitable therapeutic intervention for a child in this scenario because it allows the child to express their feelings and experiences through play, which is a natural form of communication for children. Through play therapy, the child can act out their experiences using toys and create a safe space to process their emotions without having to verbally communicate. It helps the child release pent-up feelings and trauma in a non-threatening environment.
Summary of other choices:
A: Individual communication with the nurse may not be as effective as play therapy in this case as the child is not yet comfortable verbalizing their feelings.
C: Family therapy may not be appropriate at this stage as the child is not ready to engage with family members about the abuse.
D: Role-play with other children on the unit may not be beneficial as it can potentially trigger more anxiety and discomfort for the abused child.
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Question 6
An acutely psychotic individual diagnosed with schizophreniaform disorder at admission is immediately placed on daily doses of risperidone. A hospitalization of 8 days' duration has been authorized by the HMO. By what hospital day would the nurse expect to note that client was demonstrating beginning trust in the nurse and reduction in hallucinations and delusions?
A. Day of admission
B. Day 3 of hospitalization
C. Day 5 of hospitalization
D. Day 7 of hospitalization
Correct answer:
The correct answer is B: Day 3 of hospitalization. At this point, the risperidone medication would have had sufficient time to begin exerting its therapeutic effects on the individual's symptoms of hallucinations and delusions. It typically takes a few days for antipsychotic medications like risperidone to reach therapeutic levels in the body and start alleviating psychotic symptoms. By day 3, the individual may start to demonstrate improved trust in the nurse due to the reduction in distressing symptoms.
Incorrect options:
A: Day of admission - It is unlikely to see significant improvement in symptoms and trust on the same day of admission.
C: Day 5 of hospitalization - By this time, the medication would have likely already started showing some effects, and the individual would have had some time to build trust with the nurse.
D: Day 7 of hospitalization - Waiting until day 7 might be too late to note beginning trust and significant reduction in symptoms, as the
Which measure is advisable to take, considering that individuals with dramatic erratic personality disorders often have the ability to evade limits and manipulate others?
A. Plan frequent client-centered staff meetings.
B. Practice take-down and restraint procedures.
C. Institute written or taped change-of-shift reports.
D. Rotate staff assignments so no one is responsible for the client for a prolonged period of days.
Correct answer:
The correct answer is A: Plan frequent client-centered staff meetings. This measure is advisable as it promotes open communication, collaboration, and consistency in care. By holding regular meetings, staff can discuss concerns, share observations, and develop strategies to effectively manage individuals with erratic personality disorders. This approach helps in setting clear boundaries, identifying manipulative behaviors, and ensuring a unified team response.
Summary:
- Choice B: Practice take-down and restraint procedures is incorrect as it focuses on physical control rather than preventive strategies.
- Choice C: Institute written or taped change-of-shift reports is incorrect as it lacks real-time communication and immediate response to potential issues.
- Choice D: Rotate staff assignments so no one is responsible for the client for a prolonged period of days is incorrect as it may disrupt continuity of care and hinder the establishment of trust and rapport.
A salesman has had difficulty holding a job because he accuses co-workers of conspiring to take his sales. Today, he argued with several office mates and threatened to kill one of them. The police were called, and he was brought to the mental health center for evaluation. He has had previous admissions to the unit for stabilization of paranoid schizophrenia. When the nurse meets him, he points at staff in the nursing station and states loudly, 'They're all plotting to destroy me. Isn't that true?' Which would be the most appropriate response?
A. No, that is not true. People here are trying to help you if you will let them.'
B. Let's think about it: what reason would people have to want to destroy you?'
C. Thinking that people want to destroy you must be very frightening.'
D. That doesn't make sense; staff are health care workers, not murderers.'
Correct answer:
The correct answer is C: Thinking that people want to destroy you must be very frightening.
Rationale:
1. Acknowledges the patient's feelings: By stating that thinking people want to destroy him is frightening, the nurse shows empathy and validates his experience.
2. Validates the patient's emotions: This response does not directly agree or disagree but acknowledges the emotions behind the patient's statement.
3. Builds rapport: By showing understanding and empathy, the nurse can establish trust and rapport with the patient, leading to better communication and therapeutic relationship.
Summary of other options:
A: This response denies the patient's feelings and could potentially escalate the situation by invalidating his experiences.
B: This response may come off as confrontational and does not address the patient's underlying fears.
D: This response is dismissive and does not address the patient's emotional distress, potentially leading to further agitation.
A client seen by the rape crisis nurse 1 month after the incident states, 'I'm confused and just not myself. I have mood swings during the day, and I have nightmares at night. Sometimes I think I'm going crazy.' Other times, she is just plain afraid to be alone. The nurse should assess the client for:
A. Trauma syndrome.
B. Post-traumatic stress disorder.
C. Acute stress disorder.
D. None of the above.
Correct answer:
The correct answer is A: Trauma syndrome. This choice is correct because the client's symptoms of confusion, mood swings, nightmares, feeling like they are going crazy, and fear of being alone align with the criteria for trauma syndrome. This syndrome encompasses a range of symptoms that occur after experiencing a traumatic event, such as rape.
Choice B: Post-traumatic stress disorder (PTSD) is not the best option in this case because the client's symptoms are more indicative of acute distress and confusion rather than the criteria for a formal diagnosis of PTSD, which typically requires the persistence of symptoms over time.
Choice C: Acute stress disorder is also not the most appropriate choice because while some symptoms may align, the duration and specific criteria for this disorder may not fully match the client's presentation.
Choice D: None of the above is incorrect as trauma syndrome best fits the client's symptoms based on the information provided.
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 (NMS). The patient's symptoms align with NMS, a rare but serious side effect of antipsychotic medications like risperidone. The severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all indicative of NMS. The nurse should suspect NMS and take immediate action by placing the patient in a cooling blanket to lower the temperature and transfer him to the ICU for close monitoring and further management.
Choice B is incorrect because anticholinergic toxicity typically presents with different symptoms such as dry mouth, dilated pupils, and confusion. Choice C is incorrect as there are no signs of a psychotic relapse, and administering more antipsychotic medication could worsen the NMS. Choice D is incorrect as agranulocytosis presents with symptoms like fever and sore throat, not the combination of symptoms seen in this case.
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 (NMS). NMS is a rare but serious adverse reaction to antipsychotic medications like risperidone. The patient's symptoms of severe muscle stiffness, difficulty swallowing, altered mental status, diaphoresis, and elevated temperature, pulse, and blood pressure are all consistent with NMS. The nurse should suspect NMS due to the constellation of symptoms and vital sign changes. Placing the patient in a cooling blanket and transferring to the ICU is appropriate as NMS is a medical emergency requiring prompt intervention to lower the body temperature and provide supportive care.
Choices B, C, and D are incorrect:
B: Anticholinergic toxicity does not typically present with the specific symptoms described, such as muscle stiffness and stupor.
C: Relapse of psychosis would not explain the acute onset of symptoms and vital sign changes seen in the scenario.
D: Agranulocytosis is a rare side effect of some ant
The mother of a client newly diagnosed with schizophrenia is a nurse. She unhappily tells the nurse on the unit, 'I've tried to be a good mother, but my daughter still developed schizophrenia. When I was in school, we were taught that it was the mother's fault if a child became schizophrenic. I wish I knew what I did wrong.' The response that would help the mother evaluate models explaining schizophrenia would be:
A. I can see how you would be upset over this turn of events.'
B. New findings suggest this disorder is biologic in nature.'
C. Don't be so hard on yourself; your daughter needs you to be strong.'
D. It's difficult to see that double-bind communication produces stress for the child at the time it's occurring.'
Correct answer:
Correct answer: B
Rationale:
1. This response acknowledges the mother's distress but shifts the focus to new findings suggesting schizophrenia is biologic in nature.
2. It provides the mother with updated information that contradicts the outdated belief that mothers are to blame for schizophrenia.
3. By highlighting the biological basis of the disorder, it helps the mother understand that it is not her fault.
4. This response encourages the mother to consider scientific evidence rather than blaming herself, promoting a more accurate understanding of the condition.
Summary:
- Choice A validates the mother's feelings but doesn't offer factual information to challenge her belief.
- Choice C aims to provide emotional support but doesn't address the mother's need for accurate information.
- Choice D introduces the concept of double-bind communication, which is not directly relevant to helping the mother understand the biological nature of schizophrenia.
The elderly spouse of a female Alzheimer's client states that his wife seems to wander aimlessly from room to room looking for things in incorrect places, such as kitchen utensils in the bedroom and laundry detergent in the kitchen. He asks the nurse for suggestions of what he can do to help her. What is the nurse's best response?
A. Keep rooms well lit.'
B. Keep the home environment simple and user-friendly for her.'
C. Have clocks and calendars with large letters in several rooms of the house.'
D. Place large signs on doors or entryways that identify the room.'
Correct answer:
The correct answer is D: Place large signs on doors or entryways that identify the room. This is the best response because it directly addresses the issue of the client's confusion and disorientation by providing clear visual cues to help her navigate the home environment effectively. By labeling the rooms with large signs, the client can easily recognize where she is and find what she needs. This strategy helps reduce her anxiety and frustration, promoting a sense of independence and safety.
Choices A, B, and C are incorrect because they do not specifically target the client's cognitive challenges related to Alzheimer's disease. Keeping rooms well lit, having a simple environment, and using clocks with large letters are helpful suggestions but do not address the primary issue of the client's spatial disorientation and confusion. Placing large signs on doors directly addresses the client's specific needs and is the most effective strategy in this situation.
A patient diagnosed with serious mental illness was living successfully in a group home but wanted an apartment. The prospective landlord said, 'People like you have trouble getting along and paying their rent.' The patient and nurse meet for a problem-solving session. Which options should the nurse endorse? Select one tha does not apply.
A. Coach the patient in ways to control symptoms effectively
B. Seek out landlords less affected by the stigma associated with mental illness
C. Threaten the landlord with legal action because of the discriminatory actions
D. Have the case manager meet with the landlord to provide education about mental illness
Correct answer:
Managing symptoms so that they are less obvious or socially disruptive can reduce negative reactions and reduce rejection due to stigma. Seeking a more receptive landlord might be the most expeditious route to housing for this patient. Educating the landlord to reduce stigma might make him more receptive and give the case manager an opportunity to address some of his concerns (e.g., the case manager could arrange a payee to assure that the rent is paid each month). However, threatening a lawsuit would increase the landlords defensiveness and would likely be a long and expensive undertaking. Delaying the patients efforts to become more independent is not clinically necessary according to the data noted here; the problem is the landlords bias and response, not the patients illness. It would be unethical to encourage falsification and poor role modeling to do so; further, if falsification is discovered, it could permit the landlord to refuse or cancel her lease.
A client with obsessive-compulsive personality disorder seeks treatment for depression after the recent breakup of a relationship. The client constantly procrastinated about proposing marriage and said his girlfriend complained that he did not show her affection and that he was too controlling. Now he describes inability to sleep, poor concentration, and loss of energy since the breakup. Which outcome is a priority for the client? The client will:
A. Demonstrate assertive behavior
B. Express hope for developing a new relationship in the future
C. Identify feelings of sadness related to the failed relationship
D. List three new ways to reduce stress
Correct answer:
Rationale: The correct answer is C: Identify feelings of sadness related to the failed relationship. This is the priority outcome because the client is experiencing symptoms of depression following the breakup, such as insomnia, poor concentration, and loss of energy. By identifying and processing the feelings of sadness related to the failed relationship, the client can begin to work through the grief and start the healing process.
Summary:
A: Demonstrating assertive behavior may be beneficial for the client in the long term but is not the priority at this stage when dealing with depression.
B: Expressing hope for a new relationship may provide temporary relief but does not address the underlying issues of depression and unresolved feelings from the breakup.
D: Listing new ways to reduce stress is important for overall well-being but does not address the primary concern of processing feelings of sadness and grief related to the failed relationship.
LPN exams geriatric practice questions, set 5 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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