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
The nurse who assesses a patient previously diagnosed as having paranoid personality disorder is most likely to describe the patient as:
A. superficially charming.
B. intense and impulsive.
C. guarded and distant.
D. friendly and open.
Show answer and rationale
Correct answer: C — guarded and distant.
The correct answer is C: guarded and distant. This is because individuals with paranoid personality disorder typically exhibit suspiciousness, mistrust, and a reluctance to confide in others. They tend to be hypervigilant and wary of others, leading them to appear guarded and distant.
A: Superficially charming is incorrect because individuals with paranoid personality disorder are more likely to be cautious and suspicious rather than charming.
B: Intense and impulsive is incorrect as this description is more characteristic of individuals with borderline personality disorder, not paranoid personality disorder.
D: Friendly and open is incorrect because individuals with paranoid personality disorder are more likely to be reserved and cautious in their interactions.
In summary, the correct answer is C because individuals with paranoid personality disorder typically exhibit guarded and distant behavior due to their suspicious and mistrustful nature.
Question 2
A 28-year-old female client was admitted 3 days ago after she ran nude through the streets shouting that she was the 'Queen of Hearts.' Since admission, the client remains delusional, shouts obscenities, and demonstrates loosely associated thoughts. Based on these data, the nurse should develop a nursing diagnosis of:
A. Risk for violence
B. Defensive coping
C. Disturbed thought processes
D. Impaired memory
Show answer and rationale
Correct answer: C — Disturbed thought processes
The correct nursing diagnosis is "Disturbed thought processes" (C) because the client's behavior of being delusional, shouting obscenities, and demonstrating loosely associated thoughts indicates a disruption in their ability to think clearly and logically. This diagnosis reflects the client's cognitive dysfunction and disorganized thinking patterns.
Choice A (Risk for violence) is incorrect because the client's behavior does not directly suggest a risk for violence towards others or themselves.
Choice B (Defensive coping) is incorrect as the client's behavior is not indicative of using defensive mechanisms to cope with stress or anxiety.
Choice D (Impaired memory) is incorrect as the client's symptoms are more indicative of thought processing issues rather than memory deficits.
In summary, the client's presentation aligns closely with symptoms of disturbed thought processes, making it the most appropriate nursing diagnosis in this case.
Question 3
What is the rationale for establishing a contract with a patient with an eating disorder at the outset of treatment?
A. The patient and nurse form a coalition that is difficult for the family to disrupt.
B. A team approach to planning therapy ensures that physical and emotional needs will be met.
C. Patient involvement in decision making increases the sense of control and promotes cooperation.
D. Permission for refeeding is essential because this measure has the potential for negative effects.
Show answer and rationale
Correct answer: C — Patient involvement in decision making increases the sense of control and promotes cooperation.
Correct Answer: C - Patient involvement in decision making increases the sense of control and promotes cooperation.
Rationale:
1. Involving the patient in decision-making empowers them and enhances their autonomy.
2. Patients with eating disorders often feel a loss of control over their lives, so involving them in treatment decisions can help restore a sense of agency.
3. Increased sense of control can lead to improved cooperation and engagement in treatment.
Summary:
A: Incorrect. Establishing a contract with a patient is not about forming a coalition against the family but about empowering the patient.
B: Incorrect. While a team approach is important, the primary rationale for establishing a contract is to involve the patient in decision-making.
D: Incorrect. Refeeding is important in eating disorder treatment, but the rationale for establishing a contract is more about promoting patient cooperation through involvement in decision-making.
Question 4
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
Show answer and rationale
Correct answer: A — anticholinergic toxicity"¦check vital signs and prepare to use a cooling blanket stat
The correct answer is A: anticholinergic toxicity. The patient is displaying symptoms such as restlessness, disorganized behavior, nonsensical verbal responses, disorientation, hot and dry skin, and dilated pupils, which are indicative of anticholinergic toxicity.
Step-by-step rationale:
1. Restlessness and disorganized behavior are common symptoms of anticholinergic toxicity.
2. Nonsensical verbal responses and disorientation are also typical signs of anticholinergic toxicity.
3. Hot and dry skin can be caused by decreased sweating due to anticholinergic effects.
4. Dilated pupils are a classic sign of anticholinergic toxicity.
5. Checking vital signs and preparing to use a cooling blanket is the appropriate immediate action to manage anticholinergic toxicity.
Summary of other choices:
- B: Relapse of psychosis does not explain the physical symptoms like dilated pupils and hot/dry skin.
- C: Neuroleptic malignant syndrome presents with
Question 5
What is the priority nursing intervention when caring for a patient with bulimia nervosa who has a history of purging?
A. Provide emotional support and assist with stress management.
B. Monitor vital signs and electrolyte levels closely.
C. Encourage the patient to exercise regularly to prevent weight gain.
D. Help the patient identify triggers for binge eating and purging behaviors.
Show answer and rationale
Correct answer: B — Monitor vital signs and electrolyte levels closely.
The correct answer is B because monitoring vital signs and electrolyte levels closely is crucial in managing a patient with bulimia nervosa who has a history of purging. Purging can lead to electrolyte imbalances and dehydration, which can have serious consequences such as cardiac arrhythmias and electrolyte disturbances. By closely monitoring vital signs and electrolyte levels, nurses can quickly identify and intervene in case of any abnormalities, preventing potential life-threatening complications.
Choice A is incorrect because emotional support and stress management are important but not the priority when dealing with physical complications from purging. Choice C is incorrect because encouraging exercise may exacerbate the patient's unhealthy behaviors and should be approached cautiously. Choice D is incorrect because identifying triggers is important but not as immediate as monitoring vital signs and electrolyte levels in this situation.
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Question 6
A client, age 42, has been battered by her husband since they were married 8 years ago. Until this hospitalization for major depression, she had avoided dealing with her situation, but she now expresses a desire to deal with the problem. The attacks are occurring more often. Which outcome is realistic for the client?
A. Citing possible ways she may have contributed to the abusive episodes
B. Verbalizing an awareness of her increasingly dangerous situation
C. Setting a goal date for divorcing her husband
D. Employing methods of retaliating in order to get even with her husband
Correct answer:
The correct answer is B: Verbalizing an awareness of her increasingly dangerous situation. This choice is the most realistic outcome for the client as it shows an initial step towards acknowledging the severity of her situation. By verbalizing awareness, the client can begin to understand the potential dangers she faces, which is crucial for developing a safety plan and seeking appropriate help.
Choice A is incorrect as it may lead to victim-blaming and does not address the root cause of the abuse. Choice C is premature as setting a goal date for divorcing her husband requires careful planning and consideration of various factors. Choice D is inappropriate as retaliation can escalate the violence and put the client at further risk.
In summary, choice B is the best option as it focuses on increasing the client's awareness of her situation, which is a crucial first step towards addressing and eventually overcoming the abusive relationship.
What is an important aspect of managing refeeding syndrome in patients with anorexia nervosa?
A. Refeeding the patient with high-calorie foods immediately.
B. Monitoring electrolytes closely during the refeeding process.
C. Allowing the patient to eat whatever they want without restrictions.
D. Restricting fluid intake to avoid water retention.
Correct answer:
The correct answer is B because monitoring electrolytes closely during refeeding is crucial to prevent life-threatening complications such as electrolyte imbalances. Refeeding syndrome can lead to shifts in electrolytes, particularly phosphorus, potassium, and magnesium, which may result in cardiac arrhythmias, respiratory failure, or even death. Close monitoring allows for timely interventions to maintain electrolyte balance.
Choice A is incorrect because refeeding a patient with high-calorie foods immediately can actually exacerbate refeeding syndrome by overwhelming the body's metabolic and electrolyte regulation processes. Choice C is incorrect because allowing the patient to eat whatever they want without restrictions can lead to rapid and uncontrolled weight gain, which may worsen medical complications. Choice D is incorrect because restricting fluid intake can also contribute to electrolyte imbalances and dehydration during refeeding.
A client being treated for anorexia nervosa is 5 feet 10 inches tall and weighs 100 pounds. The client believes she is overweight. On the days the client is scheduled to be weighed, the nurse should be prepared for the client to:
A. eagerly ask for information about her present weight.
B. dress in several layers of clothing.
C. suggest that the scale numbers be hidden from her view.
D. remind the nurse that she is ready to be weighed.
Correct answer:
Correct Answer: B - Dress in several layers of clothing.
Rationale: An individual with anorexia nervosa often engages in behaviors to manipulate their weight, such as wearing heavy clothing to increase their weight on the scale. This behavior is a result of distorted body image and fear of gaining weight. By dressing in several layers of clothing, the client may attempt to influence the scale reading to align with their perceived body image.
Summary of other choices:
A: Eagerly asking for information about her present weight is unlikely as individuals with anorexia nervosa typically avoid discussions or confrontations related to their weight.
C: Suggesting that the scale numbers be hidden is not as likely as the client may want to see the numbers to validate their belief of being overweight.
D: Reminding the nurse that she is ready to be weighed may occur, but it does not address the behavior of dressing in layers to manipulate weight.
What is a common consequence of long-term purging in patients with bulimia nervosa?
A. Improved digestive health and better nutrient absorption.
B. Increased risk of dehydration and electrolyte imbalances.
C. Improved self-esteem and body image.
D. Decreased risk of cardiovascular problems and hypertension.
Correct answer:
The correct answer is B because long-term purging in patients with bulimia nervosa can lead to increased risk of dehydration and electrolyte imbalances. Purging behaviors such as vomiting or laxative abuse can disrupt the body's fluid and electrolyte balance, potentially causing dehydration and electrolyte imbalances. These imbalances can have serious health consequences, including cardiac arrhythmias, muscle weakness, and kidney damage.
Incorrect choices:
A: Improved digestive health and better nutrient absorption - Purging does not improve digestive health or nutrient absorption; rather, it can lead to nutrient deficiencies.
C: Improved self-esteem and body image - Purging behaviors are harmful and do not lead to improved self-esteem or body image.
D: Decreased risk of cardiovascular problems and hypertension - Purging behaviors can actually increase the risk of cardiovascular problems due to electrolyte imbalances and dehydration.
A client with borderline personality disorder is having difficulty with memories of sexual abuse. She has a history of suicidal gestures, self-mutilation, sexual addiction, and substance addiction. She complains of vague pains, menstrual problems, and headaches. She entered the partial hospital program to prevent another suicide gesture or self-mutilation. The nurse recognizes that collaborative therapy may be helpful for this client and knows that the most useful collaboration in this case would be the client, the nurse, and the:
A. Occupational therapist exploring ways to reduce stress
B. Physical therapist exploring ways to reduce back pain
C. Acupuncturist exploring ways to reduce pain
D. Sexologist exploring healthy sexuality and safe sex
Correct answer:
The correct answer is A: Occupational therapist exploring ways to reduce stress. In this case, the client's symptoms and history suggest complex emotional issues related to trauma and addiction. Occupational therapy can help the client develop coping skills, manage stress, and improve functioning in daily activities. The therapist can work collaboratively with the client and nurse to address the client's emotional, physical, and social needs.
Choice B: Physical therapist exploring ways to reduce back pain focuses only on physical symptoms and does not address the underlying emotional issues. Choice C: Acupuncturist exploring ways to reduce pain also only addresses physical symptoms and does not provide comprehensive support for the client's mental health. Choice D: Sexologist exploring healthy sexuality and safe sex is not the most immediate need for the client, as her primary concerns are related to trauma, self-harm, and addiction.
The client tells the nurse, 'My husband left to go bowling with his buddies, so I had to cut myself.' The nurse using the SET method of communication will use as the initial response:
A. Tell me what made you think of that action.'
B. It concerns me to hear that you took that action.'
C. You should have called your psychiatrist.'
D. What can I do to help you now that you're here?'
Correct answer:
The correct answer is B: "It concerns me to hear that you took that action." The rationale for this is that this response demonstrates empathy and concern for the client's well-being, which is essential in building a therapeutic relationship. It acknowledges the client's statement without judgment and opens the door for further exploration of the client's feelings and reasoning behind the self-harm.
Choice A: "Tell me what made you think of that action" may come across as too direct and could be perceived as insensitive or confrontational, potentially shutting down communication.
Choice C: "You should have called your psychiatrist" is dismissive and fails to address the client's emotional needs or offer support.
Choice D: "What can I do to help you now that you're here?" is forward-thinking and assumes the client is seeking help, which may not be the case. It also does not directly address the concerning behavior of self-harm.
A 45-year-old married woman who works full time in a factory has recently been absent for 3-day periods on several occasions. Each time, she returned to work wearing dark glasses. Facial and body bruises were apparent. Her supervisor became suspicious that she was a victim of battering and referred her to the occupational health nurse. Which initial inquiry would be most important for the nurse to make?
A. Tell me what has happened to you.'
B. Did your husband beat you?'
C. Why do you let this happen?'
D. What can you do to prevent this?'
Correct answer:
The correct answer is A: "Tell me what has happened to you." This open-ended question allows the woman to share her experience without judgment or assumptions. It shows empathy and respect for her autonomy. It is crucial for the nurse to gather information directly from the patient to understand the situation fully and provide appropriate support.
Choice B is incorrect because it assumes the woman's husband is the perpetrator without giving her a chance to disclose the information herself. This can be intimidating and may not lead to a truthful response.
Choice C is incorrect because it implies blame on the victim for the abuse, which is not appropriate. It does not focus on providing support or understanding the situation.
Choice D is incorrect as it puts the responsibility on the victim to prevent the abuse, which is not a helpful approach. The focus should be on providing support and understanding the victim's situation.
The wife of a client who is being seen in the sleep clinic states that her husband snores terribly at night and that she has to shake him to get him to stop. The client complains of a headache upon wakening and often falls asleep during the day when he sits for long periods. This client is exhibiting signs and symptoms characteristic of:
A. Narcolepsy.
B. Parasomnia.
C. Sleep apnea.
D. None of the above.
Correct answer:
The correct answer is C: Sleep apnea. This client is showing classic signs of obstructive sleep apnea, including loud snoring, waking up with headaches, and excessive daytime sleepiness. Snoring and the need for physical stimulation to stop snoring are common in sleep apnea. The headaches may be due to disrupted sleep patterns and oxygen deprivation. Excessive daytime sleepiness is a result of poor quality sleep.
Choice A (Narcolepsy) is incorrect because narcolepsy is characterized by sudden, uncontrollable episodes of falling asleep during the day, often accompanied by cataplexy and sleep paralysis, which are not mentioned in the scenario.
Choice B (Parasomnia) is incorrect because parasomnias involve abnormal behaviors during sleep, such as sleepwalking or night terrors, which are not described in the scenario.
Choice D (None of the above) is incorrect because the symptoms described align with obstructive sleep apnea.
A patient is currently in an abusive relationship with the father of her only child and tells a nurse that her partner 'is really sorry for hitting me and wants to come back and be part of the family again.' The nurse should provide which intervention?
A. Share with the patient that abusers seldom voluntarily stop abusing.
B. Identify groups that focus on treatment for individuals who are abusive.
C. Tell the patient to continue the relationship, but focus on how to minimize the abuse.
D. Tell the patient's partner that any continued abuse will be reported to the police.
Correct answer:
The correct answer is B: Identify groups that focus on treatment for individuals who are abusive. This intervention is appropriate because it addresses the root cause of the abusive behavior, which is the partner's abusive tendencies. By connecting the abuser to groups that specialize in treating abusive behavior, there is a chance for change and rehabilitation.
A: Sharing with the patient that abusers seldom voluntarily stop abusing may not be helpful as it does not provide a proactive solution to address the abusive behavior.
C: Telling the patient to continue the relationship and focus on minimizing the abuse is dangerous as it normalizes and enables the abusive behavior, putting the patient at further risk.
D: Threatening the patient's partner with reporting to the police may escalate the situation and put the patient at higher risk of harm. It does not address the underlying issue of the partner's abusive behavior.
A nurse is caring for a patient with bulimia nervosa. The nurse should monitor for which of the following complications?
A. Nutritional deficiency and dehydration.
B. Respiratory failure and aspiration pneumonia.
C. Peripheral edema and hyperkalemia.
D. Mental confusion and decreased blood pressure.
Correct answer:
The correct answer is A: Nutritional deficiency and dehydration. In bulimia nervosa, recurrent episodes of binge eating followed by purging can lead to electrolyte imbalances, dehydration, and malnutrition. Monitoring for nutritional deficiencies and dehydration is crucial in managing patients with bulimia nervosa.
Explanation for why other choices are incorrect:
B: Respiratory failure and aspiration pneumonia - Although purging behaviors can increase the risk of aspiration pneumonia, it is not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
C: Peripheral edema and hyperkalemia - These complications are not typically associated with bulimia nervosa.
D: Mental confusion and decreased blood pressure - While electrolyte imbalances can lead to mental confusion, these specific complications are not as common as nutritional deficiencies and dehydration in patients with bulimia nervosa.
LPN exams geriatric practice questions, set 6 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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