You adjust care for older adults: polypharmacy, skin, confusion, and what family can safely do. Five of the 15 questions include the correct answer and rationale. The other ten keep answers in the study hub. Continue with the LPN exams exam guide or more LPN exams practice questions.
Five geriatric questions with answers
Cover the key. Write the first action. Then open the rationale and name why the other choices fail.
Question 1
Which nursing intervention will assist a client being treated in the Emergency Department for extensive soft tissue injuries to disclose an experience of domestic violence?
A. Interviewing her in the presence of another professional
B. Speaking with the client in the absence of her husband
C. Providing a safe, nonintimidating environment
D. Allowing the client to initiate the topic of violence
Show answer and rationale
Correct answer: C — Providing a safe, nonintimidating environment
Rationale for Correct Answer (C): Providing a safe, nonintimidating environment is crucial to encourage the client to disclose domestic violence. This approach helps establish trust and confidentiality, making the client feel secure to share sensitive information. It creates a conducive setting for open communication without fear of repercussions.
Summary of Incorrect Choices:
A: Interviewing her in the presence of another professional may not ensure privacy and could potentially increase the client's discomfort or fear of being overheard.
B: Speaking with the client in the absence of her husband might not guarantee safety and confidentiality, as the client may still feel threatened or hesitant to reveal the abuse.
D: Allowing the client to initiate the topic of violence puts the burden on the client, who may already be feeling overwhelmed or unable to bring up the sensitive issue without support and encouragement.
Question 2
A teacher recommends that surveys to obtain data on drug use be given to high school students when they meet for various school organizations. Why would the nurse reject this suggestion?
A. Would result in classification bias
B. Would result in confounding bias
C. Would result in personal bias
D. Would result in selection bias
Show answer and rationale
Correct answer: D — Would result in selection bias
The correct answer is D: Would result in selection bias. Giving surveys only to high school students who are part of school organizations would lead to selection bias because the sample would not be representative of the entire student population. This bias could skew the results and make them less generalizable.
A: Classification bias is not relevant in this context as it pertains to errors in categorizing individuals.
B: Confounding bias occurs when an extraneous variable influences the relationship between the independent and dependent variables, which is not applicable in this scenario.
C: Personal bias involves individual opinions or beliefs affecting data collection or interpretation, but it is not the primary concern in this case.
In summary, selecting only students from school organizations would introduce selection bias, making the survey results unreliable for generalizing to the entire student body.
Question 3
After a person was abducted and raped at gunpoint by an unknown assailant, which assessment finding best indicates the acute phase of the rape-trauma syndrome?
A. Decreased motor activity
B. Confusion and disbelief
C. Flashbacks and dreams
D. Fears and phobias
Show answer and rationale
Correct answer: B — Confusion and disbelief
The correct answer is B: Confusion and disbelief. During the acute phase of rape-trauma syndrome, the victim may experience feelings of confusion and disbelief as they try to process the traumatic event. This initial reaction is a common response to such a severe and violating experience. The victim may struggle to comprehend what has happened to them, leading to feelings of shock and disbelief. This phase is characterized by emotional numbing, disorientation, and difficulty in making decisions.
Decreased motor activity (Choice A) is not specific to the acute phase of rape-trauma syndrome and can be a general response to trauma. Flashbacks and dreams (Choice C) are more commonly associated with the intrusion phase of the syndrome, which occurs after the acute phase. Fears and phobias (Choice D) may develop later in the reorganization phase of the syndrome as the victim tries to cope with the aftermath of the trauma.
Question 4
A psychiatric technician remarks to the nurse, 'That client with dependent personality disorder is so clingy! I almost hate to see her coming my way.' The response by the nurse that will be helpful to the technician is:
A. I think everyone feels that way. It's difficult to have someone clinging.'
B. Clients with personality disorders have little regard for the rights of others.'
C. The client fears having to function independently without direction from someone else.'
D. The client is so preoccupied with perfection and structure that she's afraid to do anything at all.'
Show answer and rationale
Correct answer: C — The client fears having to function independently without direction from someone else.'
The correct answer is C: The client fears having to function independently without direction from someone else. This response is helpful because it provides insight into the underlying fear and motivation of the client's behavior. Clients with dependent personality disorder often have an excessive need to be taken care of and fear being alone or making decisions independently. This response acknowledges the client's struggle with autonomy and offers understanding without judgment.
Choice A is incorrect because it normalizes the technician's negative feelings, which does not address the client's needs. Choice B is incorrect because it makes a generalizing and negative statement about clients with personality disorders, which is stigmatizing and unhelpful. Choice D is incorrect because it describes features more commonly associated with obsessive-compulsive personality disorder, not dependent personality disorder.
Question 5
A patient with schizophrenia is admitted to the psychiatric unit in an acutely disturbed, violent state. He is given several doses of haloperidol (Haldol) and becomes calm and approachable. During rounds the nurse notices the patient has his head rotated to one side in a stiffly fixed position. His lower jaw is thrust forward and he appears severely anxious. The patient has ______, and the nurse should ______.
A. a dystonic reaction"¦administer PRN IM benztropine (Cogentin)
B. tardive dyskinesia"¦seek a change in the drug or its dosage
C. waxy flexibility"¦continue treatment with antipsychotic drugs
D. akathisia"¦administer PRN diphenhydramine (Benadryl) PO
Show answer and rationale
Correct answer: A — a dystonic reaction"¦administer PRN IM benztropine (Cogentin)
The correct answer is A: a dystonic reaction"¦administer PRN IM benztropine (Cogentin).
1. Dystonic reaction is characterized by involuntary muscle contractions, causing abnormal posture or movements.
2. The patient's symptoms of head rotation, jaw thrust, and severe anxiety align with dystonic reaction.
3. Benztropine is an anticholinergic medication used to treat dystonic reactions by blocking acetylcholine in the brain.
4. Administering benztropine promptly can alleviate the symptoms and prevent complications.
Other choices are incorrect:
B: Tardive dyskinesia develops with long-term antipsychotic use, presenting as repetitive, involuntary movements. Seeking a change in drug or dosage is not appropriate for acute dystonic reaction.
C: Waxy flexibility is a symptom of catatonia, not related to the patient's presentation of dystonic reaction.
D: Akathisia is restlessness and agitation often caused by
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Question 6
A client is admitted to a day hospital following an episode in which he purchased a gun to use while standing guard over his property to prevent a neighbor from erecting a boundary fence. His wife describes him as distrustful of the motives of others and often interpreting others' motives as threats. She mentions that one time he accused her of having an affair with a neighbor with whom she chatted occasionally. The care plan will list the priority outcome as 'Client will:
A. admit his action was excessive based on the circumstance.'
B. write the neighbor a letter of apology.'
C. demonstrate trust in the nurse.'
D. identify positive role models.'
Correct answer:
Step-by-step rationale for why choice C is correct:
1. Building trust is essential in therapeutic relationships.
2. The client's distrustful nature and misinterpretation of others' motives indicate a lack of trust.
3. By demonstrating trust in the nurse, the client can begin to address his issues with mistrust.
4. Trust in the nurse can lead to better communication and engagement in therapy.
5. Trust in the nurse is foundational for therapeutic progress and successful outcomes.
Summary of why other choices are incorrect:
- Choice A: Admitting his action was excessive is important but does not address the underlying issue of trust.
- Choice B: Writing a letter of apology to the neighbor does not directly address the client's trust issues.
- Choice D: Identifying positive role models may be helpful, but building trust with the nurse is more immediate and directly related to the client's current issues.
A client has been admitted with disorganized type schizophrenia. The nurse observes blunted affect and social isolation. He occasionally curses or calls another client a 'jerk' without provocation. The nurse asks the client how he is feeling, and he responds, 'Everybody picks on me. They frobitz me.' The nurse would assess 'frobitz' as:
A. Circumstantial speech
B. Loose associations
C. Evidence of delusional thinking
D. A neologism
Correct answer:
The correct answer is D: A neologism. A neologism is a newly coined word or expression that is not easily understood by others. In this case, the client's use of the word 'frobitz' is not a recognized word, indicating it may be a neologism. This is commonly seen in individuals with schizophrenia who create new words or distort existing ones.
A: Circumstantial speech involves excessive and unnecessary details before reaching the main point. The client's response is not characterized by this.
B: Loose associations involve a lack of logical connections between thoughts. The client's response is not demonstrating this.
C: Evidence of delusional thinking would involve fixed, false beliefs that are not based in reality. The client's use of 'frobitz' does not necessarily indicate a delusion.
In summary, the use of 'frobitz' by the client is indicative of a neologism, as it is a new and potentially meaningless
A nurse is working with a patient with anorexia nervosa. What is the priority assessment for this patient?
A. Height and weight changes.
B. Food intake and nutritional status.
C. Mental health status and body image concerns.
D. Vital signs and cardiovascular function.
Correct answer:
The correct answer is A: Height and weight changes. In anorexia nervosa, monitoring height and weight is crucial to assess the severity of malnutrition and potential complications. Weight loss is a key indicator of the patient's nutritional status and overall health decline. Height measurement also helps determine growth patterns in younger patients.
Choice B: Food intake and nutritional status, although important, is not the priority as weight changes provide a more direct reflection of the patient's nutritional status.
Choice C: Mental health status and body image concerns are significant in anorexia nervosa, but assessing height and weight takes precedence due to the immediate physical risks associated with severe malnutrition.
Choice D: Vital signs and cardiovascular function are important, but monitoring height and weight is more specific to the nutritional deficiencies seen in anorexia nervosa.
A nurse has completed the assessment for a patient who has a maladaptive response to eating regulation. Findings include the following: height, 5 feet 3 inches; current weight, 80 pounds with weight loss of 30% of body weight over the past 3 months; T, 96.6m F; BP, 68/40; P, 40; R, 20; poor skin turgor; lanugo; amenorrhea of 6 months' duration; admits to restricting intake to 350 calories daily; dissatisfied with eating pattern as evidenced by patient statement, 'I need to lose another 10 pounds to be at an ideal weight.' These assessment findings are most consistent with the medical diagnosis of:
A. bulimia nervosa.
B. anorexia nervosa.
C. binge-eating disorder.
D. disturbed body image.
Correct answer:
The correct answer is B: Anorexia nervosa. The assessment findings align with the diagnostic criteria for anorexia nervosa, including significant weight loss, restrictive eating patterns, distorted body image, amenorrhea, and physical signs like poor skin turgor and lanugo. The patient's extreme weight loss, restrictive calorie intake, dissatisfaction with weight despite being underweight, and other physical and psychological symptoms are classic indicators of anorexia nervosa.
Incorrect Choices:
A: Bulimia nervosa involves binge eating followed by compensatory behaviors, which are not evident in this case.
C: Binge-eating disorder involves recurrent episodes of binge eating without compensatory behaviors, which are not present here.
D: Disturbed body image may be present in anorexia nervosa, but the key features of weight loss, restrictive eating, and amenorrhea are more indicative of anorexia nervosa.
An elderly client who lives with her daughter and son-in-law and their three children reveals that her daughter sometimes slaps her when she does not move fast enough or spills things. The daughter is a mid-level business executive who is under considerable stress at work. The children are often left in the care of the elderly client. The husband is often out of town on business trips. The daughter states, 'I have so much to do that I become frustrated when my mother can't move fast enough or causes me extra work.' The nurse caring for the mother could appropriately suggest:
A. Family therapy.
B. Individual counseling for the daughter.
C. Respite care for the elderly client.
D. None of the above.
Correct answer:
The correct answer is A: Family therapy. Family therapy is the most appropriate suggestion because it addresses the dysfunctional dynamics within the family and provides an opportunity for all family members to work through their issues. In this scenario, the daughter's stress at work and lack of coping skills are contributing to the abuse of the elderly client. Family therapy can help the family communicate effectively, set boundaries, and address underlying issues causing the abuse.
Choice B (Individual counseling for the daughter) may help the daughter address her stress and coping mechanisms, but it does not address the family dynamics that are contributing to the abuse. Choice C (Respite care for the elderly client) provides temporary relief but does not address the root cause of the issue. Choice D (None of the above) is incorrect as family therapy is the most appropriate intervention in this case.
While planning care for a preschool child who has been physically and sexually abused, the nurse includes play therapy because it assists the child to:
A. Act out aggression in an acceptable manner
B. Express feelings that cannot easily be verbalized
C. Interact with other children in the appropriate age group
D. Learn adaptive behaviors through acting
Correct answer:
The correct answer is B: Express feelings that cannot easily be verbalized. Play therapy allows preschool children to express their emotions, trauma, and experiences through play activities, as they may not have the verbal skills to communicate their feelings effectively. This form of therapy helps the child process their emotions and experiences in a safe and non-threatening environment.
Incorrect Choices:
A: Acting out aggression in an acceptable manner is not the primary goal of play therapy for abused children. It is more about emotional expression and healing.
C: Interacting with other children in the appropriate age group is not the focus of play therapy for abused children. The primary goal is to address the trauma and emotional distress.
D: Learning adaptive behaviors through acting is not the main purpose of play therapy for abused children. It is more about emotional healing and expression.
A client with an eating disorder that has resulted in weight loss to a point 15% below normal weight tells the nurse, 'I don't need to be hospitalized. I can control myself.' The nurse continues to prepare the client for hospitalization because the vicious cycle of eating disorder behavior is fueled by:
A. feelings of power and control resulting from weight loss.
B. dysfunctional family dynamics.
C. faulty use of the defense mechanism projection.
D. lack of superego constraints on behavior.
Correct answer:
The correct answer is A: feelings of power and control resulting from weight loss. In clients with eating disorders, the behavior is often driven by a sense of control and power gained through weight loss. This reinforces the cycle of the disorder as the individual feels empowered by their ability to restrict food intake. This false sense of control becomes a driving force in the continuation of the disorder.
Incorrect answers:
B: Dysfunctional family dynamics may contribute to the development of an eating disorder, but in this scenario, the client's refusal for hospitalization is more related to their own sense of control rather than family dynamics.
C: Faulty use of the defense mechanism projection is not the primary reason for the client's resistance to hospitalization in this case.
D: Lack of superego constraints on behavior is not the main factor driving the client's refusal for hospitalization.
When people successfully adapt to their environment by using logical thought and socially appropriate ways, they are said to be functioning at the adaptive end of the _____ continuum.
A. Emotional
B. Self-protective
C. Neurobiological
D. Psychobiological
Correct answer:
The correct answer is C: Neurobiological. This is because neurobiological factors refer to the brain's functioning and how it affects behavior and cognition. When individuals adapt to their environment using logical thought and socially appropriate ways, it indicates a high level of cognitive and behavioral functioning, which is closely tied to neurobiological processes.
A: Emotional is incorrect because emotional factors focus on feelings and affective responses, not necessarily on logical thought and social appropriateness.
B: Self-protective is incorrect as it pertains to behaviors aimed at ensuring one's safety and security, which may not necessarily involve logical thought and social appropriateness.
D: Psychobiological is incorrect as it encompasses the interaction between psychological and biological processes, which may not specifically relate to adaptive functioning in the given context.
An appropriate intervention for a client with an identified nursing diagnosis of Situational low self-esteem would be:
A. Encouraging verbalization of feelings in a safe environment
B. Attempting to determine triggers to hallucinations
C. Engaging client in activities designed to permit success
D. Providing large muscle activities to relieve stress
Correct answer:
The correct answer is C: Engaging client in activities designed to permit success. This intervention is appropriate for addressing situational low self-esteem as it focuses on building the client's self-confidence through successful experiences. Engaging in activities that the client can excel at helps boost self-esteem and self-worth. By providing opportunities for success, the client can gain a sense of accomplishment, leading to improved self-esteem.
A: Encouraging verbalization of feelings in a safe environment may be beneficial for emotional expression, but it does not directly address building self-esteem through success.
B: Attempting to determine triggers to hallucinations is unrelated to addressing situational low self-esteem.
D: Providing large muscle activities to relieve stress may be helpful for stress management but does not directly target improving self-esteem through success.
Police bring a 63-year-old woman to the emergency room, reporting that her behavior is disorganized and disruptive, that her speech makes little sense, and that she does not seem able to take care of herself. The woman has had elective surgeries at the hospital previously and was seen in the ER last week after a fall; records show no history of similar symptoms or mental illness. The ER physician speaks with the patient but does not examine her medically, diagnoses her with schizophrenia, and orders admission to the inpatient psychiatric unit. Which response by the nurse would be most appropriate?
A. Ask another physician with more of an interest in psychiatry to also take a look at this patient, explaining that you just want to be as thorough as possible.
B. Suggest that a psychiatric consult be requested before admitting the patient to a psychiatric unit, to validate the diagnosis and speed the initiation of medication.
C. Remind the physician that schizophrenia usually develops earlier in life, that such presentations may be caused by medical problems, and suggest a medical work-up.
D. Note that the patient's blood pressure and respirations were elevated when she arrived, and suggest that they be evaluated before admitting the patient to the psychiatric unit.
Correct answer:
The correct answer is C because it demonstrates critical thinking and patient advocacy. By reminding the physician that schizophrenia typically develops earlier in life and suggesting a medical work-up, the nurse is advocating for a comprehensive approach to ruling out potential medical causes for the patient's symptoms before jumping to a psychiatric diagnosis. This approach aligns with best practices in patient care and ensures that all possible underlying causes are considered and addressed appropriately.
Choice A is incorrect because it does not address the need for a medical work-up to rule out physical causes of the symptoms. Choice B is incorrect as it focuses on validating the diagnosis and initiating medication rather than investigating potential medical issues. Choice D is incorrect as it only addresses the patient's vital signs, overlooking the need for a thorough medical evaluation.
LPN exams geriatric practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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