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 admitted to the eating disorders unit has yellow skin, the extremities are cold, and the heart rate is 42 bpm. The patient weighs 70 pounds; height is 5 feet 4 inches. The patient is quiet during the assessment saying only, "I will not eat until I lose enough weight to look thin." Select the best initial nursing diagnosis.
A. Anxiety related to fear of weight gain
B. Disturbed body image related to weight loss
C. Ineffective coping related to lack of conflict resolution skills
D. Imbalanced nutrition: less than body requirements related to self-starvation
Show answer and rationale
Correct answer: D — Imbalanced nutrition: less than body requirements related to self-starvation
The correct initial nursing diagnosis is D: Imbalanced nutrition: less than body requirements related to self-starvation. The patient's symptoms indicate severe malnutrition from self-starvation, leading to the yellow skin, cold extremities, low heart rate, and underweight status. The patient's statement reflects their distorted perception of body image and the extreme measures taken to achieve thinness. Choice A (Anxiety related to fear of weight gain) is not the best initial diagnosis as it focuses on anxiety rather than the critical issue of malnutrition. Choice B (Disturbed body image related to weight loss) is not the best initial diagnosis as it does not address the immediate risk of severe malnutrition. Choice C (Ineffective coping related to lack of conflict resolution skills) is not the best initial diagnosis as it does not prioritize the life-threatening malnutrition present in this case.
Question 2
A patient who has been hospitalized for 2 days remains delusional and anxious and does not yet appear to be ready to give up the delusions. What intervention will best help the patient focus less on the delusion?
A. Schedule time for the patient to read and listen to music.
B. Plan activities that require physical skills and constructive use of time.
C. Begin planning for discharge by engaging the patient in psychoeducation.
D. Discuss personal goals related to improved socialization with the patient.
Show answer and rationale
Correct answer: B — Plan activities that require physical skills and constructive use of time.
The correct answer is B because engaging in activities that require physical skills and constructive use of time can help the patient shift their focus away from the delusions. Physical activities can help reduce anxiety and provide a sense of accomplishment, which can help distract the patient from the delusions. It also promotes a sense of normalcy and routine, which can aid in grounding the patient in reality.
Choice A is incorrect because reading and listening to music may not actively engage the patient in a way that helps them shift their focus from the delusions. Choice C is incorrect because planning for discharge may be premature and may not address the immediate need to distract the patient from the delusions. Choice D is incorrect because discussing personal goals related to improved socialization may not be effective in helping the patient focus less on the delusions at this stage.
Question 3
A psychiatric technician mentions to the nurse, 'All these clients with Axis II problems! It makes me wonder how so many mothers could have been such poor parents and messed up their kids so badly!' The response by the nurse that helps put the development of personality disorders into perspective is:
A. Parenting is the responsibility of fathers, too, so don't blame only mothers.'
B. Personality disorder is often related to sexual abuse that occurs without parental knowledge.'
C. There is some evidence to suggest a biologic component to personality disorders.'
D. Peer interactions may be more important in child development than parental involvement.'
Show answer and rationale
Correct answer: C — There is some evidence to suggest a biologic component to personality disorders.'
Step-by-step rationale for why choice C is correct:
1. Personality disorders are complex conditions influenced by a combination of genetic, environmental, and biological factors.
2. Research has shown evidence suggesting a biological component in the development of personality disorders.
3. Understanding the biological component helps to destigmatize and provide a more comprehensive view of personality disorders.
4. This response helps the psychiatric technician understand that blaming parents solely is not accurate and that multiple factors contribute to the development of personality disorders.
Summary:
Choice C is correct because it highlights the importance of considering biological factors in the development of personality disorders, providing a more holistic perspective. Choices A, B, and D are incorrect as they do not address the multifactorial nature of personality disorders.
Question 4
A family discusses the impact of a seriously mental ill member. Insurance partially covered treatment expenses, but the family spent much of their savings for care. The patients sibling says, 'My parents have no time for me.' The parents are concerned that when they are older, there will be no one to care for the patient. Which response by the nurse would be most helpful?
A. Acknowledge their concerns and consult with the treatment team about ways to bring the patients symptoms under better control
B. Give them names of financial advisors that could help them save or borrow sufficient funds to leave a trust fund to care for their loved one
C. Refer them to crisis intervention services to learn ways to manage caregiver stress and provide titles of some helpful books for families
D. Discuss benefits of participating in National Alliance on Mental Illness (NAMI) programs and ways to help the patient become more independent
Show answer and rationale
Correct answer: D — Discuss benefits of participating in National Alliance on Mental Illness (NAMI) programs and ways to help the patient become more independent
The family has raised a number of concerns, but the major issues appear to be the effects caregiving has had on the family and their concerns about the patients future. The National Alliance on Mental Illness (NAMI) offers support, education, resources, and access to other families who have experience with the issues now facing this family. NAMI can help address caregiver burden and planning for the future needs of SMI persons. Improving the patients symptom control and general functioning can help reduce caregiver burden but would likely be a slow process, whereas NAMI involvement could benefit them on a number of fronts, possibly in a shorter time period. The family will need more than financial planning; their issues go beyond financial. The family is distressed but not in crisis. Crisis intervention is not an appropriate resource for the longer-term issues and needs affecting this family.
Question 5
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 emphasizes the importance of transitional objects like a blanket for young children to provide comfort and security as they develop a sense of self and separation from their primary caregiver. This theory aligns with the situation described, where the child's attachment to the blanket symbolizes the bond with the mother.
Explanation for why the other choices are incorrect:
B: Freud's developmental theory focuses on psychosexual stages and the role of unconscious processes, not specifically on transitional objects.
C: Kernberg's conceptualization of object constancy pertains to personality disorders and object relations in adult psychotherapy, not child development.
D: Sullivan's theory of 'good me' is about interpersonal relationships and self-esteem, not directly related to transitional objects in child development.
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Question 6
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
Correct answer:
The correct answer is C: Disturbed thought processes. The client's behavior of being delusional, shouting obscenities, and demonstrating loosely associated thoughts indicates a disturbance in thought processes. This nursing diagnosis focuses on the client's cognitive functioning and perception of reality.
A: Risk for violence is not the most appropriate diagnosis in this case as there is no direct evidence of the client being a risk to herself or others.
B: Defensive coping does not address the client's specific symptoms of delusions and disorganized thinking.
D: Impaired memory is not the most appropriate diagnosis as the client's symptoms are more indicative of a broader disturbance in thought processes rather than just memory deficits.
Therefore, choice C is the most suitable nursing diagnosis based on the client's presentation of delusional behavior and disorganized thoughts.
A client with antisocial personality disorder yells, 'Shut up about that, or I'll punch you in the nose!' and shakes his fist at another client in a group meeting after the client speaks negatively of illicit drug use. The nurse quickly determines that the client is at risk to act violently against others as evidenced by his aggressive behavior, verbal threats, and a history of impulsivity. Which is the best approach for the nurse to use?
A. Seclude the client to protect the other clients and staff.
B. Put the client in restraints to protect the milieu.
C. Explore alternate ways to handle frustrating topics in the group.
D. Tell the client to leave the group until he can behave appropriately.
Correct answer:
The correct answer is C: Explore alternate ways to handle frustrating topics in the group. This approach is best because it focuses on addressing the underlying issue causing the client's aggression rather than just isolating or restraining the client. By exploring alternate ways to handle frustrating topics, the nurse can help the client develop healthier coping mechanisms and communication skills. This approach promotes therapeutic engagement and supports the client's growth and development.
Secluding the client (choice A) may escalate the situation and reinforce the client's aggressive behavior. Putting the client in restraints (choice B) is a restrictive measure that should only be used as a last resort for imminent danger. Telling the client to leave the group (choice D) may not address the root cause of the aggression and could lead to avoidance of addressing the client's issues.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
A. Helping the loved one with memory and communication problems.
B. Providing a stable, routine environment.
C. Providing complete assistance with physical care.
D. None of the above.
Correct answer:
Rationale:
1. During the middle stage of Alzheimer's disease, individuals often experience memory and communication problems.
2. Caregivers need to assist with memory tasks and facilitate effective communication.
3. Helping the loved one with memory and communication problems is crucial for their well-being and quality of life.
4. This responsibility helps maintain a sense of connection and understanding between the caregiver and the individual with Alzheimer's.
Summary:
- Option A is correct as it aligns with the specific needs of individuals in the middle stage of Alzheimer's.
- Option B is incorrect as providing a stable, routine environment is more relevant in the early stages.
- Option C is incorrect as complete assistance with physical care is more common in the later stages.
- Option D is incorrect as caregiver responsibilities are essential in all stages of the disease.
Which of the following actions by a home health nurse can decrease the risk of experiencing unsafe conditions while in a family's home?
A. Research and learn more about the surrounding neighborhood before the visit.
B. Maintain situational awareness of other people and pets in the hom
D. Make the visit as brief as possible to minimize time spent in the hom
Correct answer:
The correct answer is A: Research and learn more about the surrounding neighborhood before the visit. This action allows the nurse to understand potential safety risks in the area, such as crime rates or hazards, enabling them to take necessary precautions. By being informed, the nurse can better assess the environment and plan accordingly to ensure their safety.
Choice B is not as effective as A because maintaining situational awareness alone may not provide enough information about the specific risks in the neighborhood.
Choice D is incorrect because making the visit as brief as possible does not address potential safety concerns in the neighborhood. It may even rush the nurse, leading to oversight of safety measures.
Overall, choice A is the best option as it directly addresses the need to proactively reduce the risk of encountering unsafe conditions in the family's home.
A patient diagnosed with a serious mental illness died suddenly at age 52. The patient lived in the community for 5 years without relapse and held supported employment the past 6 months. The distressed family asks, 'How could this happen?' Which response by the nurse accurately reflects research and addresses the family's question?
A. A certain number of people die young from undetected diseases, and its just one of those sad things that sometimes happen.'
B. Mentally ill people tend to die much younger than others, perhaps because they do not take as good care of their health, smoke more, or are overweight.'
C. We will have to wait for the autopsy to know what happened. There were some medical problems, but we were not expecting death.'
D. We are all surprised. The patient had been doing so well and saw the nurse every other week.'
Correct answer:
The family is in distress. Because they do not understand his death, they are less able to accept it and seek specific information to help them understand what happened. Persons with serious mental illness die an average of 25 years prematurely. Contributing factors include failing to provide for their own health needs (e.g forgetting to take medicine), inability to access or pay for care, higher rates of smoking, poor diet, criminal victimization, and stigma. The most accurate answer indicates that seriously mentally ill people are at much higher risk of premature death for a variety of reasons. Staff would not have been surprised that the patient died prematurely, and they would not attribute his death to random, undetected medical problems. Although the cause of death will not be reliably established until the autopsy, this response fails to address the familys need for information.
For those family members who desire to care at home for loved ones who have been given a diagnosis of Alzheimer's disease, it is important for the nurse to ensure that the family is aware of which caregiver skills and responsibilities will be necessary. What is one of the responsibilities of the caregiver during the middle stage of the disease?
A. Helping the loved one with memory and communication problems
B. Providing a stable, routine environment
C. Providing complete assistance with physical care
D. Adapting to the changing personality and behavior of the loved one
Correct answer:
The correct answer is D: Adapting to the changing personality and behavior of the loved one. During the middle stage of Alzheimer's disease, individuals may experience significant changes in personality and behavior. Caregivers need to adapt to these changes by being patient, understanding, and flexible. This responsibility is crucial for maintaining a positive and supportive relationship with the loved one.
A: Helping the loved one with memory and communication problems is important, but it is more relevant in the early stages of the disease when these issues are more prominent.
B: Providing a stable, routine environment is essential throughout all stages of Alzheimer's disease, not just the middle stage.
C: Providing complete assistance with physical care may become necessary in the later stages of the disease when the individual's physical abilities decline significantly.
Which point should be included in teaching patients and families about relapse?
A. Patients who relapse are those who have failed to take their medications.
B. Caffeine and nicotine can reduce the effectiveness of antipsychotic drugs.
C. With support, education, and adherence to treatment, patients will not relapse.
D. Posthospitalization education about medication side effects is usually ineffective.
Correct answer:
Step-by-step rationale for why answer B is correct:
1. Caffeine and nicotine are known to reduce the effectiveness of antipsychotic drugs.
2. Teaching patients and families about this can help them understand the importance of avoiding these substances.
3. By avoiding caffeine and nicotine, patients can improve the effectiveness of their treatment and reduce the risk of relapse.
4. This information empowers patients and families to make informed decisions to support treatment outcomes.
Summary of why other choices are incorrect:
A: Incorrect because relapse can occur due to various factors, not just medication non-adherence.
C: Incorrect because relapse is a complex issue that may not be entirely prevented even with support, education, and adherence.
D: Incorrect because education about medication side effects is still valuable, even if it may not entirely prevent relapse.
The nurse notes that a male client, who is taking an antipsychotic medication, is constantly moving from chair to chair during a group activity, and he complains that he feels 'nervous and jittery inside.' The nurse is aware that this client most likely is experiencing:
A. Akinesia
B. Dystonia
C. Dyskinesia
D. Akathisia
Correct answer:
The correct answer is D: Akathisia. Akathisia is a common side effect of antipsychotic medications characterized by an inner feeling of restlessness and an inability to sit still. In this case, the client's constant movement and complaints of feeling 'nervous and jittery inside' align with the symptoms of akathisia.
A: Akinesia refers to a lack of movement or muscle weakness, which is not consistent with the client's presentation.
B: Dystonia is a movement disorder characterized by involuntary muscle contractions, typically presenting as sustained muscle contractions or abnormal postures.
C: Dyskinesia refers to abnormal, involuntary movements, which are not reflective of the client's symptoms in this scenario.
In summary, the client's symptoms of restlessness and inability to sit still indicate that he is likely experiencing akathisia, making option D the correct choice.
Nurses at a homeless clinic are concerned that homeless clients rarely return to have the nurses assess the findings of their tuberculosis (TB) skin tests. What should the clinic's policy be regarding the screening test findings?
A. Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation.
B. Have homeless individuals read their TB skin test, if necessary, and mail in results on a postage-paid card coded to protect privacy.
C. Re-administer the TB skin test if the client returns later than scheduled for test interpretation.
D. Routinely refer all homeless clients for chest x-rays.
Correct answer:
The correct answer is A: Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation. This approach ensures proactive follow-up and increases the likelihood of clients returning for test interpretation. Calling clients directly allows for immediate communication and personalized reminders, addressing the issue of non-compliance among the homeless population.
Option B is not ideal as relying on homeless individuals to read and mail in their TB skin test results may lead to inaccuracies, lack of follow-up, and potential privacy breaches. Option C is not recommended as re-administering the TB skin test may not be necessary and can lead to unnecessary testing and costs. Option D of routinely referring all homeless clients for chest x-rays is excessive and not warranted without first interpreting the TB skin test results.
Which information would be important to incorporate when teaching about medications for dementia in a caregiver's support group? Select all that apply.
A. Antipsychotic medications have been shown to be the most useful category of drugs in reducing behavioral problems in dementias.
B. Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
C. None of the currently available medications for dementias provide a cure.
D. None of the above.
Correct answer:
The correct answer is B because it accurately conveys important information about medications for dementia to caregivers. It emphasizes that most medications do not significantly improve functioning but may slow disease progression in a subset of patients. This is crucial for setting realistic expectations.
Choice A is incorrect because antipsychotic medications are not the most useful category of drugs for reducing behavioral problems in dementia; they are associated with serious side effects and should be used cautiously.
Choice C is incorrect because it is essential for caregivers to understand that medications do not cure dementia; managing symptoms and slowing progression are the primary goals.
Choice D is incorrect as the correct answer is B, which provides valuable information for caregivers to understand the limitations and benefits of medications for dementia.
LPN exams geriatric practice questions, set 8 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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