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 homeless family brought their father to the public health clinic after he reported bleeding when he went to the bathroom. Which nursing action is most appropriate?
A. Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night
B. Refer the man to a urologist to address the urinary bleeding
C. Suggest that the family take him to an urgent care center immediately
D. Treat the urinary infection and give the man medication to take to prevent the return of infection
Show answer and rationale
Correct answer: A — Begin tests to determine the cause of the bleeding while asking about other family concerns from nutrition to shelter for the night
The correct answer is A. Beginning tests to determine the cause of the bleeding while asking about other family concerns is appropriate because it addresses the immediate health issue while also considering the family's holistic needs. By conducting tests, the nurse can identify the underlying cause of the bleeding and provide necessary treatment. Additionally, inquiring about other family concerns such as nutrition and shelter shows a comprehensive approach to care, considering social determinants of health.
Choice B is incorrect because referring the man to a urologist bypasses the initial assessment and testing that should be done at the clinic. Choice C is incorrect as suggesting urgent care does not address the immediate need for assessment and testing. Choice D is incorrect because assuming a urinary infection without proper assessment can lead to incorrect treatment.
Question 2
The nurse at the clinic is interviewing a patient who offers a number of vague somatic complaints that might not ordinarily prompt a visit to a caregiver: fatigue, back pain, and seems tense. After having spoken of the symptoms, the nurse can best serve the patient by:
A. Asking if the patient has ever had psychiatric counseling.
B. Completing a structured abuse assessment protocol.
C. Suggesting the patient take a break from work.
D. None of the above.
Show answer and rationale
Correct answer: B — Completing a structured abuse assessment protocol.
The correct answer is B: Completing a structured abuse assessment protocol. In this scenario, the patient presents with vague somatic complaints that could potentially be indicative of underlying abuse. By completing an abuse assessment protocol, the nurse can uncover any possible abuse the patient may be experiencing, which could be the root cause of their symptoms. This approach is crucial in ensuring the patient's safety and well-being.
Choice A is incorrect because assuming the symptoms are solely related to psychiatric issues without exploring other potential causes can lead to overlooking important factors. Choice C is incorrect as suggesting a break from work may not address the underlying issue and could potentially worsen the patient's situation. Choice D is incorrect as taking no action could result in the patient's condition worsening without proper intervention.
Question 3
A client displays disorganized thinking, difficult-to-follow speech, and silly, inappropriate affect. The client isolates himself from other clients and staff, ignores unit activities, and often seems to be listening and responding to unseen stimuli. This client's behavior most closely conforms to the characteristic behavior of:
A. Residual schizophrenia
B. Schizoaffective disorder
C. Paranoid schizophrenia
D. Disorganized schizophrenia
Show answer and rationale
Correct answer: D — Disorganized schizophrenia
The correct answer is D: Disorganized schizophrenia. The client's symptoms of disorganized thinking, difficult-to-follow speech, inappropriate affect, social withdrawal, and hallucinations (responding to unseen stimuli) align with the diagnostic criteria for Disorganized Schizophrenia. This subtype is characterized by disorganized behavior, speech, and affect, as well as social withdrawal and hallucinations.
A: Residual schizophrenia does not involve active psychotic symptoms like hallucinations or delusions, which are present in the client's behavior described.
B: Schizoaffective disorder combines symptoms of schizophrenia and mood disorders, and the client's symptoms do not strongly suggest a mood disorder component.
C: Paranoid schizophrenia typically involves prominent delusions and auditory hallucinations, which are not emphasized in the client's behavior described.
Question 4
The physician and advanced practice nurse are considering which antipsychotic medication to prescribe for a patient with schizophrenia who demonstrates auditory hallucinations, apathy, anhedonia, and poor social functioning. The patient is overweight and has hypertension. Bearing these facts in mind, the drug the nurse should advocate would be:
A. clozapine (Clozaril).
B. haloperidol (Haldol).
C. olanzapine (Zyprexa).
D. aripiprazole (Abilify).
Show answer and rationale
Correct answer: D — aripiprazole (Abilify).
The correct answer is D: aripiprazole (Abilify). Aripiprazole is a second-generation antipsychotic that is less likely to cause weight gain and metabolic side effects compared to other antipsychotics. This is important since the patient is already overweight and has hypertension. Aripiprazole also has a lower risk of causing sedation, which can be beneficial for addressing apathy and anhedonia without worsening social functioning.
A: Clozapine is effective for treatment-resistant schizophrenia but is associated with significant weight gain and metabolic side effects.
B: Haloperidol is a first-generation antipsychotic with a high risk of extrapyramidal side effects and is not ideal for a patient with hypertension.
C: Olanzapine is known for causing significant weight gain and metabolic effects, making it a less suitable choice for an overweight patient with hypertension.
Question 5
Which of the following is a priority intervention for a patient with bulimia nervosa who is experiencing electrolyte imbalances?
A. Encourage the patient to drink fluids and increase food intake.
B. Monitor the patient's heart rate and electrolyte levels closely.
C. Provide high-protein foods to help restore energy.
D. Instruct the patient to avoid any form of physical exercise.
Show answer and rationale
Correct answer: B — Monitor the patient's heart rate and electrolyte levels closely.
The correct answer is B. Monitoring the patient's heart rate and electrolyte levels closely is crucial in managing electrolyte imbalances in patients with bulimia nervosa. Electrolyte imbalances, often caused by purging behaviors, can lead to serious complications like cardiac arrhythmias. Close monitoring allows for timely interventions such as electrolyte replacement therapy to prevent cardiac issues.
A: Encouraging the patient to drink fluids and increase food intake is not the priority when dealing with electrolyte imbalances as it may worsen the imbalance.
C: Providing high-protein foods may be beneficial for overall nutrition but does not address the immediate need to correct electrolyte imbalances.
D: Instructing the patient to avoid physical exercise is not directly related to managing electrolyte imbalances and may not address the underlying issue effectively.
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Question 6
A client, age 34, has been physically abused by her husband five times during the past 2 years. During her last discussion with the nurse, the client stated, 'I probably should not keep going back to my husband, since he continues to abuse me.' The nurse is aware that the final decision to leave a batterer:
A. Often occurs after the victim suffers a serious injury
B. Is usually a gradual process that occurs over time
C. Is more likely if the client has approval from the church
D. Is made with the batterer's permission
Correct answer:
The correct answer is B: Is usually a gradual process that occurs over time.
Rationale:
1. Leaving an abusive partner is a complex and difficult decision that often requires careful planning and support.
2. Victims may face various barriers such as financial dependence, emotional attachment, and fear of further violence.
3. It is rare for victims to abruptly leave without considering their safety and well-being.
4. The statement 'I probably should not keep going back' indicates a gradual realization and contemplation of leaving.
Summary:
A: The decision to leave is not solely based on serious injury; victims may leave before any significant harm occurs.
C: Approval from the church may influence the victim's decision but is not a determining factor.
D: Leaving an abusive partner should not require the batterer's permission; it is a personal choice made by the victim.
A worker is characterized by her co-workers as 'painfully shy' and lacking in self-confidence. Her co-workers say she stays in her cubicle all day, never coming out for breaks or lunch. One day after falling on the ice in the parking lot, she goes to the nurse's office, where she apologizes for falling and mentions that she hopes the company will not fire her for being so clumsy. With which diagnosis is this presentation most consistent?
A. Avoidant
B. Dependent
C. Histrionic
D. Paranoid
Correct answer:
The correct answer is A: Avoidant. This diagnosis is consistent because the worker exhibits characteristics of extreme shyness, lack of self-confidence, social avoidance, and fear of rejection or criticism. By apologizing excessively for a simple accident and expressing worry about being fired for it, the worker's behavior aligns with the avoidance of social situations and excessive concern about negative evaluation typical of Avoidant Personality Disorder.
Choice B: Dependent, does not fit as the worker is not displaying excessive need for others to take responsibility for major areas of her life.
Choice C: Histrionic, is not a match as this disorder is characterized by attention-seeking behavior, which is not evident in the worker's presentation.
Choice D: Paranoid, is not the correct diagnosis as the worker does not display distrust or suspiciousness towards others.
A 25-year-old individual was brought by ambulance to the emergency room. The patient's sensorium alternates between clouded and clear, and the patient becomes agitated both physically and verbally when approached. The patient's cognitive impairment is most consistent with:
A. Delirium
B. Dementia
C. Sundown syndrome
D. Early-onset Alzheimer disease
Correct answer:
The correct answer is A: Delirium. Delirium is characterized by acute onset, fluctuating course, altered level of consciousness, and cognitive impairment. In this case, the patient's alternating sensorium and agitation suggest an acute confusional state, which is typical of delirium. Delirium is often caused by underlying medical conditions, medications, or substance abuse.
Summary of other choices:
B: Dementia is a chronic, progressive cognitive decline that does not typically present with acute onset and fluctuating symptoms like delirium.
C: Sundown syndrome refers to worsening of symptoms in the evening and is often seen in patients with dementia, not in this acute and fluctuating presentation.
D: Early-onset Alzheimer's disease is a form of dementia that typically has a more insidious onset and does not present with acute fluctuations in cognition like delirium.
The community health nurse is working with a group of sexual assault survivors. During a group discussion, the nurse offers each client 10 minutes to share their feelings with the group. This action by the nurse is consistent with which of the CDC's principles of trauma-informed care?
A. Cultural, historical, and gender issues
B. Empowerment and choice
C. Collaboration and mutuality
D. Trustworthiness and transparency
Correct answer:
The correct answer is B: Empowerment and choice. By offering each client 10 minutes to share their feelings, the nurse is providing them with a sense of empowerment and choice in deciding how they want to express themselves. This aligns with the principle of empowering survivors to have control over their own experiences and decisions.
A: Cultural, historical, and gender issues - While important in trauma-informed care, this choice does not directly relate to the nurse's action of offering time for sharing feelings.
C: Collaboration and mutuality - This involves working together with clients, which is valuable, but does not directly address the individual choice given to each client in this scenario.
D: Trustworthiness and transparency - Important principles for building trust, but not directly related to the nurse's action of empowering survivors through choice.
When a patient with anorexia nervosa is admitted for treatment, the milieu should provide: (Select all that apply.)
A. Flexible mealtimes.
B. Unscheduled weight checks.
C. Adherence to a selected menu.
D. None of the above.
Correct answer:
The correct answer is A: Flexible mealtimes. In the treatment of anorexia nervosa, providing flexible mealtimes allows patients to regain a sense of control over their eating habits, which is crucial in their recovery process. This approach helps to reduce anxiety around food and promotes a healthier relationship with eating.
Choice B: Unscheduled weight checks can be triggering and anxiety-provoking for patients with anorexia nervosa, as weight monitoring can be a significant source of distress for them.
Choice C: Adherence to a selected menu may reinforce rigid eating patterns and control issues related to food, which can be counterproductive in the treatment of anorexia nervosa.
Choice D: None of the above is incorrect because providing flexible mealtimes is essential in creating a supportive and therapeutic environment for patients with anorexia nervosa.
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.'
Correct answer:
Step-by-step rationale for correct answer (C):
1. Personality disorders are complex and have multifactorial causes.
2. Research suggests a biological component to personality disorders, such as genetic predispositions.
3. This understanding helps to shift the blame away from solely poor parenting.
4. It aligns with the biopsychosocial model, which considers biological, psychological, and social factors.
5. This response promotes a holistic view of personality development.
Summary of why other choices are incorrect:
A: Shifts focus to gender roles, which is not directly relevant to the etiology of personality disorders.
B: Narrowly associates personality disorders with sexual abuse, ignoring other contributing factors.
D: Overemphasizes peer interactions over parental influence, which is not supported by extensive research on personality development.
A 34-year-old client with residual schizophrenia frequently displays ambivalence. The community mental health nurse suggests that a realistic short-term outcome for this client problem is that client will:
A. Decide his or her own daily schedule
B. Refuse to attend activities
C. Choose which clinic staff member to work with
D. Choose between two outfits to wear each morning
Correct answer:
The correct answer is D: Choose between two outfits to wear each morning. This outcome is realistic because it focuses on a concrete and manageable task that the client can achieve, promoting independence and decision-making skills. It also addresses the issue of ambivalence by providing the client with limited choices, which can help reduce anxiety and facilitate decision-making.
A: Decide his or her own daily schedule - This option may be too overwhelming for a client with residual schizophrenia and may not directly address the issue of ambivalence.
B: Refuse to attend activities - This option is negative and does not promote progress or independence for the client.
C: Choose which clinic staff member to work with - This option may not be directly related to the client's ambivalence or daily functioning, making it less relevant as a short-term goal.
A patient diagnosed with schizophrenia reveals to the nurse that voices have warned of danger and adds, 'They're so loud they frighten me. Do you hear them?' The nurse's best initial response would be:
A. I know these voices are very real to you, but I don't hear them.'
B. Don't worry. You're safe in the hospital. I won't let anything happen to you.'
C. Tell me more about the voices. Are they men or women? How many are there?'
D. What do you do in order to keep yourself occupied so you don't hear the voices?'
Correct answer:
The correct answer is A because it acknowledges the patient's experience without dismissing or invalidating it. By stating, "I know these voices are very real to you, but I don't hear them," the nurse validates the patient's reality and expresses empathy. This response helps build trust and rapport, which is crucial in establishing a therapeutic relationship.
Choice B is incorrect because it dismisses the patient's concerns and offers false reassurance, which may not be effective in addressing the patient's distress.
Choice C is incorrect as it focuses on gathering more information about the voices without addressing the patient's immediate emotional distress.
Choice D is incorrect because it shifts the focus away from the patient's current experience and onto distractions, which may not be helpful in addressing the patient's distressing symptoms.
A patient was admitted to the mental health unit after arguing with co-workers and threatening to kill them. He is diagnosed with paranoid schizophrenia. On the unit he is aloof and suspicious. He mentioned that two physicians he saw talking were plotting to kill him. On the basis of data gathered at this point, which two primary nursing diagnoses should the nurse consider?
A. Disturbed thought processes and Risk for other-directed violence
B. Spiritual distress and Social isolation
C. Risk for loneliness and Knowledge deficit
D. Disturbed personal identity and Nonadherence
Correct answer:
The correct answer is A: Disturbed thought processes and Risk for other-directed violence.
1. Disturbed thought processes: The patient's delusions (believing physicians are plotting to kill him) indicate disorganized thinking, a hallmark of paranoid schizophrenia.
2. Risk for other-directed violence: The patient's threatening behavior towards co-workers suggests a potential for violence towards others.
Incorrect choices:
B: Spiritual distress and Social isolation - Not directly related to the patient's current symptoms of paranoid delusions and threat of violence.
C: Risk for loneliness and Knowledge deficit - The patient's issues are more severe than loneliness or knowledge deficit.
D: Disturbed personal identity and Nonadherence - While these issues may be relevant in schizophrenia, they are not the primary concerns presented in this scenario.
What is the primary goal for a nurse treating a patient with anorexia nervosa?
A. To help the patient achieve optimal body weight quickly.
B. To restore the patient's nutritional balance and weight.
C. To involve the patient in daily exercise routines to improve physical health.
D. To encourage the patient to undergo intensive psychotherapy.
Correct answer:
The primary goal for a nurse treating a patient with anorexia nervosa is to restore the patient's nutritional balance and weight. This is because individuals with anorexia nervosa often have severe malnutrition and weight loss, which can lead to serious health complications. By focusing on restoring nutritional balance and weight, the nurse can help improve the patient's physical health and overall well-being. Encouraging the patient to achieve optimal body weight quickly (choice A) may not be realistic or safe, as rapid weight gain can have negative consequences. Involving the patient in daily exercise routines (choice C) may exacerbate the patient's compulsive behaviors around food and exercise. Encouraging the patient to undergo intensive psychotherapy (choice D) is important, but it is not the primary goal in the initial treatment of anorexia nervosa.
LPN exams geriatric practice questions, set 9 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
No. Nursier is independent practice. Register through the official path named on the LPN exams exam guide.
The first five questions already include the rationale. Start full practice to unlock the remaining keys, missed-question review, and the rest of the bank.
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