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 RN exams exam guide or more RN 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
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 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
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
Show answer and rationale
Correct answer: C — Identify feelings of sadness related to the failed relationship
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.
Question 4
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.'
Show answer and rationale
Correct answer: B — New findings suggest this disorder is biologic in nature.'
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.
Question 5
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
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Question 6
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.
Correct answer:
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.
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.
Correct answer:
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.
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 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 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.
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 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.
Correct answer:
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.
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.
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.
Correct answer:
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.
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.
RN exams geriatric practice questions, set 12 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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Keep going past these 15 questions
Missed-question review, longer banks, and the rest of 20,000+ nursing practice questions open when you start studying.
