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
Which organization had the largest influence in the specialty of gerontological nursing?
A. American Association of Retired Persons (AARP)
B. John Hartford Foundation
C. Medicare
D. Mutual of Omaha Insurance
Show answer and rationale
Correct answer: B — John Hartford Foundation
The correct answer is B: John Hartford Foundation. The John Hartford Foundation is known for its significant contributions to the field of gerontological nursing through funding research, education, and initiatives to improve care for older adults. The foundation has supported the development of gerontological nursing programs and resources, making it a key influencer in advancing the specialty.
Explanation for other choices:
A: American Association of Retired Persons (AARP) primarily focuses on advocacy and support for older adults but does not have a direct influence on the specialty of gerontological nursing.
C: Medicare is a federal health insurance program for individuals aged 65 and older, but it does not specifically impact the development of gerontological nursing as an organization.
D: Mutual of Omaha Insurance is an insurance company and does not have a direct role in shaping the field of gerontological nursing.
Question 2
Which of the following best describes the concept of "cognitive reserve" in older adults?
A. It refers to the brain's ability to compensate for damage through enhanced neurogenesis.
B. It refers to the relationship between cognitive decline and physical health.
C. It is the brain's ability to maintain function despite age-related changes and pathology.
D. It is the process of developing new cognitive abilities later in life.
Show answer and rationale
Correct answer: C — It is the brain's ability to maintain function despite age-related changes and pathology.
The correct answer is C: "It is the brain's ability to maintain function despite age-related changes and pathology." Cognitive reserve in older adults refers to the brain's ability to withstand age-related changes and pathology while maintaining cognitive function. This concept suggests that individuals with higher cognitive reserve may show fewer cognitive deficits even in the presence of brain damage or pathology.
Choice A is incorrect because cognitive reserve is not about compensating for damage through enhanced neurogenesis but rather about maintaining function despite changes.
Choice B is incorrect because cognitive reserve is not specifically about the relationship between cognitive decline and physical health; it focuses on maintaining cognitive function.
Choice D is incorrect because cognitive reserve is not about developing new cognitive abilities later in life but rather preserving existing cognitive function.
Question 3
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.
Show answer and rationale
Correct answer: A — Nutritional deficiency and dehydration.
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.
Question 4
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 5
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.
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Question 6
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
Correct answer:
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.
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
Correct answer:
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.
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.'
Correct answer:
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.
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
Correct answer:
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.
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
Correct answer:
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
What is the primary consideration when initiating care for older adults with palliative care needs?
A. Focusing primarily on managing pain with medications
B. Identifying goals of care through open conversations with the patient and family
C. Avoiding advanced medical treatments
D. Prescribing hospice care immediately to relieve suffering
Correct answer:
The correct answer is B: Identifying goals of care through open conversations with the patient and family. This is crucial because palliative care for older adults should be person-centered and align with their preferences and values. By engaging in open conversations, healthcare providers can understand the individual's goals, values, and wishes, allowing for care to be tailored accordingly. This approach emphasizes holistic care beyond just managing pain and considers the patient's emotional, spiritual, and social needs.
Incorrect choices:
A: Focusing primarily on managing pain with medications overlooks the importance of addressing other aspects of care.
C: Avoiding advanced medical treatments is not always appropriate as each situation should be assessed individually.
D: Prescribing hospice care immediately may not be necessary or desired by the patient, as it depends on their specific needs and preferences.
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
Correct answer:
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.
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.'
Correct answer:
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.
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
RN exams geriatric practice questions, set 14 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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