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
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 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.
Question 2
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.
Show answer and rationale
Correct answer: C — Explore alternate ways to handle frustrating topics in the group.
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.
Question 3
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.
Show answer and rationale
Correct answer: A — Helping the loved one with memory and communication problems.
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.
Question 4
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.
Show answer and rationale
Correct answer: C — Explore alternate ways to handle frustrating topics in the group.
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.
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
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 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 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.
A retirement community is divided into different communities with different activities available for the residents. There is one community for individuals ages 65 to 74 years, one for individuals ages 75 to 85 years, and one for individuals older than age 85 years. This is consistent with which theory of aging?
A. Role theory
B. Disengagement theory
C. Age-stratification theory
D. Social exchange theory
Correct answer:
The correct answer is C: Age-stratification theory. This theory suggests that age is a powerful determinant of social organization. In the given scenario, the retirement community is structured based on age groups, indicating stratification by age. This separation aligns with the concept of age-based social hierarchies and differing opportunities and resources based on age.
Choice A (Role theory) focuses on how individuals adapt to social roles as they age, which is not directly reflected in the scenario. Choice B (Disengagement theory) posits that aging individuals withdraw from societal roles, which is not evident in the active engagement of residents in different age-specific communities. Choice D (Social exchange theory) emphasizes the relationships individuals form based on rewards and costs, which is not the primary focus in the scenario compared to the age-based stratification.
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.
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.
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.
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.
A significant factor contributing to the prevalence of chronic conditions among baby boomers is that:
A. They experienced a higher rate of physical activity during their youth.
B. They were exposed to unhealthy lifestyle choices and environments in their formative years.
C. They had better access to preventive healthcare services than previous generations.
D. They were educated about nutrition and wellness from an early age.
Correct answer:
The correct answer is B because baby boomers were exposed to unhealthy lifestyle choices and environments in their formative years, contributing to the prevalence of chronic conditions. This is supported by research showing that environmental factors, such as diet and exposure to toxins, play a significant role in the development of chronic illnesses. Additionally, unhealthy habits established in youth can have long-term effects on health.
Choice A is incorrect because higher physical activity rates during youth would typically lead to better health outcomes, not increased chronic conditions. Choice C is incorrect as better access to preventive healthcare services would likely reduce chronic conditions, not increase them. Choice D is incorrect because education about nutrition and wellness would typically lead to healthier lifestyle choices and lower rates of chronic conditions.
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.
RN exams geriatric practice questions, set 17 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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