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
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
Show answer and rationale
Correct answer: D — Akathisia
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.
Question 2
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.
Show answer and rationale
Correct answer: A — Call all homeless clients 48 hours after TB skin testing to remind them to return to the clinic for test interpretation.
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.
Question 3
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.
Show answer and rationale
Correct answer: B — Most currently available medications slow the progress of the disease in 20% to 50% of patients but usually do not significantly improve functioning.
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.
Question 4
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
Show answer and rationale
Correct answer: D — Adapting to the changing personality and behavior of the loved one
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.
Question 5
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.
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Question 6
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
Correct answer:
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.
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.
Correct answer:
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.
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.
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
Correct answer:
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.
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).
Correct answer:
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.
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.
Correct answer:
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.
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
Correct answer:
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.
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.
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.
Correct answer:
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.
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.
RN exams geriatric practice questions, set 18 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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