RN exams geriatric practice questions set 19

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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.

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Correct Answer: B Rationale: The thymus gland is responsible for producing T-cells, crucial for immune responses. As individuals age, the thymus gland shrinks and becomes less efficient, reducing the production of new T-cells. This decline in T-cell production weakens the immune response in older adults, making them more susceptible to infections. Therefore, choice B is correct. Summary of Incorrect Choices: A: Aging does not increase the production of white blood cells. In fact, the immune system may weaken with age due to a decline in key immune cells. C: Aging does not improve the body's ability to recognize and fight off pathogens. Instead, it often leads to a decline in immune function. D: While some inflammatory responses may increase with age, excessive inflammation can actually be harmful and contribute to age-related diseases, rather than providing protection.

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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.

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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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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.

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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.

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The correct answer is A because suggesting appropriate resources like respite care and a senior citizens' center shows the nurse's understanding of the client's needs for social interaction and support. This approach addresses the client's isolation and the daughter's need for assistance in caring for her father. Choice B is incorrect because simply telling the daughter to allow her father to participate does not address the underlying issues of the client feeling in the way and the daughter's need for support. Choice C is incorrect as it ignores the client's need for social interaction and the daughter's need for assistance, prioritizing peace over the client's well-being. Choice D is incorrect as offering to stay with the client while he is isolated does not address the broader issue of the client's need for social engagement and the daughter's need for support.

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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.

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The correct answer is B. Fewer than 50% of older adults utilize available preventive services. This is important for a community health initiative as it highlights a gap in healthcare utilization among seniors. By recognizing this statistic, the nurse can tailor the initiative to target the barriers preventing seniors from accessing preventive services. Rationale: 1. Option A is incorrect because stating that approximately 60% of older adults actively participate in preventive health services is misleading. The actual utilization rate is lower. 2. Option C is incorrect as it focuses on preference for alternative medicine rather than actual utilization of preventive health services. 3. Option D is incorrect as it states preventive health services are equally utilized by older and younger adults, which is not supported by data regarding senior healthcare utilization.

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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.