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 teacher comes to the mental health clinic saying a co-worker recently confronted her about behaviors that are annoying to other co-workers. She is now experiencing moderate to severe levels of anxiety. The co-worker told the patient that others find her very difficult because she is a perfectionist and micromanages the tasks of others on the teaching team, always demanding that things should be done according to her plans. The co-worker mentioned that the patient made everyone feel as though everything they tried was inadequate, and they feel frustrated and angry. The patient states she likes her co-workers and only wanted to help them be successful. The nurse realizes the patient's behaviors are most consistent with:
A. obsessive-compulsive personality disorder.
B. narcissistic personality disorder.
C. histrionic personality disorder.
D. schizoid personality disorder.
Show answer and rationale
Correct answer: A — obsessive-compulsive personality disorder.
The correct answer is A: obsessive-compulsive personality disorder. This is because the patient's behaviors of being a perfectionist, micromanaging tasks, demanding things be done according to her plans, and making others feel inadequate align with the diagnostic criteria for obsessive-compulsive personality disorder. Individuals with this disorder are preoccupied with orderliness, perfectionism, and control.
Choice B: narcissistic personality disorder, is incorrect because the patient's behaviors are not characterized by a sense of grandiosity, a lack of empathy, or a need for admiration, which are hallmark features of narcissistic personality disorder.
Choice C: histrionic personality disorder, is incorrect as individuals with this disorder typically display attention-seeking behavior, emotional instability, and excessive emotionality, none of which are evident in the patient's presentation.
Choice D: schizoid personality disorder, is incorrect as individuals with this disorder tend to be socially detached, have limited emotional expression, and prefer solitary activities, which do not align with the
Question 2
A patient with borderline personality disorder has been making steady progress but one day gets a phone call from her boyfriend, who breaks off their relationship. Although she has not self-injured in over 2 months, she makes repeated lacerations on her forearm. Which statement about this and most maladaptive behaviors seen in personality disorders is most accurate?
A. People with personality disorders rarely achieve lasting improvement.
B. However dysfunctional, most behavior is the person's best effort to cope.
C. People with personality disorders are at the mercy of others' actions.
D. What appears to be improvement can be manipulation instead.
Show answer and rationale
Correct answer: B — However dysfunctional, most behavior is the person's best effort to cope.
The correct answer is B: However dysfunctional, most behavior is the person's best effort to cope. In this scenario, the patient's self-injury following the breakup is a maladaptive coping mechanism to deal with emotional distress. Individuals with personality disorders often engage in maladaptive behaviors as a way to cope with overwhelming emotions or stress. This behavior may not be effective or healthy, but it is their attempt to manage their internal struggles.
A: People with personality disorders rarely achieve lasting improvement - This statement is incorrect as individuals with personality disorders can make progress with therapy and support.
C: People with personality disorders are at the mercy of others' actions - This statement is incorrect as individuals with personality disorders have agency over their behaviors, even if they struggle with emotional regulation.
D: What appears to be improvement can be manipulation instead - This statement is incorrect as improvement in behavior should not be automatically attributed to manipulation; it could genuinely reflect progress in coping skills.
Question 3
A 91-year-old female client with dementia is being seen by the home health nurse. Both she and her husband, who is 92 years old, were very active until her dementia became debilitating. Since that time, the client does not recognize her husband or children, forgets how to eat and dress, and wanders about the house day and night. Her husband wants to keep her at home to care for her, but the nurse notices that he is increasingly tired with each visit. What is the nurse's priority intervention for the nursing diagnosis of caregiver role strain?
A. Discuss strategies to coordinate care and other responsibilities
B. Encourage involvement in support groups
C. Identify resources to include financial, legal, and respite care
D. Stress the importance of self-nurturing
Show answer and rationale
Correct answer: A — Discuss strategies to coordinate care and other responsibilities
The correct answer is A: Discuss strategies to coordinate care and other responsibilities. The priority intervention for caregiver role strain is to help the husband effectively manage caring for his wife with dementia. By discussing strategies to coordinate care and other responsibilities, the nurse can assist the husband in creating a plan to ensure the client's needs are met while also addressing his own well-being. This intervention will help alleviate the husband's increasing tiredness and provide support in managing the caregiving responsibilities.
Summary of other choices:
B: Encourage involvement in support groups - While support groups can be beneficial, the immediate priority is to address the husband's caregiving responsibilities.
C: Identify resources to include financial, legal, and respite care - While important, these resources may not directly address the husband's current strain in caring for his wife.
D: Stress the importance of self-nurturing - While self-care is important, the immediate focus should be on assisting the husband in managing his caregiving responsibilities.
Question 4
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
A. admission to an unlocked residential crisis unit.
B. inpatient hospitalization on a locked unit.
C. attending a day treatment program for 4 weeks.
D. admission to a partial hospital program.
Show answer and rationale
Correct answer: B — inpatient hospitalization on a locked unit.
The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate given the patient's presentation. The patient is experiencing severe positive symptoms of schizophrenia, such as delusions and disorganized behavior, posing a risk to himself and others by expressing intent to obtain a gun. Additionally, the patient is neglecting basic needs, indicating a need for close monitoring and intervention. Inpatient hospitalization on a locked unit provides a structured and secure environment for intensive treatment, ensuring safety and stabilization.
Incorrect choices:
A: Admission to an unlocked residential crisis unit may not provide the level of monitoring and security needed for a patient with active psychotic symptoms and self-harm potential.
C: Attending a day treatment program for 4 weeks does not address the acute safety concerns and level of impairment displayed by the patient.
D: Admission to a partial hospital program may not offer the round-the-clock supervision and immediate intervention required for someone at risk of harming themselves or others.
Question 5
Which of the following interventions is most effective in managing chronic pain in older adults?
A. Increased use of narcotic medications
B. Cognitive behavioral therapy (CBT) combined with physical therapy
C. Isolation to avoid further stress
D. Surgery for all pain types
Show answer and rationale
Correct answer: B — Cognitive behavioral therapy (CBT) combined with physical therapy
The correct answer is B, Cognitive Behavioral Therapy (CBT) combined with physical therapy. This intervention is effective in managing chronic pain in older adults because it addresses both the psychological and physical aspects of pain. CBT helps individuals change negative thought patterns and behaviors related to pain, leading to improved pain management. Physical therapy can help improve physical function and reduce pain through exercises and techniques.
A: Increased use of narcotic medications may provide short-term relief but can lead to dependence and other negative side effects in older adults.
C: Isolation can worsen mental health and exacerbate pain symptoms due to lack of social support and interaction.
D: Surgery is not suitable for all types of chronic pain in older adults and should only be considered as a last resort after conservative interventions have been tried.
In summary, B is the most effective intervention as it addresses both psychological and physical aspects of chronic pain in older adults, unlike the other options which may have limitations or negative consequences.
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Question 6
Identify the Healthy People 2020 emerging issues in the health of older adults.
A. Coordinating care for the older adult population
B. Assisting older adults in the management of their own care
C. Identifying levels of training for those caring for older adults
D. Making community resources available for older adults
Correct answer:
The correct answer is A: Coordinating care for the older adult population. This is a key emerging issue in the health of older adults as it focuses on improving the integration and coordination of healthcare services to ensure comprehensive and efficient care delivery. This includes addressing the complex needs of older adults, promoting continuity of care, and enhancing communication among healthcare providers.
Rationale:
1. Coordinating care addresses the holistic needs of older adults.
2. It aims to prevent fragmented care and improve health outcomes.
3. Enhances collaboration among healthcare providers and community resources.
4. Promotes patient-centered care and improves quality of life for older adults.
Other Choices:
B: Assisting older adults in the management of their own care - While important, this focuses on individual responsibility rather than systemic coordination.
C: Identifying levels of training for those caring for older adults - Relevant but not a primary emerging issue in the health of older adults.
D: Making community resources available for older adults - Important, but
A 91-year-old female client with dementia is being seen by the home health nurse. Both she and her husband, who is 92 years old, were very active until her dementia became debilitating. Since that time, the client does not recognize her husband or children, forgets how to eat and dress, and wanders about the house day and night. Her husband wants to keep her at home to care for her, but the nurse notices that he is increasingly tired with each visit. What is the nurse's priority intervention for the nursing diagnosis of caregiver role strain?
A. Discuss strategies to coordinate care and other responsibilities
B. Encourage involvement in support groups
C. Identify resources to include financial, legal, and respite care
D. Stress the importance of self-nurturing
Correct answer:
The correct answer is A: Discuss strategies to coordinate care and other responsibilities. The priority intervention for caregiver role strain is to help the husband effectively manage caring for his wife with dementia. By discussing strategies to coordinate care and other responsibilities, the nurse can assist the husband in creating a plan to ensure the client's needs are met while also addressing his own well-being. This intervention will help alleviate the husband's increasing tiredness and provide support in managing the caregiving responsibilities.
Summary of other choices:
B: Encourage involvement in support groups - While support groups can be beneficial, the immediate priority is to address the husband's caregiving responsibilities.
C: Identify resources to include financial, legal, and respite care - While important, these resources may not directly address the husband's current strain in caring for his wife.
D: Stress the importance of self-nurturing - While self-care is important, the immediate focus should be on assisting the husband in managing his caregiving responsibilities.
A patient with many positive symptoms of schizophrenia, whose behavior is disorganized and who is highly anxious, tells the nurse in the psychiatric emergency department, 'You have got to help me. I do not know what is going on. I think someone is trying to wipe me out. I have to get a gun.' The patient, a college student, lives alone and has no family or support system in the immediate area. He has not left his room in 2 weeks, has not eaten in several days, and is unkempt. Of the available treatment settings, the nurse should recommend:
A. admission to an unlocked residential crisis unit.
B. inpatient hospitalization on a locked unit.
C. attending a day treatment program for 4 weeks.
D. admission to a partial hospital program.
Correct answer:
The correct answer is B: inpatient hospitalization on a locked unit. This option is the most appropriate given the patient's presentation. The patient is experiencing severe positive symptoms of schizophrenia, such as delusions and disorganized behavior, posing a risk to himself and others by expressing intent to obtain a gun. Additionally, the patient is neglecting basic needs, indicating a need for close monitoring and intervention. Inpatient hospitalization on a locked unit provides a structured and secure environment for intensive treatment, ensuring safety and stabilization.
Incorrect choices:
A: Admission to an unlocked residential crisis unit may not provide the level of monitoring and security needed for a patient with active psychotic symptoms and self-harm potential.
C: Attending a day treatment program for 4 weeks does not address the acute safety concerns and level of impairment displayed by the patient.
D: Admission to a partial hospital program may not offer the round-the-clock supervision and immediate intervention required for someone at risk of harming themselves or others.
An older married couple move to a continuing care retirement community. The older woman who was always very social and outgoing quickly joins an exercise group, a book club, and a knitting circle. The older man who was always very solitary adopts a routine of a long daily walk and registers for an online course in creative writing. The behaviors of the older couple are consistent with which theory of aging?
A. Activity theory
B. Continuity theory
C. Social exchange theory
D. Disengagement theory
Correct answer:
The correct answer is B: Continuity theory. This theory suggests that as individuals age, they strive to maintain a sense of consistency in their activities, interests, and relationships. In this scenario, both the older woman and man are adapting their lifestyles to maintain a sense of continuity with their past selves. The woman continues to engage in social activities, reflecting her outgoing nature, while the man maintains his solitary habits but explores new interests, such as creative writing, to fulfill his need for personal growth.
A: Activity theory focuses on the idea that continued engagement in activities leads to a higher quality of life in old age. While the older woman's active engagement aligns with this theory, the older man's solitary activities do not fully support this concept.
C: Social exchange theory emphasizes the balance of costs and benefits in social relationships. This theory is not directly applicable to the scenario as it does not address the individuals' personal activities and interests.
D: Disengagement theory suggests that older adults gradually withdraw
What is the most effective strategy for preventing relapse in patients with anorexia nervosa?
A. Providing a strict, rigid meal plan that the patient must follow.
B. Offering frequent, supportive counseling to address underlying issues.
C. Encouraging the patient to self-monitor their food intake only.
D. Reassuring the patient that their weight will stabilize without further intervention.
Correct answer:
The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors.
Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa.
Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery.
Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse's first action should be to:
A. Take the client's vital signs
B. Restrain the client to prevent injury
C. Obtain a pm order for a psychotropic medication
D. Ask the client for information about his medications
Correct answer:
The correct answer is A: Take the client's vital signs. The first step in assessing any client in the emergency department is to ensure their physiological stability. Vital signs provide essential information about the client's current physical condition, such as heart rate, blood pressure, respiratory rate, and temperature. In this case, the client's alternating states of hyperalertness and difficulty in arousal, disorientation, confusion, agitation, memory impairment, delusions, and misinterpretations of surroundings indicate a potential medical emergency. Therefore, taking the client's vital signs is crucial to determine if there are any immediate life-threatening conditions that need to be addressed promptly.
Summary of other choices:
B: Restrain the client to prevent injury - Restraint should only be used as a last resort for safety concerns and after assessing the client's physical condition.
C: Obtain a PRN order for a psychotropic medication - Administering psychotropic medication should not be the first action without assessing the client's physical condition and
A client with catatonic schizophrenia has been posturing, standing with his left arm upraised and his right foot off the floor. For the most part, he ignores attempts at nursing intervention but will occasionally walk, sit, or lie down for a few minutes. The client eats standing up if the nurse brings a tray to the room. The priority nursing order would be to:
A. Insist that client sit or lie down for 30 minutes hourly
B. Assess for lower extremity edema bid
C. Provide high-calorie drinks hourly
D. Take client to activities therapy once daily
Correct answer:
The correct answer is B: Assess for lower extremity edema bid. It is important to assess for lower extremity edema in this client with catatonic schizophrenia as posturing in a standing position for prolonged periods can lead to decreased circulation and potential development of edema. This assessment is crucial to monitor the client's physical health and prevent complications such as deep vein thrombosis.
Choice A is incorrect as insisting the client sit or lie down for 30 minutes hourly may not address the underlying issue of potential lower extremity edema and could potentially worsen the client's condition by causing distress.
Choice C is incorrect as providing high-calorie drinks hourly does not address the immediate physical health concern of lower extremity edema and may not be appropriate without a comprehensive assessment of the client's nutritional needs.
Choice D is incorrect as taking the client to activities therapy once daily does not address the immediate need for assessing lower extremity edema and may not be suitable if the client's physical health
A 17-year-old client is admitted to the ED after being alternately hyperalert and difficult to arouse. His symptoms all started within the last few hours, during which time he became disoriented and confused. His behavior was agitated and restless, and his memory was impaired, especially for recent events. The client displayed some delusions and misinterpretations of his surroundings. The nurse's first action should be to:
A. Take the client's vital signs
B. Restrain the client to prevent injury
C. Obtain a pm order for a psychotropic medication
D. Ask the client for information about his medications
Correct answer:
The correct answer is A: Take the client's vital signs. The first step in assessing any client in the emergency department is to ensure their physiological stability. Vital signs provide essential information about the client's current physical condition, such as heart rate, blood pressure, respiratory rate, and temperature. In this case, the client's alternating states of hyperalertness and difficulty in arousal, disorientation, confusion, agitation, memory impairment, delusions, and misinterpretations of surroundings indicate a potential medical emergency. Therefore, taking the client's vital signs is crucial to determine if there are any immediate life-threatening conditions that need to be addressed promptly.
Summary of other choices:
B: Restrain the client to prevent injury - Restraint should only be used as a last resort for safety concerns and after assessing the client's physical condition.
C: Obtain a PRN order for a psychotropic medication - Administering psychotropic medication should not be the first action without assessing the client's physical condition and
A patient, aged 82 years, has Alzheimer's disease. She lives with her daughter's family and goes to a day care facility on weekdays. The family cares for her during the evening and at night. Noting the patient had several bruises, the nurse discussed her observations with the daughter, who became defensive and said that her mother was very difficult to manage because she is confused and wanders all night. She says the bruises resulted from a fall down stairs. The daughter states, "I have lost my mother, and I cannot bear it anymore. It is wrecking my family."Â The nursing intervention that should take priority is:
A. Teaching the daughter more about the effects of Alzheimer's disease.
B. Identifying two options for caregiver respite and care assistance at night.
C. Supporting the daughter to grieve the loss of her mother's ability to function.
D. Teaching the family how to give physical care more effectively and efficiently.
Correct answer:
The correct answer is B: Identifying two options for caregiver respite and care assistance at night. This is the priority intervention because it addresses the immediate need to ensure the patient's safety and well-being while also supporting the daughter who is struggling to cope. By identifying options for caregiver respite and care assistance at night, the daughter can get the help she needs to manage her mother's care effectively without feeling overwhelmed. This intervention promotes both the patient's safety and the daughter's mental well-being.
Choices A, C, and D are incorrect:
A: Teaching the daughter more about the effects of Alzheimer's disease. While education is important, in this scenario, the immediate need is to address caregiver respite and care assistance.
C: Supporting the daughter to grieve the loss of her mother's ability to function. While supporting the daughter emotionally is important, ensuring the patient's safety should take priority.
D: Teaching the family how to give physical care more effectively and efficiently. While this is important
What is the most effective strategy for preventing relapse in patients with anorexia nervosa?
A. Providing a strict, rigid meal plan that the patient must follow.
B. Offering frequent, supportive counseling to address underlying issues.
C. Encouraging the patient to self-monitor their food intake only.
D. Reassuring the patient that their weight will stabilize without further intervention.
Correct answer:
The correct answer is B because offering frequent, supportive counseling to address underlying issues is the most effective strategy for preventing relapse in patients with anorexia nervosa. Counseling helps patients explore and work through the root causes of their disorder, such as body image issues, low self-esteem, or past trauma. It also provides ongoing support and guidance in developing healthy coping mechanisms and behaviors.
Choice A is incorrect because providing a strict, rigid meal plan can exacerbate feelings of control and restriction, which are common triggers for relapse in individuals with anorexia nervosa.
Choice C is incorrect as solely focusing on self-monitoring food intake may not address the psychological and emotional factors contributing to the disorder, which are crucial for long-term recovery.
Choice D is incorrect because reassuring the patient that their weight will stabilize without further intervention ignores the complexities of anorexia nervosa and does not address the underlying issues that need to be resolved for sustained recovery.
RN exams geriatric practice questions, set 2 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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