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 child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother reports that the child fell down the stairs in her home. Her mother is with her and describes her as a 'clumsy kid.' The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
A. Bloody nose and blackened eyes
B. Unhealed fractures revealed on x-ray
C. Clinging to her mother as she attempted to leave
D. Struggling with the staff that attempts to obtain a blood specimen
Show answer and rationale
Correct answer: B — Unhealed fractures revealed on x-ray
The correct answer is B - Unhealed fractures revealed on x-ray. This finding indicates chronic physical abuse as unhealed fractures suggest repeated trauma over time. This is concerning because chronic abuse can lead to severe physical and emotional consequences for the child.
A: Bloody nose and blackened eyes may indicate acute physical abuse, but not necessarily chronic abuse.
C: Clinging to her mother as she attempted to leave is a behavior often seen in children who are anxious or scared in a medical setting, but it does not specifically indicate chronic physical abuse.
D: Struggling with the staff that attempts to obtain a blood specimen could be a response to fear or discomfort with medical procedures, which does not definitively point to chronic abuse.
Question 2
Which is an accurate statement regarding gerontological nursing education?
A. Gerontological nursing content has long been integrated into the curriculum of the typical school of nursing.
B. Undergraduate nursing programs extensively cover gerontological nursing in dedicated courses, comparable with the coverage of psychiatric nursing.
C. When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care.
D. Accreditation of a nursing program guarantees that appropriate amounts of gerontological nursing content are included in the curriculum.
Show answer and rationale
Correct answer: C — When content is integrated throughout a curriculum, less than 25% is devoted to geriatric care.
The correct answer is C because it highlights a common issue in nursing education where gerontological nursing content is often underrepresented, with less than 25% of the curriculum dedicated to geriatric care. This is accurate as many nursing programs prioritize other areas over gerontology.
A is incorrect as gerontological nursing integration has historically been lacking in nursing curricula. B is incorrect because undergraduate programs often lack extensive coverage of gerontological nursing compared to other specialties like psychiatric nursing. D is incorrect as accreditation does not guarantee specific proportions of gerontological nursing content in the curriculum. Thus, choice C is the most accurate statement regarding gerontological nursing education.
Question 3
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.' The client has remained delusional since admission. An initial expected outcome would be that the client will:
A. Allow the nurse to logically dispute the delusion
B. Distinguish external boundaries
C. Engage in reality-oriented conversation
D. Explain why she thinks she is the 'Queen of Hearts'
Show answer and rationale
Correct answer: C — Engage in reality-oriented conversation
The correct answer is C: Engage in reality-oriented conversation. This is the most appropriate initial expected outcome because it focuses on helping the client ground herself in reality. Engaging in reality-oriented conversation can help the client understand and acknowledge her delusions, leading to potential insight and eventual treatment.
A: Allowing the nurse to logically dispute the delusion may not be effective initially as the client may not be receptive to this approach during the acute phase of her delusion.
B: Distinguishing external boundaries may not address the underlying delusional beliefs and may not be the most immediate concern.
D: Explaining why she thinks she is the 'Queen of Hearts' may reinforce the delusion rather than challenging it.
Question 4
A patient has acute anxiety related to an automobile accident 2 hours ago. The patient needs teaching about drugs from which group?
A. Tricyclic antidepressants
B. Antipsychotic drugs
C. Antimanic drugs
D. Benzodiazepines
Show answer and rationale
Correct answer: D — Benzodiazepines
The correct answer is D: Benzodiazepines. Benzodiazepines are commonly used in the treatment of acute anxiety due to their rapid onset of action and effectiveness in managing symptoms such as panic attacks. They work by enhancing the inhibitory neurotransmitter GABA, leading to sedative and anxiolytic effects. Tricyclic antidepressants (Choice A) are not the first-line treatment for acute anxiety. Antipsychotic drugs (Choice B) are primarily used for conditions such as schizophrenia and bipolar disorder, not acute anxiety. Antimanic drugs (Choice C) are used to manage symptoms of mania in conditions like bipolar disorder, not acute anxiety. Therefore, the correct choice is Benzodiazepines due to their rapid efficacy and established role in managing acute anxiety.
Question 5
A patient has acute anxiety related to an automobile accident 2 hours ago. The patient needs teaching about drugs from which group?
A. Tricyclic antidepressants
B. Antipsychotic drugs
C. Antimanic drugs
D. Benzodiazepines
Show answer and rationale
Correct answer: D — Benzodiazepines
The correct answer is D: Benzodiazepines. Benzodiazepines are commonly used in the treatment of acute anxiety due to their rapid onset of action and effectiveness in managing symptoms such as panic attacks. They work by enhancing the inhibitory neurotransmitter GABA, leading to sedative and anxiolytic effects. Tricyclic antidepressants (Choice A) are not the first-line treatment for acute anxiety. Antipsychotic drugs (Choice B) are primarily used for conditions such as schizophrenia and bipolar disorder, not acute anxiety. Antimanic drugs (Choice C) are used to manage symptoms of mania in conditions like bipolar disorder, not acute anxiety. Therefore, the correct choice is Benzodiazepines due to their rapid efficacy and established role in managing acute anxiety.
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Question 6
Which instruction has priority when teaching a patient taking clozapine (Clozaril)?
A. Avoid unprotected sex.
B. Report sore throat and fever immediately.
C. Reduce foods high in polyunsaturated fats.
D. Use over-the-counter preparations for rashes.
Correct answer:
The correct answer is B: Report sore throat and fever immediately. This is because clozapine can cause a serious condition called agranulocytosis, which is characterized by a dangerously low white blood cell count. Sore throat and fever can be early signs of this condition, so it is crucial to report them immediately to prevent serious complications.
Avoiding unprotected sex (choice A) is important for overall health but is not directly related to clozapine use. Reducing foods high in polyunsaturated fats (choice C) is not a priority as it does not impact the safety or effectiveness of clozapine. Using over-the-counter preparations for rashes (choice D) is not advised as rashes can be a side effect of clozapine, and professional medical advice should be sought.
At 11:00 AM, a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol). However, he last had it at 8:00 AM, and it is ordered only every 4 hours. Which nursing response would be most therapeutic?
A. I'm sorry, it's not quite time yet; please come back again in 1 hour.'
B. I'm sorry, it's not quite time yet; please come back again at 12 noon.'
C. It's not time yet; please come back when both hands of the clock point straight up.'
D. It's not time yet; I will let you know when it is time. Perhaps a nap would help?'
Correct answer:
The correct answer is C because it provides a clear, concrete instruction that the patient can easily understand. By stating "come back when both hands of the clock point straight up," the nurse offers a specific and visual cue for the patient to know when it's time for the medication. This approach aligns with the patient's concrete thinking and helps him grasp the concept of time more effectively.
Choice A is incorrect because stating "in 1 hour" may be too abstract for a patient with concrete thinking. Choice B is also incorrect as it provides a general time frame without a visual reference, which may confuse the patient. Choice D is incorrect as suggesting a nap does not address the patient's request for medication and does not provide a clear time frame.
A student transfers from a hometown college to a university 200 miles away after breaking up with her boyfriend of 2 years. She was slow to make friends at the university. The history shows a close relationship with her mother and sister. She began eating large quantities when she felt sad, and then she induced vomiting. When the student's schoolwork declined, she sought help from the university health clinic. During the initial interview, what priority issue should the nurse address?
A. Losses
B. Sleep patterns
C. School activities
D. Menstrual flow
Correct answer:
The correct answer is A: Losses. The priority issue the nurse should address is the student's recent breakup and difficulty making friends, which are significant losses impacting her emotional well-being. By addressing these losses, the nurse can help the student process her emotions and develop coping strategies.
B: Sleep patterns may be affected by the student's emotional distress, but it is a secondary concern compared to addressing the underlying losses.
C: School activities are important, but the root cause of the student's decline in schoolwork is likely related to her emotional state following the breakup.
D: Menstrual flow is not the priority issue at this time as it is not directly related to the student's emotional struggles and academic decline.
The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:
A. Supporting the client during curative care
B. Providing support for family, relatives, and caregivers
C. Arranging for nursing home placement
D. Tracking the progress of medical, legal, and financial records
Correct answer:
The correct answer is B: Providing support for family, relatives, and caregivers. This is because Alzheimer's disease not only affects the individual but also has a significant impact on their family and caregivers. Providing support to them is crucial for maintaining the overall well-being of the client. Choice A is incorrect as Alzheimer's disease does not have a curative treatment. Choice C is incorrect as nursing home placement is not always necessary and should be considered as a last resort. Choice D is incorrect as tracking medical, legal, and financial records is important but not a major goal in the care plan for Alzheimer's clients. Supporting the family and caregivers helps in creating a supportive environment for the client and ensures holistic care.
The nurse is aware, when developing a care plan, that the three major goals of care for the client in whom Alzheimer's disease has been diagnosed include providing for the client's safety and well-being, therapeutically managing the client's behaviors, and:
A. Supporting the client during curative care
B. Providing support for family, relatives, and caregivers
C. Arranging for nursing home placement
D. Tracking the progress of medical, legal, and financial records
Correct answer:
The correct answer is B: Providing support for family, relatives, and caregivers. This is because Alzheimer's disease not only affects the individual but also has a significant impact on their family and caregivers. Providing support to them is crucial for maintaining the overall well-being of the client. Choice A is incorrect as Alzheimer's disease does not have a curative treatment. Choice C is incorrect as nursing home placement is not always necessary and should be considered as a last resort. Choice D is incorrect as tracking medical, legal, and financial records is important but not a major goal in the care plan for Alzheimer's clients. Supporting the family and caregivers helps in creating a supportive environment for the client and ensures holistic care.
An elderly woman is brought to the clinic by her daughter. The client states that she has had a cold for several days. Her daughter states that her mother has been confused about when her routine medications are to be taken and that her mother has never experienced confusion before. Based on this information, it is important that the nurse ask the client whether:
A. There is a history of mental illness in the family.
B. She has been given a diagnosis of a mental health disorder in the past.
C. She can recall her last visit to a physician.
D. None of the above.
Correct answer:
The correct answer is A: There is a history of mental illness in the family. This is important because the sudden onset of confusion in an elderly person could be indicative of a new mental health issue or cognitive decline. Asking about a family history of mental illness can provide valuable insights into potential genetic predispositions or underlying conditions that may be contributing to the client's confusion.
Choices B and C are incorrect because the client's own history of mental health diagnosis or ability to recall a physician visit are not directly related to the sudden onset of confusion. Choice D is incorrect because asking about a family history of mental illness could provide crucial information in understanding the client's current condition.
A male patient diagnosed with paranoid schizophrenia typically relates effectively with female staff but angrily tells the male nurse, 'You act like a homosexual. None of the men trust you or want to be around you.' The nurse, who is heterosexual, is perplexed by the patient's statements and discusses the event with his mentor. Which explanation most likely underlies the patient's behavior?
A. The patient was unleashing unconscious, hostile feelings toward the nurse.
B. The patient feared the nurse would reject him, so he coped by rejecting the nurse first.
C. It was the patient's way of distancing himself from potential emotional intimacy.
D. The patient was coping with homosexual urges by projecting them onto the nurse.
Correct answer:
The correct answer is D because the patient's accusation of the nurse being homosexual and implying that other men do not trust him or want to be around him suggests projection of the patient's own homosexual urges onto the nurse. This defense mechanism of projection helps the patient avoid acknowledging and dealing with his own uncomfortable feelings by attributing them to someone else.
Option A is incorrect because the patient's behavior is more about projecting feelings onto the nurse rather than unconscious hostility. Option B is incorrect as it focuses on the patient's fear of rejection rather than projecting his own feelings onto the nurse. Option C is incorrect as it does not address the specific dynamic of projecting homosexual urges onto the nurse.
Which behavior would the nurse expect to observe in a person who commits psychic rape?
A. The perpetrator gives money to the patient after the rape.
B. The perpetrator seduces the patient by providing wine, flowers, and music.
C. The perpetrator threatens the patient to submit or else be severely beaten.
D. The perpetrator mentions always including violent bondage in sexual activities.
Correct answer:
The correct answer is D because mentioning violent bondage in sexual activities indicates a pattern of behavior associated with psychic rape, where the perpetrator exerts control and inflicts harm on the victim. This choice aligns with the power dynamics and manipulation typically seen in cases of psychic rape.
A: Giving money after the rape does not necessarily indicate psychic rape and is more characteristic of bribery or transactional behavior.
B: Seduction with wine, flowers, and music may indicate manipulation but does not specifically relate to the psychological violation inherent in psychic rape.
C: Threatening the patient with violence is a form of physical coercion rather than psychic rape, which involves psychological manipulation and violation.
A child, age 9, is being evaluated in the Emergency Department at the hospital. Her mother reports that the child fell down the stairs in her home. Her mother is with her and describes her as a 'clumsy kid.' The nurse practitioner suspects child abuse. Which of these findings indicates that physical abuse may be a chronic problem for the child?
A. Bloody nose and blackened eyes
B. Unhealed fractures revealed on x-ray
C. Clinging to her mother as she attempted to leave
D. Struggling with the staff that attempts to obtain a blood specimen
Correct answer:
The correct answer is B - Unhealed fractures revealed on x-ray. This finding indicates chronic physical abuse as unhealed fractures suggest repeated trauma over time. This is concerning because chronic abuse can lead to severe physical and emotional consequences for the child.
A: Bloody nose and blackened eyes may indicate acute physical abuse, but not necessarily chronic abuse.
C: Clinging to her mother as she attempted to leave is a behavior often seen in children who are anxious or scared in a medical setting, but it does not specifically indicate chronic physical abuse.
D: Struggling with the staff that attempts to obtain a blood specimen could be a response to fear or discomfort with medical procedures, which does not definitively point to chronic abuse.
At 11:00 AM, a patient with schizophrenia who exhibits concrete thinking asks the nurse for PRN acetaminophen (Tylenol). However, he last had it at 8:00 AM, and it is ordered only every 4 hours. Which nursing response would be most therapeutic?
A. I'm sorry, it's not quite time yet; please come back again in 1 hour.'
B. I'm sorry, it's not quite time yet; please come back again at 12 noon.'
C. It's not time yet; please come back when both hands of the clock point straight up.'
D. It's not time yet; I will let you know when it is time. Perhaps a nap would help?'
Correct answer:
The correct answer is C because it provides a clear, concrete instruction that the patient can easily understand. By stating "come back when both hands of the clock point straight up," the nurse offers a specific and visual cue for the patient to know when it's time for the medication. This approach aligns with the patient's concrete thinking and helps him grasp the concept of time more effectively.
Choice A is incorrect because stating "in 1 hour" may be too abstract for a patient with concrete thinking. Choice B is also incorrect as it provides a general time frame without a visual reference, which may confuse the patient. Choice D is incorrect as suggesting a nap does not address the patient's request for medication and does not provide a clear time frame.
RN exams geriatric practice questions, set 21 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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