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 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, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. 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. Exploring the possibility of patient social isolation.
D. Asking the patient to disrobe to check for signs of abuse.
Show answer and rationale
Correct answer: B — Completing a structured abuse assessment protocol.
The correct answer is B: Completing a structured abuse assessment protocol. Given the patient's vague complaints, tension, reluctance to provide more information, and hurry to leave, these could be signs of potential abuse. Completing a structured abuse assessment protocol allows the nurse to systematically assess for any signs of abuse, which could be contributing to the patient's somatic complaints. This approach is necessary to ensure the patient's safety and well-being.
Incorrect choices:
A: Asking if the patient has ever had psychiatric counseling - This choice does not directly address the potential abuse concerns indicated by the patient's behavior.
C: Exploring the possibility of patient social isolation - While social isolation could be a contributing factor, the urgency to leave and reluctance to provide information are more indicative of potential abuse.
D: Asking the patient to disrobe to check for signs of abuse - This choice is invasive and inappropriate without first completing a structured abuse assessment protocol to determine if abuse is likely.
Question 2
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
Show answer and rationale
Correct answer: B — Assess for lower extremity edema bid
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
Question 3
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." 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.
Show answer and rationale
Correct answer: B — Identifying two options for caregiver respite and care assistance at night.
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
Question 4
A patient with swelling and a laceration above the right eye states, 'I don't know what caused me to fall and cut my head on the door frame in my bedroom. I'm lucky my spouse was home to take me to the hospital.' The patient's spouse appears nervous but smiles when mentioning that the patient is 'so clumsy at times.' Which nursing intervention should the nurse give priority attention to when addressing this patient's needs?
A. Provide a thorough assessment that includes a focus on signs of old injuries.
B. Interview the patient regarding the circumstances surrounding this suspicious fall.
C. Directly ask the patient if spousal abuse is occurring or has ever occurred.
D. Notify security that there is a possibility that this patient is a victim of physical abuse.
Show answer and rationale
Correct answer: A — Provide a thorough assessment that includes a focus on signs of old injuries.
The correct answer is A: Provide a thorough assessment that includes a focus on signs of old injuries. This is the priority intervention because the patient's statement, combined with the spouse's behavior, raises suspicion of potential domestic abuse. By assessing for signs of old injuries, the nurse can gather crucial information to determine if the patient is a victim of abuse.
Choice B: Interview the patient regarding the circumstances surrounding this suspicious fall may be important, but assessing for signs of old injuries takes priority as it provides concrete evidence of potential abuse.
Choice C: Directly ask the patient if spousal abuse is occurring or has ever occurred is necessary, but the patient may not feel comfortable disclosing abuse directly. Assessing for old injuries can provide objective evidence.
Choice D: Notify security that there is a possibility that this patient is a victim of physical abuse is premature without concrete evidence. Assessing for old injuries should be done first to gather information before taking further action.
Question 5
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, headaches, and sleep disturbance. The patient seems tense, and after having spoken of the symptoms, seems reluctant to provide more information and is in a hurry to leave. 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. Exploring the possibility of patient social isolation.
D. Asking the patient to disrobe to check for signs of abuse.
Show answer and rationale
Correct answer: B — Completing a structured abuse assessment protocol.
The correct answer is B: Completing a structured abuse assessment protocol. Given the patient's vague complaints, tension, reluctance to provide more information, and hurry to leave, these could be signs of potential abuse. Completing a structured abuse assessment protocol allows the nurse to systematically assess for any signs of abuse, which could be contributing to the patient's somatic complaints. This approach is necessary to ensure the patient's safety and well-being.
Incorrect choices:
A: Asking if the patient has ever had psychiatric counseling - This choice does not directly address the potential abuse concerns indicated by the patient's behavior.
C: Exploring the possibility of patient social isolation - While social isolation could be a contributing factor, the urgency to leave and reluctance to provide information are more indicative of potential abuse.
D: Asking the patient to disrobe to check for signs of abuse - This choice is invasive and inappropriate without first completing a structured abuse assessment protocol to determine if abuse is likely.
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Question 6
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
A. Explain that others eat the food and are not harmed
B. Allow client to select food from vending machines
C. Assist client with personal hygiene and grooming
D. Not allow client to verbalize delusional thoughts
Correct answer:
The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his specific delusion of food being poisoned. By allowing the client to select food from vending machines, he can choose items he believes are safe, which can help alleviate his paranoia and increase his trust in the care being provided. This approach promotes a therapeutic relationship and empowers the client in making choices about his care.
Explanation of why other choices are incorrect:
A: Explaining that others eat the food and are not harmed may not be effective as the client's delusion is strong, and rational arguments may not be helpful in this case.
C: Assisting with personal hygiene and grooming is important but does not directly address the client's delusion about food being poisoned.
D: Not allowing the client to verbalize delusional thoughts can escalate the client's distress and hinder the therapeutic relationship. It is essential to acknowledge the client's experiences and work towards building trust and rapport
A 63-year-old female has been admitted to the hospital for cholecystitis. She is accompanied by her sister, who provides all the assessment data while the client sits and stares somewhat vacantly. You determine that the client is single, lives alone, and lost her job as a secretary last year when she was unable to learn a new computer system. The sister states she has recently had to manage the client's shopping, meal preparation, and finances. Which of the following are appropriate nursing diagnoses?
A. Pain, self-care deficits, situational low self-esteem
B. Anxiety, self-care deficits, disturbed thought processes
C. Impaired home maintenance, disturbed thought process, impaired verbal communication
D. Disturbed body image, anxiety, pain
Correct answer:
The correct answer is C: Impaired home maintenance, disturbed thought process, impaired verbal communication.
Rationale:
1. Impaired home maintenance: The client is unable to take care of herself and her living environment due to the need for assistance in shopping, meal preparation, and finances.
2. Disturbed thought process: The client's vacant stare and inability to learn new tasks suggest cognitive impairment or confusion.
3. Impaired verbal communication: The client's lack of verbal interaction and reliance on her sister for assessment data indicate difficulties in expressing herself.
Summary:
A: Pain, self-care deficits, situational low self-esteem - Pain is not mentioned in the scenario, and the client's issues go beyond self-care deficits and low self-esteem.
B: Anxiety, self-care deficits, disturbed thought processes - While anxiety and disturbed thought processes may be present, impaired home maintenance and impaired verbal communication are more appropriate diagnoses based on the scenario.
D: Disturbed body image, anxiety, pain - Disturbed
A nurse planning teaching for a parent group concerned with preventing family violence can discuss the fact that exposure to violence in the media:
A. Has no effect on the increase of violence in society
B. Assists individuals to distinguish appropriate behaviors from inappropriate behaviors
C. Desensitizes people to the violence around them
D. Broadens the viewer's knowledge about world happenings
Correct answer:
The correct answer is C: Desensitizes people to the violence around them. Exposure to violence in the media can desensitize individuals, leading them to become less sensitive or responsive to violent acts in real life. This desensitization can contribute to a normalization of violence and reduce the perceived severity of violent behaviors. This can potentially lead to an increase in tolerance for violence in society.
Incorrect choices:
A: Has no effect on the increase of violence in society - This is incorrect because research has shown that exposure to media violence can have an impact on behavior.
B: Assists individuals to distinguish appropriate behaviors from inappropriate behaviors - This is incorrect as exposure to violence in the media may blur the lines between appropriate and inappropriate behaviors.
D: Broadens the viewer's knowledge about world happenings - This is incorrect as exposure to violence in the media may not necessarily lead to a broader understanding of world events, especially if the focus is on sensationalized or graphic content.
In the document “Recommended Baccalaureate Competencies and Curricular Guidelines for the Nursing Care of Older Adults” developed by the American Association of Colleges of Nursing and the Hartford Institute for Geriatric Nursing, recommendations include which of the following?
A. Provision of a free-standing course in gerontology within the curriculum
B. Integration of gerontological content throughout the curriculum
C. Requirement of gerontological certification for all students before completion of a BSN program
D. Structured clinical experiences with older adults across the continuum of care
Correct answer:
The correct answer is B: Integration of gerontological content throughout the curriculum. This is because integrating gerontological content throughout the curriculum ensures that nursing students are exposed to and learn about caring for older adults in various courses, rather than just in a standalone course. This approach better prepares students to provide holistic care to older adults in different clinical settings.
A: Provision of a free-standing course in gerontology within the curriculum may limit exposure to gerontological content and may not provide a comprehensive understanding of caring for older adults.
C: Requiring gerontological certification for all students before completion of a BSN program is not mentioned in the document and may not be feasible or necessary for all nursing students.
D: While structured clinical experiences with older adults across the continuum of care are essential, this alone may not ensure that students receive a comprehensive education in gerontological care if the content is not integrated throughout the curriculum.
The client tells the nurse, 'I thought my psychiatrist was the best doctor in the world. I thought he understood me completely. Now, I hate him! He doesn't understand me at all. He's just dumping me to go on a 2-week vacation.' The nurse assesses the client's description of feelings about the physician as evidence of the use of:
A. Splitting
B. Projective identification
C. Isolation of affect
D. Dissociation
Correct answer:
The correct answer is A: Splitting. Splitting is a defense mechanism where a person sees things in extremes of either all good or all bad. In this scenario, the client initially idealizes the psychiatrist as the best doctor, then suddenly devalues and hates him for taking a vacation, indicating a shift from all good to all bad. This extreme change in perception is characteristic of splitting.
B: Projective identification involves projecting one's own feelings onto another person and then identifying with those projected feelings. This choice does not fit the scenario as the client is not projecting their feelings onto the psychiatrist.
C: Isolation of affect refers to the separation of feelings from ideas and events. The client's strong emotions towards the psychiatrist do not demonstrate a lack of emotional expression or detachment from feelings.
D: Dissociation is a defense mechanism where thoughts, feelings, and experiences are separated from conscious awareness. The client's reaction does not suggest a disconnection from reality or consciousness.
A patient with swelling and a laceration above the right eye states, 'I don't know what caused me to fall and cut my head on the door frame in my bedroom. I'm lucky my spouse was home to take me to the hospital.' The patient's spouse appears nervous but smiles when mentioning that the patient is 'so clumsy at times.' Which nursing intervention should the nurse give priority attention to when addressing this patient's needs?
A. Provide a thorough assessment that includes a focus on signs of old injuries.
B. Interview the patient regarding the circumstances surrounding this suspicious fall.
C. Directly ask the patient if spousal abuse is occurring or has ever occurred.
D. Notify security that there is a possibility that this patient is a victim of physical abuse.
Correct answer:
The correct answer is A: Provide a thorough assessment that includes a focus on signs of old injuries. This is the priority intervention because the patient's statement, combined with the spouse's behavior, raises suspicion of potential domestic abuse. By assessing for signs of old injuries, the nurse can gather crucial information to determine if the patient is a victim of abuse.
Choice B: Interview the patient regarding the circumstances surrounding this suspicious fall may be important, but assessing for signs of old injuries takes priority as it provides concrete evidence of potential abuse.
Choice C: Directly ask the patient if spousal abuse is occurring or has ever occurred is necessary, but the patient may not feel comfortable disclosing abuse directly. Assessing for old injuries can provide objective evidence.
Choice D: Notify security that there is a possibility that this patient is a victim of physical abuse is premature without concrete evidence. Assessing for old injuries should be done first to gather information before taking further action.
A client who has been diagnosed as having paranoid schizophrenia is highly suspicious and delusional. He hears voices telling him terrorists are plotting to assassinate him. He refuses to eat, saying the food is poisoned. The nursing action that best addresses his needs is to:
A. Explain that others eat the food and are not harmed
B. Allow client to select food from vending machines
C. Assist client with personal hygiene and grooming
D. Not allow client to verbalize delusional thoughts
Correct answer:
The correct answer is B: Allow client to select food from vending machines. This option respects the client's autonomy and addresses his specific delusion of food being poisoned. By allowing the client to select food from vending machines, he can choose items he believes are safe, which can help alleviate his paranoia and increase his trust in the care being provided. This approach promotes a therapeutic relationship and empowers the client in making choices about his care.
Explanation of why other choices are incorrect:
A: Explaining that others eat the food and are not harmed may not be effective as the client's delusion is strong, and rational arguments may not be helpful in this case.
C: Assisting with personal hygiene and grooming is important but does not directly address the client's delusion about food being poisoned.
D: Not allowing the client to verbalize delusional thoughts can escalate the client's distress and hinder the therapeutic relationship. It is essential to acknowledge the client's experiences and work towards building trust and rapport
A nurse planning teaching for a parent group concerned with preventing family violence can discuss the fact that exposure to violence in the media:
A. Has no effect on the increase of violence in society
B. Assists individuals to distinguish appropriate behaviors from inappropriate behaviors
C. Desensitizes people to the violence around them
D. Broadens the viewer's knowledge about world happenings
Correct answer:
The correct answer is C: Desensitizes people to the violence around them. Exposure to violence in the media can desensitize individuals, leading them to become less sensitive or responsive to violent acts in real life. This desensitization can contribute to a normalization of violence and reduce the perceived severity of violent behaviors. This can potentially lead to an increase in tolerance for violence in society.
Incorrect choices:
A: Has no effect on the increase of violence in society - This is incorrect because research has shown that exposure to media violence can have an impact on behavior.
B: Assists individuals to distinguish appropriate behaviors from inappropriate behaviors - This is incorrect as exposure to violence in the media may blur the lines between appropriate and inappropriate behaviors.
D: Broadens the viewer's knowledge about world happenings - This is incorrect as exposure to violence in the media may not necessarily lead to a broader understanding of world events, especially if the focus is on sensationalized or graphic content.
A short-term goal for a patient with anorexia nervosa is 'Patient will select and eat a balanced diet.' The nurse writes which of the following nursing interventions into the care plan that will foster attainment of this goal?
A. Allow patient to weigh self every time a meal is completely eaten.
B. Assist the patient to fill out the dietary menus to ensure a balanced diet.
C. Encourage the patient to engage in only appropriate compensatory exercise.
D. Implement contracted consequences 50% of the time if a meal is not completed.
Correct answer:
The correct answer is B: Assist the patient to fill out the dietary menus to ensure a balanced diet. This intervention is appropriate because it directly supports the goal of the patient selecting and eating a balanced diet. By assisting the patient in filling out dietary menus, the nurse can help the patient make informed choices about their food intake, ensuring they are consuming a variety of nutrients necessary for a balanced diet. This intervention promotes patient autonomy and education, empowering the patient to make healthier choices.
Choice A is incorrect because allowing the patient to weigh themselves every time a meal is eaten does not directly address the goal of selecting and eating a balanced diet.
Choice C is incorrect because encouraging compensatory exercise may lead to unhealthy behaviors and does not focus on achieving a balanced diet.
Choice D is incorrect because implementing contracted consequences for incomplete meals may create a negative environment and does not promote a positive approach to achieving a balanced diet.
What is the most important aspect of nursing care for patients with anorexia nervosa during refeeding?
A. Refeed the patient with high-calorie foods quickly to gain weight.
B. Start with small, manageable portions and gradually increase caloric intake.
C. Restrict food choices to healthy foods only.
D. Encourage the patient to take food supplements in addition to meals.
Correct answer:
The correct answer is B: Start with small, manageable portions and gradually increase caloric intake. This approach is essential because refeeding syndrome can occur in patients with anorexia nervosa, where rapid refeeding can lead to severe electrolyte imbalances and potentially life-threatening complications. Starting with small portions helps to prevent this syndrome by allowing the body to gradually adjust to increased caloric intake. Additionally, it helps in preventing overwhelming the patient with large amounts of food, which can trigger anxiety and resistance to eating.
Incorrect choices:
A: Refeed the patient with high-calorie foods quickly to gain weight - This can lead to refeeding syndrome and is not a safe approach.
C: Restrict food choices to healthy foods only - Restricting food choices can exacerbate disordered eating behaviors and does not address the need for gradual refeeding.
D: Encourage the patient to take food supplements in addition to meals - While supplements can be helpful, they should not be a primary focus over balanced
RN exams geriatric practice questions, set 3 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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