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 nurse is caring for a patient with anorexia nervosa who is refusing to eat. What should the nurse do first?
A. Provide a structured meal plan and encourage the patient to eat.
B. Avoid discussing food intake to reduce anxiety.
C. Allow the patient to skip meals to avoid pressure.
D. Offer incentives for eating a full meal.
Show answer and rationale
Correct answer: A — Provide a structured meal plan and encourage the patient to eat.
The correct answer is A: Provide a structured meal plan and encourage the patient to eat. This is the first step because patients with anorexia nervosa often struggle with disordered eating behaviors and need guidance and support to establish healthy eating habits. Providing a structured meal plan helps the patient understand the importance of regular and balanced meals. Encouraging the patient to eat helps address their resistance and fear around food.
Incorrect choices:
B: Avoid discussing food intake to reduce anxiety - This choice is incorrect because avoiding discussing food intake does not address the underlying issue and may perpetuate the patient's disordered eating behavior.
C: Allow the patient to skip meals to avoid pressure - Allowing the patient to skip meals enables their unhealthy behavior and does not promote recovery.
D: Offer incentives for eating a full meal - While incentives may be used as a motivational tool, they do not address the core issue of establishing a healthy relationship with food.
Question 2
The nurse plans activities for older women born between 1920 and 1930 and who reside in an assisted-living facility. Which is the best intervention for the nurse to implement?
A. Have them bake cookies twice a week.
B. Conduct interviews for specific interests.
C. Arrange dog and cat visits from volunteers.
D. Take them to the library for guest speakers.
Show answer and rationale
Correct answer: B — Conduct interviews for specific interests.
The correct answer is B: Conduct interviews for specific interests. This intervention allows the nurse to tailor activities to the individual preferences of the older women, promoting engagement and a sense of autonomy. By conducting interviews, the nurse can identify each person's unique interests and preferences, ensuring that the activities planned are meaningful and enjoyable for them. This personalized approach enhances the overall well-being of the residents.
Choices A, C, and D are incorrect because they do not focus on individual interests and preferences. While baking cookies, arranging pet visits, and attending library events can be enjoyable activities for some individuals, they may not be suitable or engaging for all residents in the specified age group and setting. These options lack the personalization and customization that conducting interviews for specific interests provides, making them less effective in meeting the diverse needs and preferences of the older women in the assisted-living facility.
Question 3
According to Healthy People 2020, older adults have been identified as a priority, with a goal to improve their health, function, and quality of life. Identify the targeted chronic focus areas for improvement.
A. Diabetes
B. Arthritis
C. Congestive heart failure
D. Dementia
Show answer and rationale
Correct answer: A — Diabetes
The correct answer is A: Diabetes. Healthy People 2020 focuses on improving the health of older adults, and diabetes is a chronic condition prevalent in this population. It can significantly impact health, function, and quality of life if not managed properly. Diabetes can lead to complications such as heart disease, stroke, kidney disease, and vision problems. By targeting diabetes, the goal is to prevent these complications and improve overall health outcomes for older adults.
Summary of why other choices are incorrect:
B: Arthritis - While arthritis is common in older adults, it is not a targeted chronic focus area identified by Healthy People 2020 for this population.
C: Congestive heart failure - Although heart health is important, congestive heart failure is not specifically highlighted as a priority for improvement in older adults by Healthy People 2020.
D: Dementia - Dementia is a serious concern in the aging population, but it is not one of the targeted chronic focus areas identified by Healthy People 202
Question 4
While auditing care plans for clients with eating disorders, the nurse realizes that a nursing diagnosis appropriate for a client with anorexia nervosa as well as for a client with bulimia nervosa is:
A. ineffective denial.
B. adult failure to thrive.
C. chronic low self-esteem.
D. risk for imbalanced body temperature.
Show answer and rationale
Correct answer: C — chronic low self-esteem.
Rationale for Correct Answer (C): Chronic low self-esteem is appropriate for both anorexia nervosa and bulimia nervosa clients as these disorders are often associated with poor body image and low self-worth. Clients with these disorders commonly struggle with feelings of inadequacy and self-criticism, leading to chronic low self-esteem. This nursing diagnosis addresses the underlying emotional issues that are prevalent in both anorexia and bulimia.
Summary of Incorrect Choices:
A: Ineffective denial is not appropriate as clients with these disorders are often aware of their condition and may even have distorted perceptions about their body image.
B: Adult failure to thrive is not suitable as this nursing diagnosis is typically used for older adults who are experiencing a decline in health and functioning, not specifically related to eating disorders.
D: Risk for imbalanced body temperature is not relevant as it does not address the psychological and emotional aspects that are central to anorexia and bulimia.
Question 5
A nurse's family has moved to a rural area to be near her spouse's aging parents. What might the nurse notice about the family's new environment? Select all that apply.
A. It is very difficult to obtain continuing education, except for online programs.
B. Neighbors seem to expect the nurse to know everything about all health care and illness conditions.
C. Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are.
D. People come to the health clinic before their situation becomes relatively serious.
Show answer and rationale
Correct answer: B — Neighbors seem to expect the nurse to know everything about all health care and illness conditions.
Step 1: The correct answer is B because it reflects the phenomenon known as "role engulfment." In rural areas, individuals may perceive healthcare professionals as having a broader knowledge base due to limited access to healthcare resources.
Step 2: This expectation can lead neighbors to ask the nurse for advice on various health issues, assuming she has expertise in all areas of healthcare.
Step 3: This can create challenges for the nurse in setting boundaries and managing expectations within the community.
Step 4: Choices A, C, and D are incorrect as they do not directly address the unique challenge of role engulfment faced by healthcare professionals in rural areas.
Step 5: Choice A focuses on continuing education, which may or may not be a challenge in rural areas but is not directly related to the nurse's role perception by neighbors.
Step 6: Choice C addresses general health inquiries but does not specifically highlight the issue of role engulfment.
Step 7: Choice D describes proactive healthcare
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Question 6
The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?
A. This disorder responds well to treatment and, with follow-up, may not recur.'
B. All types of schizophrenia are chronic relapsing disorders.'
C. Outcomes are poor related to client prehospital disorganization.'
D. The usual outcome is that only partial remission is achieved.'
Correct answer:
The correct answer is A: "This disorder responds well to treatment and, with follow-up, may not recur."
Rationale:
1. Paranoid schizophrenia typically responds well to treatment, especially with early intervention.
2. With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and lead fulfilling lives.
3. Follow-up care and support are crucial in maintaining stability and preventing relapses.
Summary of why other choices are incorrect:
B: All types of schizophrenia are chronic relapsing disorders - This is not accurate as outcomes can vary depending on the subtype of schizophrenia.
C: Outcomes are poor related to client prehospital disorganization - This statement is too general and does not specifically address the prognosis of paranoid schizophrenia.
D: The usual outcome is that only partial remission is achieved - This is not always the case, as many individuals with paranoid schizophrenia can achieve full remission with appropriate treatment.
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. None of the above.
Correct answer:
The correct answer is B. Providing support for family, relatives, and caregivers is crucial in the care of a client with Alzheimer's disease as it helps to ensure a holistic approach to care. Family members and caregivers often experience significant stress and burden in caring for someone with Alzheimer's, so providing support to them can improve the overall quality of care for the client. Additionally, involving family and caregivers in the care plan can help in maintaining continuity and consistency in the client's care.
Other choices are incorrect because:
A: Supporting the client during curative care is not applicable in Alzheimer's disease as there is currently no cure for the condition.
C: Arranging for nursing home placement may be necessary in some cases, but it is not one of the three major goals of care for a client with Alzheimer's disease.
D: None of the above is incorrect as providing support for family, relatives, and caregivers is a critical aspect of care for clients with Alzheimer's disease.
In managing older adults with Alzheimer's disease, what is the most effective approach to improve quality of life?
A. Pharmacological management of behavioral symptoms only
B. Non-pharmacological interventions such as music therapy and structured routines
C. Complete physical immobilization to reduce confusion
D. Using sedatives to manage agitation
Correct answer:
The most effective approach to improve quality of life in older adults with Alzheimer's disease is non-pharmacological interventions like music therapy and structured routines. This is because these interventions have been shown to reduce behavioral symptoms, enhance cognitive function, and promote overall well-being without the potential side effects of pharmacological treatments. Music therapy can help calm and stimulate memory recall, while structured routines provide predictability and familiarity, reducing confusion and agitation. Pharmacological management of behavioral symptoms alone may not address the root causes of the behaviors and can lead to adverse effects. Physical immobilization is harmful and can worsen cognitive decline. Sedatives can have detrimental effects on cognition and may increase the risk of falls and other complications. Therefore, non-pharmacological interventions are the most effective and holistic approach to enhancing the quality of life for older adults with Alzheimer's disease.
While auditing care plans for clients with eating disorders, the nurse realizes that a nursing diagnosis appropriate for a client with anorexia nervosa as well as for a client with bulimia nervosa is:
A. ineffective denial.
B. adult failure to thrive.
C. chronic low self-esteem.
D. risk for imbalanced body temperature.
Correct answer:
Rationale for Correct Answer (C): Chronic low self-esteem is appropriate for both anorexia nervosa and bulimia nervosa clients as these disorders are often associated with poor body image and low self-worth. Clients with these disorders commonly struggle with feelings of inadequacy and self-criticism, leading to chronic low self-esteem. This nursing diagnosis addresses the underlying emotional issues that are prevalent in both anorexia and bulimia.
Summary of Incorrect Choices:
A: Ineffective denial is not appropriate as clients with these disorders are often aware of their condition and may even have distorted perceptions about their body image.
B: Adult failure to thrive is not suitable as this nursing diagnosis is typically used for older adults who are experiencing a decline in health and functioning, not specifically related to eating disorders.
D: Risk for imbalanced body temperature is not relevant as it does not address the psychological and emotional aspects that are central to anorexia and bulimia.
A nursing intervention that will be planned to occur early in the nurse-patient relationship with a client with an eating disorder is:
A. formulating a nurse-client contract.
B. using confrontation to attack denial.
C. placing the client in a therapeutic group.
D. attacking enmeshment by separating client and family.
Correct answer:
The correct answer is A: formulating a nurse-client contract. This intervention is essential early in the nurse-patient relationship with a client with an eating disorder because it establishes clear boundaries, roles, and expectations. By creating a contract, both the nurse and the client can communicate openly about their goals, responsibilities, and treatment plan. This helps build trust, promotes collaboration, and provides a framework for the therapeutic relationship.
Choices B, C, and D are incorrect:
B: Using confrontation to attack denial may be counterproductive and harmful in the early stages of the relationship as it can lead to resistance and damage trust.
C: Placing the client in a therapeutic group may be beneficial at a later stage but not necessarily an appropriate early intervention when individual needs should be addressed first.
D: Attacking enmeshment by separating client and family is not a suitable early intervention as it may cause distress and disrupt important support systems.
A nurse's family has moved to a rural area to be near her spouse's aging parents. What might the nurse notice about the family's new environment? Select all that apply.
A. It is very difficult to obtain continuing education, except for online programs.
B. Neighbors seem to expect the nurse to know everything about all health care and illness conditions.
C. Neighbors ask questions about health concerns any time they see the nurse, regardless of where they are.
D. People come to the health clinic before their situation becomes relatively serious.
Correct answer:
Step 1: The correct answer is B because it reflects the phenomenon known as "role engulfment." In rural areas, individuals may perceive healthcare professionals as having a broader knowledge base due to limited access to healthcare resources.
Step 2: This expectation can lead neighbors to ask the nurse for advice on various health issues, assuming she has expertise in all areas of healthcare.
Step 3: This can create challenges for the nurse in setting boundaries and managing expectations within the community.
Step 4: Choices A, C, and D are incorrect as they do not directly address the unique challenge of role engulfment faced by healthcare professionals in rural areas.
Step 5: Choice A focuses on continuing education, which may or may not be a challenge in rural areas but is not directly related to the nurse's role perception by neighbors.
Step 6: Choice C addresses general health inquiries but does not specifically highlight the issue of role engulfment.
Step 7: Choice D describes proactive healthcare
The wife of a client newly diagnosed with paranoid schizophrenia asks the nurse, 'My husband was well adjusted until a month ago, and then, after a lot of work stress, he got sick. What can I expect? Will he be this sick for the rest of his life?' What information can the nurse provide about prognosis?
A. This disorder responds well to treatment and, with follow-up, may not recur.'
B. All types of schizophrenia are chronic relapsing disorders.'
C. Outcomes are poor related to client prehospital disorganization.'
D. The usual outcome is that only partial remission is achieved.'
Correct answer:
The correct answer is A: "This disorder responds well to treatment and, with follow-up, may not recur."
Rationale:
1. Paranoid schizophrenia typically responds well to treatment, especially with early intervention.
2. With proper medication and therapy, individuals with paranoid schizophrenia can experience significant improvement and lead fulfilling lives.
3. Follow-up care and support are crucial in maintaining stability and preventing relapses.
Summary of why other choices are incorrect:
B: All types of schizophrenia are chronic relapsing disorders - This is not accurate as outcomes can vary depending on the subtype of schizophrenia.
C: Outcomes are poor related to client prehospital disorganization - This statement is too general and does not specifically address the prognosis of paranoid schizophrenia.
D: The usual outcome is that only partial remission is achieved - This is not always the case, as many individuals with paranoid schizophrenia can achieve full remission with appropriate treatment.
A nursing intervention that will be planned to occur early in the nurse-patient relationship with a client with an eating disorder is:
A. formulating a nurse-client contract.
B. using confrontation to attack denial.
C. placing the client in a therapeutic group.
D. attacking enmeshment by separating client and family.
Correct answer:
The correct answer is A: formulating a nurse-client contract. This intervention is essential early in the nurse-patient relationship with a client with an eating disorder because it establishes clear boundaries, roles, and expectations. By creating a contract, both the nurse and the client can communicate openly about their goals, responsibilities, and treatment plan. This helps build trust, promotes collaboration, and provides a framework for the therapeutic relationship.
Choices B, C, and D are incorrect:
B: Using confrontation to attack denial may be counterproductive and harmful in the early stages of the relationship as it can lead to resistance and damage trust.
C: Placing the client in a therapeutic group may be beneficial at a later stage but not necessarily an appropriate early intervention when individual needs should be addressed first.
D: Attacking enmeshment by separating client and family is not a suitable early intervention as it may cause distress and disrupt important support systems.
A patient, aged 77 years, has Alzheimer's disease. She goes to day care during the week and is otherwise cared for by her daughter and grandchildren. The nurse at the day care center noticed multiple bruises on the patient's palms, elbows, and buttocks. When the daughter arrived to pick her up, the nurse discussed her observations. The daughter became defensive and said that her mother was very difficult to manage. She stated, "My mother is not my mother anymore. She is confused, and she wanders all night. We have to watch her constantly. Last night I fell asleep, and she fell down the stairs. Sometimes she cannot recognize me and accuses me of trying to poison her. I can't concentrate at work, and it's wrecking the family. Sometimes I just cannot bear it."Â Which nursing diagnosis would be most important to address for this family?
A. Knowledge deficit pertaining to dementia
B. Grieving related to mother's deterioration
C. Risk for injury related to cognitive impairment
D. Caregiver role strain related to increased care needs
Correct answer:
The correct nursing diagnosis to address in this scenario is D: Caregiver role strain related to increased care needs. This is the most important as it focuses on the daughter's challenges and emotional burden due to her mother's condition. The daughter's statements reveal feelings of overwhelm, guilt, and exhaustion, which are key indicators of caregiver role strain. By addressing this nursing diagnosis, the healthcare team can provide support and resources to help the daughter cope with the demands of caring for her mother.
Choice A (Knowledge deficit pertaining to dementia) is not the most important in this situation as the daughter's issue is not lack of knowledge but rather emotional stress. Choice B (Grieving related to mother's deterioration) is not the priority as addressing the daughter's emotional strain is more urgent than addressing grief. Choice C (Risk for injury related to cognitive impairment) is also important but not as immediate as addressing the caregiver's emotional well-being.
What is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors?
A. Monitor for signs of electrolyte imbalances and dehydration.
B. Assess for any weight gain and increase exercise habits.
C. Encourage the patient to express feelings about food and body image.
D. Monitor for compulsive eating behaviors and binge episodes.
Correct answer:
The correct answer is A: Monitor for signs of electrolyte imbalances and dehydration. This is the priority assessment for a patient with bulimia nervosa who is experiencing frequent purging behaviors because purging can lead to electrolyte imbalances and dehydration, which can result in serious health complications such as cardiac arrhythmias and renal issues. Monitoring electrolyte levels and hydration status is crucial for the patient's safety and well-being.
Summary:
- Choice B is incorrect because focusing on weight gain and exercise habits is not the priority when dealing with the immediate health risks of electrolyte imbalances and dehydration.
- Choice C is incorrect as expressing feelings about food and body image is important for therapy but not the priority in this acute situation.
- Choice D is incorrect as monitoring for compulsive eating behaviors and binge episodes is more relevant for patients with binge eating disorder rather than bulimia nervosa with frequent purging behaviors.
RN exams geriatric practice questions, set 7 for nursing students in the United States. Fifteen items. Five include answers and rationales in American English.
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