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Geriatrics NCLEX Questions with
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The nurse is setting up an education session with an 85-year-old patient who will be going home on anticoagulant therapy. Which strategy would reflect consideration of aging changes that may exist with this patient? A. Show a colorful video about anticoagulation therapy. B. Present all the information in one session just before discharge. C. Give the patient pamphlets about the medications to read at home. D. Develop large-print handouts that reflect the verbal information presented. D. Develop large-print handouts that reflect the verbal information presented. Rationale: Option D addresses altered perception in two ways. First, by using visual aids to reinforce verbal instructions, one addresses the possibility of decreased ability to hear high-frequency sounds. By developing the handouts in large print, one addresses the possibility of decreased visual acuity. Option A does not allow discussion of the information; furthermore, the text and print may be small and difficult to read and understand. When developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should A. use a standardized geriatric nursing care plan. B. plan for likely long-term-care transfer to allow additional time for recovery.
C. consider the preadmission functional abilities when setting patient goals. D. minimize activity level during hospitalization. C. consider the preadmission functional abilities when setting patient goals. Rationale: The plan of care for older adults should be individualized and based on the patients current functional abilities. A standardized geriatric nursing care plan is unlikely to address individual patient needs and strengths. A patients need for discharge to a long-term-care facility is variable. Activity level should be designed to allow the patient to retain functional abilities while hospitalized and also to allow any additional rest needed for recovery from the acute process. Which information obtained by the home health nurse when making a visit to an 88 - year-old with mild forgetfulness is of the most concern? A. The patient's son uses a marked pillbox to set up the patient's medications weekly. B. The patient has lost 10 pounds (4.5 kg) during the last month. C. The patient is cared for by a daughter during the day and stays with a son at night. D. The patient tells the nurse that a close friend recently died. B. The patient has lost 10 pounds (4.5 kg) during the last month. Rationale: A 10-pound weight loss may be an indication of elder neglect or depression and requires further assessment by the nurse. A 70-year-old client asks the nurse to explain to her about hypertension. An appropriate response by the nurse as to why older clients often have hypertension is due to: A. Myocardial muscle damage B. Reduction in physical activity C. Ingestion of foods high in sodium D. Accumulation of plaque on arterial walls
D. Adults older than 65 years of age are the greatest users of prescription medications. D. Adults older than 65 years of age are the greatest users of prescription medications. Rationale: Approximately two thirds of older adults use prescription and nonprescription drugs with one third of all prescriptions being written for older adults The nurse is aware that the majority of older adults: A. Live alone B. Live in institutional settings C. Are unable to care for themselves D. Are actively involved in their community D. Are actively involved in their community The nurse works with elderly clients in a wellness screening clinic on a weekly basis. Which of the following statements made by the nurse is the most therapeutic regarding their mobility? A. "Your shoulder pain is normal for your age." B. "Continue to exercise your joints regularly to your tolerance level." C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you feel next week." D. "Don't worry about taking that combination of medications since your doctor has prescribed them." B. "Continue to exercise your joints regularly to your tolerance level." A long-term care facility sponsors a discussion group on the administration of medications. The participants have a number of questions concerning their medications. The nurse responds most appropriately by saying: A. "Don't worry about the medication's name if you can identify it by its color and shape." B. "Unless you have severe side affects, don't worry about the minor changes in
the way you feel." C. "Feel free to ask your physician why you are receiving the medications that are prescribed for you." D. "Remember that the hepatic system is primarily responsible for the pharmacotherapeutics of your medications." C. "Feel free to ask your physician why you are receiving the medications that are prescribed for you." Rationale: The nurse should encourage the older adult to question the physician and/or pharmacist about all prescribed drugs and over-the-counter drugs. The older adult should be taught the names of all drugs being taken, when and how to take them, and the desirable and undesirable effects of the drugs. In performing a physical assessment for an older adult, the nurse anticipates finding which of the following normal physiological changes of aging? A. Increased perspiration B. Increased airway resistance C. Increased salivary secretions D. Increased pitch discrimination B. Increased airway resistance Rational: Normal physiological changes of aging include increased airway resistance in the older adult. The older adult would be expected to have decreased perspiration and drier skin as they experience glandular atrophy (oil, moisture, sweat glands) in the integumentary system. The older adult would be expected to have a decrease in saliva. A normal physiological change of the older adult related to hearing is a loss of acuity for high-frequency tones (presbycusis). There are factors that influence the musculoskeletal system associated with aging. The nurse recognizes that with age:
Which of the following statements made by a family member of a client recently diagnosed with early stages of Alzheimer's disease is most reflective of an understanding of this disease process? A. "Dad has always been a fighter; he'll fight this too. He won't give up." B. "We have an appointment with his care provider to see about medication therapy." C. "Good thing we found out about this early so we can prevent this from getting worse." D. "We have a made arrangements to discuss nursing home placement for dad." B. "We have an appointment with his care provider to see about medication therapy." The nurse is planning client education for an older adult being prepared for discharge home after hospitalization for a cardiac problem. Which nursing action addresses the most commonly determined need for this age-group? A. Suggest that he purchase an emergency in-home alert system. B. Arrange for the client to receive meals delivered to his home daily. C. Encourage the client to use a compartmentalized pill storage container for his daily medications. D. Provide only written document describing the medications the client is currently prescribed. Encourage the client to use a compartmentalized pill storage container for his daily medications. An assisted living facility has provided its clients with an educational program on safe administration of prescribed medications. Which statement made by an older-adult client reflects the best understanding of safe self-administration of medications? A. "I don't seem to have problems with side effects, but I'll let my doctor know if something happens."
B. "I'm lucky since my daughter is really good about keeping up with my medications." C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something." D. "It shouldn't be too hard to keep it straight since I don't have any really serious health issues." C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand something." Which of the following client statements regarding self-medication administration by an older-adult client requires follow-up teaching by the nurse? A. "I take all the pills ordered once a day at bedtime, so I'm less likely to forget them." B. "I have one pill that needs cut in half. I am going to ask the pharmacist to do that for me." C. "The pharmacist said to keep my pills away from the sunlight, so I put them inside the kitchen cabinet." D. "My daughter comes over each morning and puts my pills into a container that sorts them by the time they are due." A. "I take all the pills ordered once a day at bedtime, so I'm less likely to forget them." Which of the following statements made by an older-adult client poses the greatest concern for the nurse conducting an assessment regarding the clients adjustment to the aging process? A. "I use to enjoy dancing and jogging so much, but now I have arthritis in my knees so that it's hard to even walk." B. "I've given my grandchildren money for college so they can live a better life than I had." C. "Growing old certainly presents all sorts of challenges. I wish I knew then what I know now."
A nurse is caring for an older adult client preparing for discharge to a nursing center after having hip surgery. Which of the following nursing responses is most therapeutic with a client's concern that she, will never go back home? A. "What makes you think that this transfer to the nursing center will be permanent?" B. "The reason for this transfer is only to support you while you continue to recuperate." C. "The decision to stay in the nursing center is yours to make. When you want to leave no one will stop you." D. "The nursing center is a lovely place with a wonderful staff of caring people. Just give it a chance. You may like it." A. "What makes you think that this transfer to the nursing center will be permanent?" A nurse caring for older adults in an assistive living facility recognizes that a clients quality of life needs are best determined by: A. Excellent physical, social, and emotional nursing assessments B. A working knowledge of this age-group's developmental needs C. A therapeutic nurse-client relationship that facilitates communication D. The client's need for complete physical, emotional, and cognitive care C. A therapeutic nurse-client relationship that facilitates communication Which of the following statements made by a nurse reflects the best understanding of the health value of conducting a blood pressure (BP) screening at a senior citizens centers health fair? A. "This is a high risk group, so assessing BP allows us to identify clients at risk and send them for treatment." B. "Older adults enjoy health fairs, so it's a good place to screen substantial numbers of clients for hypertension."
C. "Hypertension doesn't present symptoms early on, so screening elder adults is a wonderful preventive measure." D. "Blood pressure problems are common among this group, so it's a good way to monitor the effectiveness of their medications." B. "Older adults enjoy health fairs, so it's a good place to screen substantial numbers of clients for hypertension." The three common conditions affecting cognition in the older adults are: A. Stroke, MI, Cancer B. Cancer, Alzheimer's disease, Stroke C. Delirium, Depression, Dementia D. Blindness, Hearing loss, Stroke C. Delirium, Depression, Dementia A client has been recently diagnosed with Alzheimer's disease. When teaching the family about the prognosis, the nurse must explain that: A. Diet and exercise can slow the process considerably B. It usually progresses gradually with a deterioration of function C. Many individuals can be cured if the diagnosis is made early D. Few clients live more than 3 years after the diagnosis B. It usually progresses gradually with a deterioration of function An overall, general assessment of an older adult patient is best performed in which setting? A. During a meal. B. During assessment of vital signs. C. While assisting a patient with a bath. D. When assisting a patient during a walk. C. While assisting a patient with a bath.
B. Slow onset, chronic When a fall results in injury and hospitalization, a cycle of disuse may occur over time. When establishing a care plan for the patient and family to prevent this, it is important to remember disuse is most likely a result of: A. Decreasing muscle strength. B. Decreased joint mobility. C. Fear of repeated falls. D. Changes in sensory perception. C. Fear of repeated falls. What is the best resource (of those listed below) for identifying information regarding an older adult's current functional ability? A. Psychological tests and related exams B. Diagnostic x-rays and lab tests C. Family members who visit occasionally and call weekly D. Neighbor who visits daily and helps the person to the store weekly. D. Neighbor who visits daily and helps the person to the store weekly. When caring for an older adult patient, the nurse uses the following interventions to accommodate visual changes with age: A. Eye glasses in the bedside table. B. Adequate lighting and uncluttered walkways. C. Draw drapes in room to prevent glare. D. Keep bedside rails down. B. Adequate lighting and uncluttered walkways. The primary reason an older adult client is more likely to develop a pressure ulcer on the elbow as compared to a middle-age adult is: A. A reduced skin elasticity is common in the older adult
B. The attachment between the epidermis and dermis is weaker C. The older client has less subcutaneous padding on the elbows D. Older adults have a poor diet that increases risk for pressure ulcers C. The older client has less subcutaneous padding on the elbows While bathing an elderly client who has limited abilities for self-care, the nurse notices several patches of dry skin on the clients heels, elbows, and coccyx. The nurse cleans and dries all the areas well and applies a moisturizing lotion. The most appropriate immediate follow-up by the nurse to ensure appropriate nursing care for this clients skin is to: A. Revise the client's care plan to show the need for the application of moisturizing lotion B. Assume personal responsibility to apply the moisturizing lotion daily to the client's skin C. Encourage the client to tell whomever bathes her to apply the moisturizing lotion to her areas of dry skin D. Inform the staff that the client's skin is showing signs of breakdown and moisturizing lotion needs to be applied daily A. Revise the client's care plan to show the need for the application of moisturizing lotion A 76-year-old adult female is brought to a neighborhood client after being found wandering around the local park. The client appears disheveled and reports being hungry. Which of the following assessment and interview findings would cause the nurse to suspect elder abuse? (Select all that apply.) A. Falls asleep in the examination room B. Repeatedly states, "Don't hurt me." C. Chafing around wrists and ankles D. Bruises in various stages of healing
- Decreased in residual lung volume
- Decreased gas exchange
- Decreased cough efficiency
- Increased gas exchange
- Decreased gas exchange
- Decreased cough efficiency The leading cause of injury and preventable source of mortality and morbidity in older adults is
- presbycusis.
- car accidents.
- pneumonia.
- falls.
- falls. Which medication prevents the breakdown of a brain chemical important for memory and thinking and may slow the progress of Alzheimer's disease.
- memantine (Namenda)
- ozazepam (Serax)
- donepezil (Aricept)
- citalopram (Celexa)
- donepezil (Aricept) The nurse is performing an assessment on an older client who is having difficulty sleeping at night. Which statement by the client indicates the need for further teaching regarding measures to improve sleep? a) "I swim three times a week." b) "I have stopped smoking cigars." c) "I drink hot chocolate before bedtime." d) "I read for 40 minutes before bedtime."
c) "I drink hot chocolate before bedtime." Many nonpharmacological sleep aids can be used to influence sleep. However, the client should avoid caffeinated beverages and stimulants such as tea, cola, and chocolate. The client should exercise regularly, because exercise promotes sleep by burning off tension that accumulates during the day. A 20-to 30-minute walk, swim, or bicycle ride three times a week is helpful. The client should sleep on a bed with a firm mattress. Smoking and alcohol should be avoided. The client should avoid large meals; peanuts, beans, fruit, raw vegetables, and other foods that produce gas; and snacks that are high in fat because they are difficult to digest.
- Test-Taking Strategy: Note the strategic words need for further teaching. These words indicate a negative event query and ask you to select an option that is an incorrect statement. Options A, B, and D are positive statements indicating that the client understands the methods of improving sleep. A visiting nurse who observes that the older male client is confined by his daughter-in-law to his room. When the nurse suggests that he walk to the den and join the family, he says, "I'm in everyone's way; my daughter-in-law needs me to stay here." Which is the most important action for the nurse to take? a) Say to the daughter-in-law, "Confining your father-in-law to his room is inhumane." b) Suggest to the client and daughter-in-law that they consider a nursing home for the client. c) Say nothing, because it is best for the nurse to remain neutral and wait to be asked for help. d) Suggest appropriate resources to the client and daughter-in-law, such as respite care and a senior citizens' center.
complication. Think about the normal physiological changes that occur in the aging process to direct you to the correct option. The home health nurse is visiting a client for the first time. While assessing the client's medication history, it is noted that there are 19 prescriptions and several over-the-counter medications that the client has been taking. Which intervention should the nurse take first? a) Check for medication interactions. b) Determine whether there are medication duplications. c) Call the prescribing health care provider (HCP) and report polypharmacy. d) Determine whether a family member supervises medication administration c) Call the prescribing health care provider (HCP) and report polypharmacy. Polypharmacy is a concern in the older client. Duplication of medications needs to be identified before medication interactions can be determined because the nurse needs to know what the client is taking. Asking about medication administration supervision may be part of the assessment but is not a first action. The phone call to the HCP is the intervention after all other information has been collected.
- Test-Taking Strategy: Note the strategic word first. Also note that the nurse is visiting the client for the first time. Options A, C, and D should be done after possible medication duplication has been identified. The long-term care nurse is performing assessments on several of the residents. Which are normal age-related physiological change(s) the nurse expects to note? Select all that apply. a) Increased heart rate b) Decline in visual acuity
c) Decreased respiratory rate d) Decline in long-term memory e) Increased susceptibility to urinary tract infections f) Increased incidence of awakening after sleep onset b) Decline in visual acuity e) Increased susceptibility to urinary tract infections f) Increased incidence of awakening after sleep onset Geriatric Nursing Exam Questions Rationale: Anatomical changes to the eye affect the individual's visual ability, leading to potential problems with activities of daily living. Light adaptation and visual fields are reduced. Although lung function may decrease, the respiratory rate usually remains unchanged. Heart rate decreases and heart valves thicken. Age-related changes that affect the urinary tract increase an older client's susceptibility to urinary tract infections. Short-term memory may decline with age, but long-term memory usually is maintained. Change in sleep patterns is a consistent, age- related change. Older persons experience an increased incidence of awakening after sleep onset.
- Test-Taking Strategy: Focus on the subject , normal age-related changes. Read each characteristic carefully and think about the physiological changes that occur with aging to select the correct items. The healthcare provider is performing an assessment on a patient who is taking propranolol (Inderal) for supraventricular tachycardia. Which assessment finding is an indication the patient is experiencing an adverse effect of this drug? a) Dry mouth b) Bradycardia c) Urinary retention d) Paresthesia
