Download NCLEX Practice Questions for Geriatrics: A Comprehensive Guide for Nursing Students and more Exams Geriatrics in PDF only on Docsity!
NCLEX Practice Questions for Geriatrics
Latest Update Graded A+
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." โโc) "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. โโd) Suggest appropriate resources to the client and daughter-in-law,
such as respite care and a senior citizens' center.
The normal physiological changes that occur in the skin of older adults include thinning of the skin, loss of elasticity, deepening of expression lines, and wrinkling. Crusting noted on the skin would indicate a potential complication.
- Geriatric Nursing Exam Questions Test-Taking Strategy: Note the subject , a potential 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 โโc) 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
a) Dry mouth
b) Bradycardia
c) Urinary retention
d) Paresthesia โโb) Bradycardia
Propranolol is a nonselective beta-adrenergic antagonist
Which medication will decrease the heart rate and prolong the action potential and refractory period?
a) Potassium channel blocker
b) Adrenergic agonist
c) Sodium channel blocker
d) Sympathomimetic โโa) Potassium channel blocker
A patient is being discharged after the insertion of a permanent pacemaker. Which statement made by the patient indicates an understanding regarding appropriate self-care?
a) Every morning I will perform arm and shoulder stretches
b) Each day I'll take my pulse and record it in a log
c) I'll have to get rid of my microwave oven
d) I won't be able to use my electrical blanket anymore โโb) Each day I'll take my pulse and
record it in a log
Initially, patients should limit arm and shoulder activity on the operative side to prevent dislodgment of the pacing leads.
Microwave ovens and electric blankets will not adversely affect the pacemaker.
Tracking one's pulse can help the patient know if the pacemaker is working properly
The healthcare provider is caring for a patient with a diagnosis of hypomagnesemia and a QT interval of 0.50 seconds. Which of these, if noted on the cardiac monitor, is an indication the patient's condition is worsening?
a) Premature ventricular contractions
b) Narrow QRS complexes
c) An R-R interval of 1 second
d) A polymorphic ventricular tachycardia โโd) A polymorphic ventricular tachycardia
An R-R interval of 1111 second translates to a heart rate of 60606060 beats per minute, which is a normal finding.
Narrow QRS complexes are associated with a variety of tachycardias, but is not expected in this situation.
The patient's history of hypomagnesemia and prolonged QT interval puts the patient at risk of developing torsades de pointes, a polymorphic ventricular tachycardia that can potentially degenerate into a ventricular fibrillation.
A patient with a diagnosis of Wolff-Parkinson-White syndrome is undergoing a catheter ablation procedure. When caring for the patient after the procedure, which is the priority intervention?
a) Assist the patient to the bathroom to void
b) Auscultate apical pulse for a full minute every hour
c) Monitor insertion site and distal pulses
d) Assess level of consciousness โโc) Monitor insertion site and distal pulses
The extremity where the catheter was inserted will be immobilized initially, so the patient will not be allowed out of bed to use the bathroom.
The patient will be on a cardiac monitor so auscultation of the apical pulse for one minute is not a priority.
Because the catheter may cause trauma to the vessels, the healthcare provider will monitor for hematoma formation and interference of circulation distal to the insertion site.
d) There may be a delay in the conduction through the AV node. โโd) There may be a delay in
the conduction through the AV node.
The PR interval reflects the time it takes for the atria to depolarize and for the action potential to travel through the AV node and to His-Purkinje system.
Each small box on the EKG graph paper equals 0.04 seconds.
The normal PR interval is 0.12 - 0.20, point, 20 seconds, which is 3 to 5 small boxes.
This patient's PR interval is longer than normal, which is an indication of a delay in impulse conduction through the AV node.
When caring for a patient with a cardiac dysrhythmia, which laboratory value is a priority for the healthcare provider to monitor?
a) BUN and creatinine
b) Sodium, potassium, and calcium
c) Hemoglobin and hematocrit
d) PT and INR โโb) Sodium, potassium, and calcium
BUN and creatinine levels are always important to monitor when giving any drug, not only antidysrhythmia drugs.
The PT and INR will be important for patients who are on warfarin (Coumadin).
Because abnormalities in sodium, potassium and calcium levels are likely to affect depolarization and repolarization of cardiac cells, it is most important for the healthcare provider to monitor these laboratory values.
Risks and benefits are balanced when giving an antidysrhythmic drug to a treat a cardiac dysrhythmia. When does the need for the drug outweigh the risks?
a) When there is impairment in cardiac output.
b) When the dysrhythmia becomes chronic.
c) If the heart rate is 50 to 60 beats per minute
D) Cardiopulmonary resuscitation (CPR)
E) Administration of vasoconstrictors
F) Synchronized cardioversion โโD) Cardiopulmonary resuscitation (CPR)
The patient is experiencing pulseless electrical activity (PEA).
PEA is not a shockable rhythm.
High-quality CPR should be started immediately.
An important treatment for PEA is to address the underlying cause.
The underlying cause of PEA in this patient is hypovolemia, which can be treated with IV fluids and vasoconstrictors, along with CPR and epinephrine.
https://www.khanacademy.org/test-prep/nclex-rn/nclex-practice-questions/nclex-rn- questions/e/tachycardias-quiz-
