Geriatrics NCLEX Questions

The nurse administers an emergent dose of intravenous (IV) haloperidol to a patient with delirium who is combative and is putting herself and others at risk. Which priority instruction should she give the unlicensed assistive personnel immediately? A. "Please get a telemetry monitor and attach it to this patient." B. "Let's put a bed alarm under the patient's sheets right away." C. "Move everything away from the patient's bed, including the patient's phone and bedside table. D. "Please apply restraints to the patient's wrists and ankles and secure them to the immobile parts of the bed."

A. "Please get a telemetry monitor and attach it to this patient."

Nurses' knowledge of sexuality in the older adult population should include: A. Chronic illness may affect the ability to participate in sexual activity. B. Sexual response time is unchanged. C. Ability to achieve orgasm declines. D. Dryness of the vaginal walls is associated with pelvic inflammatory disease.

A. Chronic illness may affect the ability to participate in sexual activity.

Which age-related changes predispose the elderly patient to drug toxicity and extended duration of action of drugs? (Select all that apply.) A. Decreased body water B. Increased ratio of muscle to fat C. Low serum albumin D. Reduced blood flow to liver

A. Decreased body water C. Low serum albumin D. Reduced blood flow to the liver

The nurse is caring for a patient recently diagnosed with AD. The nurse knows this patient's symptoms are caused by which changes in the brain? (select all that apply) A. Neurofibrillary tangles B. Development of gumma C. Formation of aneurysms D. Neuron loss in frontal and temporal lobes E. Decreased production of neurotransmitters

A. Neurofibrillary tangles D. Neuron loss in frontal and temporal lobes E. Decreased production of neurotransmitters

What is the initial nursing intervention in preventing polypharmacy? A. Obtain a thorough medication history. B. Discontinue all herbal preparations. C. Refer the patient to a geriatric practitioner. D. Consult a pharmacist to review all medications.

A. Obtain a thorough medication histor

A patient has been diagnosed as having dementia. Which symptom should the LPN/LVN expect? A. Patient tends to confabulate. B. Patient tends to have flight of ideas. C. Patient's speech tends to be slurred. D. Patient tends to be oriented to time, place, and person.

A. Patient tends to confabulate.

An elderly patient has acute confusion after undergoing abdominal surgery. The patient most likely has: A. delirium. B. anxiety. C. dementia. D. depression

A. delirium

__________ is the intentional infliction of physical or emotional discomfort or the deprivation of basic needs necessary for comfort or survival.

Abuse

Which mental change is associated with aging? A. Confusion B. Gradual decline in cognitive skills C. Depression D. Inappropriate behavior

B. Gradual decline in cognitive skills

A patient in the middle stage of Alzheimer's disease (AD) may exhibit which characteristic or behavior? A. Mild depression B. Hallucinations C. Weight loss D. Impaired mobility

B. Hallucinations

Which statement is true regarding falls in the elderly? A. Most falls occur in the garage. B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities. C. Fall risk decreases with addition of medications. D. Sedatives reduce the risk of falls.

B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities.

An elderly patient who experiences nighttime confusion wanders from his room into the room of another patient. Which intervention will best decrease this patient's nighttime confusion? A. Administering a sedative at the hour of sleep B. Leaving a night-light on during the evening and night shifts C. Assigning a nursing assistant to sit with him until he falls asleep D. Allowing the patient to share a room with another elderly patient

B. Leaving a night-light on during the evening and night shifts

A patient is taking a psychotropic medication for agitation associated with dementia. What is a common side effect of psychotropics? A. Accelerated hypertension B. Orthostatic hypotension C. Diarrhea D. Chest pain

B. Orthostatic hypotension

Age-related eye changes may include: A. increased visual accommodation. B. macular degeneration. C. non-preventable blindness as a result of glaucoma. D. decreased ability of pupil to respond to light changes.

B. macular degeneration

A patient with dementia wanders throughout the skilled nursing facility. A nursing intervention for wandering may include: A. administering a sedative. B. maintaining a regular activity program. C. locking the patient's room from the outside. D. keeping a staff member with the patient when wandering

B. maintaining a regular activity program.

Alcoholism is often overlooked in the elderly. Cues to alcoholism include: (Select all that apply.) A. delirium. B. self-neglect. C. frequent falls. D. mental confusion.

B. self-neglect. C. frequent falls. D. mental confusion.

What should the nurse include in the teaching plan for self-medication practices of older adults? A. Eliminate unnecessary medications. B. Substitute herbal preparations for certain prescribed medications. C. Develop a drug reminder system and schedule. D. Pharmacy shop for the cheapest medications.

C. Develop a drug reminder system and schedule.

A 62-year-old woman is admitted to an assisted-living facility with symptoms of forgetfulness, irritability, difficulty following directions, and neglect of her personal hygiene. These would suggest which stage of AD? A. Late B. Early C. Moderate D. Moderate to severe

C. Moderate

The LPN/LVN reads on a patient's chart that the patient is exhibiting the sundowning phenomenon. Which behavior should the nurse expect? A. On sunny days, the patient is disoriented. B. On cloudy days, the patient is disoriented. C. The patient becomes disoriented in the evening. D. The patient is very disoriented in the morning only.

C. The patient becomes disoriented in the evening.

A patient with dysphagia is: A. fed only for pleasure. B. at low risk for nutritional deficits. C. at higher risk for pneumonia. D. able to drink thin liquids.

C. at a higher risk for pneumonia

Appropriate nursing care for a patient with urinary incontinence is to: A. insert an indwelling Foley catheter. B. order oxybutynin chloride (Ditropan). C. encourage fluids to decrease the urine concentration so it is less irritating. D. recommend herbal approaches to reduce incontinence.

C. encourage fluids to decrease the urine concentration so it is less irritating.

Medications taken early in Alzheimer's disease to improve memory and alertness work by: A. increasing dopamine in the frontal lobe. B. decreasing dopamine in the frontal lobe. C. increasing acetylcholine in the cerebral cortex. D. decreasing acetylcholine in the cerebral cortex.

C. increasing acetylcholine in the cerebral cortex.

The nurse is planning care for a patient with early AD. Interventions for which patient problems are appropriate for this patient's care plan? (select all that apply) A. Pain B. Airway patency issues C. Nutritional deficiencies D. Reduced cardiac output E. Caregiver stress and fatigue

C. nutritional deficiencies E. caregiver stress and fatigue

The patient with dementia presents to the clinic for a routine examination. The patient's daughter, who is her full-time caregiver, states to the nurse, "I just don't know how much longer I can go on caring for Mom full time. My kids feel neglected, my marriage is suffering, and I feel so run down." What is the best response by the nurse? A. "You must stay strong for your mother. You are all she has." B."Your mother's dementia will improve once we correct the cause." C. "You should discuss the many medications available for treating and reversing dementia." D. "As your mother's condition continues to deteriorate, we should discuss alternative care resources."

D. "As your mother's condition continues to deteriorate, we should discuss alternative care resources."

A patient with Alzheimer disease (AD) has been prescribed oral donepezil 10 mg. The nurse should give priority to assessing the patient for which sign of an adverse effect of this drug? A. Skin rashes B. Cardiac dysrhythmias C. Decreased blood pressure D. Gastrointestinal (GI) bleeding

D. Gastrointestinal (GI) bleeding

The nurse is planning care for a patient with dementia. Which would be an appropriate intervention to include in this patient's care plan? A. Speak loudly and slowly. B. Restrain the patient for safety. C. Involve the patient in new activities. D. Increase verbal and environmental cues.

D. Increase verbal and environmental cues.

A patient with depression may be prescribed a(n): A. phenytoin (Dilantin). B. lorazepam (Ativan). C. quetiapine (Seroquel). D. amitriptyline hydrochloride (Elavil).

D. amitriptyline hydrochloride (Elavil).

Alzheimer's disease may be suggested in its early stages by: A. magnetic resonance imaging (MRI). B. computed tomography (CT). C. positron emission tomography (PET). D. autopsy.

D. autopsy

A nursing intervention for a patient with constipation is to: A. avoid the urge to defecate. B. limit fluid intake. C. give prune juice with a noncarbonated drink. D. encourage bran cereal or whole-grain breads.

D. encourage bran cereal or whole-grain breads

________ is the use of multiple medications, often inappropriately and excessively, at the same time.

polypharmacy