NCLEX Questions Chapter 31

An older adult with new-onset delirium usually has: A. a short attention span. B. trouble naming common objects. C. outbursts of violent behavior. D. vertigo.

A Delirium manifests as an acute change in cognition that affects the domain of attention. A person with Alzheimer disease may have alterations in word finding and naming objects in addition to memory problems. A patient with posttraumatic stress disorder may exhibit outbursts of violent behavior. Vertigo is rotational spinning caused by neurologic disease in the vestibular apparatus in the ear or in the vestibular nuclei in the brainstem.

Altered cognition in older adults is commonly attributed to: A. an infection or injury. B. dementia, delirium, or depression. C. the normal aging process. D. medication side effects.

B Altered cognition in older adults is commonly attributed to three disorders: dementia, delirium, and depression.

A patient requests to be discharged to home instead of a rehabilitation hospital after a hip fracture. Which of the following is true about the difference between home care and hospital care? A. Home care is more expensive than hospitalization. B. Patients have less risk for infection in the home setting. C. Patients have been shown to recover more slowly at home than in the hospital. D. Physical therapy is available only in the hospital setting.

B Older adults may avoid the risk of infection exposure when at home. Home care is less expensive than hospitalization. Older adults have been shown to recover more quickly when at home than when placed in an institution. Home care services include skilled nursing care; primary care; physical, occupational, and speech therapy; social work; nutrition; case management; assistance with activities of daily living; and some durable medical equipment.

The Get Up and Go Test would be used to: A. determine a patient's ability to get dressed without assistance. B. assess functional activity of the patient along with safety determination. C. assess swallowing status of the patient. D. assess adults with dementia.

B The Get Up and Go Test is a reliable and valid test used to assess functional ability and safety aspects. Determination of functional assessment would be able to determine if the individual could get dressed without assistance. This test would not be used to evaluate a patient's swallowing status. The Direct Assessment of Functional Abilities assesses adults with dementia.

The Katz Index of Independence in ADL would measure the functional ability to: A. clean the house and take out the garbage. B. wash the face and hands and comb hair. C. pay the electric and telephone bills. D. do laundry and put away the clothes.

B The Katz Index of Independence in ADL is a functional assessment of a person's ability to complete activities of daily living (e.g., eating/feeding, bathing, grooming, dressing, toileting, walking, using stairs, and transferring). Cleaning the house and taking out the garbage are instrumental activities of daily living (e.g., abilities necessary for independent community living). Paying bills is an instrumental activity of daily living. Doing the laundry and putting away clothes are instrumental activities of daily living.

It is dangerous for a cognitive change to be attributed to the normal aging process because: A. cognitive change is not associated with aging. B. nurses are not trained properly to make these types of judgments. C. this may delay the diagnosis of an underlying disease process. D. the client could be saying confusing comments to avoid detection of addictions.

C Cognitive impairment resulting from disease may be attributed by patients, families, and health care providers to normal changes with aging, which can delay diagnostic workup.

When completing a health assessment of an older adult with mobility problems, the sequence should: A. begin with the physical examination followed by the health history. B. be from head to toe to prevent missing any important assessments. C. be arranged to minimize the number of position changes for the patient and the examiner. D. start with the most invasive assessments.

C If an older adult patient has limited mobility, the examiner should arrange the sequence to minimize the number of position changes for the patient. The health history should be collected before the physical examination. A head-to-toe approach may include numerous position changes and should be avoided for an older adult with mobility problems. Completing invasive assessments at the end of the examination decreases anxiety and embarrassment for an older adult patient.

Prevention and treatment of ____________ may be one of the most effective interventions aimed at reducing functional decline in an older adult. A. visual disturbances B. muscle weakness C. depression D. bladder and bowel incontinence

C Prevention and treatment of depression may be one of the most effective interventions aimed at reducing functional decline in an older adult.

Signs of caregiver burnout include: A. going to church every week. B. weight gain. C. headaches and epigastric pain. D. using an adult daycare facility.

C Signs of possible caregiver burnout include multiple somatic complaints, increased stress and anxiety, social isolation, depression, and weight loss. Social isolation is a sign of caregiver burnout. Weight loss is a sign of caregiver burnout. Use of an adult daycare facility may prevent caregiver burnout.

Which of the following would be included in an assessment of a patient's ability to perform instrumental activities of daily living? A. Balance, gait, and motor coordination B. Dressing, toileting, and using stairs C. Eating, bathing, and grooming D. Taking medications, shopping, and meal preparation

D Instrumental activities of daily living are functional abilities necessary for independent community living and include shopping, meal preparation, housekeeping, laundry, managing finances, taking medications, and using transportation. Other activities may include yard work or home maintenance and leisure activities (e.g., reading, other hobbies). Mobility or physical performance includes balance, gait, motor coordination, and endurance. Activities of daily living are tasks necessary for self-care and include eating/feeding, bathing, grooming, dressing, toileting, walking, using stairs, and transferring.

Which of the following would be an indication that an older adult should stop driving a vehicle? A. Taking insulin to control type 2 diabetes mellitus B. Difficulty walking and getting in and out of the vehicle C. A pacemaker placed 2 months ago for complete heart block D. Difficulty checking over the shoulder when backing up or changing lanes

D The American Association of Retired Persons has developed warning signs for when to stop driving. One of the warning signs is difficulty turning around to check over the shoulder while backing up or changing lanes. Type 2 diabetes mellitus and taking insulin are not indications to stop driving a vehicle. Mobility problems (e.g., difficulty walking or getting in or out of a vehicle) are not indications to stop driving a vehicle. Having a pacemaker is not an indication to stop driving a vehicle.