1. 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...
NURSING 166 NCLEX QS WITH ANSWERS
1. 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." - answer-1) C
- Rationale: 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.
2. Geriatric Nursing Exam Questions about 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. - answer-2) D
- Geriatric Nursing Exam Questions Rationale: Assisting clients and families to become aware of available
community support systems is a role and responsibility of the nurse. Observing that the client has begun
to be confined to his room makes it necessary for the nurse to intervene legally and ethically, so option
C is not appropriate and is passive in terms of advocacy. Option B suggests committing the client to a
nursing home and is a premature action on the nurse's part. Although the data provided tell the nurse
that this client requires nursing care, the nurse does not know the extent of the nursing care required.
Option A is incorrect and judgmental.
- Test-Taking Strategy: Note the strategic words most important. Using principles related to the ethical
and legal responsibility of the nurse and knowledge of the nurse's role will direct you to the correct
option. Option A is a nontherapeutic statement, option B is a premature action, and option C avoids the
situation.
3. The nurse is performing an assessment on an older adult client. Which assessment data would
indicate a potential complication associated with the skin?
, a) Crusting
b) Wrinkling
c) Deepening of expression lines
d) Thinning and loss of elasticity in the skin - answer-3) A
- Rationale: 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.
4. 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. - answer-4) B
- Rationale: 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.
5. 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 - answer-5) B, E, F
- 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.
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