A male client is seen in the clinic for benign prostatic hypertrophy (BPH). Which intervention is
essential for the practical nurse (PN) to include in the client's visit?
a. Reeducate the client about limiting fluid intake.
b. Reassure the client that his BPH is a non-life-threatening condition.
c. Assess the client for urinary hesitancy and weak or split urinary stream.
d. Inform the client that there may be a genetic predisposition for male family members. - ANSc.
Assess the client for urinary hesitancy and weak or split urinary stream.
These symptoms may indicate progression of BPH to partial obstruction of the urethra, a
medical emergency, and need to be reported to the health care provider. Fluids should be
encouraged, not limited; hydration needs to be maintained.
The oral temperature of a client with a urinary tract infection is 103° F. Which intervention should
the practical nurse (PN) implement first?
a. Instruct the client on proper hygienic practices.
b. Observe the color or odor of urine.
c. Recheck the temperature rectally.
d. Encourage fluid intake. - ANSd. Encourage fluid intake.
Fluids help to reduce fever as quickly and it is important to lower the temperature as soon as
possible.
An older adult client is being treated for toxicity related to medication use. When reviewing the
client's medical records, the nurse is most likely to find which factor is correlated with this
problem?
a. The client has forgotten to take several doses of medication.
b. The client's white blood cell count has steadily increased.
c. The client's liver function has decreased since last year.
d. The client has gained 40 pounds (18.2 kg) over 3 years. - ANSc. The client's liver function
has decreased since last year.
With aging, liver function decreases, affecting drug metabolism and detoxification. Forgetting to
take doses of medication would not cause drug toxicity; excessive doses could cause toxicity.
Elevated white blood cell counts and weight gain would not likely cause drug toxicity.
,The practical nurse (PN) assesses the older adult client's skin for signs of breakdown and
observes that the skin is intact. What interventions by the PN will help maintain healthy skin
integrity?
a. Keep the client well hydrated.
b. Remove adhesive tape quickly from the skin.
c. Avoid creams or lotions to ensure that the skin stays dry.
d. Scrub the perineum with a wet cloth after a bowel movement. - ANSa. Keep the client well
hydrated.
Keeping the client well hydrated helps prevent skin cracking and infection.
The nurse has reinforced education regarding safety aspects for antihypertensive medication
with an older adult. Which statement by the client best indicates learning has been effective?
a. "I should rest in bed most of the day when I take this medication."
b. "I will be sure to keep this medication out of the reach of children."
c. "I will need to make sure that I take this medication with some food."
d. "I will make sure that I stand up slowly if I have been sitting down." - ANSd. "I will make sure
that I stand up slowly if I have been sitting down."
Older adults are particularly likely to develop orthostatic hypotension after taking medications to
treat hypertension. It is not necessary for the older adult to stay in bed while taking this
medication. Some medications should be taken with food, others on an empty stomach. Each
medication should be individually researched. While it is important to prevent children from
consuming medications intended for the older adult, the focus of this question is the safety of
the older adult.
An older adult client tells the nurse "I do not understand how I could have a sexually transmitted
disease! My partner seems like such a nice, clean person." Which explanation should the nurse
provide?
a. Most people in your age are not interested in sexual relationships.
b. You should have discussed this with your family before you started dating.
c. Maybe you should go back to just holding hands and hugging on dates.
d. Sexually transmitted diseases are possible to have at any age of your life. - ANSd. Sexually
transmitted diseases are possible to have at any age of your life.
Sexually transmitted diseases are possible at any age. It is inappropriate, untrue, and ageist to
comment that older adults are not interested in sexual relations. It is very judgmental for the
nurse to suggest the older adult should have sought their family's input or that the older adult
should stop having sexual relations.
When observing an older client with dementia for symptoms of Sundowning syndrome, it is most
important that the practical nurse (PN) assesses for which finding?
, a. Observe for agitation at the end of the day.
b. Perform a neurological and mental status examination.
c. Monitor for medication side effects.
d. Assess for decreased gross motor movement. - ANSa. Observe for agitation at the end of the
day.
Sundowning syndrome is a pattern of agitated behavior in the evening, believed to be
associated with tiredness at the end of the day combined with fewer orienting stimuli, such as
activities and interactions.
The practical nurse (PN) working at an assisted living facility is visiting with a client whose
spouse died 8 months ago. Which behavior by the client suggests ineffective coping with the
spouse's death?
a. Frequently neglects to shower and shave.
b. Insists on visiting the gravesite once a month.
c. Joins an exercise class at the assisted living facility.
d. Keeps their photo albums out and looks through them frequently. - ANSa. Frequently neglects
to shower and shave.
Ineffective coping is manifested by behaviors that may be physically or psychologically harmful
to the individual. Neglecting personal hygiene is an example of ineffective coping.
When initially monitoring a client after a fall, which information should the practical nurse (PN)
communicate immediately to the health care provider? (Select all that apply.)
a. Change in the level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity
e. Onset of nausea and vomiting - ANSa. Change in the level of consciousness
e. Onset of nausea and vomiting
A decrease or change in the level of consciousness is usually the first indication of neurological
deterioration. Nausea and vomiting may also be present.
An older adult client is seen in the clinic for problems with urinary frequency, urgency, and
nocturia. The symptoms are an example of which condition?
a. Urinary tract infection (UTI)
b. Normal aging changes
c. Side effect of the diuretic furosemide
d. Partial obstruction of the urethra - ANSb. Normal aging changes
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