GERONTOLOGY TEST EXAM QUESTIONS WITH
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A nurse at a long-term care facility is contributing to the plan of care for a client
who has Alzheimer's disease and wanders at night. Which of the following
interventions should the nurse include in the plan?
A. Place the client in wrist restraints at night
B. Request a prescription for a psychotropic medication
C. Assign the client to a room closer to the nurse's station
D. Keep the television on at night - ANS ✓C. Assign the client to a room closer to
the nurse's station
The nurse should place the client who wanders in a room that allows for close
observation. The nurse should provide clients who wander a safe place to walk
and supervision when the client is ambulating.
A nurse is reinforcing teaching with an older adult client who is to start taking
warfarin. Which of the following statements indicates the client understands the
teaching?
A. "If I miss a dose, I will double it the next day."
B. "I can continue to eat green salads."
C. "I will need to have laboratory blood testing every 6 months to monitor the
effects of the warfarin."
D. "I should expect my urine to be pink-tinged while I am taking this medication."
- ANS ✓B. "I can continue to eat green salads."
The client should have a diet that is consistent in foods containing vitamin K,
such as green, leafy vegetables. Sudden increases or decreases in this
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consumption will alter the coagulation effects of the warfarin. The nurse should
report any alterations in consumption of foods containing vitamin K.
A nurse is collecting data from an 85-year-old client. Which of the following
findings should the nurse report to the provider?
A. A widened anterior-posterior chest diameter
B. Presence of an S4 heart sound
C. Differences in pulse strength between lower extremities
D. Post-void residual of 75 mL - ANS ✓C. Differences in pulse strength between
lower extremities
A difference in pulse strength can indicate a vascular complication. Assessment
of the peripheral vascular system should also include temperature, color,
sensation, edema, and skin integrity of both the upper and lower extremities. The
nurse should identify any differences in symmetry of these findings and report
them.
A nurse is collecting data from an older adult client who had a right-sided stroke
two days ago. For which of the following findings should the nurse notify the
provider immediately?
A. Increased restlessness
B. Weak grip on the left side
C. Decreased sensation in the lower left extremity
D. Absent gag reflex - ANS ✓A. Increased restlessness
The nurse should apply the urgent versus nonurgent priority-setting framework.
Using this framework, the nurse should consider urgent needs to be the priority
need because they pose more of a threat to the client. The nurse might also need
to use Maslow's hierarchy of needs, the ABC priority-setting framework, or
nursing knowledge to identify which finding is the most urgent. The nurse should
check the client's level of consciousness to evaluate for increases in intracranial
pressure that might have occurred. The nurse should identify increased
restlessness as a sign of possible increases in intracranial pressure, which
requires immediate intervention.
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A nurse is collecting data from an older adult client who has right-sided heart
failure. Which of the following findings is the nurse's priority to report?
A. Oxygen saturation is 92% on room air
B. The client consumes 20% of meals
C. Weight has increased 0.91 kg in 24 hr
D. The client has 1+ edema in the lower extremities - ANS ✓C. Weight has
increased 0.91 kg in 24 hr
The nurse should apply the urgent versus nonurgent priority-setting framework.
Using this framework, the nurse should consider urgent needs to be the priority
need because they pose more of a threat to the client. The nurse might also need
to use Maslow's hierarchy of needs, the ABC priority-setting framework, or
nursing knowledge to identify which finding is the most urgent. The nurse should
evaluate daily weight of client's experiencing heart failure. A weight gain of 0.45
to 0.91 kg (1 to 2 lb) overnight or 1.36 kg (3 lb) within one week is an indication
of worsening heart failure.
A nurse is assisting with the admission of an older adult client who has urinary
incontinence and smells strongly of urine. The client's partner, who has been
caring for her at home, states that he is sorry and embarrassed about the
unpleasant smell. Which of the following responses should the nurse make?
A. "A lot of clients who are cared for at home have the same problem."
B. "Don't worry about it. She will get a bath, and that will take care of the odor."
C. "It must be difficult to care for someone who has incontinence."
D. "When was the last time that she had a bath?" - ANS ✓C. "It must be difficult to
care for someone who has incontinence."
The nurse should use therapeutic responses such as acknowledgement and
empathy when addressing the client's partner. This response is nonjudgmental
and acknowledges the effort the client's partner has made. The use of therapeutic
communication also encourages further discussion and provides the nurse with
an opportunity to teach and to evaluate the need for assistance in the home.
GERONTOLOGY TEST
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