GERIATRIC NURSING Engaging staff by demonstrating how data

analysis impacts their specific work fosters

1. A. Autonomy. This principle respects a ownership and drives quality improvement
patient's right to make decisions about their own efforts. A, B, and D might be used along with C,
care, even if those decisions differ from the but focusing on direct relevance is most
healthcare provider's recommendations. effective.
Beneficence focuses on doing good, justice on
fairness in resource allocation, and responsibility 7. D. Serving soup in a mug, and offering finger
on fulfilling professional duties. foods. This approach caters to potential
challenges with dementia: difficulty using
2. C. Intermittency, hesitancy, and dribbling. utensils, decreased hand-eye coordination, and
These are hallmark symptoms of lower urinary smaller appetites. While offering choices (A) can
tract obstruction, common in benign prostatic be ideal, it might be overwhelming for someone
hypertrophy. Chills, fever, and nausea suggest with cognitive impairment. Hand feeding (B)
infection, not BPH. Dysuria (painful urination) might infantilize the patient, and reminders (C)
and hematuria (blood in urine) can occur but are might not be retained.
less common than the triad above.
8. B. "Do you have any food or drug allergies?"
3. C. Notify Adult Protective Services (APS) of Identifying potential allergic reactions to
the patient's discharge. Delaying discharge or medications or topical agents used recently is
restricting family access without proper crucial for initial assessment. While other
investigation are inappropriate. Enlisting family questions might be relevant later, understanding
might not be safe if they're involved in the allergies is more pressing.
abuse. APS can assess the situation and take
necessary actions to protect the patient. 9. B. "Do you have heart problems?" Abdominal
pain, muscle weakness, and leg cramps can be
4. B. The resident was not included in the symptoms of heart issues like congestive heart
decision making. Residents have autonomy failure. While other factors might contribute (A,
regarding their living environment. While C, D), prioritizing heart evaluation is important.
improving the view could be seen as positive,
changing the room without consent violates their 10. D. Use repeated return demonstrations to
right to participate in decisions affecting their promote the patient's retention of the involved
well-being. Provider orders don't excuse tasks. Individualized, hands-on practice allows
disregarding resident autonomy. the patient to learn at their own pace and solidify
the skill through repetition. A group setting (A)
5. A. Ask the supervisor to get an interpreter. might be distracting, family history (B) is
Effective communication is crucial. While irrelevant here, and competitive testing (C) might
attempting comfort or contacting the provider create anxiety and hinder learning.
without understanding the situation might be
counterproductive, seeking an interpreter allows 11. C. Distortion of lines and print. This is a key
proper assessment and intervention according symptom of age-related macular degeneration,
to the resident's needs. Finding an escort is affecting central vision. Depth perception (A) is
unnecessary unless specifically requested for unaffected, peripheral vision (B) might decrease
privacy. slightly, and flashes of light (D) can occur in
other retinal conditions.
6. C. Informing how data and outcomes are
directly related to the staff's daily work.
12. A. Arranging inpatient respite care for the more serious issue requiring immediate
spouse. This temporary solution allows the assessment.
patient to focus on recovery without neglecting
their spouse's needs. B and D are unnecessary 18. A. Arrange the patient's meal tray so that all
hospitalizations. C might be overkill, depending the food is in the patient's field of vision. This
on the spouse's condition and financial maximizes food intake and reduces frustration.
resources. B and C might help but don't address the
specific vision issue. D might be
13. D. Rephrase the questions slightly, and counterproductive if the patient feels isolated.
slowly repeat them in a lower voice. Asking the
family member first (A) bypasses the patient and 19. B. Inquire about the patient's current food
might not be accurate. Raising or lowering voice preferences and eating habits. Building on
(B) might not address cognitive issues. existing habits increases acceptability and
Checking presidential knowledge (C) is adherence. A is repetitive, C might overwhelm,
irrelevant. Reframing questions and speaking and D might not effectively engage the patient.
slowly encourages understanding without
singling out the patient.
20. D. Tardive dyskinesia. This involuntary
movement disorder is a potential side effect of
14. B. That the health status data of older adult neuroleptics. Lethargy (A), nausea (B), and poor
patients be documented in a retrievable form. appetite (C) are common but less concerning
Accurate documentation ensures continuity of side effects.
care and informed decision-making. A is
inaccurate, C emphasizes patient autonomy but
neglects healthcare team input, and D 21. D. Working with Hispanic groups in the
contradicts the dynamic nature of geriatric care. community. Collaboration extends beyond
individual patients. Engaging with the broader
community through culturally relevant groups
15. A. The ombudsman may proceed with the fosters trust, understanding, and effective care
investigation without identifying the individual delivery. A and B are important aspects of care,
who made the complaint, and without obtaining but not specific to collaboration. C might be
a court order or written consent. Ombudsmen helpful but doesn't demonstrate broader
protect confidentiality and have legal authority to community engagement.
investigate. B and C are incorrect, and D
requires permission only in specific situations.
22. D. The patient reports no breakthrough pain
medications are needed. Hospice care focuses
16. B. A 70-year old male patient with a total on comfort and managing symptoms, not
cholesterol level of 181 mg/dL, and a necessarily eliminating them. A caregiver
low-density lipoprotein level of 90 mg/dL. Both requesting more care implies unmet needs. B
factors contribute to arteriosclerosis. A: High indicates bypassing the hospice team for
HDL helps protect against it. C: Both LDL and individual care, and C might not reflect overall
Triglycerides are high, but LDL directly well-being.
contributes to plaque buildup. D: LDL is high, but
HDL partially mitigates its effect.
23. A. Continuity theory. This theory proposes
that individuals strive to maintain continuity and
17. D. "Have you noticed blood in your urine?" coherence with their past experiences into later
While other symptoms suggest lower urinary life. Engaging in lifelong interests like swimming
tract obstruction, hematuria could indicate a and singing aligns with this concept.
Developmental theory focuses on growth and demonstrations to promote the patient's
change, disengagement on withdrawal, and retention of the involved tasks.
physical theory on biological decline.
Question 11
The right answer was distortion of lines and
24. B. Ego integrity vs. despair. This Eriksonian
print.
stage focuses on finding meaning and purpose
in life, contrasting with despair about wasted Question 14
opportunities and a meaningless existence. The right answer was that the health status data
Disengagement (A) isn't the central issue. of older adult patients be documented in a
Self-determination (C) and self-esteem (D) are retrievable form.
important, but not the core concern here.
Question 15
The right answer was The ombudsman may
25. D. "Your parent seems to be happy with the
proceed with the investigation without identifying
arrangement. Have you discussed this situation
the individual who made the complaint, and
with him or her?" This neutral and open-ended
without obtaining a court order or written
approach acknowledges the child's concern,
consent.
validates the parent's autonomy, and
encourages family communication without taking Question 16
sides. A might be judgmental, B could create The right answer was A 75-year old female
conflict, and C is dismissive of the child's patient with a triglyceride level of 189 mg/dL,
concern. and a low-density lipoprotein level of 149 mg/dL.

Question 2 Question 17
The right answer was intermittency, hesitancy, The right answer was "Have you noticed blood
and dribbling. in your urine?"

Question 3 Question 18
The right answer was notify Adult Protective The right answer was arrange the patient's meal
Services of the patient's discharge. tray so that all the food is in the patient's field of
vision.
Question 5
The right answer was ask the supervisor to get Question 19
an interpreter. The right answer was inquire about the patient's
current food preferences and eating habits.
Question 6
The right answer was informing how data and Question 20
outcomes are directly related to the staff's daily The right answer was tardive dyskinesia.
work.
Question 21
Question 7 The right answer was working with Hispanic
The right answer was serving soup in a mug, groups in the community.
and offering finger foods.
Question 22
Question 9 The right answer was The patient reports no
The right answer was "Do you take a diuretic?" breakthrough pain medications are needed.

Question 10 Question 23
The right answer was use repeated return The right answer was Continuity.
Question 24 the client understands the methods of improving
The right answer was ego integrity vs. despair. sleep.

26. Later adulthood refers to the life stage after 29. a) Crusting
the age of 65+. This stage is characterized by The normal physiological changes that occur in
various physical, cognitive, and social changes. the skin of older adults include thinning of the
During this phase, individuals may experience skin, loss of elasticity, deepening of expression
retirement, changes in health, and adjustments lines, and wrinkling. Crusting noted on the skin
in their social roles. They may also face would indicate a potential complication.
challenges related to aging, such as declining
physical abilities and increased risk of chronic 30.
illnesses. This stage is often associated with b) Decline in visual acuity
wisdom, reflection, and the opportunity for e) Increased susceptibility to urinary tract
personal growth and fulfillment. infections
27. Erikson defines older age as a stage of life f) Increased incidence of awakening after sleep
where individuals face the psychosocial conflict onset
of integrity versus despair. This stage occurs in
late adulthood, typically after the age of 65. Geriatric Nursing Exam Questions Rationale:
During this stage, individuals reflect on their Anatomical changes to the eye affect the
lives and evaluate whether they have lived a individual's visual ability, leading to potential
meaningful and fulfilling life. Those who have a problems with activities of daily living. Light
sense of integrity feel a sense of satisfaction and adaptation and visual fields are reduced.
wisdom, while those who experience despair Although lung function may decrease, the
may feel regret and a sense of hopelessness. respiratory rate usually remains unchanged.
This stage involves coming to terms with Heart rate decreases and heart valves thicken.
mortality and accepting the limitations of aging. Age-related changes that affect the urinary tract
28. c) "I drink hot chocolate before bedtime." increase an older client's susceptibility to urinary
Many nonpharmacological sleep aids can be tract infections. Short-term memory may decline
used to influence sleep. However, the client with age, but long-term memory usually is
should avoid caffeinated beverages and maintained. Change in sleep patterns is a
stimulants such as tea, cola, and chocolate. The consistent, age-related change. Older persons
client should exercise regularly, because experience an increased incidence of awakening
exercise promotes sleep by burning off tension after sleep onset.
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
MEDICAL SURGICAL NURSING impulse that travels across the cell membrane,
1. b) Each day I'll take my pulse and record it in triggering contraction.
a log POtassium: Regulates contraction and
Initially, patients should limit arm and shoulder relaxation: After sodium initiates the contraction,
activity on the operative side to prevent potassium flows out of the cell, bringing it back
dislodgment of the pacing leads. to its resting state and enabling relaxation.
Microwave ovens and electric blankets will not Calcium: Contributes to force of contraction:
adversely affect the pacemaker. Calcium binds to proteins within the muscle
cells, allowing them to contract with more force.
2. a) Initiate a heparin infusion Regulates electrical conduction: Calcium also
influences the speed and timing of electrical
The antidysrhythmic will help control rhythm and impulses within the heart, ensuring synchronized
rate, so atropine (an anticholinergic) is not contractions.
indicated.
Cardioversion or ablation is usually reserved for 5. The correct answer is B: Place the child
patients who have not responded to on the side Protecting the airway is the top
antidysrhythmic medications. priority in a seizure. If a child is actively
Because blood tends to pool and clot in the convulsing, a patent airway and
fibrillating atria, patients with atrial fibrillation are
oxygenation must be assured.
at high risk for embolic stroke, so heparin will be
given
6. The correct answer is B: Suction
excessive tracheobronchial secretions
3. c) Monitor insertion site and distal pulses Suctioning the copious tracheobronchial
The extremity where the catheter was inserted secretions present in post-thoracic surgery
will be immobilized initially, so the patient will not clients maintains an open airway which is
be allowed out of bed to use the bathroom. always the priority nursing intervention.
The patient will be on a cardiac monitor so
auscultation of the apical pulse for one minute is 7. The correct answer is C: Prolonged
not a priority.
hypoxemia Most often, the cause of cardiac
Because the catheter may cause trauma to the
arrest in the pediatric population is
vessels, the healthcare provider will monitor for
hematoma formation and interference of prolonged hypoxemia. Children usually
circulation distal to the insertion site. have both cardiac and respiratory arrest.

4. b) Sodium, potassium, and calcium 8.The correct answer is D: Observe a return

BUN and creatinine levels are always important demonstration Since this is a psychomotor
to monitor when giving any drug, not only skill, this is the best way to know if the client
antidysrhythmia drugs. has learned the proper technique.
The PT and INR will be important for patients
who are on warfarin (Coumadin).
9. The correct answer is A: An 18 month-old
Because abnormalities in sodium, potassium
who ate an undetermined amount of crystal
and calcium levels are likely to affect
depolarization and repolarization of cardiac drain cleaner. Drain cleaner is very alkaline.
cells, it is most important for the healthcare The orange juice is acidic and will help to
provider to monitor these laboratory values. neutralize this substance.
Sodium: Initiates the heartbeat: When sodium
enters heart muscle cells, it creates an electrical
10. The correct answer is C: Anticipation of varices are dilated and tortuous vessels of
the birth Directing activities toward the esophagus that are at high risk for
preparation for the newborn''s needs and rupture if portal circulation pressures rise.
personal adjustment are indicators of
appropriate emotional response in the third 17. The correct answer is A:
trimester. Immunosuppression The decreased
immunity leads to frequent secondary
11. The correct answer is B: Excessive infections. Herpes simplex virus type 1 is an
fluoride intake The described findings are opportunistic infection. The other options
indicative of fluorosis, a condition may result in HSV-1. However they are not
characterized by an increase in the extent the most likely cause in clients with HIV.
and degree of the enamel''s porosity. This
problem can be associated with repeated 18. The old woman is in the middle of a train
swallowing of toothpaste with fluoride or railway. It is very unsafe to immobilize here
drinking water with high levels of fluoride. legs and remain still at the middle of a
railway considering that a train might come
12. The correct answer is A: Cough and anytime while waiting for an ambulance.
deep breathe every 2 hours Respiratory Safety is the utmost importance at this
infections are common because of fluid in point. If letter D is not among the choices
the retro peritoneum pushing up against the and the situation is a little less dangerous,
diaphragm causing shallow respirations. the answer will be A. Remember that in all
Encouraging the client to cough and deep cases of emergencies, removing the victim
breathe every 2 hours will diminish the from the scene to a much safer place is a
occurrence of this complication. priority.
13. The correct answer is D: Observe
swallowing patterns The nurse should 19. After a trauma, C. Inflammation will start
observe for increased swallowing frequency almost instantly. Infection occurse 24-48
to check for hemorrhage. hours after bone fracture and not
immediately. Thrombophlebitis occurs within
14. The correct answer is A: Notify the 4 to 7 days of hospitalization after prolonged
health care provider immediately The health immobilization. There is no evidence that
care provider must be contacted the client has a degenerative disease and
immediately as the client is a danger to self degenerative diseases will manifest in
and others. Hospitalization is indicated. variety of ways and not after a trauma.

15. The correct answer is A: "You think that 20. hemorrhage results in severing of the
someone wants to poison you?" This vascular supply of the bone of the femur
response acknowledges perception through and the pelvis due to the fracture leading to
a reflective question which presents bleeding causing the s/s of A. tachycardia
opportunity for discussion, clarification of and hypotension.
meaning, and expressing doubt.
21. A. The nurse has no authority order the
16. The correct answer is B: Potential radiology department for a chest x ray
complication hemorrhage Esophageal evaluation nor order for a sputum exam.
The client need not be isolated because condition of a person and so is the amount
Mantoux test do not determine the of blood in the tube.
activeness of the disease.
28. The symptoms may be associated with
22. A. Category I patients are those with a ulcerative colitis. It is a chronic inflammatory
newly diagnosed TB whose sputum culture condition producing edema and ulceration
are positive. II are for those who have that may affect the entire colon. Ulcerations
relapses while III are those with negative lead to sloughing that causes stools as
sputum culture but positive chest x ray, or many as 20 times a day which is filled with
PTB Minimal. 16. How long is the duration blood, mucous and pus. The other
of the maintenance ph symptoms are mentioned accompany the
problem.
23. Nutrition, Long term immunosupression
and drug abuse are all factors that affects 29. Explanation: During the old age the
the resistance of an individual in acquiring degenerative changes occur. The response
communicable diseases. Other factors of pain in the olderly may be lessened
includes extremes of ages, poor because of reduced acuity of touch,
environmental sanitation, poverty and poor alternations of the neural pathways and
living conditions. Diabetes insipidus does diminished process of sensory data.
not, in anyway alter a persons immune
response. 30. Explanation: The nurse should assess
thoroughly that could indicate alterations in
24. All diagnostic, case finding and cerebral functions, increased intracranial
treatment belongs to the secondary level of pressure, fractures and bleeding. Bleeding
prevention. from the ears occurs only with basal skull
fracture that contribute to increase the
25. This is unecessary. Suctioning is done intracranial pressure and brain herniation.
on PRN basis and not every hour. A,B and
C are all correct processes of suctioning a
tracheostomy.

26. * A is used in pediatric clients. B is for

children and C is for adults. 20-25 mmHg is
too much for a portable suction unit and is
not recommended

27. an RR of 18 means that James is not

tachypneic and has an adequate air
exchange. Oxygen saturation should be
more than 95%. Frank blood is not expected
in the suction tube. A slight tinged of blood
in the tube is acceptable and expected.
Amount of secretion are not in anyway
related in assessing the respiratory