NCLEX PRACTICE QUESTIONS AND ANSWERS

1. A 90-year-old patient comes to the clinic with a family member. During the health history, the
patient is unable to respond to questions in a logical manner. The gerontological nurse's action is
to:

A. ask the family member questions

B. ask the same questions in a louder and lower voice

C. determine if the patient knows the name of the current president

D. rephrase the questions slightly, and slowly repeat them in a lower voice

2. A 75-year-old patient, whose marriage ended in divorce after two years, has lived alone for the
past 50 years. Feeling as if life has had little meaning, the patient is terrified of living out the
remaining years and of dying. The age-related issue to be resolved is:

A. disengagement vs. activity

B. ego integrity vs. despair

C. self-determination vs. resignation

D. self-esteem vs. self-actualizati

3. If a patient is severely dehydrated, what effect will this have on the

complete blood count (CBC)?
a. Increased hemoglobin and hematocrit, decreased blood volume, and stable red blood cell
(RBC) count.

b. Decreased hemoglobin and hematocrit, decreased blood volume, and increased RBC count.

c. Decreased hemoglobin and hematocrit, decreased blood volume, and decreased RBC count.

d. Stable hemoglobin and hematocrit decreased blood volume and stable RBC count.

4. An older patient has an elevated blood urea nitrogen (BUN) level, but the creatinine clearance is within
normal limits. The nurse notes that the patient's appetite has been poor the past few days. What should
the nurse do about these laboratory findings?
1. Assess urine output.
2. Inform the physician of the BUN result.
3. Assess intake and output and dietary intake of protein.
4. Monitor for medication side effects related to decreased excretion by the kidneys.

5. The gerontological nurse is working in a mobile clinic to provide care to a

homeless population. Among the older adults in this population, the health
problems that the gerontological nurse most expects to find include

a. psychiatric/substance abuse disorders.

b. neurological disorders.

c. digestive disorders.

d. traumatic injuries.

6. An experienced nurse tells a younger nurse who is working in a retirement

home that older adults have "outlived their usefulness." What is the term for
this type of prejudice?
a) racism
b) ageism
c) harassment
d) whistle blowing

7. An 80-year-old client is proud of having been an elite athlete during the younger years.
Despite the client's concerted efforts to remain physically active and maintain stamina, the client
is lamenting the loss of exercise tolerance in recent years. Which response by the nurse would be
most appropriate?

A) "The normal increase in blood pressure that accompanies aging leaves you with less cardiac
reserve capacity."
B) "It is normal for your heart to contract less strongly as you age, and this makes you somewhat
less able to exercise vigorously."
C) "It is inevitable that your heart increases in size as you age, and this is associated with a loss
of cardiac function."
D) "As you age, it is common for your heart rate to become less regular and this often results in
fatigue."

8) The patient with dementia presents to the clinic for a routine examination. The patient's
daughter, who is her full-time caregiver, states to the nurse, "I just don't know how much longer I
can go on caring for Mom full time. My kids feel neglected, my marriage is suffering, and I feel
so run down." What is the best response by the nurse?
A. "You must stay strong for your mother. You are all she has."
B."Your mother's dementia will improve once we correct the cause."
C. "You should discuss the many medications available for treating and reversing dementia."
D. "As your mother's condition continues to deteriorate, we should discuss alternative care
resources."

9) An older adult client reports feeling sad and depressed. The nurse asks about life events that have
occurred recently. Which response is anticipated?

a. “My youngest child just got married. Finally!”

b. “Our grandchild was just born, and I love holding that child.”
c. I just retired from my job after working there for 45 years.”
d. ““I just retired My spouse and I are planning a trip to five countries.”

10) An older adult client has a diagnosis of presbycusis. The nurse is most likely to discover which client
problem?

a. Lack of interest in obtaining a hearing aid.

b. Loss of interest in reading books and magazines.

c. Interest in starting a new hobby.

d. Withdrawal from friends and family.

11. An older adult patient is being discharged after the insertion of a permanent pacemaker.
Which statement made by the patient indicates an understanding regarding appropriate self-care?

a) Every morning I will perform arm and shoulder stretches

b) Each day I'll take my pulse and record it in a log

c) I'll have to get rid of my microwave oven

d) I won't be able to use my electrical blanket anymore

12. Which mental change is associated with aging?

A. Confusion
B. Gradual decline in cognitive skills
C. Depression
D. Inappropriate behavior

13. A nurse is caring for a client who presents with linear clusters of fluid-containing vesicles
with some crustings. the nurse should identify the client has manifestations of which of the
following conditions?
A. Allergic reaction
B. Ringworm
C. Systemic lupus erythematosus
D. Herpes Zoster

14. Which pharmacokinetic/pharmacodynamic parameter is least affected by the aging

process?
a. Absorption
b. Distribution
c. Metabolism
d. Excretion

15. An older adult client becomes angry and depressed. The client also stops attending the card
club previously enjoyed. For which problem does the nurse assess this client?

A. Pain
B. Grief
C. Infection
D. Confusion

16. An older adult client reports passing stool about 2 to 3 times a week and often feeling full
and "bloated". Which action does the nurse take first?

A. Asks the client about the amount of daily activity

B. Tells the client to increase fiber in the diet.
C. Asks the client if this is a new problem
D. Tells the client to increase the amount of daily fluids

17. The LPN/LVN cares for a client diagnosed with dementia. Which is the most appropriate
action for the LPN/LVN to take:

A) leave the television on for 8 hours a day.

B) Place familiar objects in the client’s room
C) Darken the room during the evening hours
D) assist the client to the bathroom every 8 hours

18. The nurse is caring for a 77-year-old client diagnosed with UTI. Which is a priority
observation to make:

A) amount and concentration of urine

B) alertness and mental function
C) temperature and blood pressure
D) skin tugor and capillary refill

19. In older men, urinary incontinence is most often caused by:

A. enlargement of the prostate gland
B. weakened smooth muscles of the urethra
C. increased incidence of urinary tract infections
D. low estrogen levels

20. Older adults typically require smaller drug dosages than do younger individuals because of
the decreased function of the:
A. lungs and heart
B. pancreas and thyroid
C. liver and kidneys
D. stomach and intestines

21. The most common symptoms of benign prostatic hypertrophy are:

-chills, fever, and nausea
-dysuria, abdominal pain, and urinary retention
-intermittency, hesitancy, and dribbling
-nocturia, bladder spasms, and hematuria

22. The gerontological nurse is monitoring signs of suspected abuse in an 89-year-old patient
who was admitted from home. When planning for the patient's discharge, the nurses first action
is to:

-delay discharge by informing the provider of the suspected abuse

-enlist the help of family members with transitioning the patient home
-notify Adult Protective Services of the patient's discharge
-restrict the family members' access to the patient prior to discharge

23. An older adult client reports some mild abdominal pain, sudden constipation, and some mild
dyspnea. Which body area does the nurse assess first?

1. Respiratory
2. Abdominal
 3. Cardiac
4. Musculoskeletal

24. An older adult client asks, "Why doesn't my pulse rate go up when I take a long walk? It used
to go up when I exercised." Which response by the nurse is best?

1. "The blood vessels and heart muscle become less elastic."

2. "The heart muscle functions less efficiently with age."
3. "The stroke volume increases rather than the heart rate."
4. "The heart increases in size as the person ages."

25. An effective way to adequately provide nourishment to a patient with moderate dementia is:

1. Allowing the patient to choose foods from a varied menu.

2. Hand-feeding the patient's favorite foods.
3. Routinely reminding the patient about the need for adequate nutrition.
4. Serving soup in a mug and offering finger foods.

26. An experienced nurse tells a younger nurse who is working in a retirement home
that older adults have "outlived their usefulness." What is the term for this type of
prejudice?

a) racism
b) ageism
c) harassment
d) whistle blowing

27. The nurse assess an older adult's living arrangements and care needs with the
knowledge that elder abuse often occurs in situations in which:

a) stress in the caregiver is overwhelming.

b) programs for the elderly are not being utilized.
c) there are several generations providing the care
d) the elderly person is not appreciative of those who provide care
28. The nurse cares for an 82-year-old woman with frequent constipation. Which of the
following statements by the nurse would be inappropriate?
* “You can try light exercise for at least 30 minutes every day.”
* “You should eat dark green vegetables and whole grains.”
* “Make sure you are well hydrated. 6-8 glasses of water a day would be good.”
* “It could help to remove dairy products like milk and cheese from your diet.”
* “You can take a laxative whenever you want to have a bowel movement.”

29. The nurse is discussing end-of-life care procedures with an elderly patient who is Buddhist.
The nurse knows that the patient will most likely want to incorporate:

*Time for meditation

* Prayers to provide support and comfort
* No blood transfusions
* No autopsy and cremation

30. An older adult client reports dependent edema and that shoes feel tight. Additionally, the
client reports feeling restless & some shortness of breath. Which additional piece of information
do the nurse anticipate?

1. Weight loss of 8 pounds over the past 2 months

2. Increased appetites & ingestion of sweets
3. Increased need to urinate frequently throughout the day
4. Weigh gain of 5 pounds in the last 2 weeks

31. An older adult client reports feeling sad & depressed. The nurse asks about life events that
have occurred recently. Which response is anticipated?

1. “My youngest child just got married. Finally!”

2. “Our grandchild was just born, and I love holding that child”
3. "I just retired from my job after working there for 45 years.”
4. “My spouse and I are planning a trip to five countries."

32. An older adult client reports being cold all the time. The client asks the nurse why
this is happening. Which response by the nurse is best?
a. "Adding a sweater to your clothing when you are cold may help."
b. "The temperature in your house may need to be increased."
c. "Maybe your furnace needs to be repaired. Contact a repair person."
Your body doesn't regulate temperature as well as it used to.

32. An older adult client reports feeling sad and depressed. The nurse asks about life
events that have occurred recently. Which response is anticipated?
 a. "My spouse and I are planning a trip to five countries."
b. "Our grandchild was just born, and I love holding that child."
"I just retired from my job after working there for 45 years."
d. "My youngest child just got married. Finally!

33. An 80-year-old patient, who lives at home with a spouse, is instructed to follow a 2 g sodium
diet. The patient states, "I've always eaten the same way all my life, and I'm not going to change
now." To promote optimal dietary adherence, the gerontological nurse's initial approach is to:

a. Inform the patient about the need to follow the diet

b. Inquire about the patient's current food preferences and eating habits

c. List the variety of foods that are allowed on the diet

d. Provide dietary instructions to the patient's spouse, who prepares the meals.

34. Which question does the gerontological nurse prioritize for an 86-year-old patient with
abdominal pain, muscle weakness, and leg cramps.

a. "Do you eat a lot of meat?"

b. "Do you have heart problems?"

c. “Do you take a diuretic?"

d. "Do you walk everyday?"

35. Three months ago, an older adult patient, who lives in an apartment in a housing complex for senior
citizens, began residing with an older adult patient from the same complex. Upon learning of the
situation, the patient's adult child expresses concern to the housing administrator, who reports that both
residents have reported satisfaction with the arrangement. When the child requests advice, the
gerontological nurse's initial response is:

a. "I can understand why you are upset. Has he or she ever done something like this before?"
b. "Why don't we all talk to your parent to get his or her side of the story?"
c. "Your parent has the right to do what he or she wants because he or she is mentally competent."
d. "Your parent seems to be happy with the arrangement. Have you discussed this situation with him or
her?"
36. A nursing instructor teaching classes in gerontology to nursing students discusses myths
related to the aging of adults. Which statement is a MYTH about older adults?

a) most older adults live in their own homes

b) healthy older adults enjoy sexual activity
c) old age means mental deterioration
d) older adults want to be attractive to others

37. Which of the following are characteristics of a chronic illness (select all that apply)

a) has reversible pathologic changes

b) has a consistent, predictable clinical course
c) results in permanent deviation from normal
d) is associated with stable and unstable phases
e) always starts with an acute illness and then progresses slowly

38. Over the next 15 years, the projected number of adults 65 and older is projected to grow to what
percentage?
A.15

B. 20

C. 25

D. 30

39. Beer’s criteria is ____________-

A. list of appropriate medications which can be safely given to older adult patients
B. list of over the counter medications which can be given to older adult patients
C. A list of medications that are considered inappropriate when given to older patients
D. Beers criteria outline characteristics that help define older adult patients who can
drink a prescribed amount of alcoholic beverages under a doctor's care.

40. An older adult lives alone and is independent. The client becomes ill with a diagnosis of
gastritis. The clientʻs adult child visits and finds the client confused and weak. Which is the most
likely cause of these changes?

A. A brain lesion due to cancer

B. Dehydration from the gastritis
C. Lack of nutrients from not eating
D. Depression due to the illness

41. The nurse teaches unlicensed assistive personnel (UAP) about pressure injuries in older
clients. Which information does the nurse include?
a. The loss of subcutaneous fat and vascular changes increase the risk of pressure injuries
b. placing clients on soft surfaces prevents pressure which causes the pressure injuries
c. massaging the bony prominences every 2 hours prevents pressure injuries
d. pulling the clients up in bed changes the pressure points and reduces pressure injuries

42. An older adult client falls and fractures the left hip. After arthroplasty, the client has activity
restrictions until healing has taken place. Which client problem concerns the nurse most?
a. loss of independence
b. inability to perform activities of daily living
c. isolation from social settings
d. depression and loss of interest in living

43. Which age-related changes predispose the elderly patient to drug toxicity and extended
duration of action of drugs?

A. Decreased body of water

B. Increased ratio of muscle to fat
C. Low serum albumin
D. Reduced blood flow to live

44. What should the nurse include in the teaching plan for self-medication practices of older
adults?

A. Eliminate unnecessary medications.

B. Substitute herbal preparations for certain prescribed medications.
C. Develop a drug reminder system and schedule
D. Pharmacy shop for the cheapest medications

45. An older adult client takes verapamil daily for hypertension. New medications are prescribed
for this client. Which medication does the nurse question?
a. Cimetidine
b. Amoxicillin
c. Digoxin
d. Ferrous Sulfate
46. An older adult client lives alone and is dependent. The client becomes ill with a diagnosis of
gastritis. The client’s adult child visits and finds the client confused and weak. Which is the most
likely cause of these changes?
a. A brain lesion due to cancer.
b. Dehydration from gastritis.
c. Lack of nutrients from not eating.
d. Depression due to the illness.

47. Older Adults who become ill are more likely than younger adults to:
a.) complain about symptoms of their problems
b.) refuse to carry out lifestyle changes to promote recovery
c.) seek medical attention because of limitation on their lifestyle
d.) alter their daily living activities to accommodate new symptoms

48. A nurse who is interested in providing care for older adults should identify that most chronic
illnesses are managed in:
a.) hospice care
b.) homeless shelters
c.) the community setting
d.) an acute care hospital

49. Which chronic condition can be triggered by a repetitive stress injury to a single joint?
Answer: Osteoarthritis
A: Osteoarthritis
B: Oastoporosis
C: Rheumatoid ARthrisis
D: Gout

50. What are some examples of IADLS (instrumental Activities of Daily Living)
Answer: Money management, House-keeping, Transport
A: Bathing
B: Toileting
C: House keeping
D: napping

51. An older adult client reports difficulty with balance and memory, and some loss of
sensations. No major health issues are diagnosed for the client. The nurse anticipates which lab
test is abnormal?
A. Calcium level
B. Vitamin B12
C. Vitamin A
D. Iron level

52. An older adult client is admitted after taking an accidental overdose of medication. The nurse
assesses the client to help determine the cause of the overdose. Which does the nurse assess first?
A. Hearing
B. Vision
C. Cognition
D. Smell

53. The nurse teaches a student nurse about health care disparities and older adult
women. Which statement, if made by the student nurse, would indicate an
understanding of the teaching?

a) "Women tend to have a shorter life expectancy than men."

b) "Women tend to have fewer financial resources than men."
c) "Women are less likely to be a caregiver to their spouses."
d) "Women are more likely to have age-related cognitive impairments."

54. 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