ATI RN
geriatric nursing exam questions with rationale Questions
Question 1 of 9
An older woman retires after a long career as an elementary school principal and begins to volunteer in the local library reading to children. The older woman is very pleased with her volunteer activities. This is consistent with which theory of aging?
Correct Answer: A
Rationale: The correct answer is A: Role theory. Role theory suggests that individuals continue to seek fulfilling roles and activities in older age to maintain a sense of purpose and identity. In this scenario, the older woman's transition from a career as a school principal to volunteering at the library aligns with the idea of seeking meaningful roles. B: Disengagement theory posits that older adults withdraw from society as they age, which contradicts the woman's active engagement in volunteering. C: Age-stratification theory focuses on how age influences opportunities and constraints within society, not on individual choices like volunteering. D: Social exchange theory emphasizes reciprocal relationships and benefits gained from social interactions, which is not the primary focus in this scenario.
Question 2 of 9
Aging ordinarily leads to decreases in which of the following?
Correct Answer: D
Rationale: The correct answer is D: Serum triiodothyronine (T3) and gastric pepsin. Aging typically leads to a decrease in serum T3 levels due to reduced thyroid function. Gastric pepsin production also decreases with age, impacting digestion. A: Creatinine clearance and insulin secretion typically decrease with kidney and pancreatic function decline, not necessarily solely due to aging. B: Blood CO2 levels and saliva production are not directly affected by aging but can be influenced by various health conditions. C: Left ventricle-wall thickness may increase with age due to conditions like hypertension, and skin healing time can be affected by various factors other than just aging. In summary, the correct answer stands out as age-related declines in serum T3 and gastric pepsin levels are more directly linked to the aging process compared to the other choices.
Question 3 of 9
Mr. Abramson has been diagnosed with benign prostatic hypertrophy (BPH) by his primary care provider. The most likely symptoms that prompted him to initially seek health care is___
Correct Answer: A
Rationale: The correct answer is A: Nocturia. Nocturia, or waking up at night to urinate, is a common symptom of benign prostatic hypertrophy (BPH) due to the enlarged prostate pressing on the urethra, causing urinary frequency and urgency. Other symptoms like weak urine stream, difficulty starting urination, incomplete emptying, and dribbling may also be present. Recurrent urinary tract infections (B) are less likely to be the initial symptom of BPH, as they are more commonly associated with urinary retention or obstruction. Functional incontinence (C) is not a typical symptom of BPH, as it is more related to mobility or cognitive issues. Hematuria (D) is not a common presenting symptom of BPH, as it is more indicative of other conditions like urinary tract infections or kidney stones.
Question 4 of 9
The common symptom associated with moderate to severe peripheral arterial disease (PAD) is___.
Correct Answer: D
Rationale: The correct answer is D. Intermittent claudication, defined as pain in the lower extremities with walking that improves with rest, is a classic symptom of moderate to severe PAD. This occurs due to inadequate blood flow to the muscles during exercise. Other choices are incorrect: A is typically associated with syncope or fainting; B is more indicative of cardiovascular or pulmonary issues; and C is more commonly seen in mesenteric ischemia.
Question 5 of 9
The nurse is providing medication instructions to an older client who is taking digoxin (Lanoxin) daily. What age-related body changes could place the client at risk for digoxin toxicity?
Correct Answer: A
Rationale: The correct answer is A: Decreased lean body mass and decreased glomerular filtration rate. 1. Decreased lean body mass: With aging, there is a natural decline in muscle mass which can affect the distribution and metabolism of digoxin, potentially increasing its concentration in the body. 2. Decreased glomerular filtration rate: As individuals age, there is a decrease in kidney function, particularly in the glomerular filtration rate, which can lead to decreased excretion of digoxin, resulting in its accumulation and potential toxicity. Therefore, these age-related changes can place the older client at risk for digoxin toxicity. Summary: B: Increased muscle mass and improved renal function - This choice is incorrect as aging is associated with decreased muscle mass and declining renal function. C: Higher levels of albumin and increased drug metabolism - This choice is incorrect as aging is typically associated with decreased albumin levels and slower drug metabolism. D: Decreased hepatic function and increased body fluid
Question 6 of 9
The nurse is reviewing the care plan of an 89 yr old client who has been admitted for prostate surgery. The client is on medication for hypertension and had a recent fall at home prior to admission. The nurse would include which assessment in the care plan?
Correct Answer: B
Rationale: The correct answer is B. Checking postural blood pressures is essential to assess for orthostatic hypotension in an elderly client with a history of falls and hypertension medication. Orthostatic hypotension can lead to falls, so monitoring postural B/Ps is crucial. Checking B/P every 2 hours (choice A) is not necessary and could cause unnecessary discomfort to the client. Checking serum sodium levels (choice C) and serum creatinine levels (choice D) are not directly related to the client's risk factors for falls post-prostate surgery.
Question 7 of 9
In the management of older adults with dementia, which approach is considered best for reducing agitation and aggression?
Correct Answer: C
Rationale: The correct answer is C because consistent routines and environmental modifications have been shown to be the most effective approach in reducing agitation and aggression in older adults with dementia. This approach focuses on providing structure and familiarity, which can help decrease confusion and anxiety in individuals with dementia. Physical restraints (A) are not recommended as they can lead to further agitation and pose risks of injury. Increased sedation with antipsychotics (B) should be used as a last resort due to potential side effects and risks. Ignoring the behavior (D) is not appropriate as it can exacerbate the situation and lead to further distress for the individual.
Question 8 of 9
Postural hypotension may be caused by all of the following except______
Correct Answer: B
Rationale: Postural hypotension is a drop in blood pressure when standing up. Increased cholesterol levels do not directly affect blood pressure regulation or lead to postural hypotension. Medications, decreased baroreceptor sensitivity, and arterial stiffness can all contribute to postural hypotension by affecting blood pressure regulation mechanisms. Therefore, choice B, increased cholesterol level, is the correct answer as it does not directly cause postural hypotension.
Question 9 of 9
The nurse is performing an assessment on an older client who is having difficulty sleeping at night. What statement by the client indicates education is needed on improving sleep?
Correct Answer: C
Rationale: The correct answer is C because drinking hot chocolate before bed contains caffeine which can disrupt sleep. A is correct as exercise can promote better sleep. B is correct as smoking can affect sleep quality. D is correct as reading before bed can help relax the mind.