ATI RN
geriatric nursing exam questions with rationale Questions
Question 1 of 5
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 2 of 5
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 3 of 5
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 4 of 5
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 5
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.