ATI RN
geriatric nursing exam questions with rationale Questions
Question 1 of 9
When caring for an older adult with advanced heart failure, which intervention is most likely to improve the patient's quality of life?
Correct Answer: B
Rationale: The correct answer is B: Providing palliative care focused on symptom management and comfort. This is the most appropriate intervention for an older adult with advanced heart failure as it prioritizes quality of life by focusing on alleviating symptoms and ensuring comfort. High-dose diuretics (choice A) may lead to electrolyte imbalances and worsen the patient's condition. Initiating aggressive cardiac surgery (choice C) may be too risky and invasive for an older adult with advanced heart failure. Enforcing strict bed rest (choice D) can lead to deconditioning and muscle wasting, further compromising the patient's quality of life.
Question 2 of 9
Which of the following best describes the role of a gerontological nurse practitioner?
Correct Answer: B
Rationale: The correct answer is B because a gerontological nurse practitioner is trained to manage chronic conditions and promote health in older adults through preventive care, education, and treatment. This role involves a holistic approach to addressing the physical, mental, and social aspects of aging. Choice A is incorrect as palliative care is just one aspect of their role. Choice C is incorrect as they work in various settings, not just nursing homes. Choice D is incorrect as they work with a range of older adult patients, not just those with psychiatric conditions.
Question 3 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 4 of 9
How does polypharmacy affect older adults?
Correct Answer: B
Rationale: The correct answer is B because polypharmacy in older adults increases the risk of adverse drug reactions and interactions due to multiple medications being taken concurrently. This can lead to medication errors, decreased adherence, drug toxicity, and increased healthcare costs. Choice A is incorrect as polypharmacy does not improve overall quality of life but rather can negatively impact it. Choice C is incorrect as polypharmacy does not prevent age-related health conditions but can exacerbate them. Choice D is incorrect as polypharmacy has a significant impact on health outcomes in older adults.
Question 5 of 9
The home health nurse is visiting a client for the first time. While assessing the client's medication, it is noted that there are 19 prescription and several over-the-counter medications that the client is taking. What intervention should the nurse take first?
Correct Answer: A
Rationale: The correct answer is A: Determine whether there are medication duplications. This is the first intervention the nurse should take because medication duplications can lead to potential drug interactions and adverse effects. By identifying duplicate medications, the nurse can prevent harm to the client. Choice B: Starting to educate the client on proper medication adherence may be important, but it is not the first priority in this scenario. Choice C: Monitoring the client's blood pressure closely is not directly related to the issue of multiple medications and should not be the first intervention. Choice D: Asking the client to stop taking some medications without proper assessment and consultation with a healthcare provider can be risky and may not address the issue of medication duplications.
Question 6 of 9
In gerontological nursing, what is the most important factor in assessing the risk for elder abuse?
Correct Answer: B
Rationale: The correct answer is B: Cognitive decline or dementia. Elder abuse risk assessment in gerontological nursing involves considering cognitive decline or dementia as the most important factor. This is because individuals with cognitive impairments are more vulnerable and may have difficulty recognizing and reporting abuse. Family history of violence (A), history of physical ailments (C), and medication regimen (D) are important factors to consider but do not directly impact the elder abuse risk assessment as significantly as cognitive decline or dementia.
Question 7 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 8 of 9
An older woman with a UTI reports mild symptoms and a low-grade fever. Why didn’t she develop a higher temperature?
Correct Answer: B
Rationale: The correct answer is B because normal age-related immune changes can result in a lower fever response to illness in older adults. As people age, their immune system may not respond as vigorously to infections, leading to a muted fever response. This explains why the older woman with a UTI experienced only mild symptoms and a low-grade fever. Choice A is incorrect because the seriousness of a UTI does not necessarily correlate with the presence or absence of a fever. Choice C is incorrect as older adults can still develop fevers in response to infections. Choice D is incorrect as it is too broad and does not specifically address the age-related immune changes that impact fever response in older adults.
Question 9 of 9
Pneumonia in the older client can be caused by all of the following except_____.
Correct Answer: C
Rationale: The correct answer is C: sleep apnea. Sleep apnea is a sleep disorder characterized by pauses in breathing during sleep, which does not directly cause pneumonia. Aspiration from a poor swallow (A), community acquired pneumonia (B), and compromised immune function (D) are all known risk factors for pneumonia in older adults. Aspiration can lead to the entry of bacteria into the lungs, community-acquired pneumonia is a common cause of infection in the elderly, and compromised immune function makes older adults more susceptible to infections. Thus, sleep apnea is the only option that does not directly contribute to the development of pneumonia in older clients.