NCLEX Questions on Older Adults

Extract:

Question 1 of 5

The nurse is assessing the 84-year-old client during a routine health examination. Which finding should the nurse investigate first?

Correct Answer: B

Rationale: Impaired swallowing increases aspiration risk and may indicate a non-age-related condition, requiring priority investigation. Decreased cough, light urine, and height loss are age-related.

Question 2 of 5

The nurse is reviewing a laboratory report for a 61-year-old client. Which finding is most important for the nurse to address with the HCP?

A. Total cholesterol 180 mg/dL; was 140 at age 50 B. Erythrocyte sedimentation rate (ESR) increased C. Alkaline phosphatase increased D. AST, ALT, and serum bilirubin increased

Correct Answer: D

Rationale: Elevated liver function tests (AST, ALT, bilirubin) are not age-related and suggest liver pathology, requiring immediate HCP notification. Cholesterol, ESR, and alkaline phosphatase increases are normal with aging.

Question 3 of 5

The 62-year-old client is diagnosed with osteoporosis. Which medication, if taken by the client, should the nurse identify as posing a secondary risk factor for the client’s osteoporosis?

A. Baby aspirin daily for past 4 years B. Escitalopram 5 mg daily for past 7 months C. Multivitamin for many years D. 10-year use of budesonide nostril spray bid

Correct Answer: D

Rationale: Long-term corticosteroid use, like budesonide, is a risk factor for osteoporosis. Aspirin, escitalopram, and multivitamins (with calcium/vitamin
D) do not contribute to bone loss.

Question 4 of 5

The nurse is obtaining nutrition information from four 20-year-old female clients. All have a BM] of 20 to 23. Which client requires the most immediate follow-up?

A. The client eats three nutritious meals a day with no snacks B. The client limits her intake to 2500 calories per day C. The client eats only fruits, vegetables, seeds, and nuts D. The client eats three 350-calorie meals per day

Correct Answer: D

Rationale: By limiting meals to 350 calories each, the client consumes only 1050 calories daily, insufficient for a sedentary female’s basic energy needs, requiring immediate follow-up. Three nutritious meals may suffice, 2500 calories is appropriate, and a vegetarian diet needs protein assessment but is less urgent.

Question 5 of 5

The home health nurse suspects elder mistreatment of the 93-year-old client by the live-in caregiver. Which findings support the nurse’s conclusion? Select all that apply.

A. Client has urine burns B. Client has wrist bruises C. Client states there have been some unexplained financial expenditures D. Client is more talkative than during previous home visits E. Smell of alcohol noted on live-in caregiver’s breath

Correct Answer: A;B;C;E

Rationale: Urine burns (neglect), wrist bruises (physical abuse), unexplained expenditures (financial abuse), and caregiver alcohol use (abuser characteristic) support mistreatment. Increased talkativeness suggests comfort, not abuse.