,NUR257/NUR 257 Exam 1 | Geriatric Nursing, Chronic Illness
& Mental Health | Galen College | NCLEX-Style Q & A | 2026
Edition (PDF)
**1. The nurse is caring for an older adult client who has HIV. Which action by the nurse is most
effective to prevent exposure?**
A) Wear a mask whenever entering the room
B) Use contact isolation for all care
C) Wear gloves when contact with blood or body fluids is anticipated
D) Double-glove only when starting an IV
Correct Answer: Wear gloves when contact with blood or body fluids is anticipated
Rationale: Standard precautions, including gloves for contact with blood and body fluids, are sufficient
for HIV-positive clients. Transmission requires exposure to specific body fluids; routine airborne or
contact isolation is not indicated. Gloves should be worn whenever there is potential contact with blood,
mucous membranes, or non-intact skin.
**2. The nurse is assessing an older adult female client. Which finding would cause the nurse to further
question the client regarding possible HIV infection?**
A) One vaginal yeast infection in the past year
B) Six vaginal yeast infections within the last 12 months
C) Occasional urinary tract infections every few years
D) Mild hot flashes at night
Correct Answer: Six vaginal yeast infections within the last 12 months
Rationale: Recurrent or persistent vaginal candidiasis can be a sign of immune compromise, including
HIV infection. Older adults may not perceive themselves as at risk for HIV and may not be routinely
screened. The CDC recommends HIV screening for all adults aged 13-64 at least once, and more
frequently for those at increased risk.
,**3. A nurse is communicating with an elderly client. Which approach is most effective for clear
communication?**
A) Speak loudly and over-enunciate each word
B) Speak in a normal tone, face-to-face, with proper enunciation
C) Use a high-pitched "baby voice" to show warmth
D) Speak quickly to keep the client's attention
Correct Answer: Speak in a normal tone, face-to-face, with proper enunciation
Rationale: Effective communication with older adults involves speaking in a normal tone, facing the
client directly, and enunciating clearly without over-enunciating. There is no need to speak overly loud
or use a "baby voice," which can be perceived as patronizing. Proper enunciation and clear articulation
are key to ensuring the client understands.
**4. The nurse is promoting medication adherence in an older adult client. Which strategy is most
effective?**
A) Provide instructions once and assume understanding
B) Ensure instructions are understandable and support patient goals
C) Give all instructions to the family member instead of the client
D) Focus only on the medication schedule without addressing side effects
Correct Answer: Ensure instructions are understandable and support patient goals
Rationale: Promoting adherence involves ensuring that instructions are clear, understandable, and
aligned with the client's goals. Education should include medication compliance, importance of follow-
up appointments, and treatment education. For example, clients taking certain medications should be
instructed to rise slowly when sitting up or standing to prevent orthostatic hypotension.
**5. The nurse is using the LEARN model to communicate with a client from a different cultural
background. Which step involves listening to the client's perspective?**
A) Listen carefully to what the person is saying and observe cues to meaning
B) Explain your hypotheses and priorities
, C) Recommend a plan of action
D) Negotiate strategies and an action plan
Correct Answer: Listen carefully to what the person is saying and observe cues to meaning
Rationale: The LEARN model stands for Listen, Explain, Acknowledge, Recommend, and Negotiate. The
first step, "Listen," involves carefully attending to the client's words and nonverbal communication to
understand the meaning behind their story. This step is essential for building trust and understanding
the client's perspective before providing education or recommendations.
**6. The nurse is assessing an older adult's skin. Which finding is considered a common but NOT normal
aspect of skin aging?**
A) Dry skin (xerosis)
B) Skin tears and purpura
C) Thinning of the epidermis
D) Reduced sebum production
Correct Answer: Skin tears and purpura
Rationale: Skin tears, purpura (large purple spots from bleeding into the skin), and xerosis (excessive
dryness) are common in older adults but are not considered normal aspects of aging. They indicate skin
fragility and increased risk of injury. Age-related changes include reduced melanocytes, thinning
epidermis, reduced elastin, and reduced sebum production, but these should not result in skin
breakdown without contributing factors.
**7. The nurse is using the SPICES tool to assess an older adult. Which component is included in this
assessment tool?**
A) Sleep disorders
B) Problems with eating or feeding
C) Incontinence
D) All of the above
& Mental Health | Galen College | NCLEX-Style Q & A | 2026
Edition (PDF)
**1. The nurse is caring for an older adult client who has HIV. Which action by the nurse is most
effective to prevent exposure?**
A) Wear a mask whenever entering the room
B) Use contact isolation for all care
C) Wear gloves when contact with blood or body fluids is anticipated
D) Double-glove only when starting an IV
Correct Answer: Wear gloves when contact with blood or body fluids is anticipated
Rationale: Standard precautions, including gloves for contact with blood and body fluids, are sufficient
for HIV-positive clients. Transmission requires exposure to specific body fluids; routine airborne or
contact isolation is not indicated. Gloves should be worn whenever there is potential contact with blood,
mucous membranes, or non-intact skin.
**2. The nurse is assessing an older adult female client. Which finding would cause the nurse to further
question the client regarding possible HIV infection?**
A) One vaginal yeast infection in the past year
B) Six vaginal yeast infections within the last 12 months
C) Occasional urinary tract infections every few years
D) Mild hot flashes at night
Correct Answer: Six vaginal yeast infections within the last 12 months
Rationale: Recurrent or persistent vaginal candidiasis can be a sign of immune compromise, including
HIV infection. Older adults may not perceive themselves as at risk for HIV and may not be routinely
screened. The CDC recommends HIV screening for all adults aged 13-64 at least once, and more
frequently for those at increased risk.
,**3. A nurse is communicating with an elderly client. Which approach is most effective for clear
communication?**
A) Speak loudly and over-enunciate each word
B) Speak in a normal tone, face-to-face, with proper enunciation
C) Use a high-pitched "baby voice" to show warmth
D) Speak quickly to keep the client's attention
Correct Answer: Speak in a normal tone, face-to-face, with proper enunciation
Rationale: Effective communication with older adults involves speaking in a normal tone, facing the
client directly, and enunciating clearly without over-enunciating. There is no need to speak overly loud
or use a "baby voice," which can be perceived as patronizing. Proper enunciation and clear articulation
are key to ensuring the client understands.
**4. The nurse is promoting medication adherence in an older adult client. Which strategy is most
effective?**
A) Provide instructions once and assume understanding
B) Ensure instructions are understandable and support patient goals
C) Give all instructions to the family member instead of the client
D) Focus only on the medication schedule without addressing side effects
Correct Answer: Ensure instructions are understandable and support patient goals
Rationale: Promoting adherence involves ensuring that instructions are clear, understandable, and
aligned with the client's goals. Education should include medication compliance, importance of follow-
up appointments, and treatment education. For example, clients taking certain medications should be
instructed to rise slowly when sitting up or standing to prevent orthostatic hypotension.
**5. The nurse is using the LEARN model to communicate with a client from a different cultural
background. Which step involves listening to the client's perspective?**
A) Listen carefully to what the person is saying and observe cues to meaning
B) Explain your hypotheses and priorities
, C) Recommend a plan of action
D) Negotiate strategies and an action plan
Correct Answer: Listen carefully to what the person is saying and observe cues to meaning
Rationale: The LEARN model stands for Listen, Explain, Acknowledge, Recommend, and Negotiate. The
first step, "Listen," involves carefully attending to the client's words and nonverbal communication to
understand the meaning behind their story. This step is essential for building trust and understanding
the client's perspective before providing education or recommendations.
**6. The nurse is assessing an older adult's skin. Which finding is considered a common but NOT normal
aspect of skin aging?**
A) Dry skin (xerosis)
B) Skin tears and purpura
C) Thinning of the epidermis
D) Reduced sebum production
Correct Answer: Skin tears and purpura
Rationale: Skin tears, purpura (large purple spots from bleeding into the skin), and xerosis (excessive
dryness) are common in older adults but are not considered normal aspects of aging. They indicate skin
fragility and increased risk of injury. Age-related changes include reduced melanocytes, thinning
epidermis, reduced elastin, and reduced sebum production, but these should not result in skin
breakdown without contributing factors.
**7. The nurse is using the SPICES tool to assess an older adult. Which component is included in this
assessment tool?**
A) Sleep disorders
B) Problems with eating or feeding
C) Incontinence
D) All of the above
