COMPREHENSIVE STUDY GUIDE 300
QUESTIONS WITH CORRECT ANSWERS
⩥ A frail elderly couple asks the registered nurse (RN) if they have to
watch their salt intake because food does not taste as good as it used to
so they have to season most foods. What information should the RN
offer the couple?
A. Boredom may influence how the taste of food is perceived, and
different seasonings can stimulate taste.
B. With age, an increase in sodium intake is needed to compensate for a
decrease in renal function.
C. Short-term memory loss and confusion may be the reason they want
to over-season their food.
D. Taste buds often are dull due to atrophy so older clients should use
other seasonings instead of salt. Answer: D. Taste buds are often dull due
to atrophy so older clients should use other seasonings instead of salt.
Rationale: Taste buds atrophy with normal aging, which influences an
older client's sensitivity to taste and is often compensated for the use of
stronger tasting seasonings. (A), (B), and (C) are not normal aging
processes related to taste.
,⩥ After taking a 10-day course of an antibiotic that was ineffective, a
frail, elderly client with chronic obstructive pulmonary disease (COPD)
is admitted for pneumonia. The client has a long history of smoking and
still smokes a pack of cigarettes a day. Which finding should the
registered nurse (RN) report to the healthcare provider?
A. Barrel chest with increased chest diameter
B. Crackles and pulse oximetry level of 88%
C. Low hemoglobin and hematocrit levels
D. Arterial blood gases indicating respiratory acidosis. Answer: B.
Crackles and pulse oximetry level of 88%
Rationale: With pneumonia, crackles in the lungs and low O2 saturation
(B) can impact adequate oxygenation, which should be reported to the
HCP. (A) occurs due to chronic hyperinflation of the lungs and is
common in clients with COPD. Anemia (C) is frequently identified in
clients with COPD, and respiratory acidosis (D) due to CO2 retention
contributes to a lower blood pH.
⩥ An older female client recently moved to an assisted living facility.
The family explains to the registered nurse (RN) that the client is
unmanageable and always confused, disoriented and depressed. The
client asks the RN repeatedly, "Where am I?". How should the RN
respond?
A. Explain that she is in a new home called an assisted living
community
B. Question the client about her perception of where she might be now.
,C. Distract the client with a scenario that she is on an outing with her
family.
D. Reassure the client not to worry because she will meet new friends..
Answer: A. Explain that she is in a new home called an assisted living
community.
Rationale: Reality re-orientation (A) is the best response for a client who
is confused because the response is consistent and true. (B, C, and D) do
not provide the client with feedback that is reality based.
⩥ A new resident in an assisted living facility is an older client who is
experiencing short-term memory loss and confusion. Which activity
should the registered nurse (RN) schedule the client to do during the
day?
A. Arts and crafts
B. Current events discussion group
C. Group sing-along
D. Daily exercise group. Answer: D. Daily exercise group
Rationale: A daily exercise group (D) allows the client to mirror the
leader and minimizes the client's stress to remember. (A), (C), and a
current events discussion group (B) are thought-provoking activities that
require attention to detail and short-term memory to participate in the
group activity which may be stressful and frustrating to the resident who
has difficulty remembering sequence of the details.
, ⩥ The hospice nurse is completing a focused assessment of an older
female client with end stage Alzheimer's disease, who recently fractured
her hip. What technique should the registered nurse (RN) use to
determine the client's pain?
A. Use the FACE pain scale
B. Ask the client to rate pain on a scale of 1 to 10
C. Observe for facial grimacing
D. Review documentation of recent eating habits. Answer: C. Observe
for facial grimacing
Rationale: Observing for facial grimacing (C) is the best method for
evaluating pain for a client who cannot communicate due to Alzheimer
disease. (A) and (B) may not be understood by a client with end-stage
Alzheimer's disease. (D) is not a helpful tool for pain assessment.
⩥ An older male client arrives at the clinic for an annual physical
examination. While the nurse assesses the client, the client states that he
is having intimacy problems with his wife. Which information should
the nurse provide to elicit more information from the client?
A. Query client to clarify the client's idea of an intimacy problem.
B. Discuss benign prostatic hypertrophy (BPH) and ejaculation.
C. Explore the frequency that he experiences erectile dysfunction (ED)
D. Determine if the client's wife is young enough to get pregnant.
Answer: A. Query client to clarify the client's idea of an intimacy
problem.