Question 1
The nursing assessment of an older female elicits information that the client is diagnosed
with Raynaud's phenomenon. Which exposure should the nurse instruct the client to
avoid?
a) Alcohol consumption
b) Warm climates
c) Cold climates
d) Active exercise
CORRECT ANSWER
Cold Climates
-Can cause prolonged painful vasoconstriction of the peripheral extremities (especially
hands) in client's with Raynaud's phenomenon.
Question 2
A family member brings their aging father to the clinic because he has been alert and
oriented during the day but agitated and disoriented in the evening. The registered nurse
(RN) reviews the client's list of current medications with the client and family. Which
action taken by the RN is most important?
a) Medication review with family caregivers is the PN's responsibility
b) Multiple medications can contribute to sundowner like symptoms
c) Medication recall is the best way to evaluate the client's memory
d) Reviewing medication actions is a component of effective client care
CORRECT ANSWER
Multiple medications can contribute to sundowner like symptoms
1
, -Older clients may see a variety of healthcare providers which can increase the change of
polypharmacy that compounds the workload of metabolic pathways that may be less
efficient due to the aging process. Multiple medication interactions may contribute to
sundowner like symptoms.
Question 3
An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the
left forearm for hemodialysis. After palpating the AV fistula, which finding is an indication
that the AV fistula is functioning properly?
a) Enlarged veins
b) Redness around the site
c) Decreased pulses below the fistula
d) Marked ecchymotic areas
CORRECT ANSWER
Enlarged Veins
-The mixing of arterial and venous blood in an AV fistula causes the veins to enlarge,
which facilitate cannulation for hemodialysis
Question 4
When assessing an older client, which age-related changes in the cardiovascular system
should the registered nurse (RN) document? (Select all that apply).
a) Dyspnea
b) Chest pain
c) Cardiac murmurs
d) Widening pulse pressure
e) Irregular heart rate
CORRECT ANSWER
-Cardiac murmurs
2
, -Widening pulse pressure
Question 5
The home health registered nurse (RN) is changing an older client's wet to dry dressing.
Which observation should the RN evaluate as a therapeutic response with the removal of
the dry dressing?
a) Debridement and removal of slough and eschar
b) Drainage of purulent exudate from the wound
c) Moist skin edges around the wound field
d) Presence of capillary growth in the wound
CORRECT ANSWER
Debridement and removal of slough and eschar
-Wet to dry dressings begin with a wet packing inside of the wound, and then a dry gauze
is used to cover the wet packing to wick drainage and bacteria away from the wound to
promote healing. Removal of dried dressing provides debridement by removing exudate,
sloughing tissue, and eschar.
Question 6
Older clients are at highest risk for abuse and neglect due to which factors? (Select all that
apply)
a) Needs are greater than the caretaker's ability
b) Client's declining strength
c) Fixed income
d) Longer life expectancy
e) Lack of exposure to technology and trends
CORRECT ANSWER
3
The nursing assessment of an older female elicits information that the client is diagnosed
with Raynaud's phenomenon. Which exposure should the nurse instruct the client to
avoid?
a) Alcohol consumption
b) Warm climates
c) Cold climates
d) Active exercise
CORRECT ANSWER
Cold Climates
-Can cause prolonged painful vasoconstriction of the peripheral extremities (especially
hands) in client's with Raynaud's phenomenon.
Question 2
A family member brings their aging father to the clinic because he has been alert and
oriented during the day but agitated and disoriented in the evening. The registered nurse
(RN) reviews the client's list of current medications with the client and family. Which
action taken by the RN is most important?
a) Medication review with family caregivers is the PN's responsibility
b) Multiple medications can contribute to sundowner like symptoms
c) Medication recall is the best way to evaluate the client's memory
d) Reviewing medication actions is a component of effective client care
CORRECT ANSWER
Multiple medications can contribute to sundowner like symptoms
1
, -Older clients may see a variety of healthcare providers which can increase the change of
polypharmacy that compounds the workload of metabolic pathways that may be less
efficient due to the aging process. Multiple medication interactions may contribute to
sundowner like symptoms.
Question 3
An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the
left forearm for hemodialysis. After palpating the AV fistula, which finding is an indication
that the AV fistula is functioning properly?
a) Enlarged veins
b) Redness around the site
c) Decreased pulses below the fistula
d) Marked ecchymotic areas
CORRECT ANSWER
Enlarged Veins
-The mixing of arterial and venous blood in an AV fistula causes the veins to enlarge,
which facilitate cannulation for hemodialysis
Question 4
When assessing an older client, which age-related changes in the cardiovascular system
should the registered nurse (RN) document? (Select all that apply).
a) Dyspnea
b) Chest pain
c) Cardiac murmurs
d) Widening pulse pressure
e) Irregular heart rate
CORRECT ANSWER
-Cardiac murmurs
2
, -Widening pulse pressure
Question 5
The home health registered nurse (RN) is changing an older client's wet to dry dressing.
Which observation should the RN evaluate as a therapeutic response with the removal of
the dry dressing?
a) Debridement and removal of slough and eschar
b) Drainage of purulent exudate from the wound
c) Moist skin edges around the wound field
d) Presence of capillary growth in the wound
CORRECT ANSWER
Debridement and removal of slough and eschar
-Wet to dry dressings begin with a wet packing inside of the wound, and then a dry gauze
is used to cover the wet packing to wick drainage and bacteria away from the wound to
promote healing. Removal of dried dressing provides debridement by removing exudate,
sloughing tissue, and eschar.
Question 6
Older clients are at highest risk for abuse and neglect due to which factors? (Select all that
apply)
a) Needs are greater than the caretaker's ability
b) Client's declining strength
c) Fixed income
d) Longer life expectancy
e) Lack of exposure to technology and trends
CORRECT ANSWER
3
