GERONTOLOGICAL NURSING 10 VIEW AHEAD
2026 COMPREHENSIVE STUDY SET
◉ The nurse is aware that malnutrition is a common problem among
clients served by a community health clinic for the homeless. Which
laboratory value is the most reliable indicator of chronic protein
malnutrition?
A. Low serum albumin level
B. Low serum transferrin level
C. High hemoglobin level
D. High cholesterol level Answer: A
Rationale: Long-term protein deficiency is required to cause
significantly lowered serum albumin levels. Albumin is made by the
liver only when adequate amounts of amino acids (from protein
breakdown) are available. Albumin has a long half-life, so acute
protein loss does not significantly alter serum levels. Option B is a
serum protein with a half-life of only 8 to 10 days, so it will drop
with an acute protein deficiency. Options C and D are not clinical
measures of protein malnutrition.
◉ In completing a client's preoperative routine, the nurse finds that
the operative permit is not signed. The client begins to ask more
questions about the surgical procedure. Which action should the
nurse take next?
A. Witness the client's signature to the permit.
,B. Answer the client's questions about the surgery.
C. Inform the surgeon that the operative permit is not signed and the
client has questions about the surgery.
D. Reassure the client that the surgeon will answer any questions
before the anesthesia is administered. Answer: C
Rationale: The surgeon should be informed immediately that the
permit is not signed. It is the surgeon's responsibility to explain the
procedure to the client and obtain the client's signature on the
permit. Although the nurse can witness an operative permit, the
procedure must first be explained by the health care provider or
surgeon, including answering the client's questions. The client's
questions should be addressed before the permit is signed.
◉ The nurse is assessing several clients prior to surgery. Which
factor in a client's history poses the greatest threat for complications
to occur during surgery?
A. Taking birth control pills for the past 2 years
B. Taking anticoagulants for the past year
C. Recently completing antibiotic therapy
D. Having taken laxatives PRN for the last 6 months Answer: B
Rationale:
Anticoagulants increase the risk for bleeding during surgery, which
can pose a threat for the development of surgical complications. The
health care provider should be informed that the client is taking
these drugs. Although clients who take birth control pills may be
,more susceptible to the development of thrombi, such problems
usually occur postoperatively. A client with option C or D is at less of
a surgical risk than with option B.
◉ When assisting a client from the bed to a chair, which procedure is
best for the nurse to follow?
A. Place the chair parallel to the bed, with its back toward the head
of the bed and assist the client in moving to the chair.
B. With the nurse's feet spread apart and knees aligned with the
client's knees, stand and pivot the client into the chair.
C. Assist the client to a standing position by gently lifting upward,
underneath the axillae.
D. Stand beside the client, place the client's arms around the nurse's
neck, and gently move the client to the chair. Answer: B
Rationale: Option B describes the correct positioning of the nurse
and affords the nurse a wide base of support while stabilizing the
client's knees when assisting to a standing position. The chair
should be placed at a 45-degree angle to the bed, with the back of
the chair toward the head of the bed. Clients should never be lifted
under the axillae; this could damage nerves and strain the nurse's
back. The client should be instructed to use the arms of the chair and
should never place his or her arms around the nurse's neck; this
places undue stress on the nurse's neck and back and increases the
risk for a fall.
, ◉ Which step(s) should the nurse take when administering ear
drops to an adult client? (Select all that apply.)
A. Place the client in a side-lying position.
B. Pull the auricle upward and outward.
C. Hold the dropper 6 cm above the ear canal.
D. Place a cotton ball into the inner canal.
E. Pull the auricle down and back. Answer: A, B
Rationale: The correct answers (A and B) are the appropriate
administration of ear drops. The dropper should be held 1 cm (½
inch) above the ear canal (C). A cotton ball should be placed in the
outermost canal (D). The auricle is pulled down and back for a child
younger than 3 years of age, but not an adult (E).
◉ The nurse is instructing a client in the proper use of a metered-
dose inhaler. Which instruction should the nurse provide the client
to ensure the optimal benefits from the drug?
A. "Fill your lungs with air through your mouth and then compress
the inhaler."
B. "Compress the inhaler while slowly breathing in through your
mouth."
C. "Compress the inhaler while inhaling quickly through your nose."
D. "Exhale completely after compressing the inhaler and then
inhale." Answer: B
Rationale: The medication should be inhaled through the mouth
simultaneously with compression of the inhaler. This will facilitate
2026 COMPREHENSIVE STUDY SET
◉ The nurse is aware that malnutrition is a common problem among
clients served by a community health clinic for the homeless. Which
laboratory value is the most reliable indicator of chronic protein
malnutrition?
A. Low serum albumin level
B. Low serum transferrin level
C. High hemoglobin level
D. High cholesterol level Answer: A
Rationale: Long-term protein deficiency is required to cause
significantly lowered serum albumin levels. Albumin is made by the
liver only when adequate amounts of amino acids (from protein
breakdown) are available. Albumin has a long half-life, so acute
protein loss does not significantly alter serum levels. Option B is a
serum protein with a half-life of only 8 to 10 days, so it will drop
with an acute protein deficiency. Options C and D are not clinical
measures of protein malnutrition.
◉ In completing a client's preoperative routine, the nurse finds that
the operative permit is not signed. The client begins to ask more
questions about the surgical procedure. Which action should the
nurse take next?
A. Witness the client's signature to the permit.
,B. Answer the client's questions about the surgery.
C. Inform the surgeon that the operative permit is not signed and the
client has questions about the surgery.
D. Reassure the client that the surgeon will answer any questions
before the anesthesia is administered. Answer: C
Rationale: The surgeon should be informed immediately that the
permit is not signed. It is the surgeon's responsibility to explain the
procedure to the client and obtain the client's signature on the
permit. Although the nurse can witness an operative permit, the
procedure must first be explained by the health care provider or
surgeon, including answering the client's questions. The client's
questions should be addressed before the permit is signed.
◉ The nurse is assessing several clients prior to surgery. Which
factor in a client's history poses the greatest threat for complications
to occur during surgery?
A. Taking birth control pills for the past 2 years
B. Taking anticoagulants for the past year
C. Recently completing antibiotic therapy
D. Having taken laxatives PRN for the last 6 months Answer: B
Rationale:
Anticoagulants increase the risk for bleeding during surgery, which
can pose a threat for the development of surgical complications. The
health care provider should be informed that the client is taking
these drugs. Although clients who take birth control pills may be
,more susceptible to the development of thrombi, such problems
usually occur postoperatively. A client with option C or D is at less of
a surgical risk than with option B.
◉ When assisting a client from the bed to a chair, which procedure is
best for the nurse to follow?
A. Place the chair parallel to the bed, with its back toward the head
of the bed and assist the client in moving to the chair.
B. With the nurse's feet spread apart and knees aligned with the
client's knees, stand and pivot the client into the chair.
C. Assist the client to a standing position by gently lifting upward,
underneath the axillae.
D. Stand beside the client, place the client's arms around the nurse's
neck, and gently move the client to the chair. Answer: B
Rationale: Option B describes the correct positioning of the nurse
and affords the nurse a wide base of support while stabilizing the
client's knees when assisting to a standing position. The chair
should be placed at a 45-degree angle to the bed, with the back of
the chair toward the head of the bed. Clients should never be lifted
under the axillae; this could damage nerves and strain the nurse's
back. The client should be instructed to use the arms of the chair and
should never place his or her arms around the nurse's neck; this
places undue stress on the nurse's neck and back and increases the
risk for a fall.
, ◉ Which step(s) should the nurse take when administering ear
drops to an adult client? (Select all that apply.)
A. Place the client in a side-lying position.
B. Pull the auricle upward and outward.
C. Hold the dropper 6 cm above the ear canal.
D. Place a cotton ball into the inner canal.
E. Pull the auricle down and back. Answer: A, B
Rationale: The correct answers (A and B) are the appropriate
administration of ear drops. The dropper should be held 1 cm (½
inch) above the ear canal (C). A cotton ball should be placed in the
outermost canal (D). The auricle is pulled down and back for a child
younger than 3 years of age, but not an adult (E).
◉ The nurse is instructing a client in the proper use of a metered-
dose inhaler. Which instruction should the nurse provide the client
to ensure the optimal benefits from the drug?
A. "Fill your lungs with air through your mouth and then compress
the inhaler."
B. "Compress the inhaler while slowly breathing in through your
mouth."
C. "Compress the inhaler while inhaling quickly through your nose."
D. "Exhale completely after compressing the inhaler and then
inhale." Answer: B
Rationale: The medication should be inhaled through the mouth
simultaneously with compression of the inhaler. This will facilitate
