NURS 5461 EXAM Practice
NURS 5461 EXAM Practice Test with
200 Questions and Correct Answers
with Rationales/ NURS 5461 Adult
Gerontology Management Across the
Continuum of Care UTA
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 –
A+ TEST BANK 1
, NURS 5461 EXAM Practice
Correct Answer :(A) Debridement and removal of slough and eschar
Rationale:
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 (A). (B) is evidence of an infection. (C) is indicative of continuous
moisture that is causing the skin edges of the wound to be vulnerable to further damage. (D)
is manifested by a pink environment with serosanguineous fluid.
The home health registered nurse (RN) is assessing an older client for a pressure ulcer. Which
finding should the RN observe the area for a Stage I pressure ulcer?
A. Superficial skin breakdown and flaking
B. Deep pink, red or mottle skin
C. Subcutaneous damage or necrosis
D. Skin that blanches pink when pressed –
Correct Answer :(B) Deep pink, red or mottled skin
Rationale:
Temporary blanching of an area can last for over a minute due to poor circulation. Deep pink,
red or mottle skin (B) is a finding consistent with Stage I pressure ulcer. (A, C and D) are
evidence of a pressure ulcer at different stages of development.
An older client who is unconscious is admitted after experiencing a head injury from a fall.
Glasgow Coma Scale (GCS) is prescribed to evaluate the client. Which focused assessments
A+ TEST BANK 2
, NURS 5461 EXAM Practice
should the registered nurse (RN) use to determine the client's GCS score? (Select all that
apply.)
A. Verbal response
B. Motor response
C. Eye opening
D. Pupillary reaction
E. Hearing –
Correct Answer :(A), (B), (C)
Rationale:
(A, B, and C) are correct. The Glasgow Coma Scale evaluates verbal response (A), motor
response (B), and eye opening (C). The GSC does not evaluate pupil reaction (D) or hearing
(E).
A 64-year-old client is admitted to the hospital with a fractured right hip. One of the concerns
following surgical repair is to promote dorsiflexion. Which intervention would a nurse
implement?
A. Begin early ambulation
B. Monitor pain level
C. Provide PCA instructions
D. Provide a foot board –
Correct Answer :(D) Provide a foot board
Rationale:
A+ TEST BANK 3
, NURS 5461 EXAM Practice
A footboard supports the feet in dorsiflexion and helps prevent foot drop throughout
recovery (D). (A) and good body alignment may also reduce the possibility of foot drop,
however the footboard is maintained throughout recovery. (B) and (C) will alleviate pain but
does not promoted dorsiflexion.
You tell your 71-year-old patient that she has cataracts of her eyes. She asks you to define
cataracts. What do you say?
Complete blindness in both eyes.
Clouding of the eye lens.
Rapid blinking of the eyes.
Inability to blink. –
Correct Answer :Clouding of the eye lens.
An important part of being a GNP is not just assessing, diagnosing, and treating patients.
GNPs must be knowledgeable of medical terminology and be eloquent in defining said
terminology for patients.
In assessing a patient who has a lower extremity ulcer, the nurse assesses the temperature
and skin. The nurse checks the shape of the patient's leg. Chronic venous stasis gives the leg:
An apple shape.
A round shape.
A sausage shape.
A bowling pin shape. –
Correct Answer :A bowling pin shape.
A+ TEST BANK 4
NURS 5461 EXAM Practice Test with
200 Questions and Correct Answers
with Rationales/ NURS 5461 Adult
Gerontology Management Across the
Continuum of Care UTA
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 –
A+ TEST BANK 1
, NURS 5461 EXAM Practice
Correct Answer :(A) Debridement and removal of slough and eschar
Rationale:
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 (A). (B) is evidence of an infection. (C) is indicative of continuous
moisture that is causing the skin edges of the wound to be vulnerable to further damage. (D)
is manifested by a pink environment with serosanguineous fluid.
The home health registered nurse (RN) is assessing an older client for a pressure ulcer. Which
finding should the RN observe the area for a Stage I pressure ulcer?
A. Superficial skin breakdown and flaking
B. Deep pink, red or mottle skin
C. Subcutaneous damage or necrosis
D. Skin that blanches pink when pressed –
Correct Answer :(B) Deep pink, red or mottled skin
Rationale:
Temporary blanching of an area can last for over a minute due to poor circulation. Deep pink,
red or mottle skin (B) is a finding consistent with Stage I pressure ulcer. (A, C and D) are
evidence of a pressure ulcer at different stages of development.
An older client who is unconscious is admitted after experiencing a head injury from a fall.
Glasgow Coma Scale (GCS) is prescribed to evaluate the client. Which focused assessments
A+ TEST BANK 2
, NURS 5461 EXAM Practice
should the registered nurse (RN) use to determine the client's GCS score? (Select all that
apply.)
A. Verbal response
B. Motor response
C. Eye opening
D. Pupillary reaction
E. Hearing –
Correct Answer :(A), (B), (C)
Rationale:
(A, B, and C) are correct. The Glasgow Coma Scale evaluates verbal response (A), motor
response (B), and eye opening (C). The GSC does not evaluate pupil reaction (D) or hearing
(E).
A 64-year-old client is admitted to the hospital with a fractured right hip. One of the concerns
following surgical repair is to promote dorsiflexion. Which intervention would a nurse
implement?
A. Begin early ambulation
B. Monitor pain level
C. Provide PCA instructions
D. Provide a foot board –
Correct Answer :(D) Provide a foot board
Rationale:
A+ TEST BANK 3
, NURS 5461 EXAM Practice
A footboard supports the feet in dorsiflexion and helps prevent foot drop throughout
recovery (D). (A) and good body alignment may also reduce the possibility of foot drop,
however the footboard is maintained throughout recovery. (B) and (C) will alleviate pain but
does not promoted dorsiflexion.
You tell your 71-year-old patient that she has cataracts of her eyes. She asks you to define
cataracts. What do you say?
Complete blindness in both eyes.
Clouding of the eye lens.
Rapid blinking of the eyes.
Inability to blink. –
Correct Answer :Clouding of the eye lens.
An important part of being a GNP is not just assessing, diagnosing, and treating patients.
GNPs must be knowledgeable of medical terminology and be eloquent in defining said
terminology for patients.
In assessing a patient who has a lower extremity ulcer, the nurse assesses the temperature
and skin. The nurse checks the shape of the patient's leg. Chronic venous stasis gives the leg:
An apple shape.
A round shape.
A sausage shape.
A bowling pin shape. –
Correct Answer :A bowling pin shape.
A+ TEST BANK 4
