VERSION QUESTIONS WITH VERIFIED ANSWERS AND RATIONALES
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An older resident is newly admitted to an assisted living community. Which actions should the
registered nurse (RN) implement to provide the resident ways to maintain safe medication
administration? (Select all that apply)
A) Locked medication storage in the client's room
B) Medication administration record (MAR)
C) Payment forms for prescribed medications
D) Delivery of adequate supply of medication
E) List of findings indicating medication effectiveness
A,B,D,E
For safe self-medication in an assisted living community, the resident should be provided a
locked storage box, create a medication administration record to monitor medication, establish
adequate medication supply, and a reference to evaluate the effectiveness of medication
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
C,D
For older clients the expected age-related changes in the cardiovascular system include
murmurs and widening pulse pressure
An older client who recently moved into an assisted living community refuses to eat or join any
activities. When evaluating the client further, what should the registered nurse (RN) focus on
during the next examination?
,A) Anxiety
B) Depression
C) Exhaustion
D) Confusion
B
Depression is a symptom that an older client is likely to experience with a sudden change in
living accommodations when a loss of personal identity can create low self-esteem
The registered nurse (RN) is caring for an elderly client with functional incontinence who lives in
an assisted living community. The client is alert and mildly confused and can self ambulate.
Which nursing intervention should the RN implement?
A) Offer assistance with toileting q2 hours
B) Use protective disposal undergarment instead of underwear
C) Ask if the client has attempted to void q2 hours
D) Obtain a prescription for intermittent catherization
A
Maintaining independence and self-esteem is important for an older client with incontinence.
Toilet assistance decreases the client's chances of accidents and embarrassment by introducing
a toilet training program
The healthcare provider prescribes a new medication, atorvastatin (Lipitor, for an older client
who arrives at the clinic for an annual physical examination. What common side effect should
the registered nurse (RN) advise the client to observe for with this medication?
A) Constipation
B) Headaches
C) Muscle weakness
D) Nausea and vomiting
B
Headaches are the most common side effect with this medication, which the RN should direct
the client to report
The registered nurse (RN) is re-enforcing discharge instructions with the family of an older client
who was recently admitted for an intestinal obstruction. Which statement indicates that the
, family understands the instructions?
A) Increase protein and carbohydrates in the daily diet
B) Limit activity to bed rest for the first week and increase mobility incrementally each week
C) Report abdominal distention, constipation or any nausea and vomiting to the healthcare
provider
D) Drink liquids 2 hours after meals instead of during meals
C
These are symptoms that occur with intestinal obstruction and should be addressed
immediately
An older male client asks the registered nurse (RN) how he can reduce his incidents of
hemorrhoidal flare ups. What information should the RN offer the client about how to prevent
rectal discomfort? (Select all that apply).
A) Increase fiber and liquids in the diet to help prevent constipation and straining
B) Change exercise program to reflect less cardio-exercise and more weight training
C) Use a therapeutic cushion for frequent repositioning for periods of prolonged sitting
D) Take frequent warm sitz baths and do not use abrasive paper that can traumatize tissues
E) Establish bowel habits by scheduling daily time to defecate when the client is not rushed
A,C,D,E
Fluids, comfort measures, and establishment of a regular bowel pattern help reduce incidents of
hemorrhoid inflammation.
During the quarterly evaluations of the clients in the assisted living community, the registered
nurse (RN) assesses for findings of failure to thrive in the older population. Which findings
should the RN document and report as manifestations related to failure to thrive? (Select all
that apply.)
A) Unintentional weight loss
B) Increased weakness
C) Increased amounts of sleep
D) Irritation and agitation
E) Seeking constant attention from caregiver