NURS 5461 Adult Gerontology Final Actual
Exam Test Bank / NURS 5461 Adult
Gerontology Final Preparation /NURS 5461
Adult Gerontology Final Practice Exam
With Complete Verified Questions And Correct
Answers with Detailed Rationales Graded A +
The registered nurse (RN) is observing the skin of an older client. Which finding should the RN
document as consistent with the normal aging process?
A. Decreased elasticity
B. Tough and leathery texture
C. Shiny and edematous
D. Excessive hair growth on the head
A. Decreased elasticity
Rationale: Loss of elasticity is a common finding of the normal aging process (A). The skin of
elderly clients becomes thin and fragile with aging, not (B). When a client has peripheral edema,
the skin can be shiny and edematous (C), which is not consistent with normal aging changes. Hair
thinning and hair loss are common, not excessive hair growth (D).
The home health registered nurse (RN) visits an older female client with an ideal conduit who
has been experiencing chronic urinary tract infections (UTI). Which intervention should the RN
recommend to the client to manage the frequency of UTIs?
A. Force fluid intake to 1,000 ml daily
B. Change appliance every 4 hours
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C. Attach a larger drainage bag while sleeping
D. Allow bag to fill completely before emptying
C. Attach a larger drainage bag while sleeping
Rationale: (C) can prevent urinary reflux if the bag fills to near capacity or greater, which can
contribute to UTIs. Forcing fluids is encouraged and should exceed urinary output, which
commonly should be greater than 1,000 ml (A). (B) can increase skin irritation and increase risk
for infection by exposing the portal of entry frequently. Allowing the bag to fill completely before
emptying (D) increases risk of urinary reflux and UTIs.
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 with this medication?
A. Constipation
B. Headaches
C. Muscle weakness
D. Nausea and vomiting
B. Headaches
Rationale: Headaches (B) are the most common side effect with this medication, which the RN
should direct the client to report. (A and C) are rare occurrences with this medication. (D) is not
considered a side effect of this medication.
After a transurethral resection of the prostate (TURP), an older man returns to the medical
surgical floor with a 3-way indwelling urinary catheter. The registered nurse (RN) observes the
catheter's tubing for drainage when the client states that he needs to void. What should the RN
implement based on this finding?
A. Irrigate the bladder through the catheter port
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B. Remove the indwelling catheter
C. Explain that urgency is expected
D. Notify the healthcare provider of the symptom
A. Irrigate the bladder through the catheter port
Rationale: The feeling of urgency can be caused by blood clots that can occlude drainage of the
catheter, which is a common occurrence in the first 72 hours after a TURP. The urgency is an
indication that the client's bladder is not emptying, and the RN should irrigate catheter (A) to
relieve symptoms caused by a clot. (B) and (C) should not be implemented. (D) should be
implemented after determining if the irrigation was effective in relieving the client's complaint.
An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the left
forearm for 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 fistula
D. Marked ecchymotic areas
A. Enlarged veins
Rationale: The mixing of arterial and venous blood in an AV fistula causes the veins to enlarge
(A), which facilitate cancelation for hemodialysis. (B) may be related to local infection or
inflammation and is not a normal finding. (C) and (D) are abnormal findings that should be
reported immediately.
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. What 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
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A, B, C
Rationale: (A, B and C) are correct. Symptoms of failure to thrive in the older population include
weight loss, weakness and excessive sleep, which should be documented and evaluated by a
healthcare provider immediately. (D and E) are not usual signs and symptoms of failure to thrive
but should be reviewed by the healthcare provider.
The registered nurse (RN) is reinforcing discharge instructions to the family of an older client
with failure to thrive. What information should the RN include to promote nutritional intake for
the client? (Select all that apply.)
A. Minimize stress levels by providing the client with a quiet environment during meals
B. Provide food variations that the client can manage without assistance
C. Assist the client with eating meals in bed in a semi-Fowler's position
D. Encourage fluid intake before meals to decrease dehydration
E. Offer any type of food to the client as long as calories are consumed
A, B
Rationale: (A and B) are correct and continue to promote independence and decreased stress for
the client, which will increase the opportunity for nutritional intake. (C) increases dependence
for the older client, which can also cause decreased self-worth and depression. (D) will make the
client feel full and will decrease the client's ability to consume nutritional calories.
The registered nurse (RN) is assigned the care of an older client who returns to the unit after
surgery for closed angle glaucoma. What intervention in the plan of care should the RN bring to
the attention of the healthcare team?
A. Assist with ambulating to commode
B. Monitor intake and output q8 hours
C. Administer morphine 4 mg IM q2 hour PRN pain
D. Place an eye patch on operative eye during sleep
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