Rationales || Latest Exam || Updated || A+ Graded ||
1.A male client is seen in the clinic for benign prostatic hypertrophy (BPH). Which intervention
is essential for the practical nurse (PN) to include in the client's visit?
a. Reeducate the client about limiting fluid intake.
b. Reassure the client that his BPH is a non-life-threatening condition.
c. Assess the client for urinary hesitancy and weak or split urinary stream.
d. Inform the client that there may be a genetic predisposition for male family members. -
ANSWER c. Assess the client for urinary hesitancy and weak or split urinary stream.
2.When observing an older client with dementia for symptoms of Sundowning syndrome, it is
most important that the practical nurse (PN) assesses for which finding?
a. Observe for agitation at the end of the day.
b. Perform a neurological and mental status examination.
c. Monitor for medication side effects.
d. Assess for decreased gross motor movement. - ANSWER a. Observe for agitation at the end of
the day.
Sundowning syndrome is a pattern of agitated behavior in the evening, believed to be associated
with tiredness at the end of the day combined with fewer orienting stimuli, such as activities and
interactions.
3.The practical nurse (PN) working at an assisted living facility is visiting with a client whose
spouse died 8 months ago. Which behavior by the client suggests ineffective coping with the
spouse's death?
a. Frequently neglects to shower and shave.
,b. Insists on visiting the gravesite once a month.
c. Joins an exercise class at the assisted living facility.
d. Keeps their photo albums out and looks through them frequently. - ANSWER a. Frequently
neglects to shower and shave.
Ineffective coping is manifested by behaviors that may be physically or psychologically harmful
to the individual. Neglecting personal hygiene is an example of ineffective coping.
4.When initially monitoring a client after a fall, which information should the practical nurse
(PN) communicate immediately to the health care provider? (Select all that apply.)
a. Change in the level of consciousness
b. Increasing muscular weakness
c. Changes in pupil size bilaterally
d. Progressive nuchal rigidity
e. Onset of nausea and vomiting - ANSWER a. Change in the level of consciousness
e. Onset of nausea and vomiting
A decrease or change in the level of consciousness is usually the first indication of neurological
deterioration. Nausea and vomiting may also be present.
5.An older adult client is seen in the clinic for problems with urinary frequency, urgency, and
nocturia. The symptoms are an example of which condition?
a. Urinary tract infection (UTI)
b. Normal aging changes
c. Side effect of the diuretic furosemide
d. Partial obstruction of the urethra - ANSWER b. Normal aging changes
,Normal aging changes in the bladder are decreased capacity, increased irritability, and
incomplete emptying; these changes lead to frequency, nocturia, urgency, and vulnerability to
infection. The majority of UTIs in the older adult are asymptomatic. Classic signs of UTIs are
fever, dysuria, and flank pain.
These symptoms may indicate progression of BPH to partial obstruction of the urethra, a medical
emergency, and need to be reported to the health care provider. Fluids should be encouraged, not
limited; hydration needs to be maintained.
6.The oral temperature of a client with a urinary tract infection is 103° F. Which intervention
should the practical nurse (PN) implement first?
a. Instruct the client on proper hygienic practices.
b. Observe the color or odor of urine.
c. Recheck the temperature rectally.
d. Encourage fluid intake. - ANSWER d. Encourage fluid intake.
Fluids help to reduce fever as quickly and it is important to lower the temperature as soon as
possible.
7.An older adult client is being treated for toxicity related to medication use. When reviewing the
client's medical records, the nurse is most likely to find which factor is correlated with this
problem?
a. The client has forgotten to take several doses of medication.
b. The client's white blood cell count has steadily increased.
c. The client's liver function has decreased since last year.
d. The client has gained 40 pounds (18.2 kg) over 3 years. - ANSWER c. The client's liver
function has decreased since last year.
, With aging, liver function decreases, affecting drug metabolism and detoxification. Forgetting to
take doses of medication would not cause drug toxicity; excessive doses could cause toxicity.
Elevated white blood cell counts and weight gain would not likely cause drug toxicity.
8.The practical nurse (PN) assesses the older adult client's skin for signs of breakdown and
observes that the skin is intact. What interventions by the PN will help maintain healthy skin
integrity?
a. Keep the client well hydrated.
b. Remove adhesive tape quickly from the skin.
c. Avoid creams or lotions to ensure that the skin stays dry.
d. Scrub the perineum with a wet cloth after a bowel movement. - ANSWER a. Keep the client
well hydrated.
Keeping the client well hydrated helps prevent skin cracking and infection.
9.The nurse has reinforced education regarding safety aspects for antihypertensive medication
with an older adult. Which statement by the client best indicates learning has been effective?
a. "I should rest in bed most of the day when I take this medication."
b. "I will be sure to keep this medication out of the reach of children."
c. "I will need to make sure that I take this medication with some food."
d. "I will make sure that I stand up slowly if I have been sitting down." - ANSWER d. "I will
make sure that I stand up slowly if I have been sitting down."
Older adults are particularly likely to develop orthostatic hypotension after taking medications to
treat hypertension. It is not necessary for the older adult to stay in bed while taking this
medication. Some medications should be taken with food, others on an empty stomach. Each
medication should be individually researched. While it is important to prevent children from