Questions with Rationales EXAM 2026 || MOST RECENT
EXAM 2026|2027 ACTUAL COMPLETE REAL EXAM
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A nurse is caring for a group of older adult clients. Which
of the following manifestations indicates one of the clients
is experiencing delirium? A. A client wants to know the
current time while there is a clock on the wall. B. A client
attempts to climb out of bed and repeatedly states she
must get home.
C. A client requests extra blankets when the thermostat in the
room indicates
25.6 Degrees C (78 F).
D. A client refuses to get out of bed and has no motivation to
attend to daily hygiene. - ANSWER-B.
(Delirium is characterized by a change in cognition that occurs
over a short period of time. It results from a secondary
physiological condition (e.g., infection, surgery, prolonged
hospitalization, hypoxia, fever, medications) and is a transient
disorder. Although delirium can occur with any age, it is more
common in older adults. It frequently progresses in the evening
,hours and is sometimes called "sundown syndrome." Delirium
is characterized by alterations in memory, agitation,
restlessness, illusions, or hallucinations. A client who becomes
acutely confused and agitated may be showing manifestations
of delirium.)
The nurse is interviewing a patient in the community clinic and
gathers the following information about her: she is
intermittently homeless, a single parent with two children who
have developmental delays, and is suffering from chronic
asthma. She does not laugh or smile, does not volunteer any
information, and at times appears close to tears. She has no
support system and does not work. She is experiencing an
allostatic load. As a result, which of the following would be
present during complete patient assessment? (Select all that
apply.)
1. Post-traumatic stress disorder
2. Rising hormone levels
3. Chronic illness
4. Return of vital signs to normal
5. Depression - ANSWER-3, 5
,(PTSD usually happens in response to a traumatic event. Rising
hormone levels signify that the patient is in the acute phase of
stress, and this patient has long passed that. Return of vital
signs to normal is seen with the acute stressor being taken
away, and this patient is experiencing chronic stress)
A patient who is having difficulty managing his diabetes
mellitus responds to the news that his hemoglobin A1C, a
measure of blood sugar control over the past 90 days, has
increased by saying, "The hemoglobin A1C is wrong. My blood
sugar levels have been excellent for the last 6 months." Which
defense mechanism is the patient using?
1. Denial.
2. Conversion.
3. Dissociation.
4. Displacement. - ANSWER-1.
When doing an assessment of a young woman who was a
victim of a home invasion 3 months earlier, the nurse learns
that the woman has vivid images of the crash whenever she
hears loud yelling or a sudden noise. The nurse recognizes this
as ____________. - ANSWER-PTSD
A grandfather living in Japan worries about his two young
grandsons who
, disappeared after a tsunami. This is an
example of:
1. A situational crisis.
2. A maturational crisis.
3. An adventitious crisis.
4. A developmental crisis. - ANSWER-3.
(The tsunami is a naturally occurring disaster, which is a key
characteristic of an
adventitious
crisis)
During the assessment interview of an older woman who is
recently widowed, the nurse suspects that this woman is
experiencing a developmental crisis. Which of the following
questions provide information about the impact of this crisis?
(Select all that apply.)
1. With whom do you talk on a routine basis?
2. What do you do when you feel lonely?
3. How is having diabetes affecting your life?