Tiêu đề WORKBOOK - GERIA (KEY) ✅

COMPREHENSIVE PHASE WORKBOOK GERIA NOVEMBER 2024 Philippine Nurse Licensure Examination Review 1. Paulina is a 76 year old patient with urinary tract infection. The most dependable sign of infection in the older patient is: A. Change in mental status B. Fever and chills C. Pleuritic chest pain during inspiratory phase D. Decreased breath sounds with crackles 2. A 67 year old female client is currently admitted for breast cancer. However, during examination, you observed that the patient has shallow respirations but no sign of respiratory distress. Which of the following isn’t ABNORMAL physiologic change related to aging? A. Increased elastic recoil of the lungs B. Increased number of functional capillaries in the alveoli C. Decreased residual volume D. Decreased vital capacity 3. Tatay Clarito has been experiencing urinary incontinence. You know that her risk of urinary incontinence increases because of which of the following changes? A. Dilated urethra B. Shrinkage of penis C. Diuretic use D. Decreased bladder capacity 4. Nurse Delia works in a nursing home. In order to care for the fragile skin among the elderly, she should exclude the following: I. Apply lotion or cream on the skin II. Daily full bath III. Provide sponge bath alternately with full bath IV. Rub wash cloth briskly on the skin A. 1 only B. 2 and 4 C. 4 only D. 1 and 3 5. Orlando is a 78 years old who had been bedridden for almost a year due to generalized weakness. The following are appropriate nursing actions to prevent postural hypotension in an elderly client except: A. Advise to get out of bed gradually B. Instruct to have a daily fluid intake of 3 glasses a day C. Advise to avoid straining at stool D. Advise to avoid bending down and suddenly standing up again 6. Eufemia is an 87 year old patient who verbalized to the nurse that she feels like she hasn’t lived her purpose in life at all. In order to respond accordingly, you have to know the developmental task of the patient at this point.The developmental task of the older adult according to Erickson is: A. Identity vs. role confusion B. Intimacy vs. isolation C. Ego integrity vs. despair D. Generativity vs. stagnation 7. A booster dose of a COVID-19 vaccine is about to be administered to Rodelia, an 87 year old healthy geriatric patient. by the nurse. The nurse should remember that an older client has: A. less subcutaneous tissue and muscle mass than a younger client B. more subcutaneous tissue and less muscle mass than a younger client C. less subcutaneous tissue and more muscle mass than a younger client D. more subcutaneous tissue and muscle mass than a younger client 8. A client was given photo albums to look at during her downtime. Which of the following colors do older people see BEST? A. Blue, green and purple B. Red, yellow, and orange C. Pink and blue D. Fuchsia, Magenta, Burgundy 9. Mario came to the clinic for a monthly wellness consult. Which of the following is NOT expected to be seen in an elderly male? A. Enlarge prostate B. Presbyopia C. Absence of bowel sounds D. Diminished lung expansion 10. Lillia was diagnosed with Alzheimer’s Disease at 65. You are currently supervising a student nurse. During your planning, which of the following should be included EXCEPT? A. Have clocks or calendars in the environment B. Provide consistent routine of activities C. Spend time with the client and listen to concerns D. Address the patient by calling him “grandpa” 11. Resurreccion was found to be still awake at 11 PM by a nurse doing hourly rounds. Which statement if made by the client indicates that teaching about improving sleep is necessary? A. “I drink hot chocolate before bedtime.” B. “I have stopped smoking cigars.” C. “I swim three times a week.” D. “I read for 40 minutes before bedtime.” 12. In meeting physiological and physical needs of an elderly, the nurse should I. Keep client ambulatory as long as possible II. Maintain optimal nutritional/vitamin status III. Expose to sources of infection IV. Maintain bowel and bladder elimination through routine consistent toilet training A. Institute safety measures B. 1, 2 C. 3, 4 D. All but 3 e. 4,5 13. Delia, an 85-year-old woman, has just been admitted to a nursing home. During your initial assessment, the nurse should plan special measures to accommodate age-related sensory losses such as A. Increased hearing sensation B. Increased sensitivity to heat C. Diminished sensation of pain D. Heightened response to stimuli SITUATION: Marlene, 89 years old, is a new resident of the nursing home. She has been observed to be easily irritated and TOP RANK REVIEW ACADEMY, INC. Page 1 | 4
speaks louder than normal. She does not prefer to socialize with other residents and no longer bothers to answer telephone calls because of deterioration of her hearing. 14. The nurse aide assigned to Marlene complains that she is becoming very loud and becomes aggressive at times. You explain that this is a: A. Beginning indifference to the world around her B. Overcompensation for hearing loss C. Behavior indicative of unresolved repressed conflict of the past D. Attempt to maintain authoritative role 15. You will edit your plan of care accordingly by setting a goal which is to: A. Increase her self esteem to maintain her authoritative role B. Adjust to the loss of sensory and perceptual function C. Accept the steady loss of hearing that occurs with aging D. Participate in conversation and other social situations 16. A hearing aid was soon fitted for Marlene. She understood the proper use and wearing of this device when she says that the battery should be functional, the device is turned on and adjusted to a A. Audible level B. Therapeutic level. C. Comfortable level. D. Prescribed level. 17. Upon assessment of Marlene’s situation, the physician is considering presbycusis. Which of the following manifestations would support this diagnosis? A. The elderly usually rub her ear and has frequent headaches B. She usually talks loudly because she cannot hear her own voice C. The presence of impacted ear wax upon otoscopic exam D. She usually presents with yellowish-greenish secretion draining from the ears SITUATION: Eustacio, aged 66, was diagnosed with Alzheimer’s Disease. He has a history of sundowning. 18. Eustacio asks you, “What time is it?” The best response of the nurse to make is I. “I don’t know too. Where are we?” II. “Don’t worry Eustacio, You are safe. No one will harm you while I am here.” III. “You are Eustacio. Welcome to your new home” IV. “You are placed in this institution because you are a bad boy.” A. 1, 3 and 4 B. 3 only C. 3 and 4 D. None of the above 19. Which of the following would be an appropriate strategy in reorienting a confused client, Eustacio, to where his room is? A. Remind Mr. Andrade where his room is B. Let the other nurses know where Mr. Andrade’s room is C. Place pictures of his family on the bedside stand D. Put Mr. Andrade’s name in large letters on his forehead 20. Eustacio has had difficulty sleeping since admission. Which of the following would be the best intervention? A. Provide him with a glass of warm milk before sleeping B. Ask the physician for a mild sedative and restraints C. Encourage himto take naps during the day D. Offer a bucket of red horse beer to induce sleep 21. Hypoxia may occur in the older patients because of which of the following physiologic changes associated with aging? A. Ineffective airway clearance B. Decreased alveolar surface area C. Decreased anterior-posterior chest diameter D. Hyperventilation 22. The older patient is at higher risk for incontinence because of: A. Dilated urethra B. Increased glomerular filtration rate C. Diuretic use D. Decreased bladder capacity 23. Poling, due to her arthritis, spends most of her day lying on her beD. When she tries to rise up from the bed, she complains of dizziness when he stands up. This may indicate: A. Dementia B. A visual problem C. Functional decline D. Drug toxicity 24. Rene, aged 77, wants to have a cardiac assessment since he has a strong family history of myocardial infarction. To look for cardiac ischemia, which of the following is a most likely sign? A. ST-T wave changes B. Very high creatinine kinase level C. Chest pain radiating to the left arm D. Acute confusion 25. In screening geriatric clients for infection, which of the following signs should you look for? A. Change in mental status B. Fever C. Pain D. Decreased breath sounds with crackles 26. Nestor, 72-year-old, is admitted in a community hospital for diagnostic workup. He was found to be loitering in the hall at 1 am. He complaint of difficult of sleeping. To improve client’s sleeping pattern, the nurse should put the LAST priority to which of the following nursing measures? A. Lessen need to awaken client for medication B. Use of sedatives and anxiolytics C. Increase physical activity in late PM and early evening D. Limit napping during the day 27. Experts in the field of pain management have conducted that if pain perception is diminished in the elderly person, it is most likely secondary to a: A. Disease process B. Developmental process C. Chronic intake of medications D. Mental process 28. Yuriko is a 65 year old who frequently wears sweaters and jackets despite hot weather. , The ability to feel differences in temperature is decreased in the elderly because of: A. Inefficient heat regulating mechanism B. Deficient diaphoresis mechanism C. Decrease ability of discrimination D. Illness effect 29. Retchie complains to you that she can no longer read a text message in her phone without drawing it near her eyes. This is a manifestation of: A. Nystagmus B. Strabismus C. Presbyopia D. Diplopia 30. Paulina’s daughter complained to you that she feels like her mother disregards what she says. But in your assessment, you found out that he has a decreased ability to hear high pitched sounds. You know that thus is termed as: A. Tinnitus B. Presbycusis C. Otosclerosis D. None of the above 31. You proceeded to assess Paulina’s skin. You noticed that the skin appears to be dry, wrinkled and has a poor skin turgor; this will prompt you to be aware that the patient already has? TOP RANK REVIEW ACADEMY, INC. Page 2 | 4
A. Hypothermia B. Diminished collagen in the body and decreased sweat glands C. Diminished sweat glands only D. improved sweat glands that presents good thermoregulation 32. During your conference with the team, after the observation of Paulina’s skin, which of the following should you include except: A. Apply lotion or cream on the skin B. Avoid applying alcohol on the skin C. Provide sponge bath alternately with full bath D. Rub wash cloth briskly on the skin 33. Jaclyn has postural hypotension. You therefore include the following interventions in an elderly client except: A. Advise to get out of bed gradually B. Instruct to have a daily fluid intake of 3 glasses a day C. Advise to avoid straining at stool D. Advise to avoid bending down and suddenly standing up again 34. The following are expected reproductive changes among the elderly, which one is not? A. decrease breast tissue mass resulting to breast sagging B. lengthening of the penis but decreasing testicular size C. decrease vaginal fluids causing vaginal dryness D. enlargement of prostate gland leading to BPH 35. The nurse is performing her rounds at 2 am when she saw Marites, a 75 year old female, still wide awake. Which statement by the client indicates the need for further teaching regarding measures to improve sleep? A. "I swim three times a week." B. "I have stopped smoking cigars." C. "I drink hot chocolate before bedtime." D. "I read for 40 minutes before bedtime. 36. The nurse is performing an assessment on Martha, a 76 year old female who is bedridden due to spinal cord injury. Which assessment data would indicate a potential complication associated with the skin? A. Crusting B. Wrinkling C. Deepening of expression lines D. Thinning and loss of elasticity in the skin 37. Elisa is a 50 year old with acute heart failure and was prescribed with antidysrhythmic drugs. Risks and benefits are both considereD. When does the need for the drug outweigh the risks? A. When there is impairment in cardiac output. B. When the dysrhythmia becomes chroniC. C. If the heart rate is 50 to 60 beats per minute D. After the heart rate reaches a rate faster than 100 beats per minute 38. Nurse Rita, a home health nurse, is visiting Rosalinda, a 67 year old client, for the first time. While assessing her medications, it is noted that there are 17 prescriptions and several over-the-counter medications that the client has been taking. Which intervention should the nurse take first? A. Check for medication interactions. B. Determine whether there are medication duplications. C. Call the prescribing health care provider (HCP) and report polypharmacy. D. Determine whether a family member supervises medication administration 39. Jun, a 76 year old patient with heart failure, is being discharged after the insertion of a permanent pacemaker. Which statement made by the patient indicates an understanding regarding appropriate self-care? A. Every morning I will perform moderate to vigorous arm and shoulder stretches B. Each day I'll take my pulse and record it in a log C. I'll have to get rid of my microwave oven because it is unsafe for my pacemaker. D. I won't be able to use my electrical blanket anymore. 40. You are currently performing an admission assessment on Luisa, a 88 year old patient with heart failure who is taking propranolol (Inderal) for supraventricular tachycardiA. Which assessment finding is an indication the patient is experiencing an adverse effect of this drug? A. Dry mouth B. Propranolol C. Urinary retention D. Paresthesia 41. Which laboratory finding should you monitor for Luisa who is at risk for cardiac dysrhythmias? A. BUN and creatinine B. Sodium, potassium, and calcium C. Hemoglobin and hematocrit D. PT and INR 42. Nurse Helena, a charge nurse, tells Nurse Aya that she should be more patient in people like older adults who have "outlived their usefulness." What is the term for this type of prejudice? A. Racism B. Ageism C. Harassment D. Whistle blowing 43. Nurse Felisa teaches a student nurse about health care disparities and older adult women. Which statement, if made by the student nurse, would indicate an understanding of the teaching? A. "Women tend to have a shorter life expectancy than men." B. "Women tend to have fewer financial resources than men." C. "Women are less likely to be a caregiver to their spouses." D. "Women are more likely to have age-related cognitive impairments." 44. Conrad, 81 years old, had been in pain for 3 months but did not consult to the cliniC. Which of the following reasons is most likely the cause of the late consultation? A. prefer to be left alone B. poor health literacy C. think it's a normal part of aging D. hate clinic appointments 45. The Baby Boom generation: A. Born between 1940 and 1960 B. Is better off financially than the previous generations C. Shares many social goals and political values with each other D. Often provides care to aging parents and grandchildren 46. Nurse Luding is conducting a helath teaching session with an 85-year-old patient who will be going home on heparin therapy. Which strategy would reflect consideration of aging changes that may exist with this patient? A. Show a colorful video about anticoagulation therapy. B. Present all the information in one session just before discharge C. Give the patient pamphlets about the medications to read at home. D. Develop large-print handouts that reflect the verbal information presented. 47. Nurse Jelly is currently developing the plan of care for an older adult who is hospitalized for an acute illness, the nurse should: A.use a standardized geriatric nursing care plan. B. plan for likely long-term-care transfer to allow additional time for recovery. C. consider the preadmission functional abilities when setting patient goals. D. minimize activity level during hospitalization. TOP RANK REVIEW ACADEMY, INC. Page 3 | 4
48. Nurse Queenie is a home health nurse. She visited Tatay Esming, a 77 years old with a history of stroke. Which of the following is of the most concern? A. The patient's son uses a marked pillbox to set up the patient's medications weekly. B. The patient has lost 10 pounds (4.5 kg) during the last month. C. The patient is cared for by a daughter during the day and stays with a son at night. D. The patient tells the nurse that a close friend recently died. 49. Nanay Lorelie asks the nurse why a lot of older people have hypertension. An appropriate response by the nurse as to why older clients often have hypertension is due to: A. Myocardial muscle damage B. Reduction in physical activity C. Ingestion of foods high in sodium D. Accumulation of plaque on arterial walls 50. Which of the following interventions should be taken to help an older client to prevent osteoporosis? A. Decrease dietary calcium intake. B. Increase sedentary lifestyles C. Increase dietary protein intake. D. Encourage regular exercise. TOP RANK REVIEW ACADEMY, INC. Page 4 | 4