NURS 421 Final Questions With Complete Solutions
A 66-year-old man has undergone a digital-rectal exam (DRE)
during a visit to his family physician. The exam reveals that the
client's prostate has become enlarged since his last DRE. The
most accurate conclusion that his care provider will draw from
these findings is that they suggest:
A) Prostate cancer
B) A risk of malignancy that should be followed up
C) A normal age-related change unlikely to have consequences
D) A urinary tract infection Correct Answer B) A risk of
malignancy that should be followed up
Rationale: Prostatic enlargement is exceedingly common among
older men, but represents a risk of malignancy that necessitates
further assessment and follow-up.
A 75-year-old patient who sustained a stroke has residual left-
sided weakness. Fromthe first day of hospitalization, the patient
has been combative and demanding, and hasrefused to swallow
any medication. The most constructive nursing action is to:
A. continue to attempt to follow the physician's orders.
B. determine the patient's premorbid personality.
C. restrain the patient and request a change in the route of
medication.
D. wait for the patient to become more cooperative. Correct
Answer B. determine the patient's premorbid personality.
,A 76-year-old adult female is brought to a neighborhood client
after being found wandering around the local park. The client
appears disheveled and reports being hungry. Which of the
following assessment and interview findings would cause the
nurse to suspect elder abuse? (Select all that apply.)
A. Falls asleep in the examination room
B. Repeatedly states, "Don't hurt me."
C. Chafing around wrists and ankles
D. Bruises in various stages of healing Correct Answer B, C,
and D
A 78 yr old woman was diagnosed with colorectal cancer 18
mos ago and underwent chemotherapy. a recent CT scan has
shown has metastasized to her lungs and liver. The woman
states that she feels well and does not want to undergo any
further debilitating chemotherapy. The son and daughter are
adamantly opposed to their mother's forgoing treatment and
have appealed to the nurse. what factor is the primary
consideration in this scenario?
a. the family's wishes
b. the woman's prognosis
c. the woman's autonomy
d. the woman's treatment options Correct Answer c. the
woman's autonomy
A 78-year-old wealthy white widow lives in a luxury high-rise
condominium with her son. She has mild cognitive impairment
and needs moderate assistance with activities of daily living. She
is admitted to the hospital for pneumonia and is noted to have
,burns on her upper back. The son states that the patient burned
herself when attempting to take a shower. The nurse presents the
patient in interdisciplinary rounds, and a discussion ensues on
elder mistreatment. Which statement by a member of the team
reflects the nurse's need for further education?
A. "Even if we are not sure, we should report our suspicions."
B. "This could not possibly be elder abuse. She is white and
wealthy, abuse does not happen in these circumstances."
C. "The incidence of abuse increases with the increased time
needed by the caregiver to provide care."
D. "Most abusers are either adult children or spouses." Correct
Answer B. "This could not possibly be elder abuse. She is white
and wealthy, abuse does not happen in these circumstances."
A 90-year-old patient comes to the clinic with a family member.
During the health history, the patient is unable to respond to
questions in a logical manner. The gerontological nurse's action
is to:
A. ask the family member to answer the questions.
B. rephrase the questions slightly, and slowly repeat them in a
lower voice.
C. determine if the patient knows the name of the current
president.
D. ask a few quick questions to determine the patient's cognitive
level Correct Answer D. ask a few quick questions to
determine the patient's cognitive level
A care aide at a long-term care facility has assured the family of
a resident that their father's increasing forgetfulness is a normal
, part of the aging process. How can the nurse best respond to the
care aide's statement to the family?
A) "It's actually a myth that older people experience changes to
their memory."
B) "Memory losses are a normal age-related change many
people experience."
C) "Older adults have less working memory and slower
retrieval, but this still requires further assessment."
D) "There is no reason for healthy older adults to experience
changes in their memory unless they are experiencing
dementia." Correct Answer C) "Older adults have less working
memory and slower retrieval, but this still requires further
assessment."
Rationale: Older adults often experience delays in retrieval of
memories and working memory. Some changes in memory,
even in the absence of delirium or dementia, are to be expected
but they should not be discounted and would require further
assessment.
A client has been recently diagnosed with Alzheimer's disease.
When teaching the family about the prognosis, the nurse must
explain that:
A. Diet and exercise can slow the process considerably
B. It usually progresses gradually with a deterioration of
function
C. Many individuals can be cured if the diagnosis is made early
A 66-year-old man has undergone a digital-rectal exam (DRE)
during a visit to his family physician. The exam reveals that the
client's prostate has become enlarged since his last DRE. The
most accurate conclusion that his care provider will draw from
these findings is that they suggest:
A) Prostate cancer
B) A risk of malignancy that should be followed up
C) A normal age-related change unlikely to have consequences
D) A urinary tract infection Correct Answer B) A risk of
malignancy that should be followed up
Rationale: Prostatic enlargement is exceedingly common among
older men, but represents a risk of malignancy that necessitates
further assessment and follow-up.
A 75-year-old patient who sustained a stroke has residual left-
sided weakness. Fromthe first day of hospitalization, the patient
has been combative and demanding, and hasrefused to swallow
any medication. The most constructive nursing action is to:
A. continue to attempt to follow the physician's orders.
B. determine the patient's premorbid personality.
C. restrain the patient and request a change in the route of
medication.
D. wait for the patient to become more cooperative. Correct
Answer B. determine the patient's premorbid personality.
,A 76-year-old adult female is brought to a neighborhood client
after being found wandering around the local park. The client
appears disheveled and reports being hungry. Which of the
following assessment and interview findings would cause the
nurse to suspect elder abuse? (Select all that apply.)
A. Falls asleep in the examination room
B. Repeatedly states, "Don't hurt me."
C. Chafing around wrists and ankles
D. Bruises in various stages of healing Correct Answer B, C,
and D
A 78 yr old woman was diagnosed with colorectal cancer 18
mos ago and underwent chemotherapy. a recent CT scan has
shown has metastasized to her lungs and liver. The woman
states that she feels well and does not want to undergo any
further debilitating chemotherapy. The son and daughter are
adamantly opposed to their mother's forgoing treatment and
have appealed to the nurse. what factor is the primary
consideration in this scenario?
a. the family's wishes
b. the woman's prognosis
c. the woman's autonomy
d. the woman's treatment options Correct Answer c. the
woman's autonomy
A 78-year-old wealthy white widow lives in a luxury high-rise
condominium with her son. She has mild cognitive impairment
and needs moderate assistance with activities of daily living. She
is admitted to the hospital for pneumonia and is noted to have
,burns on her upper back. The son states that the patient burned
herself when attempting to take a shower. The nurse presents the
patient in interdisciplinary rounds, and a discussion ensues on
elder mistreatment. Which statement by a member of the team
reflects the nurse's need for further education?
A. "Even if we are not sure, we should report our suspicions."
B. "This could not possibly be elder abuse. She is white and
wealthy, abuse does not happen in these circumstances."
C. "The incidence of abuse increases with the increased time
needed by the caregiver to provide care."
D. "Most abusers are either adult children or spouses." Correct
Answer B. "This could not possibly be elder abuse. She is white
and wealthy, abuse does not happen in these circumstances."
A 90-year-old patient comes to the clinic with a family member.
During the health history, the patient is unable to respond to
questions in a logical manner. The gerontological nurse's action
is to:
A. ask the family member to answer the questions.
B. rephrase the questions slightly, and slowly repeat them in a
lower voice.
C. determine if the patient knows the name of the current
president.
D. ask a few quick questions to determine the patient's cognitive
level Correct Answer D. ask a few quick questions to
determine the patient's cognitive level
A care aide at a long-term care facility has assured the family of
a resident that their father's increasing forgetfulness is a normal
, part of the aging process. How can the nurse best respond to the
care aide's statement to the family?
A) "It's actually a myth that older people experience changes to
their memory."
B) "Memory losses are a normal age-related change many
people experience."
C) "Older adults have less working memory and slower
retrieval, but this still requires further assessment."
D) "There is no reason for healthy older adults to experience
changes in their memory unless they are experiencing
dementia." Correct Answer C) "Older adults have less working
memory and slower retrieval, but this still requires further
assessment."
Rationale: Older adults often experience delays in retrieval of
memories and working memory. Some changes in memory,
even in the absence of delirium or dementia, are to be expected
but they should not be discounted and would require further
assessment.
A client has been recently diagnosed with Alzheimer's disease.
When teaching the family about the prognosis, the nurse must
explain that:
A. Diet and exercise can slow the process considerably
B. It usually progresses gradually with a deterioration of
function
C. Many individuals can be cured if the diagnosis is made early
