geriatric nursing exam questions with rationale

Correct Answer: C

Rationale: The correct answer is C because consistent routines and environmental modifications have been shown to be the most effective approach in reducing agitation and aggression in older adults with dementia. This approach focuses on providing structure and familiarity, which can help decrease confusion and anxiety in individuals with dementia. Physical restraints (A) are not recommended as they can lead to further agitation and pose risks of injury. Increased sedation with antipsychotics (B) should be used as a last resort due to potential side effects and risks. Ignoring the behavior (D) is not appropriate as it can exacerbate the situation and lead to further distress for the individual.

Correct Answer: D

Rationale: The correct answer is D. Intermittent claudication, defined as pain in the lower extremities with walking that improves with rest, is a classic symptom of moderate to severe PAD. This occurs due to inadequate blood flow to the muscles during exercise. Other choices are incorrect: A is typically associated with syncope or fainting; B is more indicative of cardiovascular or pulmonary issues; and C is more commonly seen in mesenteric ischemia.

Correct Answer: C

Rationale: The correct answer is C: Medications and polypharmacy. In older adults, incontinence is commonly caused by medications that affect bladder control, such as diuretics, sedatives, and anticholinergics. Polypharmacy can worsen this by increasing the likelihood of drug interactions. Chronic urinary tract infections (A) can cause incontinence but are less common in older adults. Neurological disorders (B) like dementia or stroke can also lead to incontinence but are not the most common cause. Poor hydration (D) can exacerbate incontinence but is not the primary cause.

Correct Answer: A

Rationale: Holistic nursing is the correct answer because it considers the physical, emotional, social, and spiritual aspects of an individual's life in the care plan. It emphasizes treating the whole person rather than just the symptoms. Healthy People 2020 focuses on improving the overall health of the population. Maslow's hierarchy of needs prioritizes basic human needs. Orem's self-care requirements focus on the individual's ability to care for themselves. Holistic nursing is the only approach that integrates and balances all aspects of an individual's life into the care plan, making it the most comprehensive and patient-centered approach.

Correct Answer: B

Rationale: The correct answer is B because straining to void can lead to increased vagal stimulation, resulting in decreased blood pressure upon standing (orthostatic hypotension). A: age and walker use don't directly increase risk. C: a leg cast may not directly affect blood pressure. D: Premarin use is not a common cause of orthostatic hypotension.