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: B

Rationale: The correct answer is B: Providing palliative care focused on symptom management and comfort. This is the most appropriate intervention for an older adult with advanced heart failure as it prioritizes quality of life by focusing on alleviating symptoms and ensuring comfort. High-dose diuretics (choice A) may lead to electrolyte imbalances and worsen the patient's condition. Initiating aggressive cardiac surgery (choice C) may be too risky and invasive for an older adult with advanced heart failure. Enforcing strict bed rest (choice D) can lead to deconditioning and muscle wasting, further compromising the patient's quality of life.

Correct Answer: B

Rationale: Postural hypotension is a drop in blood pressure when standing up. Increased cholesterol levels do not directly affect blood pressure regulation or lead to postural hypotension. Medications, decreased baroreceptor sensitivity, and arterial stiffness can all contribute to postural hypotension by affecting blood pressure regulation mechanisms. Therefore, choice B, increased cholesterol level, is the correct answer as it does not directly cause postural hypotension.

Correct Answer: A

Rationale: The correct answer is A: Role theory. Role theory suggests that individuals continue to seek fulfilling roles and activities in older age to maintain a sense of purpose and identity. In this scenario, the older woman's transition from a career as a school principal to volunteering at the library aligns with the idea of seeking meaningful roles. B: Disengagement theory posits that older adults withdraw from society as they age, which contradicts the woman's active engagement in volunteering. C: Age-stratification theory focuses on how age influences opportunities and constraints within society, not on individual choices like volunteering. D: Social exchange theory emphasizes reciprocal relationships and benefits gained from social interactions, which is not the primary focus in this scenario.

Correct Answer: A

Rationale: The correct answer is A: Nocturia. Nocturia, or waking up at night to urinate, is a common symptom of benign prostatic hypertrophy (BPH) due to the enlarged prostate pressing on the urethra, causing urinary frequency and urgency. Other symptoms like weak urine stream, difficulty starting urination, incomplete emptying, and dribbling may also be present. Recurrent urinary tract infections (B) are less likely to be the initial symptom of BPH, as they are more commonly associated with urinary retention or obstruction. Functional incontinence (C) is not a typical symptom of BPH, as it is more related to mobility or cognitive issues. Hematuria (D) is not a common presenting symptom of BPH, as it is more indicative of other conditions like urinary tract infections or kidney stones.