geriatric nursing exam questions with rationale

Correct Answer: A

Rationale: The correct answer is A: Decreased lean body mass and decreased glomerular filtration rate. 1. Decreased lean body mass: With aging, there is a natural decline in muscle mass which can affect the distribution and metabolism of digoxin, potentially increasing its concentration in the body. 2. Decreased glomerular filtration rate: As individuals age, there is a decrease in kidney function, particularly in the glomerular filtration rate, which can lead to decreased excretion of digoxin, resulting in its accumulation and potential toxicity. Therefore, these age-related changes can place the older client at risk for digoxin toxicity. Summary: B: Increased muscle mass and improved renal function - This choice is incorrect as aging is associated with decreased muscle mass and declining renal function. C: Higher levels of albumin and increased drug metabolism - This choice is incorrect as aging is typically associated with decreased albumin levels and slower drug metabolism. D: Decreased hepatic function and increased body fluid

Correct Answer: B

Rationale: The correct answer is B because polypharmacy in older adults increases the risk of adverse drug reactions and interactions due to multiple medications being taken concurrently. This can lead to medication errors, decreased adherence, drug toxicity, and increased healthcare costs. Choice A is incorrect as polypharmacy does not improve overall quality of life but rather can negatively impact it. Choice C is incorrect as polypharmacy does not prevent age-related health conditions but can exacerbate them. Choice D is incorrect as polypharmacy has a significant impact on health outcomes in older adults.

Correct Answer: C

Rationale: The correct answer is C because life expectancy is influenced by multiple factors such as gender, ethnicity, and living environment. Gender does play a role, but it is not the sole determinant. Ethnicity and living environment also significantly impact life expectancy. Genetic factors may contribute, but they are not the primary factor affecting life expectancy. Therefore, choice C is the most comprehensive and accurate statement. Choices A and B are incorrect as they oversimplify the factors that influence life expectancy, while choice D is also incorrect as it overlooks the significant impact of other factors beyond genetics.

Correct Answer: B

Rationale: The correct answer is B because a gerontological nurse practitioner is trained to manage chronic conditions and promote health in older adults through preventive care, education, and treatment. This role involves a holistic approach to addressing the physical, mental, and social aspects of aging. Choice A is incorrect as palliative care is just one aspect of their role. Choice C is incorrect as they work in various settings, not just nursing homes. Choice D is incorrect as they work with a range of older adult patients, not just those with psychiatric conditions.

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.