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 measuring gait speed, grip strength, and weight loss are key components of assessing frailty in older adults. Gait speed reflects physical function, grip strength indicates muscle weakness, and unintentional weight loss signifies nutritional deficits, all of which are common indicators of frailty. Evaluating cognitive decline and social isolation (choice A) is important but not specific to frailty assessment. Presence of depression and anxiety (choice C) may contribute to frailty but do not directly assess it. Monitoring hydration and electrolyte levels (choice D) is important for overall health but not specific to frailty assessment.

Correct Answer: B

Rationale: The correct answer is B. Checking postural blood pressures is essential to assess for orthostatic hypotension in an elderly client with a history of falls and hypertension medication. Orthostatic hypotension can lead to falls, so monitoring postural B/Ps is crucial. Checking B/P every 2 hours (choice A) is not necessary and could cause unnecessary discomfort to the client. Checking serum sodium levels (choice C) and serum creatinine levels (choice D) are not directly related to the client's risk factors for falls post-prostate surgery.

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.