geriatric nursing exam questions with rationale

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: B

Rationale: The correct answer is B: Low calcium intake. Osteoporosis is a condition characterized by weakened bones, making them more susceptible to fractures. Calcium is essential for bone health, and a low intake can lead to decreased bone density and increased risk of osteoporosis. Physical activity, while beneficial for overall health, is not a significant risk factor for osteoporosis. High alcohol consumption can contribute to bone loss but is not as significant as low calcium intake. Genetics play a role in predisposing individuals to osteoporosis, but it is not a modifiable risk factor like low calcium intake. Thus, B is the correct answer.

Correct Answer: D

Rationale: The correct answer is D: Depression. Depression is a strong predictor of functional decline in older adults because it can lead to decreased motivation, social withdrawal, and physical symptoms that affect daily activities. Depression is also associated with cognitive impairment, which can further impact functioning. Being physically active (A) and high socioeconomic status (B) are generally positive factors for maintaining function. Advanced age (C) alone is not a strong predictor of functional decline compared to depression.

Correct Answer: D

Rationale: The correct answer is D: Ensuring early mobilization and reorientation. Delirium in hospitalized older adults is often caused by factors like immobility and disorientation. Early mobilization helps maintain physical and cognitive function, reducing the risk of delirium. Reorientation techniques help patients stay connected to reality, preventing confusion. Limiting visitors (A) can lead to social isolation, exacerbating delirium. Reducing physical restraints (B) is important but not as effective as promoting mobility. Providing a calm environment (C) is beneficial but may not address the underlying causes of delirium.

Correct Answer: B

Rationale: The correct answer is B: Identifying goals of care through open conversations with the patient and family. This is crucial because palliative care for older adults should be person-centered and align with their preferences and values. By engaging in open conversations, healthcare providers can understand the individual's goals, values, and wishes, allowing for care to be tailored accordingly. This approach emphasizes holistic care beyond just managing pain and considers the patient's emotional, spiritual, and social needs. Incorrect choices: A: Focusing primarily on managing pain with medications overlooks the importance of addressing other aspects of care. C: Avoiding advanced medical treatments is not always appropriate as each situation should be assessed individually. D: Prescribing hospice care immediately may not be necessary or desired by the patient, as it depends on their specific needs and preferences.