geriatric nursing exam questions with rationale

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.

Correct Answer: B

Rationale: The correct answer is B: Magicoreligious. This belief involves attributing illness to supernatural forces or divine punishment. In this scenario, the patient's statement implies a belief that her illness is a result of angering God, indicating a magical or religious explanation. Choice A (Biomedical) focuses on scientific and physical causes of illness, which is not reflected in the patient's statement. Choice C (Naturalistic) involves viewing illness as a part of the natural world, without supernatural elements. Choice D (Ayurvedic) is a traditional Indian system of medicine and does not relate to the patient's belief in supernatural punishment.

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: 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.

Correct Answer: C

Rationale: The correct answer is C: Coordinating care among healthcare providers. This is the most important consideration for providing care to older adults with multiple chronic conditions because it ensures that all aspects of their health are managed comprehensively and efficiently. Coordinating care among healthcare providers helps prevent medication interactions, duplicate tests, and conflicting treatment plans. It also promotes better communication and collaboration among the healthcare team, leading to improved outcomes for the patient. A: Treating each condition independently is not ideal as it may result in conflicting treatment plans and overlook the holistic nature of managing multiple chronic conditions. B: Using a single medication for all conditions is not appropriate as different conditions may require specific medications tailored to each individual's needs. D: Limiting social interactions to reduce stress is not directly related to managing multiple chronic conditions and may have negative effects on the overall well-being of the older adults.