Aging

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Sample questions from Aging

This material has 90 questions with answers and rationales. Here are the first 5.

1. 1.During a home visit, a 72-year-old client with heart failure says, "I have been too tired to weigh myself." The client reports new breathlessness when lying flat; weight is 2.3 kg above the weight recorded 4 days ago, BP 148/86 mm Hg, HR 96/min, RR 22/min, and SpO2 92% on room air. Which action should the nurse take first?

   • A.Ask the client to begin weighing daily and keep a written record
   • B.Have the client rest and recheck the weight at the next scheduled visit
   • C.Assess lung sounds and respiratory effort, then promptly notify the provider of the weight gain and worsening symptoms
   • D.Review the client's low-sodium diet and arrange a dietitian visit

   Rationale: The rapid weight gain, orthopnea, tachypnea, and reduced oxygen saturation suggest worsening fluid overload, so focused respiratory assessment and prompt escalation take priority. Diet teaching and a daily weight plan are important but do not address the possible acute deterioration. Waiting for the next visit could delay treatment.

2. 2.At change of shift in a long-term care facility, a 79-year-old resident with mild dementia has new confusion, urinary urgency, temperature 37.8 C, HR 104/min, RR 22/min, BP 106/64 mm Hg, and SpO2 95% on room air. The resident's usual BP is 138/76 mm Hg. Which actions should the nurse take? Select all that apply.

   • A.Ask a nursing assistant to obtain a urine specimen and report the result directly to the provider
   • B.Initiate facility fall precautions and assist the resident with transfers while the cause is evaluated
   • C.Document the confusion as progression of dementia and reassess at the end of the shift
   • D.Review the medication administration record and recent intake for possible contributors to the change
   • E.Perform a focused assessment, compare the findings with the resident's baseline, and promptly report the acute change

   Rationale: Acute confusion with tachycardia and a substantial drop from the resident's usual BP warrants prompt assessment and communication rather than attribution to chronic dementia. Reviewing medications and intake helps identify contributing factors, and immediate fall precautions reduce injury risk during the change in mentation. A nursing assistant may collect a specimen only according to facility policy and competency, but the assistant should not interpret or report results as a substitute for the nurse's assessment; delaying reassessment is unsafe.

3. 3.The provider prescribes digoxin 0.125 mg daily for a 84-year-old client with atrial fibrillation. Before the morning dose, the client reports nausea and seeing yellow halos; apical pulse is 52/min and potassium is 3.1 mEq/L (reference range 3.5-5.0 mEq/L). Which action should the nurse take?

   • A.Hold the digoxin and promptly notify the provider of the findings
   • B.Ask the client to drink a potassium-containing beverage before administering the dose
   • C.Administer the dose with food and reassess the pulse in 1 hour
   • D.Give the dose and request a serum digoxin level with the next routine laboratory draw

   Rationale: Bradycardia, nausea, visual changes, and hypokalemia are concerning for digoxin toxicity, and the nurse should hold the dose and promptly report the findings. Giving the medication with food does not address toxicity, while waiting for routine testing risks further harm. A potassium-containing beverage is not a safe substitute for evaluating and treating the clinically significant low potassium.

4. 4.In a community clinic, a 68-year-old client with osteoarthritis and a recent fall says, "I take a little something to sleep, but I cannot remember the name." The client is alert, BP is 128/72 mm Hg, HR 78/min, and gait is slow but steady. Which action is most appropriate before the nurse reinforces the medication plan?

   • A.Advise the client to stop all sleep aids immediately because they increase fall risk
   • B.Ask the client to bring all prescription medicines, over-the-counter products, and supplements for a medication reconciliation
   • C.Recommend taking the sleep aid earlier in the evening to reduce morning drowsiness
   • D.Ask the client to describe the sleep aid's color and shape, then document the likely medication

   Answer and rationale are in the full material.

5. 5.At 0700 in an acute care unit, a 76-year-old client with chronic kidney disease has a serum potassium of 6.2 mEq/L (reference range 3.5-5.0 mEq/L). The client is alert, reports no symptoms, and has a heart rate of 88/min. Which client should the nurse assess first?

   • A.A client with chronic back pain requesting the prescribed analgesic
   • B.A client who needs assistance choosing breakfast because of a low-sodium diet
   • C.A client awaiting discharge teaching about a new walker
   • D.The client with potassium 6.2 mEq/L and no reported symptoms

   Answer and rationale are in the full material.