Question

An older adult resident of a long term facility is experiencing frequent episodes of urinary incontinence. Which intervention is most important for the practical nurse (PN) to implement?

Answer 1

Correct Answers:

Decrease time intervals between toileting assistance.

Rationale :

🌼 Older adults in long-term care commonly experience functional urinary incontinence, where they are unable to reach the toilet in time despite having normal bladder function.

🌼 Scheduled or prompted toileting at shorter intervals is one of the most effective nursing interventions for reducing incontinent episodes.

🌼 Assisting the client to the toilet before the bladder becomes overly full helps maintain continence.

🌼 This intervention promotes independence, dignity, and skin integrity while reducing the need for absorbent products.

🌼 Frequent toileting also decreases the risk of moisture-associated skin damage and urinary tract infections.

🌼 The nurse should individualize the toileting schedule based on the client's usual voiding pattern.

🌼 Bladder training and prompted voiding are evidence-based first-line interventions in long-term care.

🌼 Decreasing the time between toileting assistance is the priority intervention because it addresses the underlying cause of frequent incontinence.

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Answer 2

Correct Answers:

Drowsiness should begin within approximately 15 minutes.

Rationale :

🌻 Eszopiclone (Lunesta) is a non-benzodiazepine hypnotic medication prescribed for insomnia.

🌻 It has a rapid onset of action, and clients should take it immediately before going to bed when they are able to remain in bed for a full night's sleep.

🌻 Drowsiness typically begins within 15 to 30 minutes, making this the most accurate response.

🌻 The medication should not be taken after a heavy or high-fat meal because food may delay its onset.

🌻 Older adults should be monitored closely for dizziness, confusion, and an increased risk of falls after taking the medication.

🌻 The client should avoid alcohol and other central nervous system depressants while using eszopiclone.

🌻 Safety measures, such as keeping the call light within reach, should be implemented before the medication takes effect.

🌻 Drowsiness beginning within approximately 15 minutes is the best explanation of the medication's expected onset.

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Answer 3

Correct Answers:

Decreased level of consciousness.

Rationale :

🌻 A decreased level of consciousness (LOC) is the earliest and most important indicator of neurological deterioration following a head injury.

🌻 Changes in LOC may indicate increased intracranial pressure (ICP), cerebral edema, or intracranial bleeding.

🌻 Early recognition is critical because neurological deterioration can progress rapidly and become life-threatening.

🌻 The nurse should immediately notify the charge nurse or healthcare provider and perform a focused neurological assessment.

🌻 Assessment should include the Glasgow Coma Scale (GCS), pupillary response, motor strength, and vital signs.

🌻 Prompt intervention can reduce the risk of brain herniation and permanent neurological damage.

🌻 Delayed recognition of decreased LOC may result in irreversible brain injury or death.

🌻 A decreased level of consciousness is an emergency finding that requires immediate reporting.

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Answer 4

Correct Answers:

Pelvic floor muscles.

Rationale :

🌸 Kegel exercises are designed to strengthen the pelvic floor muscles, which support the bladder, uterus, and rectum.

🌸 Strengthening these muscles improves urethral support and helps prevent urine leakage during activities that increase intra-abdominal pressure, such as sneezing, coughing, laughing, or lifting.

🌸 The client's symptoms are consistent with stress urinary incontinence, a common condition in older women.

🌸 Kegel exercises involve repeatedly contracting and relaxing the muscles used to stop the flow of urine.

🌸 Clients should avoid tightening the abdominal, buttock, or thigh muscles while performing the exercises.

🌸 Consistent practice several times daily for several weeks is usually required before noticeable improvement occurs.

🌸 The nurse should encourage the client to continue the exercises even if improvement is gradual.

🌸 Kegel exercises strengthen the pelvic floor muscles, helping reduce episodes of stress urinary incontinence.

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Answer 5

Correct Answers:

Fractures.

Rationale :

🌼 Osteoporosis causes loss of bone density and deterioration of bone structure, making bones fragile.

🌼 Older adults with osteoporosis are at increased risk for vertebral, hip, and wrist fractures.

🌼 Lower back pain may indicate a vertebral compression fracture, especially when no major trauma occurred.

🌼 Injury-prevention teaching focuses on reducing falls and avoiding movements that place excessive stress on weakened bones.

🌼 The client should use safe footwear, remove home hazards, improve lighting, and use assistive devices when needed.

🌼 Proper body mechanics and avoiding sudden twisting or heavy lifting also help prevent spinal injury.

🌼 Calcium, vitamin D, weight-bearing activity, and prescribed medications support bone health but do not eliminate fracture risk.

🌼 Injury prevention is emphasized primarily to prevent fractures, the major complication of osteoporosis.

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Answer 6

Correct Answers:

Encourage the resident to talk about past successes and joys

Rationale :

🌹 According to Erikson's stage of Ego Integrity vs. Despair, the major developmental task of older adulthood is to reflect on life with a sense of accomplishment and fulfillment.

🌹 Encouraging the resident to discuss past successes, meaningful experiences, and joyful memories promotes life review and helps foster ego integrity.

🌹 Life review enables older adults to accept both achievements and disappointments while finding meaning in their lives.

🌹 Clients who achieve ego integrity are more likely to experience peace, wisdom, and satisfaction rather than regret.

🌹 Osteoarthritis may limit physical function, making emotional support and opportunities for reminiscence especially valuable.

🌹 The nurse should listen attentively and encourage the resident to share important life events without judgment.

🌹 Reminiscing can improve self-esteem and reduce feelings of hopelessness or despair.

🌹 Encouraging discussion of past successes and joys best supports Erikson's developmental task of ego integrity.

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Answer 7

Correct Answers:

An outdoor game of balloon volleyball

Rationale :

✨ Balloon volleyball allows wheelchair-bound residents to participate safely in upper-body physical activity.

✨ Reaching, batting, and passing the balloon promote range of motion, coordination, and muscle use without requiring standing or walking.

✨ The activity can be adapted to each resident’s strength and mobility level.

✨ Group play also encourages social interaction, cooperation, laughter, and conversation.

✨ Mentally alert residents can follow rules, anticipate turns, and engage competitively or recreationally.

✨ The lightweight balloon reduces the risk of injury compared with heavier sports equipment.

✨ Outdoor participation also provides fresh air and environmental stimulation.

✨ Balloon volleyball best meets both the residents’ physical and social needs.

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Answer 8

Correct Answers:

Report to the charge nurse that the medication was not taken and ask for further instructions.

Rationale :

🌻 Enteric-coated (EC) tablets are specially formulated to resist dissolution in the stomach and dissolve in the intestine.

🌻 Crushing, splitting, or dissolving an enteric-coated tablet destroys its protective coating and alters how the medication is absorbed.

🌻 Since the client is unable to swallow the medication safely, the PN should not administer it in an altered form.

🌻 The appropriate action is to notify the charge nurse so the healthcare provider can be contacted for an alternative formulation or route of administration.

🌻 Alternative options may include a liquid preparation, a different medication, or another route if available.

🌻 The PN should also assess the client's swallowing difficulty and monitor for aspiration risk.

🌻 Client safety is maintained by withholding the medication until appropriate instructions are received.

🌻 Reporting the omitted medication and requesting further instructions is the safest and most appropriate intervention.

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Answer 9

Correct Answers:

A team ring-toss competition.

Rationale :

✳️ A team ring-toss competition allows wheelchair-bound residents to participate in meaningful upper-body physical activity.

✳️ Reaching, aiming, and tossing the rings help maintain range of motion, coordination, and muscle strength.

✳️ The activity can be adapted to different ability levels by changing the distance or size of the target.

✳️ Organizing residents into teams promotes social interaction, cooperation, encouragement, and friendly competition.

✳️ Mentally alert residents can understand the rules, keep score, and actively engage with teammates.

✳️ The game is safer than activities requiring standing, walking, or rapid movement.

✳️ Outdoor participation also offers fresh air and environmental stimulation.

✳️ Team ring toss best addresses both the residents’ physical and social needs.

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Answer 10

Correct Answers:

Pharmaceutical and herbal supplement use.

Rationale :

🌻 Polypharmacy refers to the use of multiple medications, including prescription drugs, over-the-counter (OTC) medications, vitamins, and herbal supplements.

🌻 Many adverse drug reactions in older adults occur because herbal supplements and OTC products interact with prescribed medications.

🌻 Obtaining a complete medication history is the highest priority during admission to identify potential drug-drug and drug-herb interactions.

🌻 Older adults are especially vulnerable because age-related changes in liver and kidney function alter medication metabolism and excretion.

🌻 The nurse should ask the client to list all medications, including doses, frequency, and the reason each is taken.

🌻 Bringing all medication bottles or an updated medication list to the hospital improves medication reconciliation and reduces errors.

🌻 Identifying unnecessary or duplicate medications helps prevent additional adverse drug events.

🌻 Collecting information about all pharmaceutical and herbal supplement use is the most important assessment for a client admitted with an adverse reaction related to polypharmacy.

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QLexNursing

1 :
An older adult resident of a long term facility is experiencing frequent episodes of urinary incontinence. Which intervention is most important for the practical nurse (PN) to implement?

3 :
Which finding in an older adult client with a head injury, should the practical nurse (PN) report immediately to the charge nurse?

5 :
An older adult female client with osteoporosis complains of pain in her lower back. The practical nurse (PN) reviews injury prevention concepts with the client as a means of preventing which complication?

6 :
The practical nurse (PN) who works in a long-term care facility applies Erickson's theory of developmental stages when implementing care for an older female resident with a diagnosis of osteoarthritis. Which intervention by the PN may assist the resident to achieve Erickson's developmental task?

7 :
The practical nurse (PN) is assisting the recreational director of a long-term care facility in planning outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity should the PN suggest that meets the physical and social needs of these residents?

8 :
An older adult client is having trouble swallowing an enteric-coated tablet. Which intervention would be appropriate for the practical nurse (PN) to implement?

9 :
The practical nurse (PN) is assisting the recreational director of a long-term care facility plan outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

10 :
An older adult is admitted to the hospital because of an adverse drug reaction related to polypharmacy. Which information is most important for the practical nurse (PN) to collect during the admission process?

QLexNursing

1 : An older adult resident of a long term facility is experiencing frequent episodes of urinary incontinence. Which intervention is most important for the practical nurse (PN) to implement?

3 : Which finding in an older adult client with a head injury, should the practical nurse (PN) report immediately to the charge nurse?

5 : An older adult female client with osteoporosis complains of pain in her lower back. The practical nurse (PN) reviews injury prevention concepts with the client as a means of preventing which complication?

7 : The practical nurse (PN) is assisting the recreational director of a long-term care facility in planning outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity should the PN suggest that meets the physical and social needs of these residents?

8 : An older adult client is having trouble swallowing an enteric-coated tablet. Which intervention would be appropriate for the practical nurse (PN) to implement?

9 : The practical nurse (PN) is assisting the recreational director of a long-term care facility plan outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

10 : An older adult is admitted to the hospital because of an adverse drug reaction related to polypharmacy. Which information is most important for the practical nurse (PN) to collect during the admission process?

1 :
An older adult resident of a long term facility is experiencing frequent episodes of urinary incontinence. Which intervention is most important for the practical nurse (PN) to implement?

3 :
Which finding in an older adult client with a head injury, should the practical nurse (PN) report immediately to the charge nurse?

5 :
An older adult female client with osteoporosis complains of pain in her lower back. The practical nurse (PN) reviews injury prevention concepts with the client as a means of preventing which complication?

7 :
The practical nurse (PN) is assisting the recreational director of a long-term care facility in planning outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity should the PN suggest that meets the physical and social needs of these residents?

8 :
An older adult client is having trouble swallowing an enteric-coated tablet. Which intervention would be appropriate for the practical nurse (PN) to implement?

9 :
The practical nurse (PN) is assisting the recreational director of a long-term care facility plan outdoor activities for the wheelchair-bound older residents who are mentally alert. Which activity meets the physical and social needs of these residents?

10 :
An older adult is admitted to the hospital because of an adverse drug reaction related to polypharmacy. Which information is most important for the practical nurse (PN) to collect during the admission process?