ATI LPN
Gerontology Nursing Questions And Answers PDF
1. Nurse R works on the geriatric medicine unit of the university hospital and provides care for numerous older adult clients nearing the end of life, many of whom have no-code orders. Which of the following situations is incompatible with the legal requirements for a no-code order?
- A. A client who is mentally competent has declared his wish to have a no-code order despite the availability of treatment options for his condition.
- B. A client has expressed her desire to have a no-code order but her daughter is adamantly opposed to it.
- C. A client clearly tells the nurse her desire to have a no-code order, which the nurse documents at the bedside.
- D. A client has been in a coma and the family has decided to put in place a no-code order.
Correct answer: C
Rationale: The correct answer is C. No-code orders require a written and signed order by a physician. Therefore, a client expressing the desire for a no-code order to a nurse, without a documented physician's order, is incompatible with legal requirements. Choices A and B are not incompatible as competent clients can make their own decisions, regardless of treatment options or family opposition. Choice D is also not incompatible as family decisions can be made on behalf of incompetent clients.
2. Which of the following actions can a nurse safely take without risk of liability?
- A. Questioning a doctor's written orders for medication
- B. Permitting a volunteer to move a patient
- C. Using a blood pressure cuff that is sometimes sticking
- D. Asking a family member to deliver routine medication to a patient's room
Correct answer: A
Rationale: The correct answer is A: Questioning a doctor's written orders for medication. Under the doctrine of respondent superior, nurses can face liability risks for various actions. Permitting volunteers to move patients, using malfunctioning equipment, or tasking unqualified staff can pose liability risks. Questioning medication orders is a responsibility to ensure patient safety. It is crucial for nurses to clarify any doubts or raise concerns about medication orders to prevent potential harm to patients.
3. A nurse is assessing a client with osteoporosis who is experiencing severe pain. The client's respiratory rate is 14/min. Which of the following medications should the nurse administer first?
- A. Promethazine
- B. Hydromorphone
- C. Ketorolac
- D. Amitriptyline
Correct answer: B
Rationale: The correct answer is B, Hydromorphone. Hydromorphone is an opioid analgesic commonly used to manage severe pain effectively. In this case, the client's stable respiratory rate of 14/min indicates that it is safe to administer an opioid for pain relief. Promethazine (choice A) is an antiemetic and antihistamine, not the first choice for severe pain management. Ketorolac (choice C) is a nonsteroidal anti-inflammatory drug (NSAID) that may not be potent enough for severe pain relief associated with osteoporosis. Amitriptyline (choice D) is a tricyclic antidepressant, not typically used as a first-line medication for severe pain.
4. A healthcare provider is caring for four clients. Which of the following tasks can the healthcare provider delegate to an assistive personnel?
- A. Perform chest compressions during cardiac resuscitation
- B. Perform a dressing change for a new amputee
- C. Assess the effectiveness of antiemetic medication
- D. Provide discharge instructions
Correct answer: A
Rationale: Performing chest compressions during cardiac resuscitation is a critical life-saving intervention that can be delegated to an assistive personnel during an emergency. This task requires immediate action and basic training, making it appropriate for delegation. Performing a dressing change for a new amputee involves specialized knowledge and skills, typically performed by licensed healthcare providers. Assessing the effectiveness of medication requires critical thinking and decision-making skills that are within the scope of a licensed healthcare provider. Providing discharge instructions involves educating the patient on post-discharge care and follow-up, which is typically done by a healthcare provider to ensure clear communication and understanding.
5. A nurse has administered medications to a group of clients. For which of the following client situations should the nurse complete an incident report?
- A. Administering acetaminophen to an NPO client
- B. Administering insulin lispro to an NPO client
- C. Administering medication to the incorrect client
- D. Administering anticoagulants without checking INR
Correct answer: B
Rationale: The correct answer is B because administering insulin lispro to an NPO client can lead to hypoglycemia due to the lack of food to balance the medication. This situation poses a serious risk to the client's safety and should be documented in an incident report. Choice A is not as critical as insulin administration for an NPO client. Choice C is also serious but does not pose an immediate risk to the client's health. Choice D, administering anticoagulants without checking the INR, is important but does not require an incident report unless adverse effects occur, as it may not immediately endanger the client's life.
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