Geriatric Nurse Practitioner (NCLEX Questions 1-5)

Begin answering Geriatric Nurse Practitioner now . . .


1. A Spanish-speaking client arrives at the triage desk in the emergency department and states to the nurse, “No speak English, need interpreter.” Which is the best action for the nurse to take?

a) Have one of the client’s family members interpret.
b) Have the Spanish-speaking triage receptionist interpret.
c) Page an interpreter from the hospital’s interpreter services.
d) Obtain a Spanish-English dictionary and attempt to triage the client.

2. Geriatric Nurse Practitioner is performing a neurological assessment on a client and elicits a positive Romberg’s sign. The nurse makes this determination based on which observation?

a) An involuntary rhythmic, rapid, twitching of the eyeballs.
b) A dorsiflexion of the ankle and great toe with fanning of the other toes.
c) A significant sway when the client stands erect with feet together, arms at the side, and the eyes closed.
d) A lack of normal sense of position when the client is unable to return extended fingers to a point of reference.

3. The nurse notes documentation that a client is exhibiting Cheyne-Stokes respirations. On assessment of the client, the nurse should expect to note which finding?

a) Rhythmic respirations with periods of apnea
b) Regular rapid and deep, sustained respirations
c) Totally irregular respiration in rhythm and depth
d) Irregular respirations with pauses at the end of inspiration and expiration

4. Geriatric Nurse Practitioner notes documentation that a client has conductive hearing loss. The nurse understands that this type of hearing loss is caused by which problem?

a) A defect in the cochlea
b) A defect in the 8th cranial nerve
c) A physical obstruction to the transmission of sound waves
d) A defect in the sensory fibers that lead to the cerebral cortex

5. While performing a cardiac assessment on a client with an incompetent heart valve, the nurse auscultates a murmur. Which describes the sound of a heart murmur?

a) Lub-dub sounds
b) Scratchy, leathery heart noise
c) Gentle blowing or swooshing noise
d) Abrupt, high-pitched snapping noise




Geriatric Nurse Practitioner
Answers and Rationale

1) C
- Rationale: The best action is to have a professional hospital-based interpreter translate for the client. English-speaking family members may not appropriately understand what is asked of them and may paraphrase what the client is actually saying. Also, client confidentiality as well as accurate information may be compromised when a family member or a non–health care provider acts as interpreter.

- Test-Taking Strategy: Note the strategic word best . Initially focus on what the client needs. In this case the client needs and asks for an interpreter. Next keep in mind the issue of confidentiality and making sure that information is obtained in the most efficient and accurate way. This will assist in eliminating options A, B, and D.

2) C
- Geriatric Nurse Practitioner Rationale: In Romberg’s test, the client is asked to stand with the feet together and the arms at the sides, and to close the eyes and hold the position; normally the client can maintain posture and balance. A positive Romberg’s sign is a vestibular neurological sign that is found when a client exhibits a loss of balance when closing the eyes. This may occur with cerebellar ataxia, loss of proprioception, and loss of vestibular function. A lack of normal sense of position coupled with an inability to return extended fingers to a point of reference is a finding that indicates a problem with coordination. A positive gaze nystagmus evaluation results in an involuntary rhythmic, rapid, twitching of the eyeballs. A positive Babinski’s test results in dorsiflexion of the ankle and great toe with fanning of the other toes; if this occurs in anyone older than 2 years it indicates the presence of central nervous system disease.

- Test-Taking Strategy: Note the subject , Romberg’s test. You can easily answer this question if you can recall that the client’s balance is tested in this test.

3) A
- Rationale: Cheyne-Stokes respirations are rhythmic respirations with periods of apnea and can indicate a metabolic dysfunction in the cerebral hemisphere or basal ganglia. Neurogenic hyperventilation is a regular, rapid and deep, sustained respiration that can indicate a dysfunction in the low midbrain and middle pons. Ataxic respirations are totally irregular in rhythm and depth and indicate a dysfunction in the medulla. Apneustic respirations are irregular respirations with pauses at the end of inspiration and expiration and can indicate a dysfunction in the middle or caudal pons.

- Taking Strategy: Focus on the subject , the characteristics of Cheyne-Stokes respirations. Recalling that periods of apnea occur with this type of respiration will help direct you to the correct answer.

4) C
- Rationale: A conductive hearing loss occurs as a result of a physical obstruction to the transmission of sound waves. A sensorineural hearing loss occurs as a result of a pathological process in the inner ear, a defect in the 8th cranial nerve, or a defect of the sensory fibers that lead to the cerebral cortex.

- Geriatric Nurse Practitioner Test-Taking Strategy: Focus on the subject , a conductive hearing loss. Noting the relationship of the word conductive in the question and transmission in the correct option will direct you to this option.

5) C
- Rationale: A heart murmur is an abnormal heart sound and is described as a gentle, blowing, swooshing sound. Lub-dub sounds are normal and represent the S1 (first) heart sound and S2 (second) heart sound, respectively. A pericardial friction rub is described as a scratchy, leathery heart sound. A click is described as an abrupt, high-pitched snapping sound.

- Test-Taking Strategy: Focus on the subject , characteristics of a murmur. Eliminate option A because it describes normal heart sounds. Next recall that a murmur occurs as a result of the manner in which the blood is flowing through the cardiac chambers and valves. This will direct you to the correct option.


After you reviewed your answers through its rationale, you can now proceed to the next set of questions:

Geriatric Nurse Practitioner (NCLEX Questions 6-10)

No comments:

Enter your email address:

Delivered by FeedBurner