SKIN/ BURNS/GERON PRACTICE QUESTIONS

1. A patient has partial thickness burns to both legs and portions of his
trunk. Which of the following I.V. fluids is given first?
a. Albumin.
b. D5W.
c. Lactated Ringer’s solution.
d. 0.9% sodium chloride solution with 2 mEq of potassium per 100 ml.

2. Which of the following techniques is correct for obtaining a wound culture

specimen from a surgical site?
a. Thoroughly irrigate the wound before collecting the specimen.
b. Use a sterile swab and wipe the crusty area around the outside of the
wound.
c. Gently roll a sterile swab from the center of the wound outward
to collect drainage.
d. Use a sterile swab to collect drainage from the dressing.

3. A nurse is caring for a child who has a superficial burn. The nurse should
recognize that which of the following is the expected predominant
manifestation of a superficial burn in a child?
a. Significant tissue damage
b. Blister formation
c. Loss of skin
d. Pain

4. A child has suffered a partial-thickness second-degree burn injury of the

face and neck. Which of the following is crucial for the nurse to monitor?
a. Reassure the client that it is not painful
b. Administer pain medication
c. Use imagery to relieve the pain of the treatment
d. Maintain an airway

5. A nurse is caring for a client who suffered an electrical burn injury from
household current. What is the best method to measure the total body
surface affected by the burn?
a. Rule of tens
b. Rule of nines
c. Rule of sixes
d. Rule of sevens

6. A nurse should assess a client with a burn injury for ineffective

thermoregulation, which occurs primarily as a result of which of the following?
a. Major blood loss from injured tissue
b. Evaporation of fluid from loss of protective skin
c. Oxygen level is below 95%
d. A large wound area on the body
7. The nurse is aware that a client experiencing septic shock normally
undergoes two phases of signs and symptoms. Which of the following
indicates phase one?

a. Cold, clammy extremities, normal temperature

b. Pulmonary edema and distended (swollen) neck veins
c. normal BP, pulse and urine output
d. Hypotension, bradycardia, oliguria

8. A nurse who is caring for a burn client has an oxygen saturation of below
82%. What should be the desired oxygen saturation of a client suffering
with burns?
a. O2 saturation will remain below 95%.
b. O2 saturation will remain above 95%.
c. O2 saturation will remain above 99%.
d. O2 saturation will remain below 80%.
9. The nurse is caring for a client with severe amount of fluid loss due to a
fall. Which of the following type of shock is the client experiencing?
a. Anaphylactic shock
b. Cardiogenic shock
c. Hypovolemic shock
d. Septic shock

10. A client is brought to the EC with partial-thickness burns on the face and
neck that resulted from an explosion in an auto garage. The nurse is aware
besides maintaining an airway, which of the following is critical in the care of
this patient?
a. Maintenance of social relationships
b. Maintain infection precautions
c. Starting to accept what has happened
d. Maintaining a good attitude

11. A client was brought to the emergency department after experiencing a blow
to the head from a car crash. Which of the following can result from receiving
a trauma to the head?
a. Encephalitis
a. Obstructed airway
b. Increased intracranial pressure
c. Gastritis
12. A nurse, admitting a client burned with a flash flame, observes a burned
area which is bright red, with a moist, glistening appearance and blister
formation. The area blanches upon pressure, and the client complains of
severe pain upon exposure of the site to air. The nurse recognizes that the
depth of the burn is categorized as which of the following?
a. superficial burn
b. superficial partial thickness burn
c. deep partial thickness burn
d. full thickness burn

13. A client presents with deep partial-thickness burns to the anterior trunk and
left anterior arm, and full-thickness burns to the anterior left leg and
perineum, and superficial burns to the right anterior leg. The nurse calculates
the percentage of TBSA burned as which of the following?
a. 41.5% of TBSA
b. 32.5% of TBSA
c. 31.5% of TBSA
d. 30.5 of TBSA

14. A nurse in the emergency department is assigning triage classifications

to 4 clients admitted with burn injuries sustained in a house fire. Which of
the following clients would the nurse identify as a minor burn versus a
major burn?
a. A 45-year-old male with full-thickness burns 15% of TBSA.
b. A 42-year-old female with superficial burns 10% of TBSA
c. A 30-year-old male with burns to both hands.
d. A 17-year-old male with smoke inhalation.

15. A client with major burn injuries 45% of TBSA is admitted to the burn unit. The
nurse planning care knows that the client will likely experience which of the
following in the emergent phase?
a. Fluid volume excess
b. Malnutrition
c. Hypovolemic shock
d. Stress ulcers

16. A young adult male is rescued from a burning building after he was found by
firefighters in an enclosed room with no ventilation. The victim is confused,
hypotensive, bradycardic, and his skin coloring is dark red. Based on this
assessment data, the rescuers would suspect which of the following?
a. Carbon monoxide poisoning
b. Upper airway thermal injury
c. Lower airway thermal injury
d. Pulmonary edema
17. A client in the burn unit complains of abdominal pain followed by
hematemesis. The nurse assesses the client, and bowel sounds are
auscultated in all quadrants and the abdomen is soft and non-distended. The
nurse planning care for this client would suspect that the client is experiencing
which of the following?
a. Paralytic ileus
b. Intestinal haemorrhage
c. Curling’s ulcer
d. Esophageal varices.

18. A young adult woman calls the emergency department for advice on
emergency treatment of her husband who just spilled a large amount of
powder chemical on his arms and trunk. Which of the following is the nurse's
most appropriate course of action?
a. Instruct the wife to assist the client to the shower and wash off for
20 minutes, then come to the emergency department.
b. Ask the wife if she or the victim can identify the name of the chemical.
c. Instruct the wife to bring the victim to the hospital immediately.
d. Instruct the wife that Emergency Medical Services will be activated and
until they arrive stay with the victim and keep him calm.

19. A burn victim is being treated by emergency medical personnel at the

location of the injury. The medical personnel note that the victim has
sustained severe burns to the face, neck, and trunk. The victim is responsive
at this time and complains of difficulty breathing. Which of the following is the
most appropriate immediate action?
a. Place the client on 100% humidified oxygen by mask.
b. Intubate the client via nasotracheal tube placement.
c. Perform an emergency tracheostomy.
d. Administer bronchodilator.

20. A client with a circumferential burn to the left arm complains of severe pain
to the arm. The nurse assesses the client and notes the arm to be cool,
notes a diminished capillary refill, and has difficulty locating the radial pulse
by Doppler. Which of the following represents the nurse's most appropriate
action?
a. Notify the physician immediately and anticipate an escharotomy.
b. Administer the client his prn pain medication.
c. Elevate the client's arm.
d. Apply a cool compress to arm to alleviate swelling.
21. There has been a fire in an apartment building. All residents have been evacuated,
but many are burned. Which patients should be transported to the hospital for
treatment?

i. A 20-year-old who inhaled the smoke of the fire.

ii. A 30-year-old with second degree burns on the back of his leg.
iii. A 40-year-old with second degree burns on his right arm (about 10% of
BSA).
iv. An 8-year-old with third degree burns over 10% of his body surface area
(BSA).

A. i, ii.
B. i, iii.
C. i, iv.
D. ii, iii.

22. The nurse is assessing an 80-year-old patient and has scald burns on his hands
and both forearm (first and second degree burns on 10% of his body surface
area). What should the nurse do first?

A. Apply antibiotic cream.

B. Arrange the patient for chest x-ray.
C. Clean the wounds with warm water.
D. Cover the burns with a sterile dressing.

23. During the resuscitative phase of burn injury, which of the following indicates that
the patient is requiring additional volume with fluid resuscitation?

A. Serum albumin level of 3.8.

B. Hourly urine output of 60 mL.
C. Little fluatuation in daily weight.
D. Serum creatinine level of 2.5 mg/dL.

24. A patient is admitted to the hospital after sustaining burns to the chest, abdomen,
right arm, and right leg. Using the “rule of nines,” the nurse would determine that
about what percentage of the patient’s body surface has been burned?

A. 18%.
B. 27%.
C. 45%.
D. 64%.
25. A patient is admitted to the hospital after sustaining burns to the face,
anterior body, and anterior right leg. Using the “rule of nines,” the nurse
would determine that about what percentage of the patient’s body surface
has been burned?

A. 18.5%.
B. 27.5%.
C. 31.5%.
D. 64.5%.

26. A priority nursing diagnosis for a patient with burns during the emergent period
would be
A. Risk for infection.
B. Excess fluid volume.
C. Risk for injury (falling).
D. Imbalanced nutrition: less tahn body requirements.

27. Which of the following activities should the nurse include in the plan of care for a
patient with burn injuries to be carried out about one-half hour before the daily
whirlpool bath and dressing change?

A. Soak the dressing.

B. Remove the dressing.
C. Administer an analgesic.
D. Slit the dressing with blunt scissors.

28. The patient with a major burn injury receives total parenteral nutrition (TPN).
The expected outcome is to

A. Allow the gastrointestinal tract to rest.

B. Correct water and electrolyte imbalances.
C. Ensure adequate caloric and protein intake.
D. Provide supplemental vitamins and minerals.

29. An advantage of using biologic burn grafts is that they appear to help

A. Encourage formation of tough skin.

B. Provide for permanent wound closure.
C. Promote the growth of epithelial tissue.
D. Facilitate development of subcutaneous tissue.
30. Which of the following factors would have the least influence on the survival and
effectiveness of a burn victim’s biologic grafts?

A. Absence of infection in the wounds.

B. Immobilization of the area being grafted.
C. Adequate vascularization in the grafted area.
D. Use of analgesics as necessary for pain relief.

31. The nurse should plan to begin rehabilitation efforts for the burn patient

A. Immediately after the burn has occured.

B. After the patient’s pain has been eliminated.
C. After grafting of the burn wounds has occured.
D. After the patient’s circulatory status has been stabilized.

32. During the early phase of burn care the nurse should assess the patient for

A. Hyperkalemia.
B. Hyponatremia.
C. Hypernatremia.
D. Metabolic alkalosis.

33. Which of the following patient with burns will most likely require an
endotracheal or tracheostomy tube? A patient who has

A. Secondhand smoke inhalation.

B. Chemical burns on the chest and abdomen.
C. Electrical burns on the hands and arms causing arrhythmias.
D. Thermal burns to the head, face and airway resulting in hypoxia.

34. After initial phase of the burn injury, the patient’s plan of care will focus primarily on

A. Promoting hygiene.
B. Preventing infection.
C. Helping the patient maintain a positive self-concept.
D. Educating the patient regarding care of the skin grafts.
35. The rate at which I.V. fluids are infused is based on the burn patient’s

A. Total BSA and BSA burned.

B. Total body weight and BSA burned.
C. Height and weight and BSA burned.
D. Lean muscle mass and body surface area (BSA) burned.

36. The nurse is conducting a focused assessment of the gastrointestinal system of a

patient with a burn injury. The nurse should assess the patient for

A. Hiatal hernia.
B. Paralytic ileus.
C. Curling’s ulcer.
D. Gastric distention.

37. In acute phase of burn injury, which pain medication would most likely be given to
the patient to decrease the perception of the pain?

A. Oral antianxiety
B. Intravenous opioids.
C. Intramuscular opioids.
D. Oral analgesics such as ibuprofen or acetaminophen.

38. Using Parkland Formula, calculate the hourly rate of fluid replacement with
Lactated Ringer’s solution during the first 8 hours for a patient weighing 75 kg
with total body surface area (TBSA) burn of 40%.

A. 650 mL/hour
B. 750 mL/hour
C. 850 mL/hour
D. 950 mL/hour

39. Burns that may require skin grafting include those that are:
i. Superficial partial thickness
ii. Deep partial thickness
iii. Full thickness
A. i
B. i, ii
C. ii, iii
D. i, ii, iii
40. The doctor plans to perform an escharotomy to a circumferential burn of a lower
leg. What type of burn has the patient sustained to his lower leg?
A. Superficial
B. Full thickness
C. Deep partial thickness
D. Superficial partial thickness

41. When planning care for a client with burns on the upper torso, which
nursing diagnosis should take the highest priority?
a. Ineffective airway clearance related to edema of the respiratory passages.
b. Impaired physical mobility related to the disease process.
c. Disturbed sleep pattern related to facility environment.
d. Risk for infection related to breaks in the skin.

42. In a client with burns on the legs, which nursing intervention helps prevent
contractures?
a. Applying knee splints
b. Elevating the foot of the bed
c. Hyperextending the client’s palms
d. Performing shoulder range-of-motion exercises

43. A client comes for treatment of severe sunburn. Which instruction would
best prevent skin damage?
a. “Minimize sun exposure from 1 to 4 p.m. when the sun is strongest.”
b. “Use a sunscreen with a sun protection factor of 6 or higher.”
c. “Apply sunscreen even on overcast days.”
d. “When at the beach, sit in the shade to prevent sunburn.”

44. A client is brought to the emergency department with second- and third-degree
burns on the left arm, left anterior leg, and anterior trunk. Using the Rule of Nines,
what is the total body surface area that has been burned?
a. 18%
b. 27%
c. 30%
d. 36%

45. Which nursing intervention can help a client maintain healthy skin?
a. Keep the client well hydrated.
b. Avoid bathing the client with mild soap.
c. Remove adhesive tape quickly from the skin.
d. Recommend wearing tight-fitting clothes in hot weather.
46. A male client with psoriasis visits the dermatology clinic. When inspecting the
affected areas, the nurse expects to see which type of secondary lesion?

a. Scale
b. Crust
c. Ulcer
d. Scar

47. A female adult client with atopic dermatitis is prescribed a potent topical
corticosteroid, to be covered with an occlusive dressing. Potential problem of Risk
for injury has been identified. Which “related-to” phrase should be added to
complete the nursing diagnosis?

a. Related to potential interactions between the topical corticosteroid and other

prescribed drugs
b. Related to vasodilatory effects of the topical corticosteroid
c. Related to percutaneous absorption of the topical corticosteroid
d. Related to topical corticosteroid application to the face, neck, and intertriginous
sites

48. Which statement about herpes simplex infection is true?

a. During early pregnancy, herpes simplex infection may cause spontaneous

abortion or premature delivery.
b. Genital herpes simplex lesions are painless, fluid-filled vesicles that ulcerate and
heal in 3 to 7 days
c. Herpetic keratoconjunctivitis usually is bilateral and causes systemic symptoms.
d. A client with genital herpes lesions can have sexual contact but must use a
condom.

49. A client with a severe staphylococcal infection is receiving the aminoglycoside

gentamicin sulfate (Garamycin) by the I.V. route. The nurse should assess the
client for which adverse reaction to this drug?

a. Aplastic anemia
b. Ototoxicity
c. Cardiac arrhythmias
d. Seizures
50. A male client is diagnosed with primary herpes genitalis. Which instruction
should the nurse provide?

a. “Apply one applicator of terconazole intravaginally at bedtime for 7 days.”

b. “Apply one applicator of tioconazole intravaginally at bedtime for 7 days.”
c. “Apply acyclovir ointment to the lesions every 3 hours, six times a day for 7 days.”
d. “Apply sulconazole nitrate twice daily by massaging it gently into the lesions.”

51. Nurse Nancy plans to administer dexamethasone cream to a client who has
dermatitis over the anterior chest. How should the nurse apply this topical
agent?

a. With a circular motion, to enhance absorption.

b. With an upward motion, to increase blood supply to the affected area.
c. In long, even, outward, and downward strokes in the direction of hair growth.
d. In long, even, outward, and upward strokes in the direction opposite hair growth.

52. Nurse Rudy documents the presence of a scab on a client’s deep wound. The
nurse identifies this as which phase of wound healing?

a. Inflammatory
b. Migratory
c. Proliferative
d. Maturation

53. In an industrial accident, a male client that weighs 70 kg sustained full-

thickness burns over 40% of his body. He’s in the burn unit receiving fluid
resuscitation. Which observation shows that the fluid resuscitation is benefiting the
client?

a. A urine output consistently above 100 ml/hour

b. A weight gain of 4 lb (2 kg) in 24 hours
c. Body temperature readings all within normal limits
d. An electrocardiogram (ECG) showing no arrhythmias.
54. A female client with herpes zoster is prescribed acyclovir (Zovirax), 200 mg P.O.
every 4 hours while awake. The nurse should inform the client that this drug may
cause:

a. palpitations.
b. dizziness.
c. diarrhea.
d. metallic taste.

55. A female client sees a dermatologist for a skin problem. Later, the nurse
reviews the client’s chart and notes that the chief complaint was intertrigo. This term
refers to which condition?

a. Spontaneously occurring wheals

b. A fungus that enters the skin’s surface, causing infection
c. Inflammation of a hair follicle
d. Irritation of opposing skin surfaces caused by friction.

56. A male client who has suffered a cerebrovascular accident (CVA) is too weak
to move on his own. To help the client avoid pressure ulcers, the nurse should:

a. turn him frequently.

b. perform passive range-of-motion (ROM) exercises.
c. reduce the client’s fluid intake.
d. encourage the client to use a footboard.

57. A client is treated for a skin disorder. As a primary treatment, the client is
prescribed:

a. an I.V. corticosteroid.
b. an I.V. antibiotic.
c. an oral antibiotic.
d. a topical agent.

58. A client was diagnosed with scabies the day after discharge. The client asks
the nurse what his family should do. The most accurate response from the nurse
is:

a. “All family members will need to be treated.”

b. “If someone develops symptoms, tell him to see a physician right away.”
c. “Just be careful not to share linens and towels with family members.”
d. “After you’re treated, family members won’t be at risk for contracting scabies.”
59. When caring for a client with severe impetigo, the nurse should include which
intervention in the plan of care?

a. Placing mitts on the client’s hands

b. Administering systemic antibiotics as prescribed
c. Applying topical antibiotics as prescribed
d. Continuing to administer antibiotics for 21 days as prescribed.

60. A female client with second- and third-degree burns on the arms receives
autografts. Two days later, the nurse finds the client doing arm exercises. The
nurse knows that this client should avoid exercise because it may:

a. dislodge the autografts.

b. increase edema in the arms.
c. increase the amount of scarring.
d. decrease circulation to the fingers.

61. Nurse Troy discovers scabies when assessing a client who has just been
transferred to the medical- surgical unit from the day surgery unit. To prevent
scabies infection in other clients, the nurse should:

a. wash hands, apply a pediculicide to the client’s scalp, and remove any observable
mites.
b. isolate the client’s bed linens until the client is no longer infectious.
c. notify the nurse in the day surgery unit of a potential scabies outbreak.
d. place the client on enteric precautions.

62. Dr. Smith prescribes an emollient for a client with pruritus of recent onset. The
client asks why the emollient should be applied immediately after a bath or shower.
How should the nurse respond?

a. “This makes the skin feel soft.”

b. “This prevents evaporation of water from the hydrated epidermis.”
c. “This minimizes cracking of the dermis.”
d. “This prevents inflammation of the skin.”

63. Following a full thickness (third-degree) burn of his left arm, a female client is
treated with artificial skin. The client understands postoperative care of artificial skin
when he states that during the first 7 days after the procedure, he will restrict:

a. range of motion.
b. protein intake.
c. going outdoors.
d. fluid ingestion.
64. A client with a solar burn of the chest, back, face, and arms is seen in
urgent care. The nurse’s primary concern should be:

a. fluid resuscitation.
b. infection.
c. body image.
d. pain management.

65. The nurse is providing home care instructions to a client who has recently had a
skin graft. It’s most important that the client remember to:

a. use cosmetic camouflage techniques.

b. protect the graft from direct sunlight.
c. continue physical therapy.
d. apply lubricating lotion to the graft site.

66. A client is diagnosed with gonorrhea. When teaching the client about this
disease, the nurse should include which instruction?

a. “Avoid sexual intercourse until you’ve completed treatment, which takes 14 to 21

days.”
b. “Wash your hands thoroughly to avoid transferring the infection to your eyes.”
c. “If you have intercourse before treatment ends, tell sexual partners of your
status and have them wash well after intercourse.”
d. “If you don’t get treatment, you may develop meningitis and suffer
widespread central nervous system (CNS) damage.”

67. A female client with atopic dermatitis is prescribed medication for

photochemotherapy. The nurse stresses the need to protect the eyes. After
administering medication for photochemotherapy, the client must protect the eyes for:

a. 4 hours.
b. 8 hours.
c. 24 hours.
d. 48 hours.
68. A female client with genital herpes simplex. Genital herpes simplex increases the
risk of:
a. cancer of the ovaries.
b. cancer of the uterus.
c. cancer of the cervix.
d. cancer of the vagina.

69. Which of the following is the initial intervention for a male client with external
bleeding?
a. Elevation of the extremity
b. Pressure point control
c. Direct pressure
d. Application of a tourniquet.

70. A nurse is preparing to complete an admission assessment on a client

that is partially hearing impaired. The best approach would be to do
which of the following?
a. Request that a family member be present.
b. Prepare written questions that cover the assessment criteria.
c. Speak slowly in a low-pitched voice while facing the client.
d. Perform the physical assessment only at this time.

71. Which of these problems is related to aging for a 76 year old client.
a. Hyperopia
b. Conductive hearing loss
c. Presbycusis
d. Tinnitus

72. Pain in the elderly requires careful assessment because older people
have which of the following characteristics?
a. Increased pain tolerance
b. Decreased pain tolerance
c. Are likely to experience chronic pain
d. Experience reduced sensory perception

73. A nurse is working in a geriatric screening clinic. The nurse would expect
that the skin of the normal elderly client will demonstrate which of the
following characteristics?
a. Dehydration causing the skin to swell.
b. Moist skin turgor
c. Skin turgor showing a loss of elasticity.
d. Overhydration causing the skin to wrinkle

74. A 78-year-old visually impaired client is admitted to the nursing unit. Which
of the following interventions would be most appropriate in reducing
sensory deprivation?
a. Close curtains to reduce glare.
b. Keep doors open to provide bright light into the room
c. Keep curtains open to allow the sun to shine brightly in the room
d. Keep lights in the room dimmed.
 75. Which of the following are NOT associated with the aging process.

a. Increased visual impairment

b. Increased calorie requirements
c. Decreased sensation to heat and cold
d. Decreased subcutaneous fat

76. A nurse is teaching a patient about a newly prescribed drug. What

could cause a geriatric patient to have difficulty retaining
knowledge about prescribed medications?

a. Decreased plasma drug levels

b. Sensory deficits
c. Lack of family support
d. History of Tourette syndrome

77. To prevent loneliness of a newly admitted client to a nursing home,

the nurse would

a. provide group learning activities

b. provide one-to-one contact with the resident
c. allow residents to wander the halls to get acquainted
d. share a daily listing of activities and invite the resident to participate

78. Which of the following might cause the nurse to suspect elderly
abuse when making a home visit?

a. The temperature in the house is 25°C.

b. There is a bruise on the client’s right leg.
c. The client is sitting alone in front of her house.
d. There are only bread and peanut butter in the refrigerator.
79. When an elderly client is hospitalized with pneumonia, the best action
to encourage the client to eat is to

a. provide small, more frequent meals.

b. ensure the client is adequately hydrated.
c. provide a high-calorie snack of the client’s choice.
d. secure an order for a daily multivitamin to stimulate appetite.

80. Which finding might lead the nurse to suspect a nutritional alteration for
an elderly client admitted to a nursing home?

a. Shiny hair.
b. Pale tongue.
c. Ridged nails.
d. Moist conjunctiva.

81. The loss of lean muscle mass that occurs with aging can be diminished
or reversed by

a. high-protein diet.
b. anaerobic exercise.
c. strength training exercise.
d. small doses of anabolic hormones.

82. The leading cause of death in the elderly is

a. cancer.
b. infectious disease.
c. cardiovascular disease.
d. complications from falls.

83. The aging theory that says” the body just falls apart when it gets old” is

a. biological theory.
b. continuity theory.
c. developmental theory.
d. disengagement theory.

84. What is the greatest threat to the mental well-being of the elderly?

a. Pain.
b. Anxiety.
c. Alcoholism.
d. Depression.
85. Madam Lam, 62 years has urinary incontinence during cough. What is your
advice to her?

a. Perform pelvic floor exercise.

b. Take more fruits and vegetables.
c. Take balance diet to strengthen muscle.
d. Perform full range of movement exercise.

86. Mr. Lim aged 78 years old with dementia was sent to the nursing home by his
family. The most effective action taken to help him to adjust to the new
environment is

a. restrict family visits for the first 2 weeks.

b. suggest family members to bring his favorite things from home.
c. admit him as quickly as possible so that he does not have time to think.
d. involve him in as many activities as soon as possible so he can meet
other residents.

87. A nurse is assessing an elderly client who reports frequent falls. Which intervention
would be most appropriate to reduce the client’s risk of falling?
a. Recommend the use of side rails on the bed.
b. Ensure the client is using a properly fitted walker.
c. Provide education on wearing non-slip shoes.
d. Encourage the client to avoid physical activity to reduce risk.

88. Mr. John, 80 years old, is hospitalized for dehydration. To prevent this from
happening again, the nurse should advise him to:
a. Consume more fluids only when thirsty.
b. Keep a daily log of fluid intake and set fluid goals.
c. Increase intake of caffeine-containing beverages.
d. Decrease physical activity to reduce fluid loss.

89. A nurse is educating an elderly client with osteoarthritis about joint care. Which of
the following would be the most effective advice?
a. Avoid using any joints that are painful.
b. Limit daily movement to prevent further joint damage.
c. Apply heat to affected joints before activity to ease stiffness.
d. Perform weight-bearing exercises daily to improve bone strength.

90. An elderly client with mild cognitive impairment becomes easily agitated during
hospital stays. The nurse’s most effective intervention would be:
a. Administer a sedative to calm the patient.
b. Place the client in a room with multiple other patients.
c. Minimize environmental changes and maintain a routine.
d. Encourage frequent visits from multiple family members.
91. An elderly client with diabetes is having difficulty managing insulin injections due to
poor vision. The nurse's best response would be:
a. Recommend switching to oral diabetic medications.
b. Refer the client to a home health aide for insulin administration.
c. Suggest the client delegate insulin administration to a family member.
d. Educate the client on using insulin pens with larger, easy-to-read numbers.

92. A nurse is caring for a 90-year-old client with moderate dementia who has been
wandering around the nursing home. The best intervention is:
a. Restrict the client to bed rest to prevent injury.
b. Involve the client in regular, supervised physical activities.
c. Use a physical restraint to ensure the client remains safe.
d. Request that family members stay with the client at all times.

93. An elderly patient is experiencing urinary incontinence at night. Which intervention

would the nurse recommend to promote nighttime continence?
a. Limit fluid intake after dinner.
b. Teach the patient to double void before bed.
c. Increase fluid intake before bedtime to ensure bladder is full.
d. Place the patient on a bowel regimen to prevent constipation.

94. A nurse is educating an elderly client with a history of chronic constipation. Which
dietary modification would be most effective in managing this condition?
a. Increase the intake of dairy products.
b. Suggest reducing fluid intake to avoid overhydration.
c. Encourage high-fiber foods such as fruits and whole grains.
d. Recommend a diet rich in protein and low in carbohydrates.

95. A geriatric patient is prescribed a new medication that causes dizziness. The best
nursing intervention to prevent falls related to this side effect is:
a. Suggest the patient use a walker at all times.
b. Advise the patient to remain in bed to avoid dizziness.
c. Recommend discontinuing the medication immediately.
d. Educate the patient to change positions slowly from sitting to standing.