CPNRE - Canadian Practical Nurse Registration Examination Gerontological and Palliative Care Questions and Answers Flashcards

An elderly client with dementia repeatedly asks to go home during evening hours. Which nursing intervention best addresses sundowning behaviour?

Answer: Increase lighting in the room and engage the client in a calm activity

Increased lighting and calm redirection reduce confusion and agitation associated with sundowning syndrome.

A palliative care client reports breakthrough pain rated 8/10 despite scheduled opioid therapy. What is the nurse's priority action?

Answer: Notify the physician and administer prescribed breakthrough analgesic

Uncontrolled breakthrough pain requires timely administration of the prescribed PRN analgesic and prompt physician notification.

When assessing an older adult for fall risk, which single factor carries the greatest predictive value?

Answer: History of a previous fall

A prior fall history is the strongest single predictor of future falls in the older adult population.

A PN is caring for a dying client whose family insists on continuing aggressive IV hydration against the client's advance directive. The PN's first action is to:

Answer: Consult the palliative care team and refer the conflict to the care team and ethics committee if needed

Conflicts between family wishes and a valid advance directive require interprofessional consultation and may involve an ethics committee.

Which pressure injury stage is characterized by full-thickness skin loss with visible subcutaneous fat but no exposed bone, tendon, or muscle?

Answer: Stage 3

Stage 3 pressure injuries involve full-thickness skin loss exposing subcutaneous tissue without deeper structure involvement.

An older adult on long-term warfarin therapy is started on a new antibiotic. Which nursing action is most important?

Answer: Monitor INR more frequently and observe for signs of bleeding

Many antibiotics potentiate warfarin's anticoagulant effect, so closer INR monitoring and bleeding surveillance are essential.

A palliative client develops the 'death rattle' — noisy, wet-sounding respirations. Which intervention should the nurse implement first?

Answer: Reposition the client and explain the sound to the family

Repositioning can reduce pooling of secretions, and educating the family about this normal dying process alleviates their distress.