CPNRE CPNRE - Canadian Practical Nurse Registration Examination Gerontological and Palliative Care Questions and Answers 1 — Questions and Answers
Question 1: An elderly client with dementia is refusing to take their morning medications. What is the most appropriate nursing action?
- Force the medications immediately
- Document the refusal and report to the charge nurse (Correct answer)
- Crush the medications and mix them into food without consent
- Ignore the refusal and try again later
Correct answer: Document the refusal and report to the charge nurse
Documenting the refusal and notifying the charge nurse respects client autonomy while ensuring appropriate follow-up care.
Question 2: Which assessment finding in an older adult would most concern the nurse regarding fall risk?
- Blood pressure of 118/76 mmHg
- Postural hypotension of 25 mmHg drop (Correct answer)
- Heart rate of 72 bpm
- Oral temperature of 36.8°C
Correct answer: Postural hypotension of 25 mmHg drop
A postural blood pressure drop of 20 mmHg or more is a significant fall risk factor in older adults.
Question 3: A palliative care client rates their pain as 8/10 despite scheduled analgesia. What is the priority nursing action?
- Wait until the next scheduled dose
- Reassess in 30 minutes
- Administer a breakthrough dose as ordered and notify the physician (Correct answer)
- Encourage distraction techniques only
Correct answer: Administer a breakthrough dose as ordered and notify the physician
Uncontrolled pain in palliative care requires prompt administration of breakthrough analgesia and physician notification.
Question 4: When providing end-of-life care, the nurse notices the client's breathing has become irregular with long pauses. This pattern is called:
- Kussmaul breathing
- Cheyne-Stokes respiration (Correct answer)
- Biot's respiration
- Tachypnea
Correct answer: Cheyne-Stokes respiration
Cheyne-Stokes respiration is characterized by cycles of increasing and decreasing depth with periods of apnea, common near death.
Question 5: Which intervention best promotes dignity for a client receiving palliative care?
- Making all care decisions for the client to reduce stress
- Involving the client and family in care planning (Correct answer)
- Limiting visitors to reduce fatigue
- Avoiding discussion of death to minimize distress
Correct answer: Involving the client and family in care planning
Involving the client and family in care planning respects autonomy and promotes dignity throughout the end-of-life process.
Question 6: An older adult client has a sacral pressure injury that appears as a shallow open wound with a red-pink wound bed. How is this classified?
- Stage 1
- Stage 2 (Correct answer)
- Stage 3
- Stage 4
Correct answer: Stage 2
A Stage 2 pressure injury presents as a shallow open wound with a red-pink wound bed, indicating partial-thickness skin loss.
CPNRE CPNRE - Canadian Practical Nurse Registration Examination Gerontological and Palliative Care Questions and Answers 1
An elderly client with dementia is refusing to take their morning medications.
What is the most appropriate nursing action?