NUR 2214 Final Exam | 2026/2027 Edition | 85
Original Questions with Evidence-Based Verified
Answers Rasmussen University Nursing Care of
the Older Adult | Expert-Aligned Q&A |
Certification-Ready Format
Introduction
This 85-question comprehensive competency assessment focuses on gerontological
nursing domains, emphasizing physiological changes of aging, chronic disease
management, cognitive and mental health assessment, polypharmacy, safety,
ethical decision-making, palliative support, and holistic end-of-life care. Items
integrate evidence-based standards, functional assessment, fall prevention,
medication safety, delirium recognition, dementia communication, caregiver
support, and quality-of-life priorities to support optimal care for older adult
populations. All questions are aligned with current evidence-based practice
guidelines and gerontological nursing standards for 2026-2027.
Content Area Overview: 85 Questions
Content Area Questions Key Topics Weight
Physiological Vision, hearing, skin,
Changes of Aging respiratory reserve, nutrition,
17 20%
and Health falls, immunization, activity,
Promotion sleep, thermoregulation
Chronic Conditions Heart failure, diabetes, COPD,
and Multisystem 22 pneumonia, kidney disease, 25%
Disorders osteoporosis, Parkinson
,Content Area Questions Key Topics Weight
disease, arthritis,
hypertension, stroke
Cognitive, Mental Delirium, dementia,
Health, and depression, grief, isolation,
17 20%
Psychosocial mistreatment, communication,
Assessment spirituality, caregiver burden
Medication reconciliation,
Medication
renal clearance, Beers criteria,
Management,
15 anticoagulants, adherence, 18%
Polypharmacy, and
adverse effects, herb-drug
Safety
interactions
Palliative care, hospice,
End-of-Life Care,
advance directives, comfort,
Ethics, and 14 17%
autonomy, caregiver support,
Palliative Support
grief, ethical dilemmas
1. An older adult asks why night driving has become more difficult. Which
age-related change should the nurse include in teaching?
• A. Increased lens flexibility
• B. Decreased pupil size and slower adaptation to glare
• C. Improved peripheral vision
• D. Faster dark adaptation than younger adults
Correct Answer: B. Decreased pupil size and slower adaptation to glare
Rationale: Normal aging reduces pupil size (senile miosis) and slows adaptation to
changes in lighting, making night driving and glare recovery more difficult. The
lens becomes less flexible (presbyopia), peripheral vision decreases, and dark
,adaptation slows, not improves. These changes increase fall risk and driving safety
concerns in older adults.
Why Wrong? A, C, D are incorrect because lens flexibility decreases with age,
peripheral vision declines, and dark adaptation slows rather than improves. These
options reflect misunderstandings of normal age-related visual changes.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; AGS Healthy Aging Resources.
2. A nurse teaches an older adult about maintaining skin integrity. Which
instruction is MOST appropriate?
• A. Scrub dry areas vigorously each day
• B. Use very hot water to improve circulation
• C. Avoid reporting new skin breakdown
• D. Use mild soap, moisturize dry skin, and inspect pressure areas daily
Correct Answer: D. Use mild soap, moisturize dry skin, and inspect pressure
areas daily
Rationale: Skin changes with aging include thinning, decreased elasticity, reduced
sebaceous gland activity, and slower wound healing. Mild soap preserves skin pH
and natural oils; moisturizers prevent dryness and cracking; daily inspection allows
early detection of pressure injuries. Hot water strips natural oils and increases
dryness; vigorous scrubbing damages fragile skin.
Why Wrong? A, B, C are incorrect because vigorous scrubbing damages fragile
skin, hot water increases dryness, and failure to report skin breakdown delays
intervention and increases complication risk.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; AHRQ Pressure Injury Prevention Guidelines.
3. An 82-year-old patient reports difficulty hearing high-pitched sounds and
following conversations in crowded rooms. Which nursing action is MOST
appropriate?
, • A. Refer the patient for a hearing evaluation
• B. Speak clearly, face the patient, and minimize background noise
during interactions
• C. Recommend the patient avoid social situations
• D. Increase the volume of all communications
Correct Answer: B. Speak clearly, face the patient, and minimize background
noise during interactions
Rationale: Presbycusis (age-related hearing loss) typically affects high-frequency
sounds and makes speech discrimination difficult, especially in noisy
environments. Facing the patient allows lip-reading; clear speech and reduced
background noise enhance comprehension. Avoiding social situations would
increase isolation and depression risk. Increasing volume alone is ineffective and
may distort speech.
Why Wrong? A is appropriate but not the first intervention; C promotes social
isolation; D may cause discomfort without improving speech discrimination.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; HHS Healthy People 2030.
4. An older adult has a body mass index (BMI) of 22 kg/m². Which statement
reflects appropriate nutritional counseling for this patient?
• A. "You need to gain weight to reduce mortality risk"
• B. "Maintaining a BMI between 21-25 kg/m² is generally recommended
for healthy aging"
• C. "Your BMI is too high and requires immediate intervention"
• D. "Older adults should maintain a BMI below 20 for optimal health"
Correct Answer: B. "Maintaining a BMI between 21-25 kg/m² is generally
recommended for healthy aging"
Rationale: For older adults, a BMI in the range of 21-25 kg/m² is generally
associated with optimal health outcomes. Slight higher BMI may be protective in
older adults (the "obesity paradox" in some conditions). Undernutrition and
Original Questions with Evidence-Based Verified
Answers Rasmussen University Nursing Care of
the Older Adult | Expert-Aligned Q&A |
Certification-Ready Format
Introduction
This 85-question comprehensive competency assessment focuses on gerontological
nursing domains, emphasizing physiological changes of aging, chronic disease
management, cognitive and mental health assessment, polypharmacy, safety,
ethical decision-making, palliative support, and holistic end-of-life care. Items
integrate evidence-based standards, functional assessment, fall prevention,
medication safety, delirium recognition, dementia communication, caregiver
support, and quality-of-life priorities to support optimal care for older adult
populations. All questions are aligned with current evidence-based practice
guidelines and gerontological nursing standards for 2026-2027.
Content Area Overview: 85 Questions
Content Area Questions Key Topics Weight
Physiological Vision, hearing, skin,
Changes of Aging respiratory reserve, nutrition,
17 20%
and Health falls, immunization, activity,
Promotion sleep, thermoregulation
Chronic Conditions Heart failure, diabetes, COPD,
and Multisystem 22 pneumonia, kidney disease, 25%
Disorders osteoporosis, Parkinson
,Content Area Questions Key Topics Weight
disease, arthritis,
hypertension, stroke
Cognitive, Mental Delirium, dementia,
Health, and depression, grief, isolation,
17 20%
Psychosocial mistreatment, communication,
Assessment spirituality, caregiver burden
Medication reconciliation,
Medication
renal clearance, Beers criteria,
Management,
15 anticoagulants, adherence, 18%
Polypharmacy, and
adverse effects, herb-drug
Safety
interactions
Palliative care, hospice,
End-of-Life Care,
advance directives, comfort,
Ethics, and 14 17%
autonomy, caregiver support,
Palliative Support
grief, ethical dilemmas
1. An older adult asks why night driving has become more difficult. Which
age-related change should the nurse include in teaching?
• A. Increased lens flexibility
• B. Decreased pupil size and slower adaptation to glare
• C. Improved peripheral vision
• D. Faster dark adaptation than younger adults
Correct Answer: B. Decreased pupil size and slower adaptation to glare
Rationale: Normal aging reduces pupil size (senile miosis) and slows adaptation to
changes in lighting, making night driving and glare recovery more difficult. The
lens becomes less flexible (presbyopia), peripheral vision decreases, and dark
,adaptation slows, not improves. These changes increase fall risk and driving safety
concerns in older adults.
Why Wrong? A, C, D are incorrect because lens flexibility decreases with age,
peripheral vision declines, and dark adaptation slows rather than improves. These
options reflect misunderstandings of normal age-related visual changes.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; AGS Healthy Aging Resources.
2. A nurse teaches an older adult about maintaining skin integrity. Which
instruction is MOST appropriate?
• A. Scrub dry areas vigorously each day
• B. Use very hot water to improve circulation
• C. Avoid reporting new skin breakdown
• D. Use mild soap, moisturize dry skin, and inspect pressure areas daily
Correct Answer: D. Use mild soap, moisturize dry skin, and inspect pressure
areas daily
Rationale: Skin changes with aging include thinning, decreased elasticity, reduced
sebaceous gland activity, and slower wound healing. Mild soap preserves skin pH
and natural oils; moisturizers prevent dryness and cracking; daily inspection allows
early detection of pressure injuries. Hot water strips natural oils and increases
dryness; vigorous scrubbing damages fragile skin.
Why Wrong? A, B, C are incorrect because vigorous scrubbing damages fragile
skin, hot water increases dryness, and failure to report skin breakdown delays
intervention and increases complication risk.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; AHRQ Pressure Injury Prevention Guidelines.
3. An 82-year-old patient reports difficulty hearing high-pitched sounds and
following conversations in crowded rooms. Which nursing action is MOST
appropriate?
, • A. Refer the patient for a hearing evaluation
• B. Speak clearly, face the patient, and minimize background noise
during interactions
• C. Recommend the patient avoid social situations
• D. Increase the volume of all communications
Correct Answer: B. Speak clearly, face the patient, and minimize background
noise during interactions
Rationale: Presbycusis (age-related hearing loss) typically affects high-frequency
sounds and makes speech discrimination difficult, especially in noisy
environments. Facing the patient allows lip-reading; clear speech and reduced
background noise enhance comprehension. Avoiding social situations would
increase isolation and depression risk. Increasing volume alone is ineffective and
may distort speech.
Why Wrong? A is appropriate but not the first intervention; C promotes social
isolation; D may cause discomfort without improving speech discrimination.
Reference: Eliopoulos, C. (2026). Gerontological Nursing (10th ed.). Wolters
Kluwer; HHS Healthy People 2030.
4. An older adult has a body mass index (BMI) of 22 kg/m². Which statement
reflects appropriate nutritional counseling for this patient?
• A. "You need to gain weight to reduce mortality risk"
• B. "Maintaining a BMI between 21-25 kg/m² is generally recommended
for healthy aging"
• C. "Your BMI is too high and requires immediate intervention"
• D. "Older adults should maintain a BMI below 20 for optimal health"
Correct Answer: B. "Maintaining a BMI between 21-25 kg/m² is generally
recommended for healthy aging"
Rationale: For older adults, a BMI in the range of 21-25 kg/m² is generally
associated with optimal health outcomes. Slight higher BMI may be protective in
older adults (the "obesity paradox" in some conditions). Undernutrition and
