,GALEN|NU176/NU 176 Geriatric Nursing
1. Which statement best describes the primary goal of palliative care for the older adult?
A) To provide aggressive curative treatments to prolong life
B) To prevent and relieve suffering and improve quality of life for patients with serious illness
C) To offer services only to patients who are actively dying
D) To replace hospice care for terminally ill patients
Correct Answer: B) To prevent and relieve suffering and improve quality of life for patients with
serious illness
Rationale: Palliative care focuses on improving quality of life by managing pain, symptoms, and stress
for patients with serious illness. It can be provided alongside curative treatments and is not limited to
end-of-life care. Hospice is a specific type of palliative care for terminally ill patients.
2. A nurse is caring for an older adult who is approaching end of life. Which assessment finding is most
indicative of impending death?
A) Increased appetite and thirst
B) Warm, dry skin with good turgor
C) Cheyne-Stokes respirations and cool, mottled extremities
D) Increased energy and alertness
Correct Answer: C) Cheyne-Stokes respirations and cool, mottled extremities
Rationale: Cheyne-Stokes respirations (alternating apnea and deep breathing) and cool, mottled
extremities are common signs of impending death due to decreased perfusion and neurological
changes. Increased appetite, warm skin, and increased energy are not typical.
3. A hospice nurse is providing education to a family about the philosophy of hospice care. Which
statement by a family member indicates a correct understanding?
A) "Hospice care is only provided in a hospital setting."
,B) "Hospice care focuses on comfort and quality of life rather than curing the disease."
C) "Hospice care requires that the patient stop all medications."
D) "Hospice care is only available for patients with cancer."
Correct Answer: B) "Hospice care focuses on comfort and quality of life rather than curing the
disease."
Rationale: Hospice care is a philosophy of care that prioritizes comfort, dignity, and quality of life for
terminally ill patients. It can be provided in various settings, does not require stopping all medications
(only those not related to comfort), and is available for any terminal diagnosis.
4. An older adult with advanced dementia is enrolled in hospice. The family asks why the patient is no
longer receiving antibiotics for a urinary tract infection. What is the nurse's best response?
A) "Antibiotics are not effective in older adults."
B) "The focus of care has shifted to comfort, and we manage symptoms without treating the
infection."
C) "The patient's immune system is too weak to fight the infection."
D) "We will restart antibiotics if the patient develops a fever."
Correct Answer: B) "The focus of care has shifted to comfort, and we manage symptoms without
treating the infection."
Rationale: In hospice, the goal is comfort. Treating an infection with antibiotics may not align with the
patient's goals if it prolongs suffering without improving quality of life. The focus is on symptom
management, not curing the underlying condition.
5. A nurse is assessing an older adult for signs of pain. The patient has dementia and is unable to
verbalize. Which behavioral indicator should the nurse prioritize?
A) Increased appetite and social engagement
B) Facial grimacing, moaning, and guarding
C) Sleeping peacefully through the night
D) Normal vital signs and relaxed posture
, Correct Answer: B) Facial grimacing, moaning, and guarding
Rationale: In patients with cognitive impairment, pain is often expressed through nonverbal behaviors
such as grimacing, moaning, guarding, or agitation. Normal vital signs and relaxed posture do not rule
out pain. Pain assessment tools like the PAINAD scale should be used.
6. According to Erikson's theory of psychosocial development, what is the primary developmental task
of late adulthood?
A) Generativity versus stagnation
B) Integrity versus despair
C) Identity versus role confusion
D) Intimacy versus isolation
Correct Answer: B) Integrity versus despair
Rationale: Erikson's final stage, integrity versus despair, involves older adults reflecting on their lives.
Achieving a sense of fulfillment and wisdom leads to integrity, while regret and despair result from
unresolved conflicts. Generativity occurs in middle adulthood.
7. The nurse is caring for an older adult who is grieving the recent death of a spouse. Which statement
by the nurse is most therapeutic?
A) "You should focus on the positive memories."
B) "I understand how you feel; I lost my mother last year."
C) "Tell me more about what you are feeling right now."
D) "You are strong; you will get through this."
Correct Answer: C) "Tell me more about what you are feeling right now."
Rationale: This open-ended statement encourages the patient to express their feelings, which is
therapeutic. Offering false reassurance, making the conversation about the nurse, or giving advice are
communication blocks.
1. Which statement best describes the primary goal of palliative care for the older adult?
A) To provide aggressive curative treatments to prolong life
B) To prevent and relieve suffering and improve quality of life for patients with serious illness
C) To offer services only to patients who are actively dying
D) To replace hospice care for terminally ill patients
Correct Answer: B) To prevent and relieve suffering and improve quality of life for patients with
serious illness
Rationale: Palliative care focuses on improving quality of life by managing pain, symptoms, and stress
for patients with serious illness. It can be provided alongside curative treatments and is not limited to
end-of-life care. Hospice is a specific type of palliative care for terminally ill patients.
2. A nurse is caring for an older adult who is approaching end of life. Which assessment finding is most
indicative of impending death?
A) Increased appetite and thirst
B) Warm, dry skin with good turgor
C) Cheyne-Stokes respirations and cool, mottled extremities
D) Increased energy and alertness
Correct Answer: C) Cheyne-Stokes respirations and cool, mottled extremities
Rationale: Cheyne-Stokes respirations (alternating apnea and deep breathing) and cool, mottled
extremities are common signs of impending death due to decreased perfusion and neurological
changes. Increased appetite, warm skin, and increased energy are not typical.
3. A hospice nurse is providing education to a family about the philosophy of hospice care. Which
statement by a family member indicates a correct understanding?
A) "Hospice care is only provided in a hospital setting."
,B) "Hospice care focuses on comfort and quality of life rather than curing the disease."
C) "Hospice care requires that the patient stop all medications."
D) "Hospice care is only available for patients with cancer."
Correct Answer: B) "Hospice care focuses on comfort and quality of life rather than curing the
disease."
Rationale: Hospice care is a philosophy of care that prioritizes comfort, dignity, and quality of life for
terminally ill patients. It can be provided in various settings, does not require stopping all medications
(only those not related to comfort), and is available for any terminal diagnosis.
4. An older adult with advanced dementia is enrolled in hospice. The family asks why the patient is no
longer receiving antibiotics for a urinary tract infection. What is the nurse's best response?
A) "Antibiotics are not effective in older adults."
B) "The focus of care has shifted to comfort, and we manage symptoms without treating the
infection."
C) "The patient's immune system is too weak to fight the infection."
D) "We will restart antibiotics if the patient develops a fever."
Correct Answer: B) "The focus of care has shifted to comfort, and we manage symptoms without
treating the infection."
Rationale: In hospice, the goal is comfort. Treating an infection with antibiotics may not align with the
patient's goals if it prolongs suffering without improving quality of life. The focus is on symptom
management, not curing the underlying condition.
5. A nurse is assessing an older adult for signs of pain. The patient has dementia and is unable to
verbalize. Which behavioral indicator should the nurse prioritize?
A) Increased appetite and social engagement
B) Facial grimacing, moaning, and guarding
C) Sleeping peacefully through the night
D) Normal vital signs and relaxed posture
, Correct Answer: B) Facial grimacing, moaning, and guarding
Rationale: In patients with cognitive impairment, pain is often expressed through nonverbal behaviors
such as grimacing, moaning, guarding, or agitation. Normal vital signs and relaxed posture do not rule
out pain. Pain assessment tools like the PAINAD scale should be used.
6. According to Erikson's theory of psychosocial development, what is the primary developmental task
of late adulthood?
A) Generativity versus stagnation
B) Integrity versus despair
C) Identity versus role confusion
D) Intimacy versus isolation
Correct Answer: B) Integrity versus despair
Rationale: Erikson's final stage, integrity versus despair, involves older adults reflecting on their lives.
Achieving a sense of fulfillment and wisdom leads to integrity, while regret and despair result from
unresolved conflicts. Generativity occurs in middle adulthood.
7. The nurse is caring for an older adult who is grieving the recent death of a spouse. Which statement
by the nurse is most therapeutic?
A) "You should focus on the positive memories."
B) "I understand how you feel; I lost my mother last year."
C) "Tell me more about what you are feeling right now."
D) "You are strong; you will get through this."
Correct Answer: C) "Tell me more about what you are feeling right now."
Rationale: This open-ended statement encourages the patient to express their feelings, which is
therapeutic. Offering false reassurance, making the conversation about the nurse, or giving advice are
communication blocks.
