Question 1: A 75-year-old patient is admitted for dehydration. The nurse notes that the
patient has dry, wrinkled skin and decreased skin turgor. Which age-related change
contributes to this finding?
A. Increased number of sweat glands
B. Increased elastin in the dermis
C. Decreased subcutaneous fat and loss of skin elasticity
D. Increased capillary refill time
CORRECT ANSWER: C. Decreased subcutaneous fat and loss of skin elasticity.
Rationale: Aging skin undergoes atrophy of the dermal and epidermal layers, leading to
a loss of subcutaneous fat, elasticity, and moisture, making it prone to wrinkling and
decreased turgor.
Question 2: An 80-year-old patient reports di iculty hearing high-pitched sounds. This
sensorineural hearing loss, known as presbycusis, is primarily caused by:
A. Cerumen impaction
B. Ossification of the middle ear bones
C. Atrophy of the organ of Corti and hair cells in the cochlea
D. Perforation of the tympanic membrane
CORRECT ANSWER: C. Atrophy of the organ of Corti and hair cells in the cochlea.
Rationale: Presbycusis is an age-related sensorineural hearing loss caused by changes
in the inner ear, specifically the atrophy of the organ of Corti and hair cells in the
cochlea.
Question 3: An older adult patient with osteoarthritis is experiencing chronic pain. The
nurse understands that the most appropriate initial non-pharmacological intervention
for this patient is:
A. A strong prescription opioid.
B. Bed rest and immobilization of the a ected joints.
C. Application of heat and cold therapy and a low-impact exercise program.
D. A high-impact aerobic exercise regimen.
CORRECT ANSWER: C. Application of heat and cold therapy and a low-impact
exercise program.
Rationale: Non-pharmacological interventions such as heat/cold therapy and low-
impact exercises (e.g., walking, swimming) are the first-line treatments for osteoarthritis
to improve joint function and reduce pain.
,Question 4: The nurse is assessing an older adult patient's cognitive function. Which of
the following findings is considered an expected age-related change, rather than a sign
of dementia?
A. Forgetting the names of close family members.
B. An occasional inability to find the right word.
C. Getting lost in familiar neighborhoods.
D. A significant and rapid decline in problem-solving abilities.
CORRECT ANSWER: B. An occasional inability to find the right word.
Rationale: Some age-related cognitive changes include slower processing speed and
occasional word-finding di iculty. Significant memory loss, disorientation, and rapid
cognitive decline are not normal and warrant further investigation.
Question 5: A 78-year-old patient is prescribed digoxin for heart failure. The nurse
should monitor the patient closely for signs of digoxin toxicity, which is often
potentiated in older adults due to:
A. Increased liver metabolism.
B. Increased renal clearance of the drug.
C. Decreased glomerular filtration rate (GFR) and lean body mass.
D. Increased protein binding of the drug.
CORRECT ANSWER: C. Decreased glomerular filtration rate (GFR) and lean body
mass.
Rationale: Age-related decline in renal function (GFR) and lean body mass decreases
the clearance of digoxin, leading to higher serum levels and an increased risk of toxicity.
Question 6: The nurse is teaching a group of older adults about the prevention of falls.
Which of the following instructions is most important to include?
A. "Walk with your eyes closed to improve balance."
B. "Wear shoes with non-skid soles and use handrails."
C. "Keep your home brightly lit only at night."
D. "Avoid using assistive devices like canes or walkers."
CORRECT ANSWER: B. "Wear shoes with non-skid soles and use handrails."
Rationale: Fall prevention strategies include wearing appropriate footwear, using
assistive devices, maintaining good lighting, and removing tripping hazards.
,Question 7: The nurse is caring for a patient with dementia who is experiencing
"sundowning." What is the most appropriate nursing intervention?
A. Increase the patient's ca eine intake in the evening.
B. Schedule the patient's bath late in the evening.
C. Provide a calming, structured environment and maintain a consistent routine.
D. Place the patient in a room with the television on high volume.
CORRECT ANSWER: C. Provide a calming, structured environment and maintain a
consistent routine.
Rationale: Sundowning, or increased confusion and agitation in the late afternoon and
evening, is often managed with a structured routine, adequate daytime activity, and a
calm environment.
Question 8: A 72-year-old patient has a new diagnosis of type 2 diabetes mellitus. The
nurse should consider which age-related change when teaching this patient about
managing their blood glucose?
A. Increased thirst sensation will make it easy to detect hyperglycemia.
B. Renal function is typically increased, so glucose will be excreted quickly.
C. Decreased thirst sensation may mask symptoms of hyperglycemia.
D. The patient will need more insulin due to increased tissue sensitivity.
CORRECT ANSWER: C. Decreased thirst sensation may mask symptoms of
hyperglycemia.
Rationale: Older adults often have a decreased sensation of thirst, which can lead to
under-recognition of hyperglycemia and dehydration.
Question 9: A patient with Alzheimer's disease is resistant to taking a bath. The nurse
should:
A. Force the patient to take a bath to maintain hygiene.
B. Wait until the patient is more cooperative.
C. Use a calm, gentle approach and o er a sponge bath or shower at a time when the
patient is most relaxed.
D. Ask the family to insist the patient bathe.
CORRECT ANSWER: C. Use a calm, gentle approach and o er a sponge bath or
shower at a time when the patient is most relaxed.
, Rationale: Patients with dementia may be frightened by the bathing process. A calm,
gentle approach, respecting the patient's preferences, and choosing a good time can
reduce agitation.
Question 10: A 68-year-old patient is undergoing a routine physical exam. The nurse
notes a decrease in height from the patient's previous visit. The nurse understands that
this is most likely due to:
A. Osteoporosis and vertebral compression fractures.
B. Kyphosis and loss of muscle mass.
C. Scoliosis and joint degeneration.
D. Spinal stenosis and disc herniation.
CORRECT ANSWER: A. Osteoporosis and vertebral compression fractures.
Rationale: Loss of height in older adults is commonly caused by compression fractures
of the vertebrae due to osteoporosis, leading to a shortened spine.
Question 11: The nurse is assessing an older adult's nutritional status. The patient lives
alone and reports a recent unintentional weight loss of 10 pounds in the past month.
Which of the following should the nurse suspect as a contributing factor?
A. Increased appetite.
B. Social isolation and di iculty preparing meals.
C. Increased physical activity.
D. Improved financial status.
CORRECT ANSWER: B. Social isolation and di iculty preparing meals.
Rationale: Social isolation, di iculty with cooking, and poor dentition are common
causes of malnutrition and weight loss in older adults.
Question 12: An 82-year-old patient is prescribed a benzodiazepine for anxiety. The
nurse should be aware that this medication is considered potentially inappropriate for
older adults due to the risk of:
A. Hyperactivity.
B. Increased appetite.
C. Hypertension.
D. Falls and cognitive impairment.
CORRECT ANSWER: D. Falls and cognitive impairment.
patient has dry, wrinkled skin and decreased skin turgor. Which age-related change
contributes to this finding?
A. Increased number of sweat glands
B. Increased elastin in the dermis
C. Decreased subcutaneous fat and loss of skin elasticity
D. Increased capillary refill time
CORRECT ANSWER: C. Decreased subcutaneous fat and loss of skin elasticity.
Rationale: Aging skin undergoes atrophy of the dermal and epidermal layers, leading to
a loss of subcutaneous fat, elasticity, and moisture, making it prone to wrinkling and
decreased turgor.
Question 2: An 80-year-old patient reports di iculty hearing high-pitched sounds. This
sensorineural hearing loss, known as presbycusis, is primarily caused by:
A. Cerumen impaction
B. Ossification of the middle ear bones
C. Atrophy of the organ of Corti and hair cells in the cochlea
D. Perforation of the tympanic membrane
CORRECT ANSWER: C. Atrophy of the organ of Corti and hair cells in the cochlea.
Rationale: Presbycusis is an age-related sensorineural hearing loss caused by changes
in the inner ear, specifically the atrophy of the organ of Corti and hair cells in the
cochlea.
Question 3: An older adult patient with osteoarthritis is experiencing chronic pain. The
nurse understands that the most appropriate initial non-pharmacological intervention
for this patient is:
A. A strong prescription opioid.
B. Bed rest and immobilization of the a ected joints.
C. Application of heat and cold therapy and a low-impact exercise program.
D. A high-impact aerobic exercise regimen.
CORRECT ANSWER: C. Application of heat and cold therapy and a low-impact
exercise program.
Rationale: Non-pharmacological interventions such as heat/cold therapy and low-
impact exercises (e.g., walking, swimming) are the first-line treatments for osteoarthritis
to improve joint function and reduce pain.
,Question 4: The nurse is assessing an older adult patient's cognitive function. Which of
the following findings is considered an expected age-related change, rather than a sign
of dementia?
A. Forgetting the names of close family members.
B. An occasional inability to find the right word.
C. Getting lost in familiar neighborhoods.
D. A significant and rapid decline in problem-solving abilities.
CORRECT ANSWER: B. An occasional inability to find the right word.
Rationale: Some age-related cognitive changes include slower processing speed and
occasional word-finding di iculty. Significant memory loss, disorientation, and rapid
cognitive decline are not normal and warrant further investigation.
Question 5: A 78-year-old patient is prescribed digoxin for heart failure. The nurse
should monitor the patient closely for signs of digoxin toxicity, which is often
potentiated in older adults due to:
A. Increased liver metabolism.
B. Increased renal clearance of the drug.
C. Decreased glomerular filtration rate (GFR) and lean body mass.
D. Increased protein binding of the drug.
CORRECT ANSWER: C. Decreased glomerular filtration rate (GFR) and lean body
mass.
Rationale: Age-related decline in renal function (GFR) and lean body mass decreases
the clearance of digoxin, leading to higher serum levels and an increased risk of toxicity.
Question 6: The nurse is teaching a group of older adults about the prevention of falls.
Which of the following instructions is most important to include?
A. "Walk with your eyes closed to improve balance."
B. "Wear shoes with non-skid soles and use handrails."
C. "Keep your home brightly lit only at night."
D. "Avoid using assistive devices like canes or walkers."
CORRECT ANSWER: B. "Wear shoes with non-skid soles and use handrails."
Rationale: Fall prevention strategies include wearing appropriate footwear, using
assistive devices, maintaining good lighting, and removing tripping hazards.
,Question 7: The nurse is caring for a patient with dementia who is experiencing
"sundowning." What is the most appropriate nursing intervention?
A. Increase the patient's ca eine intake in the evening.
B. Schedule the patient's bath late in the evening.
C. Provide a calming, structured environment and maintain a consistent routine.
D. Place the patient in a room with the television on high volume.
CORRECT ANSWER: C. Provide a calming, structured environment and maintain a
consistent routine.
Rationale: Sundowning, or increased confusion and agitation in the late afternoon and
evening, is often managed with a structured routine, adequate daytime activity, and a
calm environment.
Question 8: A 72-year-old patient has a new diagnosis of type 2 diabetes mellitus. The
nurse should consider which age-related change when teaching this patient about
managing their blood glucose?
A. Increased thirst sensation will make it easy to detect hyperglycemia.
B. Renal function is typically increased, so glucose will be excreted quickly.
C. Decreased thirst sensation may mask symptoms of hyperglycemia.
D. The patient will need more insulin due to increased tissue sensitivity.
CORRECT ANSWER: C. Decreased thirst sensation may mask symptoms of
hyperglycemia.
Rationale: Older adults often have a decreased sensation of thirst, which can lead to
under-recognition of hyperglycemia and dehydration.
Question 9: A patient with Alzheimer's disease is resistant to taking a bath. The nurse
should:
A. Force the patient to take a bath to maintain hygiene.
B. Wait until the patient is more cooperative.
C. Use a calm, gentle approach and o er a sponge bath or shower at a time when the
patient is most relaxed.
D. Ask the family to insist the patient bathe.
CORRECT ANSWER: C. Use a calm, gentle approach and o er a sponge bath or
shower at a time when the patient is most relaxed.
, Rationale: Patients with dementia may be frightened by the bathing process. A calm,
gentle approach, respecting the patient's preferences, and choosing a good time can
reduce agitation.
Question 10: A 68-year-old patient is undergoing a routine physical exam. The nurse
notes a decrease in height from the patient's previous visit. The nurse understands that
this is most likely due to:
A. Osteoporosis and vertebral compression fractures.
B. Kyphosis and loss of muscle mass.
C. Scoliosis and joint degeneration.
D. Spinal stenosis and disc herniation.
CORRECT ANSWER: A. Osteoporosis and vertebral compression fractures.
Rationale: Loss of height in older adults is commonly caused by compression fractures
of the vertebrae due to osteoporosis, leading to a shortened spine.
Question 11: The nurse is assessing an older adult's nutritional status. The patient lives
alone and reports a recent unintentional weight loss of 10 pounds in the past month.
Which of the following should the nurse suspect as a contributing factor?
A. Increased appetite.
B. Social isolation and di iculty preparing meals.
C. Increased physical activity.
D. Improved financial status.
CORRECT ANSWER: B. Social isolation and di iculty preparing meals.
Rationale: Social isolation, di iculty with cooking, and poor dentition are common
causes of malnutrition and weight loss in older adults.
Question 12: An 82-year-old patient is prescribed a benzodiazepine for anxiety. The
nurse should be aware that this medication is considered potentially inappropriate for
older adults due to the risk of:
A. Hyperactivity.
B. Increased appetite.
C. Hypertension.
D. Falls and cognitive impairment.
CORRECT ANSWER: D. Falls and cognitive impairment.
