NSG 3850 GERONTOLOGICAL NURSING
EXAM 2 PRACTICE. GALEN COLLEGE
OF NURSING (U.S.) | COMPLETE
VERIFIED ANSWERS 2026/2027
1. An 82-year-old client is admitted with suspected myocardial infarction. Which presentation
should the nurse consider as the most common atypical symptom in this age group?
A. Sudden onset of dyspnea and confusion
B. Crushing pain radiating to the left arm
C. Substernal chest pressure
D. Severe diaphoresis and nausea
Answer: A
Conceptual Explanation: Older adults often present with atypical symptoms of MI, such as
dyspnea, fatigue, or acute confusion, rather than classic chest pain due to age-related
changes in pain perception.
,2. When assessing an elderly patient for Peripheral Artery Disease (PAD), which clinical
finding is most indicative of the condition?
A. Intermittent claudication that improves with rest
B. Painless brownish discoloration around the ankles
C. Pitting edema in both lower extremities
D. Warm, flushed skin on the calves
Answer: A
Conceptual Explanation: Intermittent claudication, or pain with walking that is relieved
by rest, is a hallmark sign of PAD. Brownish discoloration and edema are more typical of
chronic venous insufficiency.
3. A nurse is reviewing the medications of a 75-year-old patient with heart failure. Which
medication should be used with extreme caution according to the Beers Criteria?
A. Lisinopril
B. Furosemide
C. Digoxin at doses greater than 0.125 mg/day
D. Metoprolol
Answer: C
, Conceptual Explanation: Digoxin in doses higher than 0.125 mg/day is associated with
increased toxicity in older adults due to decreased renal clearance and should generally be
avoided.
4. What is the primary pathophysiology behind the increased incidence of systolic
hypertension in the elderly population?
A. Hypertrophy of the right ventricle
B. Decreased production of renin and aldosterone
C. Increased peripheral vascular resistance and arterial stiffness
D. Increased elasticity of the aortic arch
Answer: C
Conceptual Explanation: Aging leads to structural changes in the arteries, including
collagen cross-linking and loss of elastin, which increases arterial stiffness and systolic
blood pressure.
5. An older adult presents with a sudden change in mental status, tachypnea, and a normal
body temperature. The nurse should prioritize screening for which condition?
A. Early-stage Alzheimer’s disease
B. Sepsis or Pneumonia
C. Age-related cognitive decline
D. Chronic obstructive pulmonary disease
EXAM 2 PRACTICE. GALEN COLLEGE
OF NURSING (U.S.) | COMPLETE
VERIFIED ANSWERS 2026/2027
1. An 82-year-old client is admitted with suspected myocardial infarction. Which presentation
should the nurse consider as the most common atypical symptom in this age group?
A. Sudden onset of dyspnea and confusion
B. Crushing pain radiating to the left arm
C. Substernal chest pressure
D. Severe diaphoresis and nausea
Answer: A
Conceptual Explanation: Older adults often present with atypical symptoms of MI, such as
dyspnea, fatigue, or acute confusion, rather than classic chest pain due to age-related
changes in pain perception.
,2. When assessing an elderly patient for Peripheral Artery Disease (PAD), which clinical
finding is most indicative of the condition?
A. Intermittent claudication that improves with rest
B. Painless brownish discoloration around the ankles
C. Pitting edema in both lower extremities
D. Warm, flushed skin on the calves
Answer: A
Conceptual Explanation: Intermittent claudication, or pain with walking that is relieved
by rest, is a hallmark sign of PAD. Brownish discoloration and edema are more typical of
chronic venous insufficiency.
3. A nurse is reviewing the medications of a 75-year-old patient with heart failure. Which
medication should be used with extreme caution according to the Beers Criteria?
A. Lisinopril
B. Furosemide
C. Digoxin at doses greater than 0.125 mg/day
D. Metoprolol
Answer: C
, Conceptual Explanation: Digoxin in doses higher than 0.125 mg/day is associated with
increased toxicity in older adults due to decreased renal clearance and should generally be
avoided.
4. What is the primary pathophysiology behind the increased incidence of systolic
hypertension in the elderly population?
A. Hypertrophy of the right ventricle
B. Decreased production of renin and aldosterone
C. Increased peripheral vascular resistance and arterial stiffness
D. Increased elasticity of the aortic arch
Answer: C
Conceptual Explanation: Aging leads to structural changes in the arteries, including
collagen cross-linking and loss of elastin, which increases arterial stiffness and systolic
blood pressure.
5. An older adult presents with a sudden change in mental status, tachypnea, and a normal
body temperature. The nurse should prioritize screening for which condition?
A. Early-stage Alzheimer’s disease
B. Sepsis or Pneumonia
C. Age-related cognitive decline
D. Chronic obstructive pulmonary disease
