NUR 2755 MULTIDIMENSIONAL CARE IV | FINAL EXAM PREP AND
STUDY GUIDE
1. An 82-year-old patient who lives independently is admitted after a fall at
home. The patient reports that the fall occurred while getting up quickly
during the night to use the bathroom and denies losing consciousness.
Which nursing assessment is most important when determining potentially
reversible contributors to the fall?
A. Ask only about the patient's favorite activities
B. Determine the patient's childhood immunization history
C. Review medications, orthostatic vital signs, vision, gait, footwear, and
environmental hazards
D. Assume the fall resulted solely from normal aging
Answer: C
2. A practical nurse is caring for an 89-year-old patient who has gradually
become less able to perform bathing, dressing, and meal preparation.
Which distinction is most important when assessing the patient's functional
status?
A. Determine whether limitations involve activities of daily living and
instrumental activities of daily living
B. Determine whether the patient has developed normal age-related
forgetfulness
C. Determine whether the patient has increased appetite
D. Determine whether the patient sleeps more than eight hours
Answer: A
3. An older adult tells the nurse, “I am afraid that getting older automatically
means I will become dependent on everyone.” Which response best reflects
an appropriate understanding of aging?
A. Dependence is unavoidable after age 75
B. Aging always produces significant cognitive decline
C. Older adults should avoid challenging activities
pg. 1
, D. Aging involves normal changes, but substantial disability is not an
inevitable consequence of growing older
Answer: D
4. An 84-year-old patient is being evaluated for dehydration after several days
of poor oral intake. The nurse recognizes that older adults may be
particularly vulnerable to dehydration because of which age-related
change?
A. Increased total body water
B. Reduced thirst sensation and decreased renal concentrating ability
C. Increased renal blood flow
D. Increased intracellular fluid volume
Answer: B
5. A nurse assesses the skin of an 86-year-old patient and notes that it is thin,
dry, and less elastic than it was earlier in life. Which explanation best
describes these findings?
A. They necessarily indicate severe malnutrition
B. They prove that the patient has a systemic infection
C. Age-related reductions in collagen, subcutaneous tissue, and skin
hydration contribute to these changes
D. They indicate that the patient has developed an autoimmune disorder
Answer: C
6. An older adult has a medication regimen that includes eight prescription
medications and several over-the-counter products. Which nursing action is
most important for reducing medication-related harm?
A. Complete a comprehensive medication reconciliation, including
nonprescription drugs and supplements
B. Encourage the patient to take all medications simultaneously
C. Recommend stopping medications that are expensive
D. Assume over-the-counter medications are harmless
Answer: A
pg. 2
, 7. An 80-year-old patient develops dizziness and weakness after standing from
a chair. The blood pressure decreases substantially while the heart rate
changes minimally. Which finding is most consistent with this presentation?
A. Hyperglycemia
B. Orthostatic hypotension
C. Increased intracranial pressure
D. Hyperthermia
Answer: B
8. A practical nurse is teaching an older adult about preventing orthostatic
symptoms. Which instruction is most appropriate?
A. Remain in bed throughout the day
B. Avoid drinking fluids
C. Stand rapidly to improve circulation
D. Change positions slowly and sit at the bedside before standing
Answer: D
9. An 87-year-old patient reports difficulty hearing conversations in a crowded
dining room but understands speech when the speaker is close and facing
the patient. Which nursing intervention is most appropriate?
A. Shout directly into the patient's ear
B. Speak rapidly so the patient does not lose concentration
C. Face the patient, reduce background noise, and speak clearly at a normal
pace
D. Communicate only through written instructions
Answer: C
10. An older adult with decreased visual acuity is being admitted to a long-
term-care facility. Which environmental intervention best promotes safety?
A. Keep frequently used items in consistent, easily accessible locations
B. Move furniture frequently to encourage adaptation
C. Keep the room dim at all times
D. Place personal belongings on the floor beside the bed
pg. 3
, Answer: A
11. A 91-year-old patient reports difficulty reading medication labels because of
declining near vision. Which nursing action is most appropriate?
A. Tell the patient to memorize medication colors
B. Encourage use of adequate lighting and appropriately prescribed visual
aids
C. Tell the patient to stop taking all medications
D. Recommend taking medications only when symptoms occur
Answer: B
12. A patient with presbycusis repeatedly misunderstands verbal instructions.
Which approach is most appropriate?
A. Speak from another room
B. Cover the mouth while speaking
C. Use a high-pitched voice
D. Face the patient and use a lower-pitched, clearly articulated voice
Answer: D
13. An 85-year-old patient is admitted with pneumonia. The patient is suddenly
confused and inattentive compared with the previous day. Which feature
most strongly suggests delirium rather than dementia?
A. Gradual memory decline over several years
B. Stable cognitive impairment without fluctuation
C. Acute onset with fluctuating attention and awareness
D. Long-standing difficulty managing finances
Answer: C
14. A patient with a known history of dementia becomes acutely more
confused and restless during hospitalization. Which nursing response is
most appropriate?
A. Assume the dementia has suddenly progressed
B. Assess for acute causes such as infection, medication effects, pain,
dehydration, hypoxia, or metabolic abnormalities
pg. 4
STUDY GUIDE
1. An 82-year-old patient who lives independently is admitted after a fall at
home. The patient reports that the fall occurred while getting up quickly
during the night to use the bathroom and denies losing consciousness.
Which nursing assessment is most important when determining potentially
reversible contributors to the fall?
A. Ask only about the patient's favorite activities
B. Determine the patient's childhood immunization history
C. Review medications, orthostatic vital signs, vision, gait, footwear, and
environmental hazards
D. Assume the fall resulted solely from normal aging
Answer: C
2. A practical nurse is caring for an 89-year-old patient who has gradually
become less able to perform bathing, dressing, and meal preparation.
Which distinction is most important when assessing the patient's functional
status?
A. Determine whether limitations involve activities of daily living and
instrumental activities of daily living
B. Determine whether the patient has developed normal age-related
forgetfulness
C. Determine whether the patient has increased appetite
D. Determine whether the patient sleeps more than eight hours
Answer: A
3. An older adult tells the nurse, “I am afraid that getting older automatically
means I will become dependent on everyone.” Which response best reflects
an appropriate understanding of aging?
A. Dependence is unavoidable after age 75
B. Aging always produces significant cognitive decline
C. Older adults should avoid challenging activities
pg. 1
, D. Aging involves normal changes, but substantial disability is not an
inevitable consequence of growing older
Answer: D
4. An 84-year-old patient is being evaluated for dehydration after several days
of poor oral intake. The nurse recognizes that older adults may be
particularly vulnerable to dehydration because of which age-related
change?
A. Increased total body water
B. Reduced thirst sensation and decreased renal concentrating ability
C. Increased renal blood flow
D. Increased intracellular fluid volume
Answer: B
5. A nurse assesses the skin of an 86-year-old patient and notes that it is thin,
dry, and less elastic than it was earlier in life. Which explanation best
describes these findings?
A. They necessarily indicate severe malnutrition
B. They prove that the patient has a systemic infection
C. Age-related reductions in collagen, subcutaneous tissue, and skin
hydration contribute to these changes
D. They indicate that the patient has developed an autoimmune disorder
Answer: C
6. An older adult has a medication regimen that includes eight prescription
medications and several over-the-counter products. Which nursing action is
most important for reducing medication-related harm?
A. Complete a comprehensive medication reconciliation, including
nonprescription drugs and supplements
B. Encourage the patient to take all medications simultaneously
C. Recommend stopping medications that are expensive
D. Assume over-the-counter medications are harmless
Answer: A
pg. 2
, 7. An 80-year-old patient develops dizziness and weakness after standing from
a chair. The blood pressure decreases substantially while the heart rate
changes minimally. Which finding is most consistent with this presentation?
A. Hyperglycemia
B. Orthostatic hypotension
C. Increased intracranial pressure
D. Hyperthermia
Answer: B
8. A practical nurse is teaching an older adult about preventing orthostatic
symptoms. Which instruction is most appropriate?
A. Remain in bed throughout the day
B. Avoid drinking fluids
C. Stand rapidly to improve circulation
D. Change positions slowly and sit at the bedside before standing
Answer: D
9. An 87-year-old patient reports difficulty hearing conversations in a crowded
dining room but understands speech when the speaker is close and facing
the patient. Which nursing intervention is most appropriate?
A. Shout directly into the patient's ear
B. Speak rapidly so the patient does not lose concentration
C. Face the patient, reduce background noise, and speak clearly at a normal
pace
D. Communicate only through written instructions
Answer: C
10. An older adult with decreased visual acuity is being admitted to a long-
term-care facility. Which environmental intervention best promotes safety?
A. Keep frequently used items in consistent, easily accessible locations
B. Move furniture frequently to encourage adaptation
C. Keep the room dim at all times
D. Place personal belongings on the floor beside the bed
pg. 3
, Answer: A
11. A 91-year-old patient reports difficulty reading medication labels because of
declining near vision. Which nursing action is most appropriate?
A. Tell the patient to memorize medication colors
B. Encourage use of adequate lighting and appropriately prescribed visual
aids
C. Tell the patient to stop taking all medications
D. Recommend taking medications only when symptoms occur
Answer: B
12. A patient with presbycusis repeatedly misunderstands verbal instructions.
Which approach is most appropriate?
A. Speak from another room
B. Cover the mouth while speaking
C. Use a high-pitched voice
D. Face the patient and use a lower-pitched, clearly articulated voice
Answer: D
13. An 85-year-old patient is admitted with pneumonia. The patient is suddenly
confused and inattentive compared with the previous day. Which feature
most strongly suggests delirium rather than dementia?
A. Gradual memory decline over several years
B. Stable cognitive impairment without fluctuation
C. Acute onset with fluctuating attention and awareness
D. Long-standing difficulty managing finances
Answer: C
14. A patient with a known history of dementia becomes acutely more
confused and restless during hospitalization. Which nursing response is
most appropriate?
A. Assume the dementia has suddenly progressed
B. Assess for acute causes such as infection, medication effects, pain,
dehydration, hypoxia, or metabolic abnormalities
pg. 4
