NURSING CARE OF THE OLDER ADULT
- ADVANCED PRACTICE QUESTIONS
AND ANSWERS
1. A 78-year-old patient presents with sudden onset confusion and agitation. Which
assessment tool is most appropriate for the nurse to use to identify the underlying cause?
A. Confusion Assessment Method (CAM)
B. Mini-Mental State Examination (MMSE)
C. Geriatric Depression Scale (GDS)
D. The Braden Scale
Answer: A
Conceptual Explanation: The CAM is the gold standard for assessing delirium, which is
characterized by sudden onset and fluctuating levels of consciousness. The MMSE
measures cognitive impairment but is less sensitive to acute changes like delirium.
2. An older adult is prescribed a new anticholinergic medication. Which side effect should the
nurse prioritize during education to prevent serious injury?
A. Orthostatic hypotension
,B. Dry mouth
C. Urinary frequency
D. Tachycardia
Answer: A
Conceptual Explanation: While dry mouth is common, orthostatic hypotension
significantly increases the risk of falls and hip fractures in the elderly, making it a safety
priority.
3. When assessing a 90-year-old patient for pain, which behavior is most indicative of
discomfort in a patient with advanced dementia?
A. Asking for Tylenol
B. Increased respiratory rate and facial grimacing
C. Sleeping through the night
D. Maintaining a steady gait during ambulation
Answer: B
Conceptual Explanation: Non-verbal cues such as grimacing, moaning, or physiological
changes like tachypnea are primary indicators of pain in patients who can no longer
communicate verbally.
, 4. According to the Beers Criteria, which medication class should be avoided in older adults
due to the risk of gastrointestinal bleeding and renal failure?
A. Long-term use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
B. ACE inhibitors
C. H2-receptor antagonists
D. Calcium channel blockers
Answer: A
Conceptual Explanation: NSAIDs are flagged by the Beers Criteria for older adults due to
high risks of GI bleeds and negative impacts on renal function.
5. An older adult patient reports frequent nocturia. What is the priority nursing intervention
to ensure safety?
A. Restrict all fluids after 2:00 PM
B. Insert an indwelling urinary catheter
C. Administer a sedative to help the patient sleep
D. Place a commode at the bedside
Answer: D
Conceptual Explanation: A bedside commode reduces the distance the patient must travel
in the dark, minimizing fall risk without the risks associated with catheters or severe fluid
restriction.
- ADVANCED PRACTICE QUESTIONS
AND ANSWERS
1. A 78-year-old patient presents with sudden onset confusion and agitation. Which
assessment tool is most appropriate for the nurse to use to identify the underlying cause?
A. Confusion Assessment Method (CAM)
B. Mini-Mental State Examination (MMSE)
C. Geriatric Depression Scale (GDS)
D. The Braden Scale
Answer: A
Conceptual Explanation: The CAM is the gold standard for assessing delirium, which is
characterized by sudden onset and fluctuating levels of consciousness. The MMSE
measures cognitive impairment but is less sensitive to acute changes like delirium.
2. An older adult is prescribed a new anticholinergic medication. Which side effect should the
nurse prioritize during education to prevent serious injury?
A. Orthostatic hypotension
,B. Dry mouth
C. Urinary frequency
D. Tachycardia
Answer: A
Conceptual Explanation: While dry mouth is common, orthostatic hypotension
significantly increases the risk of falls and hip fractures in the elderly, making it a safety
priority.
3. When assessing a 90-year-old patient for pain, which behavior is most indicative of
discomfort in a patient with advanced dementia?
A. Asking for Tylenol
B. Increased respiratory rate and facial grimacing
C. Sleeping through the night
D. Maintaining a steady gait during ambulation
Answer: B
Conceptual Explanation: Non-verbal cues such as grimacing, moaning, or physiological
changes like tachypnea are primary indicators of pain in patients who can no longer
communicate verbally.
, 4. According to the Beers Criteria, which medication class should be avoided in older adults
due to the risk of gastrointestinal bleeding and renal failure?
A. Long-term use of Non-Steroidal Anti-Inflammatory Drugs (NSAIDs)
B. ACE inhibitors
C. H2-receptor antagonists
D. Calcium channel blockers
Answer: A
Conceptual Explanation: NSAIDs are flagged by the Beers Criteria for older adults due to
high risks of GI bleeds and negative impacts on renal function.
5. An older adult patient reports frequent nocturia. What is the priority nursing intervention
to ensure safety?
A. Restrict all fluids after 2:00 PM
B. Insert an indwelling urinary catheter
C. Administer a sedative to help the patient sleep
D. Place a commode at the bedside
Answer: D
Conceptual Explanation: A bedside commode reduces the distance the patient must travel
in the dark, minimizing fall risk without the risks associated with catheters or severe fluid
restriction.
