NUR163/NUR 163 Exam 2 V3 | Concepts of
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. An elderly patient presents with a sudden onset of confusion and agitation. Which
condition should the nurse prioritize for assessment?
A. Alzheimer’s Disease
B. Delirium
C. Normal age-related decline
D. Vascular Dementia
Correct Answer: B
Rationale: Delirium is characterized by an acute and rapid onset of confusion, often
triggered by an underlying medical issue such as infection or medication. Unlike dementia,
which is a slow and progressive decline, delirium is often reversible once the root cause is
treated. The nurse must immediately investigate physiological causes like a UTI or
electrolyte imbalance to ensure patient safety.
2. The nurse is reviewing the medication list of an 80-year-old patient. Which medication is
most likely listed on the Beers Criteria as potentially inappropriate for the elderly?
A. Acetaminophen
,B. Lisinopril
C. Diphenhydramine
D. Metformin
Correct Answer: C
Rationale: Diphenhydramine is a first-generation antihistamine with strong
anticholinergic effects that increase the risk of falls and confusion in older adults. The Beers
Criteria specifically warns against its use in the elderly due to the high risk of sedation and
blurred vision. Nurses should advocate for safer alternatives for sleep or allergy
management in this population.
3. A patient with heart failure reports a sudden weight gain of 3 pounds in 24 hours. What is
the nurse’s priority action?
A. Document the finding and re-weigh the patient in the morning.
B. Notify the healthcare provider immediately.
C. Instruct the patient to increase fluid intake to flush the system.
D. Encourage the patient to perform range-of-motion exercises.
Correct Answer: B
Rationale: A rapid weight gain in a heart failure patient is a primary indicator of fluid
volume excess and impending exacerbation. Waiting until the next day could lead to
, pulmonary edema or respiratory distress. The nurse must notify the provider so that
diuretic therapy can be adjusted to prevent further complications.
4. Which assessment finding is considered a typical sign of a Urinary Tract Infection (UTI) in an
elderly patient?
A. High fever and chills
B. Increased urgency and burning
C. New onset of confusion or falls
D. Severe flank pain
Correct Answer: C
Rationale: Older adults often lack the classic symptoms of a UTI, such as fever or dysuria,
due to an aging immune system. Instead, they frequently present with atypical symptoms
like acute mental status changes or increased frequency of falls. Assessment of urine and
cognitive status is critical when an elderly patient exhibits a sudden change in behavior.
5. An elderly patient with COPD is prescribed oxygen at 2L/min via nasal cannula. Why is it
important to maintain this low flow rate?
A. To prevent oxygen toxicity in the lungs.
B. To minimize the cost of oxygen therapy for the facility.
C. High flow rates can suppress the patient’s hypoxic drive to breathe.
D. High flow oxygen causes severe nasal mucosal drying.
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. An elderly patient presents with a sudden onset of confusion and agitation. Which
condition should the nurse prioritize for assessment?
A. Alzheimer’s Disease
B. Delirium
C. Normal age-related decline
D. Vascular Dementia
Correct Answer: B
Rationale: Delirium is characterized by an acute and rapid onset of confusion, often
triggered by an underlying medical issue such as infection or medication. Unlike dementia,
which is a slow and progressive decline, delirium is often reversible once the root cause is
treated. The nurse must immediately investigate physiological causes like a UTI or
electrolyte imbalance to ensure patient safety.
2. The nurse is reviewing the medication list of an 80-year-old patient. Which medication is
most likely listed on the Beers Criteria as potentially inappropriate for the elderly?
A. Acetaminophen
,B. Lisinopril
C. Diphenhydramine
D. Metformin
Correct Answer: C
Rationale: Diphenhydramine is a first-generation antihistamine with strong
anticholinergic effects that increase the risk of falls and confusion in older adults. The Beers
Criteria specifically warns against its use in the elderly due to the high risk of sedation and
blurred vision. Nurses should advocate for safer alternatives for sleep or allergy
management in this population.
3. A patient with heart failure reports a sudden weight gain of 3 pounds in 24 hours. What is
the nurse’s priority action?
A. Document the finding and re-weigh the patient in the morning.
B. Notify the healthcare provider immediately.
C. Instruct the patient to increase fluid intake to flush the system.
D. Encourage the patient to perform range-of-motion exercises.
Correct Answer: B
Rationale: A rapid weight gain in a heart failure patient is a primary indicator of fluid
volume excess and impending exacerbation. Waiting until the next day could lead to
, pulmonary edema or respiratory distress. The nurse must notify the provider so that
diuretic therapy can be adjusted to prevent further complications.
4. Which assessment finding is considered a typical sign of a Urinary Tract Infection (UTI) in an
elderly patient?
A. High fever and chills
B. Increased urgency and burning
C. New onset of confusion or falls
D. Severe flank pain
Correct Answer: C
Rationale: Older adults often lack the classic symptoms of a UTI, such as fever or dysuria,
due to an aging immune system. Instead, they frequently present with atypical symptoms
like acute mental status changes or increased frequency of falls. Assessment of urine and
cognitive status is critical when an elderly patient exhibits a sudden change in behavior.
5. An elderly patient with COPD is prescribed oxygen at 2L/min via nasal cannula. Why is it
important to maintain this low flow rate?
A. To prevent oxygen toxicity in the lungs.
B. To minimize the cost of oxygen therapy for the facility.
C. High flow rates can suppress the patient’s hypoxic drive to breathe.
D. High flow oxygen causes severe nasal mucosal drying.
