NUR163/NUR 163 Exam 2 V2 | Concepts of
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for an 82-year-old client who is experiencing acute confusion and
agitation. Which condition should the nurse prioritize as a potential cause of these
symptoms?
A. Alzheimer’s disease
B. Urinary tract infection (UTI)
C. Normal age-related memory loss
D. Late-stage Parkinson’s disease
Correct Answer: B
Rationale: In the elderly population, acute confusion and sudden changes in mental status
are frequently the primary symptoms of a systemic infection such as a UTI. Unlike
dementia, which has a slow and progressive onset, delirium is acute and often reversible
once the underlying cause is treated. The nurse must assess for physical causes before
assuming cognitive decline is due to a chronic neurological condition.
2. Which age-related change in the cardiovascular system significantly increases the risk of
orthostatic hypotension in older adults?
A. Increased heart rate response to stress
,B. Increased elasticity of the aorta
C. Decreased thickness of the left ventricular wall
D. Decreased sensitivity of baroreceptors
Correct Answer: D
Rationale: Aging causes baroreceptors in the carotid sinus and aorta to become less
sensitive to changes in blood pressure. This delay in response causes a lag in
vasoconstriction when moving from a lying to a standing position, leading to a sudden drop
in pressure. The nurse should instruct patients to rise slowly and dangle their feet at the
bedside to prevent falls.
3. An elderly client with limited mobility is at risk for skin breakdown. Which intervention
should the nurse include in the care plan to maintain skin integrity?
A. Apply alcohol-based lotions to the skin
B. Vigorously massage bony prominences
C. Reposition the client at least every 2 hours
D. Restrict fluid intake to prevent incontinence
Correct Answer: C
Rationale: Frequent repositioning relieves prolonged pressure on tissues, which is the
primary cause of pressure ulcers in immobile patients. Massaging bony prominences is
contraindicated because it can cause deep tissue damage to fragile elderly skin. The nurse
,should also ensure the skin is kept clean and dry while avoiding harsh, drying agents like
alcohol.
4. A nurse is educating an older adult about the importance of vaccines. Which vaccine is
specifically recommended for adults over the age of 65 to prevent a common cause of
hospitalization?
A. HPV vaccine
B. Meningococcal B vaccine
C. Rotavirus vaccine
D. Pneumococcal polysaccharide vaccine (PPSV23)
Correct Answer: D
Rationale: The pneumococcal vaccine is vital for older adults because they are at higher
risk for severe complications from pneumonia and bacteremia. Pneumonia remains a
leading cause of death and hospitalization in the geriatric population due to age-related
changes in the respiratory system. The CDC recommends this vaccine for all adults aged 65
or older to enhance immunity against Streptococcus pneumoniae.
5. Which of the following describes ‘polypharmacy,’ a common concern in geriatric nursing?
A. Using only one pharmacy to fill all prescriptions
B. A decrease in the number of prescribed drugs over time
C. Taking five or more medications concurrently
, D. The use of generic medications instead of brand names
Correct Answer: C
Rationale: Polypharmacy is generally defined as the concurrent use of five or more
medications, which increases the risk for adverse drug reactions and drug-drug
interactions. It often occurs when multiple providers prescribe medications without
coordination, leading to redundant or conflicting therapies. Nurses play a critical role in
medication reconciliation to identify and reduce unnecessary drug use in older patients.
6. An 80-year-old patient reports difficulty hearing high-pitched sounds and understands
speech better in a quiet room. The nurse identifies this as:
A. Tinnitus
B. Presbycusis
C. Otosclerosis
D. Meniere’s disease
Correct Answer: B
Rationale: Presbycusis is the age-related sensorineural hearing loss that typically affects
the ability to hear high-frequency sounds. Patients often struggle to distinguish consonants
and find that background noise interferes significantly with communication. Nurses should
speak clearly, face the patient, and use a lower tone of voice to facilitate better
understanding.
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for an 82-year-old client who is experiencing acute confusion and
agitation. Which condition should the nurse prioritize as a potential cause of these
symptoms?
A. Alzheimer’s disease
B. Urinary tract infection (UTI)
C. Normal age-related memory loss
D. Late-stage Parkinson’s disease
Correct Answer: B
Rationale: In the elderly population, acute confusion and sudden changes in mental status
are frequently the primary symptoms of a systemic infection such as a UTI. Unlike
dementia, which has a slow and progressive onset, delirium is acute and often reversible
once the underlying cause is treated. The nurse must assess for physical causes before
assuming cognitive decline is due to a chronic neurological condition.
2. Which age-related change in the cardiovascular system significantly increases the risk of
orthostatic hypotension in older adults?
A. Increased heart rate response to stress
,B. Increased elasticity of the aorta
C. Decreased thickness of the left ventricular wall
D. Decreased sensitivity of baroreceptors
Correct Answer: D
Rationale: Aging causes baroreceptors in the carotid sinus and aorta to become less
sensitive to changes in blood pressure. This delay in response causes a lag in
vasoconstriction when moving from a lying to a standing position, leading to a sudden drop
in pressure. The nurse should instruct patients to rise slowly and dangle their feet at the
bedside to prevent falls.
3. An elderly client with limited mobility is at risk for skin breakdown. Which intervention
should the nurse include in the care plan to maintain skin integrity?
A. Apply alcohol-based lotions to the skin
B. Vigorously massage bony prominences
C. Reposition the client at least every 2 hours
D. Restrict fluid intake to prevent incontinence
Correct Answer: C
Rationale: Frequent repositioning relieves prolonged pressure on tissues, which is the
primary cause of pressure ulcers in immobile patients. Massaging bony prominences is
contraindicated because it can cause deep tissue damage to fragile elderly skin. The nurse
,should also ensure the skin is kept clean and dry while avoiding harsh, drying agents like
alcohol.
4. A nurse is educating an older adult about the importance of vaccines. Which vaccine is
specifically recommended for adults over the age of 65 to prevent a common cause of
hospitalization?
A. HPV vaccine
B. Meningococcal B vaccine
C. Rotavirus vaccine
D. Pneumococcal polysaccharide vaccine (PPSV23)
Correct Answer: D
Rationale: The pneumococcal vaccine is vital for older adults because they are at higher
risk for severe complications from pneumonia and bacteremia. Pneumonia remains a
leading cause of death and hospitalization in the geriatric population due to age-related
changes in the respiratory system. The CDC recommends this vaccine for all adults aged 65
or older to enhance immunity against Streptococcus pneumoniae.
5. Which of the following describes ‘polypharmacy,’ a common concern in geriatric nursing?
A. Using only one pharmacy to fill all prescriptions
B. A decrease in the number of prescribed drugs over time
C. Taking five or more medications concurrently
, D. The use of generic medications instead of brand names
Correct Answer: C
Rationale: Polypharmacy is generally defined as the concurrent use of five or more
medications, which increases the risk for adverse drug reactions and drug-drug
interactions. It often occurs when multiple providers prescribe medications without
coordination, leading to redundant or conflicting therapies. Nurses play a critical role in
medication reconciliation to identify and reduce unnecessary drug use in older patients.
6. An 80-year-old patient reports difficulty hearing high-pitched sounds and understands
speech better in a quiet room. The nurse identifies this as:
A. Tinnitus
B. Presbycusis
C. Otosclerosis
D. Meniere’s disease
Correct Answer: B
Rationale: Presbycusis is the age-related sensorineural hearing loss that typically affects
the ability to hear high-frequency sounds. Patients often struggle to distinguish consonants
and find that background noise interferes significantly with communication. Nurses should
speak clearly, face the patient, and use a lower tone of voice to facilitate better
understanding.
