NUR163/NUR 163 Exam 1 V3 | Concepts of
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. According to Erikson’s stages of psychosocial development, which task is the primary focus
for the older adult population?
A. Ego Integrity vs. Despair
B. Generativity vs. Stagnation
C. Identity vs. Role Confusion
D. Trust vs. Mistrust
Correct Answer: A
Rationale: Erikson identifies the late adulthood stage as Ego Integrity vs. Despair, where
individuals reflect on their lives. Achieving integrity means the individual feels a sense of
fulfillment and acceptance of life’s end. Failure to achieve this stage often results in regret,
bitterness, and a fear of death.
2. A nurse is assessing an elderly patient and notes a loss of skin elasticity and thinning of the
dermis. Which biological theory of aging best describes these changes?
A. Free Radical Theory
B. Cross-Linkage Theory
,C. Wear and Tear Theory
D. Endocrine Theory
Correct Answer: B
Rationale: The Cross-Linkage Theory suggests that over time, cell molecules adhere to one
another, leading to decreased elasticity in tissues like skin and blood vessels. This process
impairs the body’s ability to repair itself and results in visible signs of aging. Nurses must
recognize these changes to provide appropriate skin care and pressure ulcer prevention.
3. Which age-related cardiovascular change should the practical nurse expect when assessing
an 80-year-old patient?
A. Increased stiffness of the large arteries
B. Decreased peripheral vascular resistance
C. Increased heart rate at rest
D. Increased cardiac output during exercise
Correct Answer: A
Rationale: As people age, the large arteries lose elasticity and become stiffer, often leading
to increased systolic blood pressure. This change increases the workload on the heart and
can contribute to left ventricular hypertrophy. The nurse should monitor for hypertension
and signs of heart failure in this population.
,4. An elderly patient reports difficulty hearing high-pitched sounds and understanding
conversation in noisy environments. The nurse identifies this as:
A. Presbyopia
B. Otosclerosis
C. Tinnitus
D. Presbycusis
Correct Answer: D
Rationale: Presbycusis is the most common type of sensorineural hearing loss in older
adults, specifically affecting the ability to hear high-frequency sounds. It occurs gradually
and is often bilateral, making it difficult for patients to distinguish speech in crowded
rooms. Effective communication strategies include facing the patient and speaking in a
lower-pitched, clear voice.
5. When administering medications to an elderly patient, the nurse understands that which
physiological change most affects drug metabolism?
A. Increased gastric pH
B. Reduced liver mass and blood flow
C. Increased total body water
D. Enhanced renal filtration rate
Correct Answer: B
, Rationale: Metabolism primarily occurs in the liver, and aging typically results in
decreased liver size and blood flow. This leads to a slower rate of drug metabolism, which
can result in higher concentrations of medications in the bloodstream. Nurses must
monitor for signs of toxicity and advocate for ‘starting low and going slow’ with dosages.
6. The nurse is using the SPICES tool to assess an older adult. What does the ‘S’ in the
acronym SPICES stand for in this context?
A. Sensory perception
B. Social support
C. Sexual health
D. Sleep disorders
Correct Answer: D
Rationale: The SPICES tool is a framework used to identify common ‘geriatric syndromes’
that require nursing intervention. It stands for Sleep disorders, Problems with
eating/feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown. Utilizing
this tool helps the nurse provide comprehensive care tailored to the specific vulnerabilities
of older adults.
7. Which finding is considered a normal age-related change in the respiratory system?
A. Reduced cough reflex
B. Decreased residual volume
C. Increased vital capacity
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. According to Erikson’s stages of psychosocial development, which task is the primary focus
for the older adult population?
A. Ego Integrity vs. Despair
B. Generativity vs. Stagnation
C. Identity vs. Role Confusion
D. Trust vs. Mistrust
Correct Answer: A
Rationale: Erikson identifies the late adulthood stage as Ego Integrity vs. Despair, where
individuals reflect on their lives. Achieving integrity means the individual feels a sense of
fulfillment and acceptance of life’s end. Failure to achieve this stage often results in regret,
bitterness, and a fear of death.
2. A nurse is assessing an elderly patient and notes a loss of skin elasticity and thinning of the
dermis. Which biological theory of aging best describes these changes?
A. Free Radical Theory
B. Cross-Linkage Theory
,C. Wear and Tear Theory
D. Endocrine Theory
Correct Answer: B
Rationale: The Cross-Linkage Theory suggests that over time, cell molecules adhere to one
another, leading to decreased elasticity in tissues like skin and blood vessels. This process
impairs the body’s ability to repair itself and results in visible signs of aging. Nurses must
recognize these changes to provide appropriate skin care and pressure ulcer prevention.
3. Which age-related cardiovascular change should the practical nurse expect when assessing
an 80-year-old patient?
A. Increased stiffness of the large arteries
B. Decreased peripheral vascular resistance
C. Increased heart rate at rest
D. Increased cardiac output during exercise
Correct Answer: A
Rationale: As people age, the large arteries lose elasticity and become stiffer, often leading
to increased systolic blood pressure. This change increases the workload on the heart and
can contribute to left ventricular hypertrophy. The nurse should monitor for hypertension
and signs of heart failure in this population.
,4. An elderly patient reports difficulty hearing high-pitched sounds and understanding
conversation in noisy environments. The nurse identifies this as:
A. Presbyopia
B. Otosclerosis
C. Tinnitus
D. Presbycusis
Correct Answer: D
Rationale: Presbycusis is the most common type of sensorineural hearing loss in older
adults, specifically affecting the ability to hear high-frequency sounds. It occurs gradually
and is often bilateral, making it difficult for patients to distinguish speech in crowded
rooms. Effective communication strategies include facing the patient and speaking in a
lower-pitched, clear voice.
5. When administering medications to an elderly patient, the nurse understands that which
physiological change most affects drug metabolism?
A. Increased gastric pH
B. Reduced liver mass and blood flow
C. Increased total body water
D. Enhanced renal filtration rate
Correct Answer: B
, Rationale: Metabolism primarily occurs in the liver, and aging typically results in
decreased liver size and blood flow. This leads to a slower rate of drug metabolism, which
can result in higher concentrations of medications in the bloodstream. Nurses must
monitor for signs of toxicity and advocate for ‘starting low and going slow’ with dosages.
6. The nurse is using the SPICES tool to assess an older adult. What does the ‘S’ in the
acronym SPICES stand for in this context?
A. Sensory perception
B. Social support
C. Sexual health
D. Sleep disorders
Correct Answer: D
Rationale: The SPICES tool is a framework used to identify common ‘geriatric syndromes’
that require nursing intervention. It stands for Sleep disorders, Problems with
eating/feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown. Utilizing
this tool helps the nurse provide comprehensive care tailored to the specific vulnerabilities
of older adults.
7. Which finding is considered a normal age-related change in the respiratory system?
A. Reduced cough reflex
B. Decreased residual volume
C. Increased vital capacity
