Western Governors University
CCN: HLTH 2500
Course Number: D399
Course Title: Introduction to Gerontology
Exam: Objective Assessment
Date:2026
A 79-year-old woman with moderate Alzheimer’s disease is admitted from a long-term care
facility with acute confusion, agitation, and urinary incontinence. Her baseline cognitive status is
described as “pleasantly forgetful.” Laboratory results reveal leukocytosis and positive urine
cultures. Which nursing intervention is the priority during the acute phase of her illness?
A. Encourage uninterrupted daytime sleep
B. Apply physical restraints to prevent wandering
C. Assess for reversible causes of delirium and maintain safety
D. Reorient the patient once per shift only
Correct Answer: C
Rationale: Delirium superimposed on dementia is common in geriatric patients and often
precipitated by infections. Early identification and treatment of reversible causes while maintaining
patient safety is the priority nursing intervention.
---
An 84-year-old man with chronic heart failure reports fatigue, weight gain, dyspnea on exertion,
and bilateral ankle edema. Which age-related physiologic change most contributes to worsening
heart failure symptoms in older adults?
A. Increased myocardial elasticity
B. Reduced vascular stiffness
C. Decreased cardiac reserve
D. Enhanced baroreceptor sensitivity
1
,Correct Answer: C
Rationale: Aging reduces cardiac reserve and myocardial compliance, making older adults less able
to compensate for stressors such as fluid overload and increased metabolic demands.
---
True or False: Orthostatic hypotension in older adults is primarily caused by enhanced autonomic
nervous system responsiveness.
Correct Answer: False
Rationale: Aging is associated with decreased baroreceptor sensitivity and impaired autonomic
response, increasing the risk for orthostatic hypotension.
---
A frail 90-year-old woman develops pressure injuries over her sacrum despite routine
repositioning. Which additional nursing intervention best promotes wound healing?
A. Restrict protein intake to reduce renal workload
B. Increase caloric and protein intake
C. Massage reddened bony prominences vigorously
D. Limit fluid intake to prevent edema
Correct Answer: B
Rationale: Older adults require adequate nutrition, particularly protein and calories, for tissue
repair and wound healing. Malnutrition delays recovery and increases pressure injury risk.
---
Fill in the blank: The geriatric syndrome characterized by unintentional weight loss, weakness,
exhaustion, slow walking speed, and low physical activity is called __________.
Correct Answer: Frailty
Rationale: Frailty is a multidimensional syndrome associated with increased vulnerability to
stressors and poor health outcomes in older adults.
---
A nurse assesses a hospitalized older adult using the Confusion Assessment Method (CAM).
Which finding is essential for diagnosing delirium?
2
, A. Gradual cognitive decline over years
B. Sudden onset with fluctuating course
C. Presence of hallucinations only at night
D. Long-term memory impairment
Correct Answer: B
Rationale: Delirium is characterized by an acute onset and fluctuating mental status, distinguishing
it from chronic dementias.
---
A 76-year-old patient taking digoxin develops anorexia, nausea, and yellow vision. Which age-
related factor increases this patient’s risk for toxicity?
A. Increased hepatic metabolism
B. Increased glomerular filtration rate
C. Reduced renal clearance
D. Enhanced protein binding
Correct Answer: C
Rationale: Aging decreases renal function, leading to impaired drug clearance and increased risk
for toxicity, especially with medications like digoxin.
---
True or False: Polypharmacy increases the risk of falls, adverse drug reactions, and hospitalization
in older adults.
Correct Answer: True
Rationale: Polypharmacy is strongly associated with medication interactions, functional decline,
and increased morbidity among geriatric populations.
---
An 82-year-old man with Parkinson’s disease has difficulty swallowing thin liquids. Which
intervention should the nurse implement first?
A. Encourage straw use for all liquids
B. Assess swallowing ability and aspiration risk
C. Place the patient flat after meals
3
CCN: HLTH 2500
Course Number: D399
Course Title: Introduction to Gerontology
Exam: Objective Assessment
Date:2026
A 79-year-old woman with moderate Alzheimer’s disease is admitted from a long-term care
facility with acute confusion, agitation, and urinary incontinence. Her baseline cognitive status is
described as “pleasantly forgetful.” Laboratory results reveal leukocytosis and positive urine
cultures. Which nursing intervention is the priority during the acute phase of her illness?
A. Encourage uninterrupted daytime sleep
B. Apply physical restraints to prevent wandering
C. Assess for reversible causes of delirium and maintain safety
D. Reorient the patient once per shift only
Correct Answer: C
Rationale: Delirium superimposed on dementia is common in geriatric patients and often
precipitated by infections. Early identification and treatment of reversible causes while maintaining
patient safety is the priority nursing intervention.
---
An 84-year-old man with chronic heart failure reports fatigue, weight gain, dyspnea on exertion,
and bilateral ankle edema. Which age-related physiologic change most contributes to worsening
heart failure symptoms in older adults?
A. Increased myocardial elasticity
B. Reduced vascular stiffness
C. Decreased cardiac reserve
D. Enhanced baroreceptor sensitivity
1
,Correct Answer: C
Rationale: Aging reduces cardiac reserve and myocardial compliance, making older adults less able
to compensate for stressors such as fluid overload and increased metabolic demands.
---
True or False: Orthostatic hypotension in older adults is primarily caused by enhanced autonomic
nervous system responsiveness.
Correct Answer: False
Rationale: Aging is associated with decreased baroreceptor sensitivity and impaired autonomic
response, increasing the risk for orthostatic hypotension.
---
A frail 90-year-old woman develops pressure injuries over her sacrum despite routine
repositioning. Which additional nursing intervention best promotes wound healing?
A. Restrict protein intake to reduce renal workload
B. Increase caloric and protein intake
C. Massage reddened bony prominences vigorously
D. Limit fluid intake to prevent edema
Correct Answer: B
Rationale: Older adults require adequate nutrition, particularly protein and calories, for tissue
repair and wound healing. Malnutrition delays recovery and increases pressure injury risk.
---
Fill in the blank: The geriatric syndrome characterized by unintentional weight loss, weakness,
exhaustion, slow walking speed, and low physical activity is called __________.
Correct Answer: Frailty
Rationale: Frailty is a multidimensional syndrome associated with increased vulnerability to
stressors and poor health outcomes in older adults.
---
A nurse assesses a hospitalized older adult using the Confusion Assessment Method (CAM).
Which finding is essential for diagnosing delirium?
2
, A. Gradual cognitive decline over years
B. Sudden onset with fluctuating course
C. Presence of hallucinations only at night
D. Long-term memory impairment
Correct Answer: B
Rationale: Delirium is characterized by an acute onset and fluctuating mental status, distinguishing
it from chronic dementias.
---
A 76-year-old patient taking digoxin develops anorexia, nausea, and yellow vision. Which age-
related factor increases this patient’s risk for toxicity?
A. Increased hepatic metabolism
B. Increased glomerular filtration rate
C. Reduced renal clearance
D. Enhanced protein binding
Correct Answer: C
Rationale: Aging decreases renal function, leading to impaired drug clearance and increased risk
for toxicity, especially with medications like digoxin.
---
True or False: Polypharmacy increases the risk of falls, adverse drug reactions, and hospitalization
in older adults.
Correct Answer: True
Rationale: Polypharmacy is strongly associated with medication interactions, functional decline,
and increased morbidity among geriatric populations.
---
An 82-year-old man with Parkinson’s disease has difficulty swallowing thin liquids. Which
intervention should the nurse implement first?
A. Encourage straw use for all liquids
B. Assess swallowing ability and aspiration risk
C. Place the patient flat after meals
3
