,1. A nurse is teaching a postmenopausal client about the physiological changes of the
reproductive system. Which of the following statements accurately describes an expected
change?
A) The vaginal epithelium becomes thicker and more elastic.
B) The environment of the vagina becomes more acidic.
C) The labia flatten and there is a loss of subcutaneous fat.
D) The uterus increases in size and becomes more palpable.
Correct Answer: The labia flatten and there is a loss of subcutaneous fat.
Rationale: Age-related hormonal changes cause the vulva to atrophy, resulting in flattening of
the labia and a loss of subcutaneous fat and hair . The vaginal epithelium becomes thin and the
environment becomes dry and alkaline, not acidic . The uterus and ovaries decrease in size .
2. What is the primary symptom associated with vulvitis in an older adult?
A) Vaginal bleeding
B) Pruritus
C) Urinary frequency
D) Lower back pain
Correct Answer: Pruritus
Rationale: Pruritus, or itching, is the primary symptom associated with vulvitis . Vulvar problems
in older women may reflect serious disease processes such as diabetes or leukemia . Redness,
swelling, and drainage are also signs, but itching is the hallmark complaint.
3. A nurse is providing education to a patient with atrophic vaginitis. Which instruction should
the nurse include to prevent further irritation?
,A) Use a douche daily to cleanse the area.
B) Apply petroleum jelly as a lubricant.
C) Wear cotton underwear and avoid perfumed soaps.
D) Perform a vinegar rinse twice weekly.
Correct Answer: Wear cotton underwear and avoid perfumed soaps.
Rationale: Patients with atrophic vaginitis should wear cotton underwear and avoid douches
and the use of perfumed soaps and sprays to the genitalia . Water-based lubricants should be
used during intercourse, and keeping the genitalia clean and dry is essential .
4. A 78-year-old male patient reports a longer time to achieve an erection. The nurse
understands this is most likely due to:
A) A decrease in testosterone production
B) Normal age-related changes to the reproductive system
C) An early sign of prostate cancer
D) An adverse effect of a new medication
Correct Answer: Normal age-related changes to the reproductive system
Rationale: Normal age-related changes in the male reproductive system include a longer time to
get an erection and an enlargement of the prostate gland . There is also a reduction in sperm
count and replacement of muscle tissue with connective tissue .
5. A nurse is assessing a client for signs of osteoporosis. Which of the following is a primary risk
factor for this condition in older adults?
A) Increased calcium absorption
B) High levels of physical activity
, C) Loss of bone density and mass
D) Increased estrogen levels
Correct Answer: Loss of bone density and mass
Rationale: Osteoporosis is defined by the loss of calcium, leading to brittle bones and a loss of
bone density . This increases the risk for falls and fractures . It is a significant concern in geriatric
nursing, as it can lead to compression fractures.
6. The nurse is caring for a client with osteoporosis who is complaining of severe back pain.
What is the nurse's priority action?
A) Administer a PRN muscle relaxant
B) Assess for the possibility of a compression fracture
C) Encourage the client to increase ambulation
D) Apply a heating pad to the lower back
Correct Answer: Assess for the possibility of a compression fracture
Rationale: Severe back pain in a client with osteoporosis is a key indicator of a possible
compression fracture . The nurse should assess this possibility as a priority, as it indicates
significant bone loss and risk of further injury.
7. The nurse is reviewing the plan of care for an older adult client with osteoporosis. Which of
the following outcomes is most appropriate for this client?
A) The client will resume high-impact exercise.
B) The client will maintain current bone density and prevent falls.
C) The client will increase daily calcium intake to 3000 mg.
D) The client will demonstrate increased range of motion.
reproductive system. Which of the following statements accurately describes an expected
change?
A) The vaginal epithelium becomes thicker and more elastic.
B) The environment of the vagina becomes more acidic.
C) The labia flatten and there is a loss of subcutaneous fat.
D) The uterus increases in size and becomes more palpable.
Correct Answer: The labia flatten and there is a loss of subcutaneous fat.
Rationale: Age-related hormonal changes cause the vulva to atrophy, resulting in flattening of
the labia and a loss of subcutaneous fat and hair . The vaginal epithelium becomes thin and the
environment becomes dry and alkaline, not acidic . The uterus and ovaries decrease in size .
2. What is the primary symptom associated with vulvitis in an older adult?
A) Vaginal bleeding
B) Pruritus
C) Urinary frequency
D) Lower back pain
Correct Answer: Pruritus
Rationale: Pruritus, or itching, is the primary symptom associated with vulvitis . Vulvar problems
in older women may reflect serious disease processes such as diabetes or leukemia . Redness,
swelling, and drainage are also signs, but itching is the hallmark complaint.
3. A nurse is providing education to a patient with atrophic vaginitis. Which instruction should
the nurse include to prevent further irritation?
,A) Use a douche daily to cleanse the area.
B) Apply petroleum jelly as a lubricant.
C) Wear cotton underwear and avoid perfumed soaps.
D) Perform a vinegar rinse twice weekly.
Correct Answer: Wear cotton underwear and avoid perfumed soaps.
Rationale: Patients with atrophic vaginitis should wear cotton underwear and avoid douches
and the use of perfumed soaps and sprays to the genitalia . Water-based lubricants should be
used during intercourse, and keeping the genitalia clean and dry is essential .
4. A 78-year-old male patient reports a longer time to achieve an erection. The nurse
understands this is most likely due to:
A) A decrease in testosterone production
B) Normal age-related changes to the reproductive system
C) An early sign of prostate cancer
D) An adverse effect of a new medication
Correct Answer: Normal age-related changes to the reproductive system
Rationale: Normal age-related changes in the male reproductive system include a longer time to
get an erection and an enlargement of the prostate gland . There is also a reduction in sperm
count and replacement of muscle tissue with connective tissue .
5. A nurse is assessing a client for signs of osteoporosis. Which of the following is a primary risk
factor for this condition in older adults?
A) Increased calcium absorption
B) High levels of physical activity
, C) Loss of bone density and mass
D) Increased estrogen levels
Correct Answer: Loss of bone density and mass
Rationale: Osteoporosis is defined by the loss of calcium, leading to brittle bones and a loss of
bone density . This increases the risk for falls and fractures . It is a significant concern in geriatric
nursing, as it can lead to compression fractures.
6. The nurse is caring for a client with osteoporosis who is complaining of severe back pain.
What is the nurse's priority action?
A) Administer a PRN muscle relaxant
B) Assess for the possibility of a compression fracture
C) Encourage the client to increase ambulation
D) Apply a heating pad to the lower back
Correct Answer: Assess for the possibility of a compression fracture
Rationale: Severe back pain in a client with osteoporosis is a key indicator of a possible
compression fracture . The nurse should assess this possibility as a priority, as it indicates
significant bone loss and risk of further injury.
7. The nurse is reviewing the plan of care for an older adult client with osteoporosis. Which of
the following outcomes is most appropriate for this client?
A) The client will resume high-impact exercise.
B) The client will maintain current bone density and prevent falls.
C) The client will increase daily calcium intake to 3000 mg.
D) The client will demonstrate increased range of motion.
