NUR 163 / NUR163 Exam 1 Hondros | 2026/2027 | Care of Elderly Patients
OBJECTIVE ASSESSMENT - EXAM
NUR 163 / NUR163 Exam 1
Hondros | 2026/2027
Care of Elderly Patients
2026/2027 Official Exam
A+ Verified EDITION 2026/2027 PASSING 80%
Comprehensive geriatric nursing assessment covering age-related changes,
common geriatric syndromes, pharmacology, patient-centered care planning, and
legal and end-of-life considerations for elderly patients.
C O V E R PA G E - 1
,SECTIONS COVERED
Section 1: Age-Related Changes & Health Assessment in Older Adults
Section 2: Common Geriatric Conditions & Syndromes
Section 3: Pharmacology & Medication Management in Older Adults
Section 4: Nursing Interventions & Patient-Centered Care Planning
Section 5: Legal, Ethical & End-of-Life Considerations in Geriatric Care
This examination is a comprehensive assessment covering the core content areas of NUR 163 - Care of
Elderly Patients. Each question is worth one mark, for a total of 50 marks. A passing score of 80% (40/50) is
required. Read each question carefully, select the single best answer from the four options provided, and
review the rationale for each correct answer. All questions are at the application/analysis level of Bloom's
Taxonomy, requiring you to apply geriatric nursing knowledge to clinical scenarios and analyze elderly patient
conditions.
Section 1: Age-Related Changes & Health Assessment in Older Adults
Q1
A 78-year-old female patient presents for her annual wellness visit. The nurse notes that the patient has
lost 1.5 inches in height compared to her recorded measurement from five years ago. The nurse
understands that this height loss in older adults is primarily caused by which age-related change?
A. Loss of intervertebral disc hydration and vertebral compression
B. Decreased muscle mass in the lower extremities
C. Increased calcification of the long bones
D. Thinning of the articular cartilage in weight-bearing joints
Correct Answer: A
Rationale: Height loss in older adults is primarily caused by dehydration and thinning of the intervertebral
discs, compression fractures of the vertebrae, and kyphotic postural changes. Muscle mass loss affects
strength but not height, calcification does not shorten bones, and cartilage thinning affects joint function rather
than stature.
Q2
A nurse is performing a comprehensive geriatric assessment on an 82-year-old male. The patient
reports that he has difficulty seeing objects clearly at close range, even with his current prescription
glasses. The nurse recognizes that this visual change is most likely related to which age-related
condition?
A. Increased intraocular pressure from glaucoma
B. Development of presbyopia due to decreased lens elasticity
C. Progressive peripheral vision loss from cataracts
D. Macular degeneration causing central vision impairment
Correct Answer: B
Rationale: Presbyopia is the universal age-related loss of near vision caused by decreased elasticity of the
crystalline lens, reducing its ability to change shape for near focus. While glaucoma, cataracts, and macular
degeneration are common in older adults, difficulty with near vision in the presence of an existing prescription
, is most consistent with presbyopia progression.
Q3
During a home health visit, a nurse observes that a 75-year-old patient has difficulty hearing the nurse's
questions unless the nurse speaks directly in front of her at a raised volume. The nurse recognizes that
this pattern of hearing loss is most characteristic of which age-related change?
A. Conductive hearing loss from chronic otitis media
B. Cerumen impaction causing sudden unilateral hearing loss
C. Presbycusis causing bilateral sensorineural hearing loss affecting high-frequency sounds
D. Central auditory processing disorder from cerebrovascular disease
Correct Answer: C
Rationale: Presbycusis is the most common form of age-related hearing loss, characterized by bilateral
sensorineural deficits that primarily affect high-frequency sounds and speech discrimination. This explains
why the patient has difficulty hearing unless the speaker faces them directly at increased volume. Conductive
loss and cerumen impaction have different patterns, and central processing disorders affect interpretation
rather than volume detection.
Q4
A nurse is assessing skin turgor on an 85-year-old patient during a routine examination. The nurse
pinches the skin on the back of the patient's hand and notes that it remains tented for several seconds.
The nurse should recognize that this finding is most likely caused by which factor?
A. Severe dehydration requiring immediate fluid resuscitation
B. Kidney failure causing fluid retention in the interstitial spaces
C. Chronic malnutrition resulting in protein depletion
D. Age-related loss of subcutaneous tissue and decreased skin elasticity
Correct Answer: D
Rationale: In older adults, the skin tenting test is unreliable as a sole indicator of dehydration because
age-related loss of subcutaneous fat, decreased collagen, and reduced elastin cause the skin to tent
normally. While dehydration can cause tenting, the nurse must assess additional indicators such as mucous
membranes, urine output, and lab values before attributing this finding solely to fluid volume deficit.
Q5
A nurse is reviewing laboratory results for a 70-year-old male patient. The results show a hemoglobin of
12.8 g/dL and a hematocrit of 38%. The nurse should recognize that these values may reflect which
age-related hematological change?
A. A normal age-related decline in hemoglobin and hematocrit levels
B. Myelodysplastic syndrome requiring bone marrow biopsy
C. Acute gastrointestinal bleeding from a peptic ulcer
D. Iron deficiency anemia from poor dietary intake
Correct Answer: A
Rationale: Hemoglobin and hematocrit values gradually decline with age due to decreased bone marrow
cellularity and reduced erythropoietin production. These values, while slightly lower than young adult norms,
are within acceptable ranges for older adults and do not automatically indicate pathology. The nurse should
compare with the patient's baseline values before investigating further.
Q6
OBJECTIVE ASSESSMENT - EXAM
NUR 163 / NUR163 Exam 1
Hondros | 2026/2027
Care of Elderly Patients
2026/2027 Official Exam
A+ Verified EDITION 2026/2027 PASSING 80%
Comprehensive geriatric nursing assessment covering age-related changes,
common geriatric syndromes, pharmacology, patient-centered care planning, and
legal and end-of-life considerations for elderly patients.
C O V E R PA G E - 1
,SECTIONS COVERED
Section 1: Age-Related Changes & Health Assessment in Older Adults
Section 2: Common Geriatric Conditions & Syndromes
Section 3: Pharmacology & Medication Management in Older Adults
Section 4: Nursing Interventions & Patient-Centered Care Planning
Section 5: Legal, Ethical & End-of-Life Considerations in Geriatric Care
This examination is a comprehensive assessment covering the core content areas of NUR 163 - Care of
Elderly Patients. Each question is worth one mark, for a total of 50 marks. A passing score of 80% (40/50) is
required. Read each question carefully, select the single best answer from the four options provided, and
review the rationale for each correct answer. All questions are at the application/analysis level of Bloom's
Taxonomy, requiring you to apply geriatric nursing knowledge to clinical scenarios and analyze elderly patient
conditions.
Section 1: Age-Related Changes & Health Assessment in Older Adults
Q1
A 78-year-old female patient presents for her annual wellness visit. The nurse notes that the patient has
lost 1.5 inches in height compared to her recorded measurement from five years ago. The nurse
understands that this height loss in older adults is primarily caused by which age-related change?
A. Loss of intervertebral disc hydration and vertebral compression
B. Decreased muscle mass in the lower extremities
C. Increased calcification of the long bones
D. Thinning of the articular cartilage in weight-bearing joints
Correct Answer: A
Rationale: Height loss in older adults is primarily caused by dehydration and thinning of the intervertebral
discs, compression fractures of the vertebrae, and kyphotic postural changes. Muscle mass loss affects
strength but not height, calcification does not shorten bones, and cartilage thinning affects joint function rather
than stature.
Q2
A nurse is performing a comprehensive geriatric assessment on an 82-year-old male. The patient
reports that he has difficulty seeing objects clearly at close range, even with his current prescription
glasses. The nurse recognizes that this visual change is most likely related to which age-related
condition?
A. Increased intraocular pressure from glaucoma
B. Development of presbyopia due to decreased lens elasticity
C. Progressive peripheral vision loss from cataracts
D. Macular degeneration causing central vision impairment
Correct Answer: B
Rationale: Presbyopia is the universal age-related loss of near vision caused by decreased elasticity of the
crystalline lens, reducing its ability to change shape for near focus. While glaucoma, cataracts, and macular
degeneration are common in older adults, difficulty with near vision in the presence of an existing prescription
, is most consistent with presbyopia progression.
Q3
During a home health visit, a nurse observes that a 75-year-old patient has difficulty hearing the nurse's
questions unless the nurse speaks directly in front of her at a raised volume. The nurse recognizes that
this pattern of hearing loss is most characteristic of which age-related change?
A. Conductive hearing loss from chronic otitis media
B. Cerumen impaction causing sudden unilateral hearing loss
C. Presbycusis causing bilateral sensorineural hearing loss affecting high-frequency sounds
D. Central auditory processing disorder from cerebrovascular disease
Correct Answer: C
Rationale: Presbycusis is the most common form of age-related hearing loss, characterized by bilateral
sensorineural deficits that primarily affect high-frequency sounds and speech discrimination. This explains
why the patient has difficulty hearing unless the speaker faces them directly at increased volume. Conductive
loss and cerumen impaction have different patterns, and central processing disorders affect interpretation
rather than volume detection.
Q4
A nurse is assessing skin turgor on an 85-year-old patient during a routine examination. The nurse
pinches the skin on the back of the patient's hand and notes that it remains tented for several seconds.
The nurse should recognize that this finding is most likely caused by which factor?
A. Severe dehydration requiring immediate fluid resuscitation
B. Kidney failure causing fluid retention in the interstitial spaces
C. Chronic malnutrition resulting in protein depletion
D. Age-related loss of subcutaneous tissue and decreased skin elasticity
Correct Answer: D
Rationale: In older adults, the skin tenting test is unreliable as a sole indicator of dehydration because
age-related loss of subcutaneous fat, decreased collagen, and reduced elastin cause the skin to tent
normally. While dehydration can cause tenting, the nurse must assess additional indicators such as mucous
membranes, urine output, and lab values before attributing this finding solely to fluid volume deficit.
Q5
A nurse is reviewing laboratory results for a 70-year-old male patient. The results show a hemoglobin of
12.8 g/dL and a hematocrit of 38%. The nurse should recognize that these values may reflect which
age-related hematological change?
A. A normal age-related decline in hemoglobin and hematocrit levels
B. Myelodysplastic syndrome requiring bone marrow biopsy
C. Acute gastrointestinal bleeding from a peptic ulcer
D. Iron deficiency anemia from poor dietary intake
Correct Answer: A
Rationale: Hemoglobin and hematocrit values gradually decline with age due to decreased bone marrow
cellularity and reduced erythropoietin production. These values, while slightly lower than young adult norms,
are within acceptable ranges for older adults and do not automatically indicate pathology. The nurse should
compare with the patient's baseline values before investigating further.
Q6
