PNR 108/PNR108 Exam 4 V1 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. An older adult patient is admitted with a hip fracture and shows signs of sudden confusion
and agitation. Which condition should the nurse suspect first?
A. Delirium
B. Dementia
C. Depression
D. Schizophrenia
Correct Answer: A
Explanation: Delirium is characterized by an acute onset of confusion and is often
reversible if the underlying cause is treated. In the elderly, physiological stressors such as
fractures or infections are common triggers for delirium. It is essential to distinguish this
from the slow, progressive decline seen in dementia.
2. When assessing an elderly patient for signs of physical abuse, which finding should the
nurse prioritize for reporting?
A. Skin tears on the forearms
B. Presence of a Stage 1 pressure ulcer
C. Dry mucous membranes
D. Multiple bruises in various stages of healing
,Correct Answer: D
Explanation: Bruises in different stages of healing often indicate repeated trauma, which is
a significant red flag for physical abuse. While skin tears and pressure ulcers are concerns,
they can occur due to age-related fragility or mobility issues. Nurses are mandated
reporters and must notify the appropriate authorities of any suspected elder abuse.
3. What is the primary goal of hospice care for a patient with a terminal illness?
A. To optimize quality of life and provide comfort
B. To prolong life through mechanical ventilation
C. To provide aggressive curative treatments
D. To facilitate rehabilitation back to independent living
Correct Answer: A
Explanation: Hospice care focuses on palliative measures rather than curative treatments
for patients with a prognosis of six months or less to live. The philosophy centers on
managing pain and symptoms to ensure the patient’s remaining time is as comfortable as
possible. It also provides psychological and spiritual support to both the patient and their
family.
4. An elderly patient reports difficulty seeing objects clearly in the center of their vision but
can see things on the periphery. Which condition is likely?
A. Glaucoma
B. Cataracts
, C. Diabetic retinopathy
D. Age-related macular degeneration
Correct Answer: D
Explanation: Age-related macular degeneration (AMD) involves the deterioration of the
macula, which is responsible for central vision. Patients often describe a blurred or dark
spot in the center of their visual field while maintaining peripheral vision. Early detection
and management are vital to slow the progression of this condition.
5. Which age-related change in the renal system increases the risk of drug toxicity in older
adults?
A. Decreased number of functioning nephrons
B. Increased glomerular filtration rate
C. Increased bladder capacity
D. Enhanced ability to concentrate urine
Correct Answer: A
Explanation: The reduction in functioning nephrons and overall renal blood flow leads to a
decreased glomerular filtration rate (GFR) in the elderly. This decline means drugs are
cleared from the body more slowly, leading to higher plasma concentrations. Consequently,
nurses must monitor for signs of toxicity even when standard dosages are administered.
Nursing Q&A with Rationale | Fortis College
1. An older adult patient is admitted with a hip fracture and shows signs of sudden confusion
and agitation. Which condition should the nurse suspect first?
A. Delirium
B. Dementia
C. Depression
D. Schizophrenia
Correct Answer: A
Explanation: Delirium is characterized by an acute onset of confusion and is often
reversible if the underlying cause is treated. In the elderly, physiological stressors such as
fractures or infections are common triggers for delirium. It is essential to distinguish this
from the slow, progressive decline seen in dementia.
2. When assessing an elderly patient for signs of physical abuse, which finding should the
nurse prioritize for reporting?
A. Skin tears on the forearms
B. Presence of a Stage 1 pressure ulcer
C. Dry mucous membranes
D. Multiple bruises in various stages of healing
,Correct Answer: D
Explanation: Bruises in different stages of healing often indicate repeated trauma, which is
a significant red flag for physical abuse. While skin tears and pressure ulcers are concerns,
they can occur due to age-related fragility or mobility issues. Nurses are mandated
reporters and must notify the appropriate authorities of any suspected elder abuse.
3. What is the primary goal of hospice care for a patient with a terminal illness?
A. To optimize quality of life and provide comfort
B. To prolong life through mechanical ventilation
C. To provide aggressive curative treatments
D. To facilitate rehabilitation back to independent living
Correct Answer: A
Explanation: Hospice care focuses on palliative measures rather than curative treatments
for patients with a prognosis of six months or less to live. The philosophy centers on
managing pain and symptoms to ensure the patient’s remaining time is as comfortable as
possible. It also provides psychological and spiritual support to both the patient and their
family.
4. An elderly patient reports difficulty seeing objects clearly in the center of their vision but
can see things on the periphery. Which condition is likely?
A. Glaucoma
B. Cataracts
, C. Diabetic retinopathy
D. Age-related macular degeneration
Correct Answer: D
Explanation: Age-related macular degeneration (AMD) involves the deterioration of the
macula, which is responsible for central vision. Patients often describe a blurred or dark
spot in the center of their visual field while maintaining peripheral vision. Early detection
and management are vital to slow the progression of this condition.
5. Which age-related change in the renal system increases the risk of drug toxicity in older
adults?
A. Decreased number of functioning nephrons
B. Increased glomerular filtration rate
C. Increased bladder capacity
D. Enhanced ability to concentrate urine
Correct Answer: A
Explanation: The reduction in functioning nephrons and overall renal blood flow leads to a
decreased glomerular filtration rate (GFR) in the elderly. This decline means drugs are
cleared from the body more slowly, leading to higher plasma concentrations. Consequently,
nurses must monitor for signs of toxicity even when standard dosages are administered.
