PNR 108/PNR108 Exam 3 V1 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. A 75-year-old client is admitted with a diagnosis of dehydration. Which physiological
change associated with aging contributes most to this condition?
A. Increased sensation of thirst in the hypothalamus
B. Decreased total body water and reduced thirst perception
C. Increased glomerular filtration rate (GFR)
D. Hyperactive renin-angiotensin-aldosterone system
Correct Answer: B
Explanation: As individuals age, there is a physiological decrease in total body water and a
diminished sensation of thirst, making them more susceptible to dehydration. The kidneys
also lose their ability to concentrate urine as effectively. The nurse must prioritize
monitoring fluid intake because elderly clients may not realize they are thirsty until they
are severely depleted.
2. The nurse is preparing a teaching plan for an older adult regarding sleep hygiene. Which
statement should the nurse include?
A. Older adults generally require more deep sleep (Stage IV) than younger adults.
B. Taking a long afternoon nap will help compensate for nighttime wakefulness.
C. Drinking a glass of wine before bed is an effective way to maintain sleep.
,D. Circadian rhythm changes often cause older adults to fall asleep earlier and wake up
earlier.
Correct Answer: D
Explanation: Age-related changes in the circadian rhythm often lead to an ‘advanced sleep
phase,’ where the individual feels sleepy earlier in the evening and wakes earlier in the
morning. Deep sleep stages (Stage III and IV) actually decrease as one ages, leading to more
frequent awakenings. Encouraging consistent sleep-wake cycles is a primary nursing
intervention for this population.
3. An 82-year-old client reports difficulty seeing objects clearly in the center of their vision,
while peripheral vision remains intact. The nurse suspects which condition?
A. Glaucoma
B. Cataracts
C. Retinal Detachment
D. Age-related Macular Degeneration (AMD)
Correct Answer: D
Explanation: Age-related Macular Degeneration is characterized by the loss of central
vision, which is necessary for tasks like reading and driving. In contrast, glaucoma typically
causes a loss of peripheral vision, often referred to as tunnel vision. The nurse should
assess the client’s ability to perform activities of daily living that require sharp central
focus.
, 4. The nurse is administering several medications to an older adult. Which pharmacokinetic
change increases the risk of drug toxicity in this patient?
A. Increased hepatic blood flow
B. Increased gastric acidity
C. Reduced serum albumin levels
D. Decreased body fat percentage
Correct Answer: C
Explanation: Aging often leads to decreased serum albumin levels, which means there are
fewer binding sites for protein-bound drugs, resulting in higher levels of free (active) drug
in the bloodstream. This significantly increases the risk of toxicity, especially with drugs
like warfarin or phenytoin. Nurses must monitor for adverse effects closely when an
elderly client is on multiple protein-bound medications.
5. Which assessment finding is a typical sign of a Urinary Tract Infection (UTI) in an elderly
client?
A. High fever and chills
B. Acute confusion or altered mental status
C. Severe flank pain
D. Urgent need to void with large volumes
Correct Answer: B
Nursing Q&A with Rationale | Fortis College
1. A 75-year-old client is admitted with a diagnosis of dehydration. Which physiological
change associated with aging contributes most to this condition?
A. Increased sensation of thirst in the hypothalamus
B. Decreased total body water and reduced thirst perception
C. Increased glomerular filtration rate (GFR)
D. Hyperactive renin-angiotensin-aldosterone system
Correct Answer: B
Explanation: As individuals age, there is a physiological decrease in total body water and a
diminished sensation of thirst, making them more susceptible to dehydration. The kidneys
also lose their ability to concentrate urine as effectively. The nurse must prioritize
monitoring fluid intake because elderly clients may not realize they are thirsty until they
are severely depleted.
2. The nurse is preparing a teaching plan for an older adult regarding sleep hygiene. Which
statement should the nurse include?
A. Older adults generally require more deep sleep (Stage IV) than younger adults.
B. Taking a long afternoon nap will help compensate for nighttime wakefulness.
C. Drinking a glass of wine before bed is an effective way to maintain sleep.
,D. Circadian rhythm changes often cause older adults to fall asleep earlier and wake up
earlier.
Correct Answer: D
Explanation: Age-related changes in the circadian rhythm often lead to an ‘advanced sleep
phase,’ where the individual feels sleepy earlier in the evening and wakes earlier in the
morning. Deep sleep stages (Stage III and IV) actually decrease as one ages, leading to more
frequent awakenings. Encouraging consistent sleep-wake cycles is a primary nursing
intervention for this population.
3. An 82-year-old client reports difficulty seeing objects clearly in the center of their vision,
while peripheral vision remains intact. The nurse suspects which condition?
A. Glaucoma
B. Cataracts
C. Retinal Detachment
D. Age-related Macular Degeneration (AMD)
Correct Answer: D
Explanation: Age-related Macular Degeneration is characterized by the loss of central
vision, which is necessary for tasks like reading and driving. In contrast, glaucoma typically
causes a loss of peripheral vision, often referred to as tunnel vision. The nurse should
assess the client’s ability to perform activities of daily living that require sharp central
focus.
, 4. The nurse is administering several medications to an older adult. Which pharmacokinetic
change increases the risk of drug toxicity in this patient?
A. Increased hepatic blood flow
B. Increased gastric acidity
C. Reduced serum albumin levels
D. Decreased body fat percentage
Correct Answer: C
Explanation: Aging often leads to decreased serum albumin levels, which means there are
fewer binding sites for protein-bound drugs, resulting in higher levels of free (active) drug
in the bloodstream. This significantly increases the risk of toxicity, especially with drugs
like warfarin or phenytoin. Nurses must monitor for adverse effects closely when an
elderly client is on multiple protein-bound medications.
5. Which assessment finding is a typical sign of a Urinary Tract Infection (UTI) in an elderly
client?
A. High fever and chills
B. Acute confusion or altered mental status
C. Severe flank pain
D. Urgent need to void with large volumes
Correct Answer: B
