NU 627 Exam 4 Herzing Actual Exam
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1. Ototoxicity from Aspirin
A 62-year-old who has worked on an assembly line since he was 24 years
old began taking aspirin for arthritis 6 months ago. The client presents to
the nurse with hearing problems and ringing in the ears. Which of the
following problems should the nurse suspect?
A) Tinnitus
B) Vertigo
C) Ototoxicity
D) Impacted cerumen
Correct Answer: C. Ototoxicity
Rationale: The older adult has symptoms of ototoxicity. Aspirin is a
known ototoxic drug. Tinnitus is the persistent sensation of ringing in the
ears, which is one of this client's symptoms, but it is a symptom rather than
the underlying problem.
2. Most Common Form of Hearing Loss
What is the most common form of hearing loss in the United States?
A) Presbycusis
B) Otosclerosis
, C) Noise-induced hearing loss
D) Conductive hearing loss
Correct Answer: A. Presbycusis
Rationale: Presbycusis is age-related sensorineural hearing loss and is the
most common form of hearing loss in the United States, affecting
approximately one-third of adults over age 65.
3. Most Common Affective/Mood Disorder in Old Age
The most common affective or mood disorder of old age is:
A) Dementia
B) Depression
C) Delirium
D) Alzheimer's
Correct Answer: B. Depression
Rationale: Depression is the most common affective/mood disorder in
older adults. Dementia and Alzheimer's disease are neurocognitive
disorders, not mood disorders. Delirium is an acute confusional state.
4. Medications and Polypharmacy
When prescribing medications to an 80-year-old patient, the provider will:
A) Start with the maximum recommended dose to ensure effectiveness.
B) Consult the Beers list to help identify potentially problematic drugs.
C) Prescribe no more than five medications to avoid polypharmacy.
D) Review the medication list annually at the yearly physical.
Correct Answer: B. Consult the Beers list to help identify potentially
problematic drugs.
, Rationale: The Beers Criteria is a list of potentially inappropriate
medications for older adults. It helps healthcare providers identify
medications that may cause adverse effects in this population, recognize
drugs with limited efficacy, and consider safer alternatives.
5. Geriatric Depression Presentation
An older adult patient presents with fatigue, weight loss, and social
withdrawal. The patient denies feeling sad. The nurse should:
A) Conclude that the patient is not depressed.
B) Recognize that older adults may present with somatic symptoms
rather than overt sadness.
C) Refer the patient for neurologic evaluation.
D) Increase physical activity to improve mood.
Correct Answer: B. Recognize that older adults may present with
somatic symptoms rather than overt sadness.
Rationale: Depression in older adults often presents with somatic
symptoms (fatigue, weight loss, sleep disturbances) rather than overt
sadness or tearfulness. This atypical presentation can lead to
underdiagnosis.
6. Priority Intervention for Delirium
A patient is being treated for delirium. The nurse recognizes that the
priority intervention is:
A) Identifying and treating the underlying cause
B) Administering scheduled antipsychotic medications
C) Placing the patient in a quiet room with minimal stimulation
D) Restraining the patient to prevent injury
, Correct Answer: A. Identifying and treating the underlying cause
Rationale: Delirium is a medical emergency. The priority intervention is to
identify and treat the underlying cause (infection, medication, electrolyte
imbalance, etc.).
7. Nursing Interventions for Visual Impairment
A nurse is caring for an older adult patient with visual impairment. Which of
the following interventions are appropriate to promote safety? (Select all
that apply)
A) Place eyeglasses in the bedside table.
B) Provide adequate lighting and uncluttered walkways.
C) Draw drapes in the room to prevent glare.
D) Keep bedside rails down to prevent entrapment.
Correct Answers: B, C
Rationale: Adequate lighting and uncluttered walkways help compensate
for decreased visual acuity and reduce fall risk. Drawing drapes to prevent
glare is helpful for older adults with sensitivity to bright light. Eyeglasses
should be within reach but not necessarily in a bedside table where they
could be knocked off. Bedside rails are a safety consideration but should be
assessed individually.
8. Age-Related Vision Changes
A 75-year-old patient reports difficulty reading small print and needing
more light to see clearly. These changes are most consistent with:
A) Cataracts
B) Glaucoma
C) Presbyopia
D) Macular degeneration
Correct Answer: C. Presbyopia
Rationale: Presbyopia is the age-related loss of the eye's ability to focus on
near objects due to stiffening of the lens. It typically becomes noticeable
2026/2027 – 100% Verified Questions
with Complete Solutions & Rationales –
Pass Guaranteed –Graded A+ INSTANT
DOWNLOAD
1. Ototoxicity from Aspirin
A 62-year-old who has worked on an assembly line since he was 24 years
old began taking aspirin for arthritis 6 months ago. The client presents to
the nurse with hearing problems and ringing in the ears. Which of the
following problems should the nurse suspect?
A) Tinnitus
B) Vertigo
C) Ototoxicity
D) Impacted cerumen
Correct Answer: C. Ototoxicity
Rationale: The older adult has symptoms of ototoxicity. Aspirin is a
known ototoxic drug. Tinnitus is the persistent sensation of ringing in the
ears, which is one of this client's symptoms, but it is a symptom rather than
the underlying problem.
2. Most Common Form of Hearing Loss
What is the most common form of hearing loss in the United States?
A) Presbycusis
B) Otosclerosis
, C) Noise-induced hearing loss
D) Conductive hearing loss
Correct Answer: A. Presbycusis
Rationale: Presbycusis is age-related sensorineural hearing loss and is the
most common form of hearing loss in the United States, affecting
approximately one-third of adults over age 65.
3. Most Common Affective/Mood Disorder in Old Age
The most common affective or mood disorder of old age is:
A) Dementia
B) Depression
C) Delirium
D) Alzheimer's
Correct Answer: B. Depression
Rationale: Depression is the most common affective/mood disorder in
older adults. Dementia and Alzheimer's disease are neurocognitive
disorders, not mood disorders. Delirium is an acute confusional state.
4. Medications and Polypharmacy
When prescribing medications to an 80-year-old patient, the provider will:
A) Start with the maximum recommended dose to ensure effectiveness.
B) Consult the Beers list to help identify potentially problematic drugs.
C) Prescribe no more than five medications to avoid polypharmacy.
D) Review the medication list annually at the yearly physical.
Correct Answer: B. Consult the Beers list to help identify potentially
problematic drugs.
, Rationale: The Beers Criteria is a list of potentially inappropriate
medications for older adults. It helps healthcare providers identify
medications that may cause adverse effects in this population, recognize
drugs with limited efficacy, and consider safer alternatives.
5. Geriatric Depression Presentation
An older adult patient presents with fatigue, weight loss, and social
withdrawal. The patient denies feeling sad. The nurse should:
A) Conclude that the patient is not depressed.
B) Recognize that older adults may present with somatic symptoms
rather than overt sadness.
C) Refer the patient for neurologic evaluation.
D) Increase physical activity to improve mood.
Correct Answer: B. Recognize that older adults may present with
somatic symptoms rather than overt sadness.
Rationale: Depression in older adults often presents with somatic
symptoms (fatigue, weight loss, sleep disturbances) rather than overt
sadness or tearfulness. This atypical presentation can lead to
underdiagnosis.
6. Priority Intervention for Delirium
A patient is being treated for delirium. The nurse recognizes that the
priority intervention is:
A) Identifying and treating the underlying cause
B) Administering scheduled antipsychotic medications
C) Placing the patient in a quiet room with minimal stimulation
D) Restraining the patient to prevent injury
, Correct Answer: A. Identifying and treating the underlying cause
Rationale: Delirium is a medical emergency. The priority intervention is to
identify and treat the underlying cause (infection, medication, electrolyte
imbalance, etc.).
7. Nursing Interventions for Visual Impairment
A nurse is caring for an older adult patient with visual impairment. Which of
the following interventions are appropriate to promote safety? (Select all
that apply)
A) Place eyeglasses in the bedside table.
B) Provide adequate lighting and uncluttered walkways.
C) Draw drapes in the room to prevent glare.
D) Keep bedside rails down to prevent entrapment.
Correct Answers: B, C
Rationale: Adequate lighting and uncluttered walkways help compensate
for decreased visual acuity and reduce fall risk. Drawing drapes to prevent
glare is helpful for older adults with sensitivity to bright light. Eyeglasses
should be within reach but not necessarily in a bedside table where they
could be knocked off. Bedside rails are a safety consideration but should be
assessed individually.
8. Age-Related Vision Changes
A 75-year-old patient reports difficulty reading small print and needing
more light to see clearly. These changes are most consistent with:
A) Cataracts
B) Glaucoma
C) Presbyopia
D) Macular degeneration
Correct Answer: C. Presbyopia
Rationale: Presbyopia is the age-related loss of the eye's ability to focus on
near objects due to stiffening of the lens. It typically becomes noticeable
