• NURS 5461 Exam 09/11/2026
NURS 5461 / NURS5461 (Latest Update 2026 /
2027) Adult Gerontology Management Across
the Continuum of Care | Questions & Answers |
Grade A | 100% Correct - UTA
An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the left forearm for for
hemodialysis. After palpating the AV fistula, which finding is an indication that the AV fistula is functioning
properly?
A. Enlarged veins
B. Redness around the site
C. Decreased pulses below fistula
D. Marked ecchymotic areas - Correct Answer :(A) Enlarged veins
Rationale: The mixing of arterial and venous blood in an AV fistula causes the veins to enlarge (A), which
facilitate cancelation for hemodialysis. (B) may be related to local infection or inflammation and is not a normal
finding. (C) and (D) are abnormal findings that should be reported immediately.
P 1
, • NURS 5461 Exam 09/11/2026
During the quarterly evaluations of the clients in the assisted living community, the registered nurse (RN)
assesses for findings of failure to thrive in the older population. What findings should the RN document and
report as manifestations related to failure to thrive? (Select all that apply.)
A. Unintentional weight loss
B. Increased weakness
C. Increased amounts of sleep
D. Irritation and agitation
E. Seeking constant attention from caregiver - Correct Answer :(A) Unintentional weight loss
(B) Increased weakness
(C) Increased amounts of sleep
Rationale: (A, B and C) are correct. Symptoms of failure to thrive in the older population include weight loss,
weakness and excessive sleep, which should be documented and evaluated by a healthcare provider
immediately. (D and E) are not usual signs and symptoms of failure to thrive but should be reviewed by the
healthcare provider.
The registered nurse (RN) is reinforcing discharge instructions to the family of an older client with failure to
thrive. What information should the RN include to promote nutritional intake for the client? (Select all that
apply.)
A. Minimize stress levels by providing the client with a quiet environment during meals
B. Provide food variations that the client can manage without assistance
C. Assist the client with eating meals in bed in a semi-Fowler's position
D. Encourage fluid intake before meals to decrease dehydration
E. Offer any type of food to the client as long as calories are consumed - Correct Answer :(A) Minimize stress
level by providing the client with a quiet environment during meals
(B) Provide food variations that the client can manage without assistance
Rationale: (A and B) are correct and continue to promote independence and decreased stress for the client,
which will increase the opportunity for nutritional intake. (C) increases dependence for the older client, which
can also cause decreased self-worth and depression. (D) will make the client feel full and will decrease the
client's ability to consume nutritional calories.
P 2
, • NURS 5461 Exam 09/11/2026
The registered nurse (RN) is assigned the care of an older client who returns to the unit after surgery for closed
angle glaucoma. What intervention in the plan of care should the RN bring to the attention of the healthcare
team?
A. Assist with ambulating to commode
B. Monitor intake and output q8 hours
C. Administer morphine 4 mg IM q2 hour PRN pain
D. Place an eye patch on operative eye during sleep - Correct Answer :(C) Administer morphine 4 mg IM q2 hour
PRN pain
Rationale: Morphine side effects include nausea, vomiting and constipation, causing straining on stool, all of
which can increase intraocular pressure and cause intraocular bleeding during the postoperative period.
Administration of morphine 0.4 mg IM q2 hours PRN pain (C) should be discussed with the healthcare team to
determine the risk of the side effects for the client. (A), (B) and (D) are interventions that do not place the client
at risk.
After a recent total hip replacement, an older female client, who transferred to a rehabilitation facility
placement, asks the registered nurse (RN) if she broke her hip because she is old. How should the RN best
respond?
A. Hip fractures can occur in any age group and require strength conditioning
B. With aging, everything tends to break down more easily the older one gets
C. Older people tend to look down instead of ahead, increasing the risk of falls
D. Older women commonly lose bone calcium, which increases the risk of fracture - Correct Answer :(D) Older
women commonly lose bone calcium which increases the risk of fracture.
Rationale: The best response is to provide the client with an explanation based on aging and demineralization of
the bone (D) in older females, especially after menopause. (A, B and C) offer other responses but are not client
centered in response to her expressed self-concern.
An older male client is admitted for emergency treatment of acute closed-angle glaucoma. The registered nurse
(RN) begins administering the prescribed miotic medications and glycerin (Glycol) therapy. Which intervention is
most important for the RN to maintain during the client's therapy?
A. Maintain lighting control in the room during therapy
B. Monitor intake and output q2 hours for 24 hours
C. Place an eye patch over the affected eye during sleep
P 3
, • NURS 5461 Exam 09/11/2026
D. Administer the eye drops at the scheduled intervals - Correct Answer :(B) Monitor intake and output q2 hours
for 24 hours
Rationale: Monitoring intake and output (B) is most important during the administration of glycerin (Glycol) due
to the rapid acting osmotic diuretic effect of glycerin therapy. (A, C and D) are components of care, but the most
important action during glycerin administration is evaluation of output.
The home health registered nurse (RN) visits an older woman with heart failure (HF) who is on complete bed
rest. Which intervention is most important for the RN to suggest to the client to prevent complications related
to immobility?
A. Get as much sleep as possible
B. Perform leg exercises while in bed
C. increase protein intake to combat fatigue
D. Invite friends to visit to decrease risk for depression - Correct Answer :(B) Perform leg exercises while in bed.
Rationale: The client is at risk for complications related to immobility. (B) should be performed frequently to
decrease the risk for thrombophlebitis. (A, C and D) are measures to help the client while on bedrest, but the
most important complication that the client is at risk for deep vein thrombosis.
An older client is admitted with a preliminary diagnosis of Addison's disease. Which skin finding should the
registered nurse (RN) document that is typical with Addison's disease?
A. Moon face
B. Hyperpigmentation
C. Excessive acne
D. Multiple skin tags - Correct Answer :(B) Hyperpigmentation
Rationale: Addision's disease is characterized by a deficiency in the production of adrenal cortex hormones,
which results in anterior pituitary feedback to secrete stimulating hormones, such as melanocyte stimulating
hormone (MSH) that increases melanin production. (B) is seen in clients with Addison's disease. (A and C) are
typical of Cushing's syndrome which is due to excessive adrenal cortisol. (D) are not associated with Addison's
disease.
P 4
NURS 5461 / NURS5461 (Latest Update 2026 /
2027) Adult Gerontology Management Across
the Continuum of Care | Questions & Answers |
Grade A | 100% Correct - UTA
An older client with chronic kidney disease (CKD) has an arteriovenous fistula (AV) in the left forearm for for
hemodialysis. After palpating the AV fistula, which finding is an indication that the AV fistula is functioning
properly?
A. Enlarged veins
B. Redness around the site
C. Decreased pulses below fistula
D. Marked ecchymotic areas - Correct Answer :(A) Enlarged veins
Rationale: The mixing of arterial and venous blood in an AV fistula causes the veins to enlarge (A), which
facilitate cancelation for hemodialysis. (B) may be related to local infection or inflammation and is not a normal
finding. (C) and (D) are abnormal findings that should be reported immediately.
P 1
, • NURS 5461 Exam 09/11/2026
During the quarterly evaluations of the clients in the assisted living community, the registered nurse (RN)
assesses for findings of failure to thrive in the older population. What findings should the RN document and
report as manifestations related to failure to thrive? (Select all that apply.)
A. Unintentional weight loss
B. Increased weakness
C. Increased amounts of sleep
D. Irritation and agitation
E. Seeking constant attention from caregiver - Correct Answer :(A) Unintentional weight loss
(B) Increased weakness
(C) Increased amounts of sleep
Rationale: (A, B and C) are correct. Symptoms of failure to thrive in the older population include weight loss,
weakness and excessive sleep, which should be documented and evaluated by a healthcare provider
immediately. (D and E) are not usual signs and symptoms of failure to thrive but should be reviewed by the
healthcare provider.
The registered nurse (RN) is reinforcing discharge instructions to the family of an older client with failure to
thrive. What information should the RN include to promote nutritional intake for the client? (Select all that
apply.)
A. Minimize stress levels by providing the client with a quiet environment during meals
B. Provide food variations that the client can manage without assistance
C. Assist the client with eating meals in bed in a semi-Fowler's position
D. Encourage fluid intake before meals to decrease dehydration
E. Offer any type of food to the client as long as calories are consumed - Correct Answer :(A) Minimize stress
level by providing the client with a quiet environment during meals
(B) Provide food variations that the client can manage without assistance
Rationale: (A and B) are correct and continue to promote independence and decreased stress for the client,
which will increase the opportunity for nutritional intake. (C) increases dependence for the older client, which
can also cause decreased self-worth and depression. (D) will make the client feel full and will decrease the
client's ability to consume nutritional calories.
P 2
, • NURS 5461 Exam 09/11/2026
The registered nurse (RN) is assigned the care of an older client who returns to the unit after surgery for closed
angle glaucoma. What intervention in the plan of care should the RN bring to the attention of the healthcare
team?
A. Assist with ambulating to commode
B. Monitor intake and output q8 hours
C. Administer morphine 4 mg IM q2 hour PRN pain
D. Place an eye patch on operative eye during sleep - Correct Answer :(C) Administer morphine 4 mg IM q2 hour
PRN pain
Rationale: Morphine side effects include nausea, vomiting and constipation, causing straining on stool, all of
which can increase intraocular pressure and cause intraocular bleeding during the postoperative period.
Administration of morphine 0.4 mg IM q2 hours PRN pain (C) should be discussed with the healthcare team to
determine the risk of the side effects for the client. (A), (B) and (D) are interventions that do not place the client
at risk.
After a recent total hip replacement, an older female client, who transferred to a rehabilitation facility
placement, asks the registered nurse (RN) if she broke her hip because she is old. How should the RN best
respond?
A. Hip fractures can occur in any age group and require strength conditioning
B. With aging, everything tends to break down more easily the older one gets
C. Older people tend to look down instead of ahead, increasing the risk of falls
D. Older women commonly lose bone calcium, which increases the risk of fracture - Correct Answer :(D) Older
women commonly lose bone calcium which increases the risk of fracture.
Rationale: The best response is to provide the client with an explanation based on aging and demineralization of
the bone (D) in older females, especially after menopause. (A, B and C) offer other responses but are not client
centered in response to her expressed self-concern.
An older male client is admitted for emergency treatment of acute closed-angle glaucoma. The registered nurse
(RN) begins administering the prescribed miotic medications and glycerin (Glycol) therapy. Which intervention is
most important for the RN to maintain during the client's therapy?
A. Maintain lighting control in the room during therapy
B. Monitor intake and output q2 hours for 24 hours
C. Place an eye patch over the affected eye during sleep
P 3
, • NURS 5461 Exam 09/11/2026
D. Administer the eye drops at the scheduled intervals - Correct Answer :(B) Monitor intake and output q2 hours
for 24 hours
Rationale: Monitoring intake and output (B) is most important during the administration of glycerin (Glycol) due
to the rapid acting osmotic diuretic effect of glycerin therapy. (A, C and D) are components of care, but the most
important action during glycerin administration is evaluation of output.
The home health registered nurse (RN) visits an older woman with heart failure (HF) who is on complete bed
rest. Which intervention is most important for the RN to suggest to the client to prevent complications related
to immobility?
A. Get as much sleep as possible
B. Perform leg exercises while in bed
C. increase protein intake to combat fatigue
D. Invite friends to visit to decrease risk for depression - Correct Answer :(B) Perform leg exercises while in bed.
Rationale: The client is at risk for complications related to immobility. (B) should be performed frequently to
decrease the risk for thrombophlebitis. (A, C and D) are measures to help the client while on bedrest, but the
most important complication that the client is at risk for deep vein thrombosis.
An older client is admitted with a preliminary diagnosis of Addison's disease. Which skin finding should the
registered nurse (RN) document that is typical with Addison's disease?
A. Moon face
B. Hyperpigmentation
C. Excessive acne
D. Multiple skin tags - Correct Answer :(B) Hyperpigmentation
Rationale: Addision's disease is characterized by a deficiency in the production of adrenal cortex hormones,
which results in anterior pituitary feedback to secrete stimulating hormones, such as melanocyte stimulating
hormone (MSH) that increases melanin production. (B) is seen in clients with Addison's disease. (A and C) are
typical of Cushing's syndrome which is due to excessive adrenal cortisol. (D) are not associated with Addison's
disease.
P 4
