,NU 176/NU176 Exam 2 | Geriatric Nursing (2026) Q&A |
Galen College
1. Which characteristic most accurately distinguishes chronic pain from acute pain
in an older adult?
A) It always produces an elevated temperature
B) It persists or recurs beyond the expected period of healing
C) It occurs only after surgical procedures
D) It is always associated with visible tissue injury
Correct Answer: It persists or recurs beyond the expected period of healing
Rationale: Chronic pain continues or recurs beyond the usual healing period and
may require long - term management. It can occur with persistent disease,
neuropathic conditions, or musculoskeletal disorders. Unlike acute pain, its
intensity does not necessarily indica te the extent of tissue damage. Older adults
may also communicate chronic pain differently because of sensory or cognitive
changes .
2. An older adult with mild cognitive impairment reports pain. Which approach is
most appropriate for assessing their pain?
A) Assume pain is absent if there is no grimacing
B) Ask the person to describe the pain using their own words
C) Depend exclusively on family observations
D) Avoid asking about pain to prevent anxiety
Correct Answer: Ask the person to describe the pain using their own words
Rationale: Self - report remains the preferred source of pain information whenever
an older adult can communicate reliably. Cognitive impairment does not
automatically eliminate the ability to report pain. Behavioral observations and
,caregiver information can supplement assessment, but they should not replace the
individual's report when meaningful self - report is possible .
3. Which pain assessment scale is most appropriate for an older adult who can
communicate reliably?
A) Numeric rating scale
B) Apgar scale
C) Braden scale
D) Glasgow Coma Scale
Correct Answer: Numeric rating scale
Rationale: A numeric pain scale is appropriate when the patient can understand and
communicate a numerical rating. The Apgar scale assesses newborns, the Braden
scale assesses pressure injury risk, and the Glasgow Coma Scale assesses level of
consciousness .
4. An older adult with advanced dementia cannot provide a reliable verbal pain
rating. Which approach is most appropriate?
A) Assume the patient has no pain
B) Use behavioral and observational pain indicators
C) Ask only the roommate about pain
D) Avoid pain treatment to prevent side effects
Correct Answer: Use behavioral and observational pain indicators
Rationale: When self - report is unreliable, behavioral changes, facial expressions,
vocalizations, and other validated observational indicators can help assess pain.
Assuming no pain or avoiding treatment would be inappropriate and potentially
harmful .
, 5. Which behavior may indicate pain in an older adult with cognitive impairment?
A) New agitation and resistance to care
B) Stable behavior with no changes
C) Increased appetite and improved mood
D) Improved sleep quality
Correct Answer: New agitation and resistance to care
Rationale: Pain may manifest through behavioral changes such as agitation,
grimacing, withdrawal, guarding, or resistance when verbal reporting is limited.
Stable behavior, increased appetite, and improved sleep are not indicative of pain .
6. Which principle should guide pain management in older adults?
A) Use the same treatment for everyone regardless of condition
B) Individualize treatment based on the patient's condition and response
C) Avoid nonpharmacologic interventions
D) Treat only severe pain
Correct Answer: Individualize treatment based on the patient's condition and
response
Rationale: Older adults differ in pain causes, comorbidities, medications, kidney
function, and treatment responses, requiring individualized management. Using the
same treatment for everyone, avoiding nonpharmacologic interventions, or treating
only severe pain wou ld be inappropriate .
7. An older adult reports severe pain but has a normal heart rate and blood
pressure. How should the nurse interpret this finding?
A) The pain must be mild
B) The report is unreliable
Galen College
1. Which characteristic most accurately distinguishes chronic pain from acute pain
in an older adult?
A) It always produces an elevated temperature
B) It persists or recurs beyond the expected period of healing
C) It occurs only after surgical procedures
D) It is always associated with visible tissue injury
Correct Answer: It persists or recurs beyond the expected period of healing
Rationale: Chronic pain continues or recurs beyond the usual healing period and
may require long - term management. It can occur with persistent disease,
neuropathic conditions, or musculoskeletal disorders. Unlike acute pain, its
intensity does not necessarily indica te the extent of tissue damage. Older adults
may also communicate chronic pain differently because of sensory or cognitive
changes .
2. An older adult with mild cognitive impairment reports pain. Which approach is
most appropriate for assessing their pain?
A) Assume pain is absent if there is no grimacing
B) Ask the person to describe the pain using their own words
C) Depend exclusively on family observations
D) Avoid asking about pain to prevent anxiety
Correct Answer: Ask the person to describe the pain using their own words
Rationale: Self - report remains the preferred source of pain information whenever
an older adult can communicate reliably. Cognitive impairment does not
automatically eliminate the ability to report pain. Behavioral observations and
,caregiver information can supplement assessment, but they should not replace the
individual's report when meaningful self - report is possible .
3. Which pain assessment scale is most appropriate for an older adult who can
communicate reliably?
A) Numeric rating scale
B) Apgar scale
C) Braden scale
D) Glasgow Coma Scale
Correct Answer: Numeric rating scale
Rationale: A numeric pain scale is appropriate when the patient can understand and
communicate a numerical rating. The Apgar scale assesses newborns, the Braden
scale assesses pressure injury risk, and the Glasgow Coma Scale assesses level of
consciousness .
4. An older adult with advanced dementia cannot provide a reliable verbal pain
rating. Which approach is most appropriate?
A) Assume the patient has no pain
B) Use behavioral and observational pain indicators
C) Ask only the roommate about pain
D) Avoid pain treatment to prevent side effects
Correct Answer: Use behavioral and observational pain indicators
Rationale: When self - report is unreliable, behavioral changes, facial expressions,
vocalizations, and other validated observational indicators can help assess pain.
Assuming no pain or avoiding treatment would be inappropriate and potentially
harmful .
, 5. Which behavior may indicate pain in an older adult with cognitive impairment?
A) New agitation and resistance to care
B) Stable behavior with no changes
C) Increased appetite and improved mood
D) Improved sleep quality
Correct Answer: New agitation and resistance to care
Rationale: Pain may manifest through behavioral changes such as agitation,
grimacing, withdrawal, guarding, or resistance when verbal reporting is limited.
Stable behavior, increased appetite, and improved sleep are not indicative of pain .
6. Which principle should guide pain management in older adults?
A) Use the same treatment for everyone regardless of condition
B) Individualize treatment based on the patient's condition and response
C) Avoid nonpharmacologic interventions
D) Treat only severe pain
Correct Answer: Individualize treatment based on the patient's condition and
response
Rationale: Older adults differ in pain causes, comorbidities, medications, kidney
function, and treatment responses, requiring individualized management. Using the
same treatment for everyone, avoiding nonpharmacologic interventions, or treating
only severe pain wou ld be inappropriate .
7. An older adult reports severe pain but has a normal heart rate and blood
pressure. How should the nurse interpret this finding?
A) The pain must be mild
B) The report is unreliable
