,Maryville NURS 623 Exam 4 | Adult-Gerontology Health
Care II (2026) Q&A
1. Which assessment finding is most characteristic of delirium in an older adult?
A) Gradual cognitive decline over months
B) Acute onset of fluctuating attention and awareness
C) Stable, alert, and oriented mental status
D) Chronic stable memory impairment
Correct Answer: Acute onset of fluctuating attention and awareness
Rationale: Delirium is characterized by an acute onset of fluctuating attention and
awareness, often with disorientation and perceptual disturbances, and it is typically
reversible. Gradual cognitive decline over months suggests dementia, stable mental status
is not consistent with delirium, and chronic stable memory impairment suggests dementia.
2. Which factor is most important to note when an older adult presents with a traumatic
injury?
A) The patient's dietary habits
B) Whether the patient is taking blood thinners
C) The patient's preferred sleeping position
D) The patient's childhood vaccination history
Correct Answer: Whether the patient is taking blood thinners
Rationale: Anticoagulant use significantly increases the risk of hemorrhage and
complications after traumatic injury, making it a critical assessment consideration. Dietary
,habits, sleeping position, and childhood vaccination history are important but are not as
immediately critical as anticoagulation status in trauma.
3. Which medication class is typically initiated at the onset of Alzheimer disease?
A) Benzodiazepines
B) Cholinesterase inhibitors
C) Typical antipsychotics
D) Stimulants
Correct Answer: Cholinesterase inhibitors
Rationale: Cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine are
initiated at the onset of Alzheimer disease to improve cognitive function by increasing
acetylcholine levels. Benzodiazepines, typical antipsychotics, and stimulants are not first-
line for Alzheimer disease.
4. Which factor contributes most to an older adult being at high risk for falls?
A) History of falls and gait instability
B) High socioeconomic status
C) Regular physical exercise
D) Adequate vitamin D intake
Correct Answer: History of falls and gait instability
Rationale: A history of falls and gait instability are major risk factors for future falls in
older adults, along with medication use, vision impairment, and environmental hazards.
High socioeconomic status, regular exercise, and adequate vitamin D intake are protective
factors.
, 5. Which sign is most characteristic of an absence seizure?
A) Blank stare with upward eye rotation
B) Convulsions with loss of consciousness
C) Localized jerking of one limb
D) Postictal confusion lasting hours
Correct Answer: Blank stare with upward eye rotation
Rationale: Absence seizures are characterized by a sudden onset of a blank stare, often
with upward eye rotation, and activity stops for a few seconds to 1 minute without a
postictal phase. Convulsions with loss of consciousness suggest generalized tonic-clonic
seizures, localized jerking suggests focal seizures, and postictal confusion lasting hours is
not typical of absence seizures.
6. Which finding is a red flag when assessing a patient with low back pain?
A) Pain relieved by rest
B) History of trauma or fever
C) Gradual onset over several months
D) Pain that improves with physical therapy
Correct Answer: History of trauma or fever
Rationale: Red flags for low back pain include a history of trauma, fever, unexplained
weight loss, history of cancer, incontinence, long-term steroid use, and intense localized
pain. Pain relieved by rest, gradual onset, and improvement with physical therapy are not
red flags.
Care II (2026) Q&A
1. Which assessment finding is most characteristic of delirium in an older adult?
A) Gradual cognitive decline over months
B) Acute onset of fluctuating attention and awareness
C) Stable, alert, and oriented mental status
D) Chronic stable memory impairment
Correct Answer: Acute onset of fluctuating attention and awareness
Rationale: Delirium is characterized by an acute onset of fluctuating attention and
awareness, often with disorientation and perceptual disturbances, and it is typically
reversible. Gradual cognitive decline over months suggests dementia, stable mental status
is not consistent with delirium, and chronic stable memory impairment suggests dementia.
2. Which factor is most important to note when an older adult presents with a traumatic
injury?
A) The patient's dietary habits
B) Whether the patient is taking blood thinners
C) The patient's preferred sleeping position
D) The patient's childhood vaccination history
Correct Answer: Whether the patient is taking blood thinners
Rationale: Anticoagulant use significantly increases the risk of hemorrhage and
complications after traumatic injury, making it a critical assessment consideration. Dietary
,habits, sleeping position, and childhood vaccination history are important but are not as
immediately critical as anticoagulation status in trauma.
3. Which medication class is typically initiated at the onset of Alzheimer disease?
A) Benzodiazepines
B) Cholinesterase inhibitors
C) Typical antipsychotics
D) Stimulants
Correct Answer: Cholinesterase inhibitors
Rationale: Cholinesterase inhibitors such as donepezil, rivastigmine, and galantamine are
initiated at the onset of Alzheimer disease to improve cognitive function by increasing
acetylcholine levels. Benzodiazepines, typical antipsychotics, and stimulants are not first-
line for Alzheimer disease.
4. Which factor contributes most to an older adult being at high risk for falls?
A) History of falls and gait instability
B) High socioeconomic status
C) Regular physical exercise
D) Adequate vitamin D intake
Correct Answer: History of falls and gait instability
Rationale: A history of falls and gait instability are major risk factors for future falls in
older adults, along with medication use, vision impairment, and environmental hazards.
High socioeconomic status, regular exercise, and adequate vitamin D intake are protective
factors.
, 5. Which sign is most characteristic of an absence seizure?
A) Blank stare with upward eye rotation
B) Convulsions with loss of consciousness
C) Localized jerking of one limb
D) Postictal confusion lasting hours
Correct Answer: Blank stare with upward eye rotation
Rationale: Absence seizures are characterized by a sudden onset of a blank stare, often
with upward eye rotation, and activity stops for a few seconds to 1 minute without a
postictal phase. Convulsions with loss of consciousness suggest generalized tonic-clonic
seizures, localized jerking suggests focal seizures, and postictal confusion lasting hours is
not typical of absence seizures.
6. Which finding is a red flag when assessing a patient with low back pain?
A) Pain relieved by rest
B) History of trauma or fever
C) Gradual onset over several months
D) Pain that improves with physical therapy
Correct Answer: History of trauma or fever
Rationale: Red flags for low back pain include a history of trauma, fever, unexplained
weight loss, history of cancer, incontinence, long-term steroid use, and intense localized
pain. Pain relieved by rest, gradual onset, and improvement with physical therapy are not
red flags.
