3272 Nursing Care of Adults &
Older Adults II
Final Exam Review
(Questions & Solutions)
2025
1
, 1. Multiple Choice
Question:
An 82-year-old male with a history of heart failure, chronic kidney
disease, and diabetes presents to the emergency department with acute
dyspnea and confusion. Which initial assessment parameter is most
critical in determining his immediate risk of decompensation?
- A. Temperature
- B. Oxygen saturation
- C. Blood glucose
- D. Jugular venous distension
Correct ANS:
B. Oxygen saturation
Rationale:
Oxygen saturation is a key indicator of tissue perfusion and respiratory
function. In a complex older patient, hypoxemia may be the earliest sign
of deterioration. Immediate identification guides prompt interventions,
such as oxygen supplementation and further assessment for underlying
causes.
---
2. Fill-in-the-Blank
Question:
The systematic framework consisting of assessment, diagnosis, planning,
implementation, and evaluation that underpins individualized patient
care is known as the __________.
Correct ANS:
nursing process
Rationale:
2
,The nursing process ensures that care is both holistic and evidence-
based, allowing for ongoing re‐assessment and modification of
interventions. It is essential for managing patients with both acute crises
and chronic conditions.
---
3. True/False
Question:
True or False: In older adults, atypical symptoms such as confusion, falls,
or general weakness can be the only manifestations of life-threatening
conditions like myocardial infarction or sepsis.
Correct ANS:
True
Rationale:
Older patients often lack classic symptoms due to physiologic changes
and multiple comorbidities. Recognizing atypical presentations is critical
to early diagnosis and treatment.
---
4. Multiple Response
Question:
When performing a comprehensive assessment in an acutely ill adult
with chronic conditions, which of the following components are
essential? (Select all that apply)
- A. Vital signs and hemodynamic status
- B. Mental status and cognitive function
- C. Nutritional status and weight history
- D. Social and cultural background
- E. Patient’s astrological sign
Correct ANSs:
3
, A, B, C, D
Rationale:
A complete assessment includes both physiologic (vital signs, nutrition)
and psychosocial (cognition, cultural beliefs) factors, ensuring a tailored
care plan. Astrological sign has no clinical relevance.
---
5. Multiple Choice
Question:
A 70-year-old female with COPD and heart failure is admitted with severe
pneumonia. To optimize her oxygenation and reduce ventilator-induced
lung injury, which ventilatory strategy should be implemented?
- A. High tidal volume ventilation
- B. Lung-protective ventilation with low tidal volumes and appropriate
PEEP
- C. Pressure-controlled ventilation with minimal PEEP
- D. Immediate transition to non-invasive ventilation
Correct ANS:
B. Lung-protective ventilation with low tidal volumes and appropriate
PEEP
Rationale:
Low tidal volume (typically ~6 mL/kg predicted body weight) and
adequate PEEP minimize ventilator-induced lung injury and are
recommended for patients with underlying respiratory pathology, such
as COPD and heart failure, especially during pneumonia exacerbations.
---
6. Fill-in-the-Blank
Question:
When adjusting medication dosages in patients with renal impairment,
4
Older Adults II
Final Exam Review
(Questions & Solutions)
2025
1
, 1. Multiple Choice
Question:
An 82-year-old male with a history of heart failure, chronic kidney
disease, and diabetes presents to the emergency department with acute
dyspnea and confusion. Which initial assessment parameter is most
critical in determining his immediate risk of decompensation?
- A. Temperature
- B. Oxygen saturation
- C. Blood glucose
- D. Jugular venous distension
Correct ANS:
B. Oxygen saturation
Rationale:
Oxygen saturation is a key indicator of tissue perfusion and respiratory
function. In a complex older patient, hypoxemia may be the earliest sign
of deterioration. Immediate identification guides prompt interventions,
such as oxygen supplementation and further assessment for underlying
causes.
---
2. Fill-in-the-Blank
Question:
The systematic framework consisting of assessment, diagnosis, planning,
implementation, and evaluation that underpins individualized patient
care is known as the __________.
Correct ANS:
nursing process
Rationale:
2
,The nursing process ensures that care is both holistic and evidence-
based, allowing for ongoing re‐assessment and modification of
interventions. It is essential for managing patients with both acute crises
and chronic conditions.
---
3. True/False
Question:
True or False: In older adults, atypical symptoms such as confusion, falls,
or general weakness can be the only manifestations of life-threatening
conditions like myocardial infarction or sepsis.
Correct ANS:
True
Rationale:
Older patients often lack classic symptoms due to physiologic changes
and multiple comorbidities. Recognizing atypical presentations is critical
to early diagnosis and treatment.
---
4. Multiple Response
Question:
When performing a comprehensive assessment in an acutely ill adult
with chronic conditions, which of the following components are
essential? (Select all that apply)
- A. Vital signs and hemodynamic status
- B. Mental status and cognitive function
- C. Nutritional status and weight history
- D. Social and cultural background
- E. Patient’s astrological sign
Correct ANSs:
3
, A, B, C, D
Rationale:
A complete assessment includes both physiologic (vital signs, nutrition)
and psychosocial (cognition, cultural beliefs) factors, ensuring a tailored
care plan. Astrological sign has no clinical relevance.
---
5. Multiple Choice
Question:
A 70-year-old female with COPD and heart failure is admitted with severe
pneumonia. To optimize her oxygenation and reduce ventilator-induced
lung injury, which ventilatory strategy should be implemented?
- A. High tidal volume ventilation
- B. Lung-protective ventilation with low tidal volumes and appropriate
PEEP
- C. Pressure-controlled ventilation with minimal PEEP
- D. Immediate transition to non-invasive ventilation
Correct ANS:
B. Lung-protective ventilation with low tidal volumes and appropriate
PEEP
Rationale:
Low tidal volume (typically ~6 mL/kg predicted body weight) and
adequate PEEP minimize ventilator-induced lung injury and are
recommended for patients with underlying respiratory pathology, such
as COPD and heart failure, especially during pneumonia exacerbations.
---
6. Fill-in-the-Blank
Question:
When adjusting medication dosages in patients with renal impairment,
4
