NUR 163
Concepts of Practical
Nursing in the Care of
Elderly Patients
Proctored Midterm Exam
2026
(With Solutions)
MULTIPLE CHOICE
An 82-year-old patient with mild dementia is refusing to take oral medications. Which
nursing intervention is most appropriate? A. Insist the patient take medications
immediately B. Offer medication with a favorite beverage and provide reminders C.
Document refusal and leave the medication tray D. Schedule the medication at a
different time when patient is not confused
Answer: B
Rationale: Offering medication with a preferred beverage and gentle reminders
encourage cooperation while respecting autonomy. Forcing or neglecting medication
are inappropriate.
2. Which physiological change in the elderly affects drug metabolism and requires
careful medication dosing?
A. Increased gastric emptying
B. Decreased hepatic blood flow and liver enzyme activity
C. Increased renal clearance
D. Enhanced absorption in the small intestine
,Answer: B
Rationale: Aging decreases hepatic blood flow and liver enzyme activity, reducing drug
metabolism and increasing risk of toxicity.
3. When caring for an elderly patient with chronic obstructive pulmonary disease
(COPD), which nursing action best reduces exacerbation risk?
A. Encouraging bed rest to conserve energy
B. Administering prescribed bronchodilators and oxygen therapy carefully
C. Avoiding all physical activity to decrease oxygen demand
D. Limiting fluid intake to prevent edema
Answer: B
Rationale: Proper medication and oxygen therapy management helps control COPD
and prevent exacerbations. Bed rest and inactivity worsen outcomes.
4. Which validation technique is best when communicating with a confused elderly
patient showing signs of delirium?
A. Reorient and lecture about reality
B. Ignore the confusion and focus on tasks
C. Use simple language and reassure feelings without confronting false beliefs
D. Speak loudly to gain attention
Answer: C
Rationale: Validation therapy helps reduce anxiety and confusion by acknowledging
feelings rather than correcting realities.
5. An elderly patient with a history of falls is prescribed a new antihypertensive. What
should the nurse monitor closely?
A. Decreased urine output
,B. Signs of postural hypotension and dizziness
C. Weight gain
D. Increased appetite
Answer: B
Rationale: Antihypertensives can cause postural hypotension, increasing fall risk in
elderly patients.
TRUE/FALSE
6. Normal aging causes significant loss of memory function leading to dementia.
Answer: False
Rationale: Normal aging may cause mild memory decline, but dementia is a
pathological condition, not normal aging.
7. Malnutrition in the elderly can result from decreased sense of taste and smell.
Answer: True
Rationale: Sensory changes reduce appetite and food enjoyment, contributing to
malnutrition.
8. Pressure ulcers in elderly patients primarily result from ischemia due to prolonged
pressure.
Answer: True
Rationale: Prolonged pressure compresses capillaries, leading to tissue ischemia and
ulceration.
9. Incontinence in elderly patients is always due to an irreversible physiological
condition.
Answer: False
Rationale: Some causes of incontinence are reversible (e.g., infections, medications).
, 10. Polypharmacy increases the risk of adverse drug reactions in elderly patients.
Answer: True
Rationale: Multiple medications increase risks of drug-drug interactions and side effects.
SHORT ANSWER
11. Describe two nursing strategies to prevent delirium in hospitalized elderly patients.
Answer:
Maintain orientation by providing clocks and calendars.
Promote sleep hygiene and reduce nighttime disturbances.
Rationale: Orienting environment and adequate rest reduce delirium risk.
12. List three risk factors contributing to elder abuse that nurses should assess.
Answer:
Social isolation
Cognitive impairment
Dependence on caregiver
Rationale: These factors increase vulnerability to abuse.
13. What vital sign change is commonly related to decreased cardiovascular reserve in
the elderly?
Answer:
Blunted heart rate response to exercise or stress.
Rationale: Aging reduces cardiac output adaptability.
Concepts of Practical
Nursing in the Care of
Elderly Patients
Proctored Midterm Exam
2026
(With Solutions)
MULTIPLE CHOICE
An 82-year-old patient with mild dementia is refusing to take oral medications. Which
nursing intervention is most appropriate? A. Insist the patient take medications
immediately B. Offer medication with a favorite beverage and provide reminders C.
Document refusal and leave the medication tray D. Schedule the medication at a
different time when patient is not confused
Answer: B
Rationale: Offering medication with a preferred beverage and gentle reminders
encourage cooperation while respecting autonomy. Forcing or neglecting medication
are inappropriate.
2. Which physiological change in the elderly affects drug metabolism and requires
careful medication dosing?
A. Increased gastric emptying
B. Decreased hepatic blood flow and liver enzyme activity
C. Increased renal clearance
D. Enhanced absorption in the small intestine
,Answer: B
Rationale: Aging decreases hepatic blood flow and liver enzyme activity, reducing drug
metabolism and increasing risk of toxicity.
3. When caring for an elderly patient with chronic obstructive pulmonary disease
(COPD), which nursing action best reduces exacerbation risk?
A. Encouraging bed rest to conserve energy
B. Administering prescribed bronchodilators and oxygen therapy carefully
C. Avoiding all physical activity to decrease oxygen demand
D. Limiting fluid intake to prevent edema
Answer: B
Rationale: Proper medication and oxygen therapy management helps control COPD
and prevent exacerbations. Bed rest and inactivity worsen outcomes.
4. Which validation technique is best when communicating with a confused elderly
patient showing signs of delirium?
A. Reorient and lecture about reality
B. Ignore the confusion and focus on tasks
C. Use simple language and reassure feelings without confronting false beliefs
D. Speak loudly to gain attention
Answer: C
Rationale: Validation therapy helps reduce anxiety and confusion by acknowledging
feelings rather than correcting realities.
5. An elderly patient with a history of falls is prescribed a new antihypertensive. What
should the nurse monitor closely?
A. Decreased urine output
,B. Signs of postural hypotension and dizziness
C. Weight gain
D. Increased appetite
Answer: B
Rationale: Antihypertensives can cause postural hypotension, increasing fall risk in
elderly patients.
TRUE/FALSE
6. Normal aging causes significant loss of memory function leading to dementia.
Answer: False
Rationale: Normal aging may cause mild memory decline, but dementia is a
pathological condition, not normal aging.
7. Malnutrition in the elderly can result from decreased sense of taste and smell.
Answer: True
Rationale: Sensory changes reduce appetite and food enjoyment, contributing to
malnutrition.
8. Pressure ulcers in elderly patients primarily result from ischemia due to prolonged
pressure.
Answer: True
Rationale: Prolonged pressure compresses capillaries, leading to tissue ischemia and
ulceration.
9. Incontinence in elderly patients is always due to an irreversible physiological
condition.
Answer: False
Rationale: Some causes of incontinence are reversible (e.g., infections, medications).
, 10. Polypharmacy increases the risk of adverse drug reactions in elderly patients.
Answer: True
Rationale: Multiple medications increase risks of drug-drug interactions and side effects.
SHORT ANSWER
11. Describe two nursing strategies to prevent delirium in hospitalized elderly patients.
Answer:
Maintain orientation by providing clocks and calendars.
Promote sleep hygiene and reduce nighttime disturbances.
Rationale: Orienting environment and adequate rest reduce delirium risk.
12. List three risk factors contributing to elder abuse that nurses should assess.
Answer:
Social isolation
Cognitive impairment
Dependence on caregiver
Rationale: These factors increase vulnerability to abuse.
13. What vital sign change is commonly related to decreased cardiovascular reserve in
the elderly?
Answer:
Blunted heart rate response to exercise or stress.
Rationale: Aging reduces cardiac output adaptability.
