,NU 176/NU176 Exam 4 | Geriatric Nursing (2026)
Actual Q&A PDF | Galen College
1. A terminally ill patient with a prognosis of 5 months is admitted for symptom
management. The nurse identifies that this patient would benefit most from
which service?
A) Palliative care only, since curative treatments must stop
B) Hospice care, focusing on comfort and quality of life
C) Aggressive chemotherapy to prolong life at any cost
D) Transfer to an intensive care unit for monitoring
Correct Answer: Hospice care, focusing on comfort and quality of life
Rationale: Hospice is appropriate for patients with a life expectancy of six
months or less who choose comfort-focused care. It emphasizes symptom
management and quality of life rather than curative treatments. Palliative care
can be concurrent with disease-modifying therapy.
2. The nurse anticipates that a postoperative patient may develop atelectasis
and plans interventions to prevent it. This is an example of which of the 3 T's of
clinical judgment?
A) Think in-action
B) Think back
C) Think ahead
D) Think abstractly
Correct Answer: Think ahead
,Rationale: "Think ahead" involves anticipating potential complications and
proactively implementing preventive measures. This clinical judgment skill helps
reduce adverse events. "Think in-action" occurs during care, "think back" is
reflective evaluation, and "think abstractly" is not a defined T.
3. A patient with dementia is agitated and pacing. Which nursing intervention is
most appropriate initially?
A) Apply a vest restraint immediately
B) Administer a sedative medication
C) Reduce environmental stimuli and use a calm, reassuring voice
D) Leave the patient alone until the behavior stops
Correct Answer: Reduce environmental stimuli and use a calm, reassuring voice
Rationale: Non-pharmacologic approaches such as decreasing noise,
maintaining a calm presence, and using gentle redirection are first-line
interventions for agitation. Restraints and sedation are last resorts and may
worsen confusion; leaving the patient alone could compromise safety.
4. An older adult reports that people are stealing from them, although there is
no evidence of theft. The nurse recognizes this as a:
A) Hallucination
B) Illusion
C) Confabulation
D) Delusion
, Correct Answer: Delusion
Rationale: A delusion is a fixed false belief that persists despite contrary
evidence. Believing others are stealing is a common paranoid delusion in
dementia. Hallucinations involve sensory perceptions without stimuli; illusions
misinterpret real stimuli; confabulation is fabricated memory.
5. The nurse is performing a Mini-Cog assessment. Which two components are
included?
A) Three-word recall and clock drawing test
B) Serial sevens and spelling backwards
C) Orientation to person, place, and time
D) Naming objects and following commands
Correct Answer: Three-word recall and clock drawing test
Rationale: The Mini-Cog consists of a three-item word recall and a clock drawing
test. It is a brief, validated screening tool for cognitive impairment. The other
options are components of the Mini-Mental State Examination (MMSE) or other
cognitive assessments.
6. A patient receiving end-of-life care develops noisy, gurgling respirations. The
nurse should:
A) Perform deep suctioning immediately
B) Administer IV fluids to thin secretions
C) Position the patient on their side and administer an anticholinergic as
prescribed
Actual Q&A PDF | Galen College
1. A terminally ill patient with a prognosis of 5 months is admitted for symptom
management. The nurse identifies that this patient would benefit most from
which service?
A) Palliative care only, since curative treatments must stop
B) Hospice care, focusing on comfort and quality of life
C) Aggressive chemotherapy to prolong life at any cost
D) Transfer to an intensive care unit for monitoring
Correct Answer: Hospice care, focusing on comfort and quality of life
Rationale: Hospice is appropriate for patients with a life expectancy of six
months or less who choose comfort-focused care. It emphasizes symptom
management and quality of life rather than curative treatments. Palliative care
can be concurrent with disease-modifying therapy.
2. The nurse anticipates that a postoperative patient may develop atelectasis
and plans interventions to prevent it. This is an example of which of the 3 T's of
clinical judgment?
A) Think in-action
B) Think back
C) Think ahead
D) Think abstractly
Correct Answer: Think ahead
,Rationale: "Think ahead" involves anticipating potential complications and
proactively implementing preventive measures. This clinical judgment skill helps
reduce adverse events. "Think in-action" occurs during care, "think back" is
reflective evaluation, and "think abstractly" is not a defined T.
3. A patient with dementia is agitated and pacing. Which nursing intervention is
most appropriate initially?
A) Apply a vest restraint immediately
B) Administer a sedative medication
C) Reduce environmental stimuli and use a calm, reassuring voice
D) Leave the patient alone until the behavior stops
Correct Answer: Reduce environmental stimuli and use a calm, reassuring voice
Rationale: Non-pharmacologic approaches such as decreasing noise,
maintaining a calm presence, and using gentle redirection are first-line
interventions for agitation. Restraints and sedation are last resorts and may
worsen confusion; leaving the patient alone could compromise safety.
4. An older adult reports that people are stealing from them, although there is
no evidence of theft. The nurse recognizes this as a:
A) Hallucination
B) Illusion
C) Confabulation
D) Delusion
, Correct Answer: Delusion
Rationale: A delusion is a fixed false belief that persists despite contrary
evidence. Believing others are stealing is a common paranoid delusion in
dementia. Hallucinations involve sensory perceptions without stimuli; illusions
misinterpret real stimuli; confabulation is fabricated memory.
5. The nurse is performing a Mini-Cog assessment. Which two components are
included?
A) Three-word recall and clock drawing test
B) Serial sevens and spelling backwards
C) Orientation to person, place, and time
D) Naming objects and following commands
Correct Answer: Three-word recall and clock drawing test
Rationale: The Mini-Cog consists of a three-item word recall and a clock drawing
test. It is a brief, validated screening tool for cognitive impairment. The other
options are components of the Mini-Mental State Examination (MMSE) or other
cognitive assessments.
6. A patient receiving end-of-life care develops noisy, gurgling respirations. The
nurse should:
A) Perform deep suctioning immediately
B) Administer IV fluids to thin secretions
C) Position the patient on their side and administer an anticholinergic as
prescribed
