PNR 108/PNR108 Final Exam V3 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. Which cognitive change is considered a normal part of the aging process?
A. Slower processing speed and reaction time
B. Inability to remember the names of close family members
C. Frequent episodes of acute confusion and disorientation
D. Loss of long-term memory and remote recall
Correct Answer: A
Explanation: As individuals age, it is normal to experience a slight decrease in the speed of
information processing and reaction times. This is attributed to physiological changes in
the nervous system rather than a disease process. Unlike dementia, these changes do not
significantly impair daily functioning or social interaction.
2. When communicating with an older adult who has presbycusis, which action should the
nurse take?
A. Speak in a high-pitched, loud voice to ensure they hear
B. Face the patient directly and speak in a low-frequency tone
C. Shout directly into the patient’s ear for maximum volume
D. Exaggerate lip movements so the patient can read lips better
Correct Answer: B
,Explanation: Presbycusis is the age-related loss of hearing, typically affecting the ability to
hear high-pitched sounds. Facing the patient directly allows for better visual cues, and
lower-pitched tones are generally easier for these patients to distinguish. Shouting or using
high-pitched tones can actually make communication more difficult and distorted for the
elderly patient.
3. An elderly patient is diagnosed with polypharmacy. What is the primary nursing priority in
this situation?
A. Encouraging the patient to stop all over-the-counter supplements
B. Instructing the patient to use different pharmacies for better pricing
C. Teaching the patient to take all medications at the same time daily
D. Conducting a comprehensive medication reconciliation at every visit
Correct Answer: D
Explanation: Polypharmacy increases the risk of drug-drug interactions and adverse
reactions in the elderly population. Regular medication reconciliation helps identify
redundant medications and potential safety hazards. This process is essential because
elderly patients often see multiple specialists who may prescribe various medications
without full knowledge of the current regimen.
4. Which age-related change in the integumentary system increases the risk for pressure
ulcers in older adults?
A. Increased vascularity of the dermis layer
, B. Thickening of the subcutaneous fat layer
C. Decreased elasticity and thinning of the skin layers
D. Increased production of sebum and sweat
Correct Answer: C
Explanation: Aging leads to the thinning of the epidermis and dermis, along with a loss of
subcutaneous fat and elasticity. These changes make the skin more fragile and susceptible
to shearing forces and pressure. Nurses must implement frequent repositioning and skin
assessments to prevent skin breakdown in this vulnerable population.
5. A nurse notes that an older patient is experiencing ‘sundowning.’ Which intervention is
most appropriate?
A. Increasing the patient’s caffeine intake in the afternoon
B. Administering a potent sedative immediately after sunset
C. Applying soft restraints to prevent the patient from wandering
D. Providing a quiet, well-lit environment in the evening
Correct Answer: D
Explanation: Sundowning is a state of increased confusion and agitation that occurs in the
late afternoon or evening in patients with dementia. Providing a calm, well-lit environment
can help orient the patient and reduce anxiety-related behaviors. Nurses should avoid
restraints and heavy sedation as these can worsen confusion and increase fall risks.
Nursing Q&A with Rationale | Fortis College
1. Which cognitive change is considered a normal part of the aging process?
A. Slower processing speed and reaction time
B. Inability to remember the names of close family members
C. Frequent episodes of acute confusion and disorientation
D. Loss of long-term memory and remote recall
Correct Answer: A
Explanation: As individuals age, it is normal to experience a slight decrease in the speed of
information processing and reaction times. This is attributed to physiological changes in
the nervous system rather than a disease process. Unlike dementia, these changes do not
significantly impair daily functioning or social interaction.
2. When communicating with an older adult who has presbycusis, which action should the
nurse take?
A. Speak in a high-pitched, loud voice to ensure they hear
B. Face the patient directly and speak in a low-frequency tone
C. Shout directly into the patient’s ear for maximum volume
D. Exaggerate lip movements so the patient can read lips better
Correct Answer: B
,Explanation: Presbycusis is the age-related loss of hearing, typically affecting the ability to
hear high-pitched sounds. Facing the patient directly allows for better visual cues, and
lower-pitched tones are generally easier for these patients to distinguish. Shouting or using
high-pitched tones can actually make communication more difficult and distorted for the
elderly patient.
3. An elderly patient is diagnosed with polypharmacy. What is the primary nursing priority in
this situation?
A. Encouraging the patient to stop all over-the-counter supplements
B. Instructing the patient to use different pharmacies for better pricing
C. Teaching the patient to take all medications at the same time daily
D. Conducting a comprehensive medication reconciliation at every visit
Correct Answer: D
Explanation: Polypharmacy increases the risk of drug-drug interactions and adverse
reactions in the elderly population. Regular medication reconciliation helps identify
redundant medications and potential safety hazards. This process is essential because
elderly patients often see multiple specialists who may prescribe various medications
without full knowledge of the current regimen.
4. Which age-related change in the integumentary system increases the risk for pressure
ulcers in older adults?
A. Increased vascularity of the dermis layer
, B. Thickening of the subcutaneous fat layer
C. Decreased elasticity and thinning of the skin layers
D. Increased production of sebum and sweat
Correct Answer: C
Explanation: Aging leads to the thinning of the epidermis and dermis, along with a loss of
subcutaneous fat and elasticity. These changes make the skin more fragile and susceptible
to shearing forces and pressure. Nurses must implement frequent repositioning and skin
assessments to prevent skin breakdown in this vulnerable population.
5. A nurse notes that an older patient is experiencing ‘sundowning.’ Which intervention is
most appropriate?
A. Increasing the patient’s caffeine intake in the afternoon
B. Administering a potent sedative immediately after sunset
C. Applying soft restraints to prevent the patient from wandering
D. Providing a quiet, well-lit environment in the evening
Correct Answer: D
Explanation: Sundowning is a state of increased confusion and agitation that occurs in the
late afternoon or evening in patients with dementia. Providing a calm, well-lit environment
can help orient the patient and reduce anxiety-related behaviors. Nurses should avoid
restraints and heavy sedation as these can worsen confusion and increase fall risks.
