NURSING 475
Gerontological Nursing
(Caring for Older Adults & Their
Families)
Midterm Exam Review
2025
The nurse is providing medication instructions to an older client who is taking digoxin
daily. The nurse explains to the client that decreased lean body mass and decreased
glomerular filtration rate, which are age-related body changes, could place the client at
risk for which complication with medication therapy?
1. Decreased absorption of digoxin
2. Increased risk for digoxin toxicity
3. Decreased therapeutic effect of digoxin
4. Increased risk for side effects related to digoxin
The nurse is caring for an older client in a long-term care facility. Which action
contributes to encouraging autonomy in the client?
1. Planning meals
2. Decorating the room
3. Scheduling haircut appointments
4. Allowing the client to choose social activities
The nurse is providing instructions to the assistive personnel (AP) regarding care of an
older client with hearing loss. What should the nurse tell the AP about older clients with
hearing loss?
1. They are often distracted.
,2. They have middle ear changes.
3. They respond to low-pitched tones.
4. They develop moist cerumen production.
The nurse is providing an educational session to new employees, and the topic is abuse
of the older client. The nurse helps the employees identify which client
as most typically a victim of abuse?
1. A man who has moderate hypertension
2. A man who has newly diagnosed cataracts
3. A woman who has advanced Parkinson's disease
4. A woman who has early diagnosed Lyme disease
The nurse is performing an assessment on an older client who is having difficulty
sleeping at night. Which statement by the client indicates the need for further
teaching regarding measures to improve sleep?
1. "I swim 3 times a week."
2. "I have stopped smoking cigars."
3. "I drink hot chocolate before bedtime."
4. "I read for 40 minutes before bedtime."
The visiting nurse observes that the older male client is confined by his daughter-in-law
to his room. When the nurse suggests that he walk to the den and join the family, he
says, "I'm in everyone's way; my daughter-in-law needs me to stay here." Which is
the most important action for the nurse to take?
1. Say to the daughter-in-law, "Confining your father-in-law to his room is
inhumane."
2. Suggest to the client and daughter-in-law that they consider a nursing
home for the client.
3. Say nothing, because it is best for the nurse to remain neutral and wait to
be asked for help.
4. Suggest appropriate resources to the client and daughter-in-law, such as
respite care and a senior citizens center.
The nurse is performing an assessment on an older adult client. Which assessment data
would indicate a potential complication associated with the skin?
1. Crusting
2. Wrinkling
3. Deepening of expression lines
4. Thinning and loss of elasticity in the skin
The long-term care nurse is performing assessments on several of the residents. Which
are normal age-related physiological changes the nurse should expect to note? Select
,all that apply.
1. Increased heart rate
2. Decline in visual acuity
3. Decreased respiratory rate
4. Decline in long-term memory
5. Increased susceptibility to urinary tract infections
6. Increased incidence of awakening after sleep onset
An older client is admitted to the hospital with a diagnosis of malnutrition. Other than
cognitive status, what other factors can increase the risk of malnutrition and
dehydration? Select all that apply.
1. Past profession
2. Physical fatigue
3. Limited mobility
4. Sensory decreases
5. Inadequate dental care
6. Family history of malnutrition
The nurse planning care for a military veteran should prioritize nursing interventions
targeted at managing which condition, if present, that commonly occurs in this
population?
1. Hypertension
2. Hyperlipidemia
3. Substance abuse disorder
4. Post-traumatic stress disorder
Which action by the nurse will best facilitate adherence to the treatment regimen for a
client with a chronic illness?
1. Arranging for home health care
2. Focusing on managing a single illness at a time
3. Communicating with one provider only to avoid confusion for the client
4. Allowing the client to teach a support person about their treatment
regimen
Which statement is true regarding falls in the elderly?
A. Most falls occur in the garage.
B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities.
C. Fall risk decreases with addition of medications.
D. Sedatives reduce the risk of falls.
Appropriate nursing care for a patient with urinary incontinence is to:
, A. insert an indwelling Foley catheter.
B. order oxybutynin chloride (Ditropan).
C. encourage fluids to decrease the urine concentration so it is less irritating.
D. recommend herbal approaches to reduce incontinence.
A nursing intervention for a patient with constipation is to:
A. avoid the urge to defecate.
B. limit fluid intake.
C. give prune juice with a noncarbonated drink.
D. encourage bran cereal or whole-grain breads.
A patient with dysphagia is:
A. fed only for pleasure.
B. at low risk for nutritional deficits.
C. at higher risk for pneumonia.
D. able to drink thin liquids.
Age-related eye changes may include:
A. increased visual accommodation.
B. macular degeneration.
C. non-preventable blindness as a result of glaucoma.
D. decreased ability of pupil to respond to light changes.
Nurses' knowledge of sexuality in the older adult population should include:
A. Chronic illness may affect the ability to participate in sexual activity.
B. Sexual response time is unchanged.
C. Ability to achieve orgasm declines.
D. Dryness of the vaginal walls is associated with pelvic inflammatory disease.
What is the initial nursing intervention in preventing polypharmacy?
A. Obtain a thorough medication history.
B. Discontinue all herbal preparations.
C. Refer the patient to a geriatric practitioner.
D. Consult a pharmacist to review all medications.
What should the nurse include in the teaching plan for self-medication practices of older adults?
A. Eliminate unnecessary medications.
B. Substitute herbal preparations for certain prescribed medications.
C. Develop a drug reminder system and schedule.
D. Pharmacy shop for the cheapest medications.
Which age-related changes predispose the elderly patient to drug toxicity and extended duration
of action of drugs? (Select all that apply.)
A. Decreased body water
B. Increased ratio of muscle to fat
C. Low serum albumin
D. Reduced blood flow to liver
Which mental change is associated with aging?
A. Confusion
B. Gradual decline in cognitive skills
C. Depression
Gerontological Nursing
(Caring for Older Adults & Their
Families)
Midterm Exam Review
2025
The nurse is providing medication instructions to an older client who is taking digoxin
daily. The nurse explains to the client that decreased lean body mass and decreased
glomerular filtration rate, which are age-related body changes, could place the client at
risk for which complication with medication therapy?
1. Decreased absorption of digoxin
2. Increased risk for digoxin toxicity
3. Decreased therapeutic effect of digoxin
4. Increased risk for side effects related to digoxin
The nurse is caring for an older client in a long-term care facility. Which action
contributes to encouraging autonomy in the client?
1. Planning meals
2. Decorating the room
3. Scheduling haircut appointments
4. Allowing the client to choose social activities
The nurse is providing instructions to the assistive personnel (AP) regarding care of an
older client with hearing loss. What should the nurse tell the AP about older clients with
hearing loss?
1. They are often distracted.
,2. They have middle ear changes.
3. They respond to low-pitched tones.
4. They develop moist cerumen production.
The nurse is providing an educational session to new employees, and the topic is abuse
of the older client. The nurse helps the employees identify which client
as most typically a victim of abuse?
1. A man who has moderate hypertension
2. A man who has newly diagnosed cataracts
3. A woman who has advanced Parkinson's disease
4. A woman who has early diagnosed Lyme disease
The nurse is performing an assessment on an older client who is having difficulty
sleeping at night. Which statement by the client indicates the need for further
teaching regarding measures to improve sleep?
1. "I swim 3 times a week."
2. "I have stopped smoking cigars."
3. "I drink hot chocolate before bedtime."
4. "I read for 40 minutes before bedtime."
The visiting nurse observes that the older male client is confined by his daughter-in-law
to his room. When the nurse suggests that he walk to the den and join the family, he
says, "I'm in everyone's way; my daughter-in-law needs me to stay here." Which is
the most important action for the nurse to take?
1. Say to the daughter-in-law, "Confining your father-in-law to his room is
inhumane."
2. Suggest to the client and daughter-in-law that they consider a nursing
home for the client.
3. Say nothing, because it is best for the nurse to remain neutral and wait to
be asked for help.
4. Suggest appropriate resources to the client and daughter-in-law, such as
respite care and a senior citizens center.
The nurse is performing an assessment on an older adult client. Which assessment data
would indicate a potential complication associated with the skin?
1. Crusting
2. Wrinkling
3. Deepening of expression lines
4. Thinning and loss of elasticity in the skin
The long-term care nurse is performing assessments on several of the residents. Which
are normal age-related physiological changes the nurse should expect to note? Select
,all that apply.
1. Increased heart rate
2. Decline in visual acuity
3. Decreased respiratory rate
4. Decline in long-term memory
5. Increased susceptibility to urinary tract infections
6. Increased incidence of awakening after sleep onset
An older client is admitted to the hospital with a diagnosis of malnutrition. Other than
cognitive status, what other factors can increase the risk of malnutrition and
dehydration? Select all that apply.
1. Past profession
2. Physical fatigue
3. Limited mobility
4. Sensory decreases
5. Inadequate dental care
6. Family history of malnutrition
The nurse planning care for a military veteran should prioritize nursing interventions
targeted at managing which condition, if present, that commonly occurs in this
population?
1. Hypertension
2. Hyperlipidemia
3. Substance abuse disorder
4. Post-traumatic stress disorder
Which action by the nurse will best facilitate adherence to the treatment regimen for a
client with a chronic illness?
1. Arranging for home health care
2. Focusing on managing a single illness at a time
3. Communicating with one provider only to avoid confusion for the client
4. Allowing the client to teach a support person about their treatment
regimen
Which statement is true regarding falls in the elderly?
A. Most falls occur in the garage.
B. Hip fractures resulting from falls are a leading cause of placement in long-term care facilities.
C. Fall risk decreases with addition of medications.
D. Sedatives reduce the risk of falls.
Appropriate nursing care for a patient with urinary incontinence is to:
, A. insert an indwelling Foley catheter.
B. order oxybutynin chloride (Ditropan).
C. encourage fluids to decrease the urine concentration so it is less irritating.
D. recommend herbal approaches to reduce incontinence.
A nursing intervention for a patient with constipation is to:
A. avoid the urge to defecate.
B. limit fluid intake.
C. give prune juice with a noncarbonated drink.
D. encourage bran cereal or whole-grain breads.
A patient with dysphagia is:
A. fed only for pleasure.
B. at low risk for nutritional deficits.
C. at higher risk for pneumonia.
D. able to drink thin liquids.
Age-related eye changes may include:
A. increased visual accommodation.
B. macular degeneration.
C. non-preventable blindness as a result of glaucoma.
D. decreased ability of pupil to respond to light changes.
Nurses' knowledge of sexuality in the older adult population should include:
A. Chronic illness may affect the ability to participate in sexual activity.
B. Sexual response time is unchanged.
C. Ability to achieve orgasm declines.
D. Dryness of the vaginal walls is associated with pelvic inflammatory disease.
What is the initial nursing intervention in preventing polypharmacy?
A. Obtain a thorough medication history.
B. Discontinue all herbal preparations.
C. Refer the patient to a geriatric practitioner.
D. Consult a pharmacist to review all medications.
What should the nurse include in the teaching plan for self-medication practices of older adults?
A. Eliminate unnecessary medications.
B. Substitute herbal preparations for certain prescribed medications.
C. Develop a drug reminder system and schedule.
D. Pharmacy shop for the cheapest medications.
Which age-related changes predispose the elderly patient to drug toxicity and extended duration
of action of drugs? (Select all that apply.)
A. Decreased body water
B. Increased ratio of muscle to fat
C. Low serum albumin
D. Reduced blood flow to liver
Which mental change is associated with aging?
A. Confusion
B. Gradual decline in cognitive skills
C. Depression
