TEST BANK FOR GERONTOLOGICAL NURSING
(PATRICIA A. TABLOSKI, 4TH ED.) | QUESTIONS
AND ANSWERS WITH RATIONALES
,Gerontological Nursing (Patricia A. Tabloski, 4th ed.) — NCLEX-style Test
Bank
Instructions:
60 multiple-choice questions
QUESTIONS
1
An 82-year-old man with a history of benign prostatic hyperplasia (BPH) reports
urinary hesitancy and nocturia. Which change in the aging urinary system best
explains his symptoms?
A. Decreased bladder capacity and decreased elastic recoil of bladder.
B. Loss of nephrons leading to polyuria.
C. Increased glomerular filtration rate (GFR) causing concentrated urine.
D. Increased detrusor muscle strength leading to urinary urgency.
Answer: A
Rationale: Aging causes decreased bladder capacity and reduced elastic recoil of
the bladder wall, which contributes to urinary frequency, nocturia, and hesitancy.
Loss of nephrons reduces kidney reserve but leads to decreased urine concentrating
ability rather than polyuria. GFR decreases with age, not increases. Detrusor
muscle strength typically decreases, not increases.
,2
A 78-year-old woman with osteoarthritis has difficulty rising from a chair and
reports pain with ambulation. Which nursing intervention best promotes safe
mobility?
A. Encourage bed rest until pain resolves.
B. Advise complete discontinuation of all analgesics to assess baseline pain.
C. Teach use of a walker adjusted to her wrist level and encourage regular, graded
activity.
D. Recommend only cane use without instruction.
Answer: C
Rationale: Proper mobility aids (e.g., walker adjusted to wrist level) and graded
activity promote function and reduce fall risk. Bed rest worsens deconditioning.
Discontinuing analgesics without cause is inappropriate. A cane may be
appropriate but must be selected and fitted; recommending one without instruction
risks falls.
3
A nurse is assessing cognitive status in an older adult. The Mini-Mental State
Examination (MMSE) shows mild impairment. Which statement best differentiates
delirium from dementia?
A. Delirium develops slowly over months; dementia is acute.
B. Delirium usually has a fluctuating course with altered attention; dementia has a
gradual onset and relatively preserved attention until later stages.
, C. Dementia always causes hallucinations; delirium never does.
D. Both delirium and dementia have identical presentations and cannot be
differentiated clinically.
Answer: B
Rationale: Delirium is typically acute, fluctuating, and marked by impaired
attention and awareness; dementia develops gradually with progressive cognitive
decline and attention is often relatively preserved early. Hallucinations can occur
in both. They are clinically differentiable.
4
Which statement about pharmacokinetic changes in older adults is true and most
important when dosing medications?
A. Older adults always have increased hepatic metabolism, reducing drug levels.
B. Age-related decrease in renal function may necessitate dose reduction or
increased dosing intervals for renally excreted drugs.
C. Volume of distribution for water-soluble drugs increases, decreasing half-life.
D. Protein binding increases in older adults due to higher albumin levels.
Answer: B
Rationale: Renal function commonly declines with age; drugs eliminated by
kidneys may accumulate and require dose adjustment. Hepatic metabolism often
decreases, not increases. Volume of distribution for water-soluble drugs often
decreases (less total body water), potentially increasing concentrations. Albumin
levels often decrease, reducing protein binding for some drugs.
(PATRICIA A. TABLOSKI, 4TH ED.) | QUESTIONS
AND ANSWERS WITH RATIONALES
,Gerontological Nursing (Patricia A. Tabloski, 4th ed.) — NCLEX-style Test
Bank
Instructions:
60 multiple-choice questions
QUESTIONS
1
An 82-year-old man with a history of benign prostatic hyperplasia (BPH) reports
urinary hesitancy and nocturia. Which change in the aging urinary system best
explains his symptoms?
A. Decreased bladder capacity and decreased elastic recoil of bladder.
B. Loss of nephrons leading to polyuria.
C. Increased glomerular filtration rate (GFR) causing concentrated urine.
D. Increased detrusor muscle strength leading to urinary urgency.
Answer: A
Rationale: Aging causes decreased bladder capacity and reduced elastic recoil of
the bladder wall, which contributes to urinary frequency, nocturia, and hesitancy.
Loss of nephrons reduces kidney reserve but leads to decreased urine concentrating
ability rather than polyuria. GFR decreases with age, not increases. Detrusor
muscle strength typically decreases, not increases.
,2
A 78-year-old woman with osteoarthritis has difficulty rising from a chair and
reports pain with ambulation. Which nursing intervention best promotes safe
mobility?
A. Encourage bed rest until pain resolves.
B. Advise complete discontinuation of all analgesics to assess baseline pain.
C. Teach use of a walker adjusted to her wrist level and encourage regular, graded
activity.
D. Recommend only cane use without instruction.
Answer: C
Rationale: Proper mobility aids (e.g., walker adjusted to wrist level) and graded
activity promote function and reduce fall risk. Bed rest worsens deconditioning.
Discontinuing analgesics without cause is inappropriate. A cane may be
appropriate but must be selected and fitted; recommending one without instruction
risks falls.
3
A nurse is assessing cognitive status in an older adult. The Mini-Mental State
Examination (MMSE) shows mild impairment. Which statement best differentiates
delirium from dementia?
A. Delirium develops slowly over months; dementia is acute.
B. Delirium usually has a fluctuating course with altered attention; dementia has a
gradual onset and relatively preserved attention until later stages.
, C. Dementia always causes hallucinations; delirium never does.
D. Both delirium and dementia have identical presentations and cannot be
differentiated clinically.
Answer: B
Rationale: Delirium is typically acute, fluctuating, and marked by impaired
attention and awareness; dementia develops gradually with progressive cognitive
decline and attention is often relatively preserved early. Hallucinations can occur
in both. They are clinically differentiable.
4
Which statement about pharmacokinetic changes in older adults is true and most
important when dosing medications?
A. Older adults always have increased hepatic metabolism, reducing drug levels.
B. Age-related decrease in renal function may necessitate dose reduction or
increased dosing intervals for renally excreted drugs.
C. Volume of distribution for water-soluble drugs increases, decreasing half-life.
D. Protein binding increases in older adults due to higher albumin levels.
Answer: B
Rationale: Renal function commonly declines with age; drugs eliminated by
kidneys may accumulate and require dose adjustment. Hepatic metabolism often
decreases, not increases. Volume of distribution for water-soluble drugs often
decreases (less total body water), potentially increasing concentrations. Albumin
levels often decrease, reducing protein binding for some drugs.
