PNR 108/PNR108 Exam 3 V3 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. A nurse is caring for an older adult client who is experiencing a sudden onset of confusion
and agitation. Which of the following conditions should the nurse suspect first?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Normal aging process
Correct Answer: C
Explanation: Delirium is characterized by an acute, sudden change in mental status and
consciousness. In older adults, this is often a medical emergency triggered by infection,
dehydration, or medication toxicity. Unlike dementia, which is progressive and slow,
delirium is frequently reversible when the underlying cause is addressed.
2. When assessing an older adult for signs of depression, which symptom should the nurse
prioritize as a common manifestation in this population?
A. Hyperactivity and increased appetite
B. Consistent verbalization of feelings of sadness
C. Physical complaints such as fatigue or chronic pain
D. Improved short-term memory recall
,Correct Answer: C
Explanation: Older adults often present with somatic symptoms rather than expressing
emotional sadness when experiencing depression. These physical complaints can include
unexplained fatigue, sleep disturbances, or persistent gastrointestinal issues. Nurses must
look beyond verbal reports of mood to identify underlying mental health concerns in
geriatric patients.
3. An older adult client is prescribed a new antihypertensive medication. Which age-related
physiological change increases the risk of adverse drug effects?
A. Decreased hepatic blood flow and glomerular filtration rate
B. Increased total body water
C. Increased muscle mass
D. Rapid gastric emptying
Correct Answer: A
Explanation: Aging leads to a decrease in liver and kidney function, which reduces the
body’s ability to metabolize and excrete medications. This physiological decline results in
drugs staying in the system longer, increasing the risk for toxicity. Dosage adjustments are
often necessary to ensure safety in the elderly population.
4. A nurse is teaching a group of nursing students about age-related changes in the
integumentary system. Which finding should the nurse include?
A. Increased subcutaneous fat over bony prominences
, B. Faster rate of epidermal cell turnover
C. Increased production of sebum and sweat
D. Decreased thickness of the dermis and loss of elasticity
Correct Answer: D
Explanation: The thinning of the dermis and loss of elastin are primary hallmarks of aging
skin. These changes lead to increased skin fragility and a higher susceptibility to pressure
ulcers and shearing injuries. The nursing care plan should focus on gentle handling and
frequent repositioning to maintain skin integrity.
5. Which intervention is most appropriate for a nurse to implement when caring for an older
client with presbycusis?
A. Facing the client and speaking clearly in a low-toned voice
B. Speaking in a high-pitched voice
C. Shouting directly into the client’s ear
D. Using complex sentences to provide more context
Correct Answer: A
Explanation: Presbycusis involves the loss of ability to hear high-frequency sounds,
making it difficult to understand speech. Speaking in a lower tone and ensuring the client
can see the speaker’s face facilitates better communication. Nurses should also minimize
background noise to prevent auditory distraction.
Nursing Q&A with Rationale | Fortis College
1. A nurse is caring for an older adult client who is experiencing a sudden onset of confusion
and agitation. Which of the following conditions should the nurse suspect first?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Normal aging process
Correct Answer: C
Explanation: Delirium is characterized by an acute, sudden change in mental status and
consciousness. In older adults, this is often a medical emergency triggered by infection,
dehydration, or medication toxicity. Unlike dementia, which is progressive and slow,
delirium is frequently reversible when the underlying cause is addressed.
2. When assessing an older adult for signs of depression, which symptom should the nurse
prioritize as a common manifestation in this population?
A. Hyperactivity and increased appetite
B. Consistent verbalization of feelings of sadness
C. Physical complaints such as fatigue or chronic pain
D. Improved short-term memory recall
,Correct Answer: C
Explanation: Older adults often present with somatic symptoms rather than expressing
emotional sadness when experiencing depression. These physical complaints can include
unexplained fatigue, sleep disturbances, or persistent gastrointestinal issues. Nurses must
look beyond verbal reports of mood to identify underlying mental health concerns in
geriatric patients.
3. An older adult client is prescribed a new antihypertensive medication. Which age-related
physiological change increases the risk of adverse drug effects?
A. Decreased hepatic blood flow and glomerular filtration rate
B. Increased total body water
C. Increased muscle mass
D. Rapid gastric emptying
Correct Answer: A
Explanation: Aging leads to a decrease in liver and kidney function, which reduces the
body’s ability to metabolize and excrete medications. This physiological decline results in
drugs staying in the system longer, increasing the risk for toxicity. Dosage adjustments are
often necessary to ensure safety in the elderly population.
4. A nurse is teaching a group of nursing students about age-related changes in the
integumentary system. Which finding should the nurse include?
A. Increased subcutaneous fat over bony prominences
, B. Faster rate of epidermal cell turnover
C. Increased production of sebum and sweat
D. Decreased thickness of the dermis and loss of elasticity
Correct Answer: D
Explanation: The thinning of the dermis and loss of elastin are primary hallmarks of aging
skin. These changes lead to increased skin fragility and a higher susceptibility to pressure
ulcers and shearing injuries. The nursing care plan should focus on gentle handling and
frequent repositioning to maintain skin integrity.
5. Which intervention is most appropriate for a nurse to implement when caring for an older
client with presbycusis?
A. Facing the client and speaking clearly in a low-toned voice
B. Speaking in a high-pitched voice
C. Shouting directly into the client’s ear
D. Using complex sentences to provide more context
Correct Answer: A
Explanation: Presbycusis involves the loss of ability to hear high-frequency sounds,
making it difficult to understand speech. Speaking in a lower tone and ensuring the client
can see the speaker’s face facilitates better communication. Nurses should also minimize
background noise to prevent auditory distraction.
