PNR 108/PNR108 Exam 3 V2 | Gerontological Nursing Q&A with Rationale | Fortis
College
1. An older adult patient is diagnosed with orthostatic hypotension. Which intervention
should the nurse prioritize in the plan of care?
A. Instructing the patient to dangle their feet at the bedside for several minutes before
standing.
B. Encouraging the patient to stand up quickly from the bed.
C. Limiting fluid intake to prevent fluid overload.
D. Administering a sedative before physical therapy.
Correct Answer: A
Explanation: Orthostatic hypotension involves a significant drop in blood pressure when
changing positions, which increases the risk for falls. Instructing the patient to dangle their
feet allows the body’s baroreceptors to adjust to the change in posture. This safety measure
is a critical component of gerontological nursing to prevent injury in the clinical setting.
2. When assessing an older adult for signs of congestive heart failure (CHF), which clinical
manifestation is most characteristic in this population?
A. Edema in the lower extremities and crackles in the lungs.
B. Sudden onset of sharp chest pain.
C. Increased appetite and weight loss.
,D. Elevated body temperature above 101 degrees Fahrenheit.
Correct Answer: A
Explanation: Edema and pulmonary crackles indicate fluid volume overload, which is a
hallmark of CHF. In older adults, these symptoms reflect the heart’s inability to pump
effectively against age-related vascular changes. Careful monitoring of daily weights and
lung sounds is essential for early detection of exacerbations.
3. An 80-year-old patient with COPD is experiencing dyspnea. Which position should the
nurse recommend to facilitate breathing?
A. Supine with a single pillow.
B. Prone to improve oxygenation.
C. Left lateral Sims position.
D. Orthopneic position leaning over a bedside table.
Correct Answer: D
Explanation: The orthopneic position allows for maximum chest expansion by utilizing
gravity to lower the diaphragm. This position is particularly beneficial for patients with
COPD who have air trapping and decreased lung compliance. Encouraging this posture can
reduce the work of breathing and improve the patient’s comfort level.
4. The nurse is reviewing the medications of an older adult who takes ten different
prescriptions. What is the primary concern regarding this patient?
A. Improved therapeutic outcomes from synergistic effects.
, B. Decreased cost of healthcare for the patient.
C. Increased risk for adverse drug reactions and polypharmacy.
D. Enhancement of the patient’s cognitive function.
Correct Answer: C
Explanation: Polypharmacy is a significant issue in gerontological nursing that increases
the risk of drug-to-drug interactions. Older adults have altered pharmacokinetics, including
reduced renal and hepatic clearance, which makes them more susceptible to toxicity. The
nurse must regularly review medication lists to identify and eliminate unnecessary or
dangerous combinations.
5. A patient is experiencing stress incontinence. Which non-pharmacological intervention
should the nurse teach the patient?
A. Restricting all fluid intake after 2:00 PM.
B. Performing Kegel exercises regularly.
C. Using an indwelling urinary catheter.
D. Increasing caffeine consumption to stimulate the bladder.
Correct Answer: B
Explanation: Kegel exercises strengthen the pelvic floor muscles, which help support the
bladder and urethra. This intervention is effective for managing stress incontinence, which
College
1. An older adult patient is diagnosed with orthostatic hypotension. Which intervention
should the nurse prioritize in the plan of care?
A. Instructing the patient to dangle their feet at the bedside for several minutes before
standing.
B. Encouraging the patient to stand up quickly from the bed.
C. Limiting fluid intake to prevent fluid overload.
D. Administering a sedative before physical therapy.
Correct Answer: A
Explanation: Orthostatic hypotension involves a significant drop in blood pressure when
changing positions, which increases the risk for falls. Instructing the patient to dangle their
feet allows the body’s baroreceptors to adjust to the change in posture. This safety measure
is a critical component of gerontological nursing to prevent injury in the clinical setting.
2. When assessing an older adult for signs of congestive heart failure (CHF), which clinical
manifestation is most characteristic in this population?
A. Edema in the lower extremities and crackles in the lungs.
B. Sudden onset of sharp chest pain.
C. Increased appetite and weight loss.
,D. Elevated body temperature above 101 degrees Fahrenheit.
Correct Answer: A
Explanation: Edema and pulmonary crackles indicate fluid volume overload, which is a
hallmark of CHF. In older adults, these symptoms reflect the heart’s inability to pump
effectively against age-related vascular changes. Careful monitoring of daily weights and
lung sounds is essential for early detection of exacerbations.
3. An 80-year-old patient with COPD is experiencing dyspnea. Which position should the
nurse recommend to facilitate breathing?
A. Supine with a single pillow.
B. Prone to improve oxygenation.
C. Left lateral Sims position.
D. Orthopneic position leaning over a bedside table.
Correct Answer: D
Explanation: The orthopneic position allows for maximum chest expansion by utilizing
gravity to lower the diaphragm. This position is particularly beneficial for patients with
COPD who have air trapping and decreased lung compliance. Encouraging this posture can
reduce the work of breathing and improve the patient’s comfort level.
4. The nurse is reviewing the medications of an older adult who takes ten different
prescriptions. What is the primary concern regarding this patient?
A. Improved therapeutic outcomes from synergistic effects.
, B. Decreased cost of healthcare for the patient.
C. Increased risk for adverse drug reactions and polypharmacy.
D. Enhancement of the patient’s cognitive function.
Correct Answer: C
Explanation: Polypharmacy is a significant issue in gerontological nursing that increases
the risk of drug-to-drug interactions. Older adults have altered pharmacokinetics, including
reduced renal and hepatic clearance, which makes them more susceptible to toxicity. The
nurse must regularly review medication lists to identify and eliminate unnecessary or
dangerous combinations.
5. A patient is experiencing stress incontinence. Which non-pharmacological intervention
should the nurse teach the patient?
A. Restricting all fluid intake after 2:00 PM.
B. Performing Kegel exercises regularly.
C. Using an indwelling urinary catheter.
D. Increasing caffeine consumption to stimulate the bladder.
Correct Answer: B
Explanation: Kegel exercises strengthen the pelvic floor muscles, which help support the
bladder and urethra. This intervention is effective for managing stress incontinence, which
