PNR 108/PNR108 Final Exam V2 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing an older adult client for signs of dehydration. Which physiological
change of aging makes this assessment more challenging?
A. Increased thirst perception
B. Decreased skin turgor and elasticity
C. Increased total body water content
D. Heightened renal concentration ability
Correct Answer: B
Explanation: Decreased skin turgor is a normal finding in the elderly due to the loss of
subcutaneous fat and elastin, making it an unreliable indicator of fluid status. In older
adults, the thirst mechanism is often diminished rather than increased, leading to a higher
risk of dehydration. Therefore, the nurse should assess mucous membranes and urine
output rather than relying solely on skin tenting.
2. When administering medications to an 85-year-old patient, the nurse should be aware that
which pharmacokinetic change is most common in this population?
A. Increased rate of drug metabolism by the liver
B. Increased glomerular filtration rate
C. Decreased ratio of body fat to lean muscle mass
,D. Prolonged half-life of lipid-soluble drugs
Correct Answer: D
Explanation: As a person ages, body fat typically increases while lean muscle mass and
total body water decrease. This causes lipid-soluble drugs to be stored in fatty tissue, which
prolongs their half-life and increases the risk of toxicity. The nurse must monitor for
cumulative effects because the liver and kidneys typically process and excrete these
substances more slowly.
3. An older adult patient is experiencing sudden onset confusion and agitation. Which
condition should the nurse suspect first?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Normal age-related cognitive decline
Correct Answer: C
Explanation: Delirium is characterized by an acute, sudden change in mental status and is
often reversible if the underlying cause, such as a urinary tract infection or medication
reaction, is treated. Unlike dementia, which is a slow and progressive decline, delirium is a
medical emergency requiring immediate assessment. Nurses must identify the baseline
cognitive function to distinguish between chronic and acute changes.
,4. Which of the following is a primary goal of the ‘Beers Criteria’ in gerontological nursing?
A. To reduce the use of potentially inappropriate medications
B. To standardize surgical procedures for older adults
C. To identify patients eligible for hospice care
D. To track the progression of Parkinson’s disease
Correct Answer: A
Explanation: The Beers Criteria provides a list of medications that are generally
considered potentially inappropriate for older adults due to a high risk of adverse effects. It
helps healthcare providers improve medication safety and reduce polypharmacy-related
complications. Following these guidelines helps decrease the incidence of falls, confusion,
and hospitalizations in the geriatric population.
5. A nurse is teaching a group of older adults about vaccines. Which immunization is
specifically recommended annually for this age group?
A. Tetanus-diphtheria (Td)
B. Pneumococcal polysaccharide vaccine (PPSV23)
C. Inactivated Influenza vaccine
D. Herpes zoster vaccine
Correct Answer: C
, Explanation: The influenza vaccine is recommended annually because the virus strains
change every year and the elderly are at high risk for complications like pneumonia. While
the pneumococcal and shingles vaccines are important, they are not administered on an
annual basis. Encouraging annual flu shots is a key health promotion strategy to reduce
morbidity in long-term care settings.
6. The nurse observes a red, non-blanchable area over the sacrum of a bedridden elderly
patient. How should this be documented?
A. Unstageable pressure injury
B. Stage II pressure injury
C. Deep tissue pressure injury
D. Stage I pressure injury
Correct Answer: D
Explanation: A Stage I pressure injury is defined as intact skin with localized non-
blanchable erythema. This indicates that the tissue is under pressure and at risk for further
breakdown if interventions are not implemented. The nurse must immediately implement
a turning schedule and use pressure-relieving devices to prevent the injury from
progressing to Stage II.
7. Which intervention is most effective in preventing falls for an older adult with orthostatic
hypotension?
A. Encouraging the patient to dangle their legs before standing
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing an older adult client for signs of dehydration. Which physiological
change of aging makes this assessment more challenging?
A. Increased thirst perception
B. Decreased skin turgor and elasticity
C. Increased total body water content
D. Heightened renal concentration ability
Correct Answer: B
Explanation: Decreased skin turgor is a normal finding in the elderly due to the loss of
subcutaneous fat and elastin, making it an unreliable indicator of fluid status. In older
adults, the thirst mechanism is often diminished rather than increased, leading to a higher
risk of dehydration. Therefore, the nurse should assess mucous membranes and urine
output rather than relying solely on skin tenting.
2. When administering medications to an 85-year-old patient, the nurse should be aware that
which pharmacokinetic change is most common in this population?
A. Increased rate of drug metabolism by the liver
B. Increased glomerular filtration rate
C. Decreased ratio of body fat to lean muscle mass
,D. Prolonged half-life of lipid-soluble drugs
Correct Answer: D
Explanation: As a person ages, body fat typically increases while lean muscle mass and
total body water decrease. This causes lipid-soluble drugs to be stored in fatty tissue, which
prolongs their half-life and increases the risk of toxicity. The nurse must monitor for
cumulative effects because the liver and kidneys typically process and excrete these
substances more slowly.
3. An older adult patient is experiencing sudden onset confusion and agitation. Which
condition should the nurse suspect first?
A. Alzheimer’s disease
B. Vascular dementia
C. Delirium
D. Normal age-related cognitive decline
Correct Answer: C
Explanation: Delirium is characterized by an acute, sudden change in mental status and is
often reversible if the underlying cause, such as a urinary tract infection or medication
reaction, is treated. Unlike dementia, which is a slow and progressive decline, delirium is a
medical emergency requiring immediate assessment. Nurses must identify the baseline
cognitive function to distinguish between chronic and acute changes.
,4. Which of the following is a primary goal of the ‘Beers Criteria’ in gerontological nursing?
A. To reduce the use of potentially inappropriate medications
B. To standardize surgical procedures for older adults
C. To identify patients eligible for hospice care
D. To track the progression of Parkinson’s disease
Correct Answer: A
Explanation: The Beers Criteria provides a list of medications that are generally
considered potentially inappropriate for older adults due to a high risk of adverse effects. It
helps healthcare providers improve medication safety and reduce polypharmacy-related
complications. Following these guidelines helps decrease the incidence of falls, confusion,
and hospitalizations in the geriatric population.
5. A nurse is teaching a group of older adults about vaccines. Which immunization is
specifically recommended annually for this age group?
A. Tetanus-diphtheria (Td)
B. Pneumococcal polysaccharide vaccine (PPSV23)
C. Inactivated Influenza vaccine
D. Herpes zoster vaccine
Correct Answer: C
, Explanation: The influenza vaccine is recommended annually because the virus strains
change every year and the elderly are at high risk for complications like pneumonia. While
the pneumococcal and shingles vaccines are important, they are not administered on an
annual basis. Encouraging annual flu shots is a key health promotion strategy to reduce
morbidity in long-term care settings.
6. The nurse observes a red, non-blanchable area over the sacrum of a bedridden elderly
patient. How should this be documented?
A. Unstageable pressure injury
B. Stage II pressure injury
C. Deep tissue pressure injury
D. Stage I pressure injury
Correct Answer: D
Explanation: A Stage I pressure injury is defined as intact skin with localized non-
blanchable erythema. This indicates that the tissue is under pressure and at risk for further
breakdown if interventions are not implemented. The nurse must immediately implement
a turning schedule and use pressure-relieving devices to prevent the injury from
progressing to Stage II.
7. Which intervention is most effective in preventing falls for an older adult with orthostatic
hypotension?
A. Encouraging the patient to dangle their legs before standing
