PNR 108/PNR108 Exam 2 V2 | Gerontological
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing an older adult client for signs of dehydration. Which finding is the most
reliable indicator of fluid volume deficit in this population?
A. Increased thirst sensation
B. Poor skin turgor on the back of the hand
C. Sunken eyeballs
D. Dry mucous membranes
Correct Answer: D
Explanation: Dry mucous membranes are a more reliable indicator of dehydration in older
adults because skin turgor naturally decreases with age due to loss of elasticity. Thirst
sensation often diminishes in the elderly, making it an unreliable early sign of fluid deficit.
Nurses should also monitor for longitudinal furrows on the tongue and orthostatic
hypotension as part of a comprehensive assessment.
2. An 80-year-old client is admitted with acute confusion and a suspected urinary tract
infection (UTI). Which term best describes this sudden change in mental status?
A. Dementia
B. Depression
C. Delirium
,D. Sundown Syndrome
Correct Answer: C
Explanation: Delirium is characterized by an acute, rapid onset of confusion and is often
reversible once the underlying cause, such as an infection, is treated. Unlike dementia,
which is a progressive and chronic decline, delirium represents a medical emergency in the
geriatric population. Nursing interventions should focus on identifying the physiological
trigger and maintaining patient safety during the episode.
3. Which developmental task, according to Erikson, is the primary focus for the older adult?
A. Generativity vs. Stagnation
B. Identity vs. Role Confusion
C. Trust vs. Mistrust
D. Integrity vs. Despair
Correct Answer: D
Explanation: Erikson defines the final stage of life as Integrity vs. Despair, where
individuals reflect on their lives to achieve a sense of fulfillment. Those who feel they have
lived a productive life achieve ego integrity, while those who regret their past may
experience despair. Nurses can support this process by encouraging life review and
reminiscence therapy.
, 4. When administering medications to an older adult, the nurse follows the ‘start low and go
slow’ rule. What is the primary rationale for this practice?
A. Increased hepatic blood flow
B. Enhanced renal clearance
C. Increased total body water content
D. Age-related changes in metabolism and excretion
Correct Answer: D
Explanation: Aging leads to a decrease in hepatic metabolism and renal excretion, which
increases the risk of drug toxicity. There is also typically an increase in body fat and a
decrease in total body water, affecting the distribution of water-soluble and fat-soluble
drugs. Close monitoring is essential to prevent adverse drug events and polypharmacy
complications.
5. A nurse is teaching a group of older adults about preventing osteoporosis. Which lifestyle
modification should be emphasized?
A. Swimming three times a week
B. Daily weight-bearing exercises
C. Increasing caffeine intake
D. Limiting sun exposure
Correct Answer: B
Nursing Q&A with Rationale | Fortis College
1. A nurse is assessing an older adult client for signs of dehydration. Which finding is the most
reliable indicator of fluid volume deficit in this population?
A. Increased thirst sensation
B. Poor skin turgor on the back of the hand
C. Sunken eyeballs
D. Dry mucous membranes
Correct Answer: D
Explanation: Dry mucous membranes are a more reliable indicator of dehydration in older
adults because skin turgor naturally decreases with age due to loss of elasticity. Thirst
sensation often diminishes in the elderly, making it an unreliable early sign of fluid deficit.
Nurses should also monitor for longitudinal furrows on the tongue and orthostatic
hypotension as part of a comprehensive assessment.
2. An 80-year-old client is admitted with acute confusion and a suspected urinary tract
infection (UTI). Which term best describes this sudden change in mental status?
A. Dementia
B. Depression
C. Delirium
,D. Sundown Syndrome
Correct Answer: C
Explanation: Delirium is characterized by an acute, rapid onset of confusion and is often
reversible once the underlying cause, such as an infection, is treated. Unlike dementia,
which is a progressive and chronic decline, delirium represents a medical emergency in the
geriatric population. Nursing interventions should focus on identifying the physiological
trigger and maintaining patient safety during the episode.
3. Which developmental task, according to Erikson, is the primary focus for the older adult?
A. Generativity vs. Stagnation
B. Identity vs. Role Confusion
C. Trust vs. Mistrust
D. Integrity vs. Despair
Correct Answer: D
Explanation: Erikson defines the final stage of life as Integrity vs. Despair, where
individuals reflect on their lives to achieve a sense of fulfillment. Those who feel they have
lived a productive life achieve ego integrity, while those who regret their past may
experience despair. Nurses can support this process by encouraging life review and
reminiscence therapy.
, 4. When administering medications to an older adult, the nurse follows the ‘start low and go
slow’ rule. What is the primary rationale for this practice?
A. Increased hepatic blood flow
B. Enhanced renal clearance
C. Increased total body water content
D. Age-related changes in metabolism and excretion
Correct Answer: D
Explanation: Aging leads to a decrease in hepatic metabolism and renal excretion, which
increases the risk of drug toxicity. There is also typically an increase in body fat and a
decrease in total body water, affecting the distribution of water-soluble and fat-soluble
drugs. Close monitoring is essential to prevent adverse drug events and polypharmacy
complications.
5. A nurse is teaching a group of older adults about preventing osteoporosis. Which lifestyle
modification should be emphasized?
A. Swimming three times a week
B. Daily weight-bearing exercises
C. Increasing caffeine intake
D. Limiting sun exposure
Correct Answer: B
