MARYVILLE UNIVERSITY NUR 323 – GERONTOLOGY
NURSING FINAL EXAM 4|QUESTIONS AND VERIFIED
ANSWERS|GRADED A+|2026 UPDATE
1. An 82-year-old patient with heart failure reports increasing shortness of breath while
walking to the bathroom. Which is the most appropriate nursing action?
A. Assess for edema, auscultate lungs, and notify the provider
B. Encourage more physical activity
C. Restrict all fluids immediately
D. Provide high-sodium snacks
Answer: A
Rationale: Early recognition of fluid overload and pulmonary congestion prevents
decompensation.
2. A patient with mild dementia becomes agitated in the late afternoon (“sundowning”).
What is the best nursing intervention?
A. Provide a calm environment with adequate lighting and familiar routines
B. Restrict fluids to prevent nighttime awakening
C. Leave the patient alone in a dim room
D. Ignore agitation as normal aging
Answer: A
Rationale: Sundowning is common; environmental modifications reduce agitation and
confusion.
3. An older adult presents with new-onset confusion, no fever, and mild urinary
symptoms. Which is the priority assessment?
A. Evaluate for urinary tract infection
B. Check blood pressure only
C. Assess skin turgor
D. Check blood glucose
Answer: A
Rationale: Older adults often present atypically; confusion may be the first sign of
infection.
4. A patient with COPD uses accessory muscles to breathe and has low oxygen
saturation. Which intervention is most appropriate?
A. Administer supplemental oxygen as prescribed and position upright
B. Encourage lying flat
, C. Limit oxygen to prevent dependence
D. Apply tight chest binding
Answer: A
Rationale: Upright positioning and oxygen improve ventilation and oxygenation.
5. Which nursing action best reduces fall risk for an older adult with poor vision and
unsteady gait?
A. Ensure clear pathways, adequate lighting, and use of assistive devices
B. Encourage walking without support
C. Keep the patient in bed
D. Reduce lighting to calm the environment
Answer: A
Rationale: Environmental safety and assistive devices prevent falls.
6. A patient takes multiple medications and reports dizziness and occasional confusion.
Which is the most appropriate nursing action?
A. Perform a medication review and notify the provider of possible interactions
B. Advise patient to stop all medications
C. Ignore the symptoms
D. Increase fluid restriction
Answer: A
Rationale: Polypharmacy increases risk of adverse effects; review is essential.
7. An 85-year-old patient reports difficulty swallowing and coughing during meals. What
is the best nursing intervention?
A. Provide small, thickened meals and maintain upright positioning during feeding
B. Encourage large meals to avoid malnutrition
C. Feed in supine position
D. Restrict all oral intake
Answer: A
Rationale: Upright position and texture modification reduce aspiration risk.
8. Which statement reflects a normal cardiovascular change with aging?
A. Increased systolic blood pressure due to arterial stiffness
B. Decreased arterial stiffness
C. Bradycardia at rest is universal
D. Increased cardiac output at rest
Answer: A
Rationale: Aging arteries lose elasticity, raising systolic pressure.
, 9. Which intervention promotes independence in ADLs for an older adult recovering from
hip surgery?
A. Encourage self-care as tolerated with assistance as needed
B. Perform all tasks for the patient
C. Restrict activity to prevent falls
D. Avoid adaptive equipment
Answer: A
Rationale: Supporting independence maintains function and self-esteem.
10. An older adult has albumin 2.8 g/dL. Which is the best interpretation?
A. Patient may have malnutrition or protein deficiency
B. Normal nutritional status
C. High protein intake
D. Indicates dehydration only
Answer: A
Rationale: Low albumin reflects poor protein nutrition and possible chronic illness.
11. A patient demonstrates confusion, slurred speech, and lethargy. Labs show sodium
125 mEq/L. Which nursing action is most important?
A. Monitor neurological status and notify provider for hyponatremia management
B. Encourage high-sodium snacks immediately
C. Restrict all fluids
D. No action needed
Answer: A
Rationale: Hyponatremia can cause neurological changes; prompt assessment and
treatment are critical.
12. Which intervention is most effective in preventing pressure ulcers?
A. Reposition every 2 hours, maintain skin hygiene, and use support surfaces
B. Massage reddened areas
C. Apply heating pads to bony prominences
D. Restrict fluid intake
Answer: A
Rationale: Relieving pressure and maintaining skin integrity prevents ulcers.
13. Which lab is most reliable for monitoring long-term glycemic control?
A. Hemoglobin A1c
B. Fasting glucose
C. Creatinine
D. Albumin
NURSING FINAL EXAM 4|QUESTIONS AND VERIFIED
ANSWERS|GRADED A+|2026 UPDATE
1. An 82-year-old patient with heart failure reports increasing shortness of breath while
walking to the bathroom. Which is the most appropriate nursing action?
A. Assess for edema, auscultate lungs, and notify the provider
B. Encourage more physical activity
C. Restrict all fluids immediately
D. Provide high-sodium snacks
Answer: A
Rationale: Early recognition of fluid overload and pulmonary congestion prevents
decompensation.
2. A patient with mild dementia becomes agitated in the late afternoon (“sundowning”).
What is the best nursing intervention?
A. Provide a calm environment with adequate lighting and familiar routines
B. Restrict fluids to prevent nighttime awakening
C. Leave the patient alone in a dim room
D. Ignore agitation as normal aging
Answer: A
Rationale: Sundowning is common; environmental modifications reduce agitation and
confusion.
3. An older adult presents with new-onset confusion, no fever, and mild urinary
symptoms. Which is the priority assessment?
A. Evaluate for urinary tract infection
B. Check blood pressure only
C. Assess skin turgor
D. Check blood glucose
Answer: A
Rationale: Older adults often present atypically; confusion may be the first sign of
infection.
4. A patient with COPD uses accessory muscles to breathe and has low oxygen
saturation. Which intervention is most appropriate?
A. Administer supplemental oxygen as prescribed and position upright
B. Encourage lying flat
, C. Limit oxygen to prevent dependence
D. Apply tight chest binding
Answer: A
Rationale: Upright positioning and oxygen improve ventilation and oxygenation.
5. Which nursing action best reduces fall risk for an older adult with poor vision and
unsteady gait?
A. Ensure clear pathways, adequate lighting, and use of assistive devices
B. Encourage walking without support
C. Keep the patient in bed
D. Reduce lighting to calm the environment
Answer: A
Rationale: Environmental safety and assistive devices prevent falls.
6. A patient takes multiple medications and reports dizziness and occasional confusion.
Which is the most appropriate nursing action?
A. Perform a medication review and notify the provider of possible interactions
B. Advise patient to stop all medications
C. Ignore the symptoms
D. Increase fluid restriction
Answer: A
Rationale: Polypharmacy increases risk of adverse effects; review is essential.
7. An 85-year-old patient reports difficulty swallowing and coughing during meals. What
is the best nursing intervention?
A. Provide small, thickened meals and maintain upright positioning during feeding
B. Encourage large meals to avoid malnutrition
C. Feed in supine position
D. Restrict all oral intake
Answer: A
Rationale: Upright position and texture modification reduce aspiration risk.
8. Which statement reflects a normal cardiovascular change with aging?
A. Increased systolic blood pressure due to arterial stiffness
B. Decreased arterial stiffness
C. Bradycardia at rest is universal
D. Increased cardiac output at rest
Answer: A
Rationale: Aging arteries lose elasticity, raising systolic pressure.
, 9. Which intervention promotes independence in ADLs for an older adult recovering from
hip surgery?
A. Encourage self-care as tolerated with assistance as needed
B. Perform all tasks for the patient
C. Restrict activity to prevent falls
D. Avoid adaptive equipment
Answer: A
Rationale: Supporting independence maintains function and self-esteem.
10. An older adult has albumin 2.8 g/dL. Which is the best interpretation?
A. Patient may have malnutrition or protein deficiency
B. Normal nutritional status
C. High protein intake
D. Indicates dehydration only
Answer: A
Rationale: Low albumin reflects poor protein nutrition and possible chronic illness.
11. A patient demonstrates confusion, slurred speech, and lethargy. Labs show sodium
125 mEq/L. Which nursing action is most important?
A. Monitor neurological status and notify provider for hyponatremia management
B. Encourage high-sodium snacks immediately
C. Restrict all fluids
D. No action needed
Answer: A
Rationale: Hyponatremia can cause neurological changes; prompt assessment and
treatment are critical.
12. Which intervention is most effective in preventing pressure ulcers?
A. Reposition every 2 hours, maintain skin hygiene, and use support surfaces
B. Massage reddened areas
C. Apply heating pads to bony prominences
D. Restrict fluid intake
Answer: A
Rationale: Relieving pressure and maintaining skin integrity prevents ulcers.
13. Which lab is most reliable for monitoring long-term glycemic control?
A. Hemoglobin A1c
B. Fasting glucose
C. Creatinine
D. Albumin
