ATI RN Leadership Retake Exams 1, 2 & 3 – 2023
Questions with Rationalized Answers!!
Exam 1: Physiological Changes & Common Geriatric Syndromes (25 questions)
1. A nurse is assessing an 80-year-old client. Which finding is an expected age-related
change?
A. Decreased systolic blood pressure
B. Increased cardiac output
C. Thickened left ventricular wall
D. Increased maximum heart rate
Answer: C
Rationale: With aging, the left ventricular wall thickens due to increased afterload. Systolic
BP typically rises, cardiac output decreases, and maximum heart rate declines.
2. An older adult reports feeling full after a few bites of food. The nurse recognizes this as:
A. Anorexia nervosa
B. Early satiety from delayed gastric emptying
C. Normal age-related increase in appetite
D. A sign of liver failure
Answer: B
Rationale: Delayed gastric emptying and reduced motility are common in aging, leading to
early satiety.
3. Which laboratory finding in an 85-year-old patient is most likely age-related rather than
pathological?
A. Creatinine 2.0 mg/dL
B. Hemoglobin 10 g/dL
C. Serum albumin 3.2 g/dL
D. eGFR 55 mL/min/1.73m²
Answer: D
Rationale: GFR declines with age (approx. 1 mL/min/year after 40). Mildly reduced eGFR
(45–60) may be normal in very old adults without other signs of kidney disease.
4. A nurse assesses skin turgor on an older adult’s sternum. The skin remains tented. This
indicates:
,A. Normal aging skin
B. Severe dehydration
C. Malnutrition
D. Overhydration
Answer: B
Rationale: Tenting is a sign of dehydration. Age-related loss of skin elasticity can affect
turgor, but sternal assessment is more reliable; tenting suggests fluid deficit.
5. Which intervention best prevents orthostatic hypotension in an older adult?
A. Encouraging rapid position changes
B. Limiting fluid intake
C. Rising slowly and dangle legs before standing
D. Wearing tight knee-high socks
Answer: C
Rationale: Slow positional changes allow baroreceptors time to adjust, reducing dizziness
and fall risk.
6. An 88-year-old has a new onset of confusion. The nurse’s priority action is to:
A. Reorient the patient to time and place
B. Assess for a urinary tract infection
C. Request a psychiatric consult
D. Administer PRN haloperidol
Answer: B
Rationale: Delirium in older adults is often due to infection (UTI, pneumonia), dehydration,
or medications. Treat underlying cause first.
7. Which symptom is characteristic of sarcopenia?
A. Involuntary weight gain
B. Loss of muscle mass and strength
C. Increased handgrip strength
D. Bone density increase
Answer: B
Rationale: Sarcopenia is age-related loss of skeletal muscle mass and function, leading to
weakness and falls.
8. A nurse teaches an older adult about preventing constipation. Which statement indicates
understanding?
A. “I will take a laxative every day.”
B. “I should drink at least 6–8 glasses of water daily.”
C. “I need to avoid all fiber.”
D. “I will stay in bed to rest my bowels.”
, Answer: B
Rationale: Adequate hydration, fiber, and mobility prevent constipation. Daily laxatives can
cause dependence.
9. An older man reports urinary frequency and nocturia. The most likely age-related cause is:
A. Prostate cancer
B. Benign prostatic hyperplasia
C. Bladder stones
D. Neurogenic bladder
Answer: B
Rationale: BPH is common in aging men, causing obstructive and irritative voiding
symptoms.
10. Which finding indicates possible dehydration in an older adult?
A. Moist mucous membranes
B. Bounding pulse
C. Dry axilla and sunken eyes
D. Jugular vein distension
Answer: C
Rationale: Dry mucous membranes, sunken eyes, and poor skin turgor are signs of
dehydration. Axilla dryness is a sensitive sign in elders.
11. A nurse notes a new tremor in an 82-year-old at rest that improves with movement. This
suggests:
A. Essential tremor
B. Parkinsonian tremor
C. Cerebellar tremor
D. Physiologic tremor
Answer: B
Rationale: Rest tremor that improves with action is classic for Parkinson’s disease. Essential
tremor is worse with movement.
12. To reduce risk of aspiration in an older adult with dysphagia, the nurse should:
A. Thin all liquids
B. Place food on the weaker side of the mouth
C. Tuck chin down when swallowing
D. Rush meals to reduce fatigue
Answer: C
Rationale: Chin-tuck maneuver protects airway. Thickened liquids, slower pace, and placing
food on stronger side are safer.
Questions with Rationalized Answers!!
Exam 1: Physiological Changes & Common Geriatric Syndromes (25 questions)
1. A nurse is assessing an 80-year-old client. Which finding is an expected age-related
change?
A. Decreased systolic blood pressure
B. Increased cardiac output
C. Thickened left ventricular wall
D. Increased maximum heart rate
Answer: C
Rationale: With aging, the left ventricular wall thickens due to increased afterload. Systolic
BP typically rises, cardiac output decreases, and maximum heart rate declines.
2. An older adult reports feeling full after a few bites of food. The nurse recognizes this as:
A. Anorexia nervosa
B. Early satiety from delayed gastric emptying
C. Normal age-related increase in appetite
D. A sign of liver failure
Answer: B
Rationale: Delayed gastric emptying and reduced motility are common in aging, leading to
early satiety.
3. Which laboratory finding in an 85-year-old patient is most likely age-related rather than
pathological?
A. Creatinine 2.0 mg/dL
B. Hemoglobin 10 g/dL
C. Serum albumin 3.2 g/dL
D. eGFR 55 mL/min/1.73m²
Answer: D
Rationale: GFR declines with age (approx. 1 mL/min/year after 40). Mildly reduced eGFR
(45–60) may be normal in very old adults without other signs of kidney disease.
4. A nurse assesses skin turgor on an older adult’s sternum. The skin remains tented. This
indicates:
,A. Normal aging skin
B. Severe dehydration
C. Malnutrition
D. Overhydration
Answer: B
Rationale: Tenting is a sign of dehydration. Age-related loss of skin elasticity can affect
turgor, but sternal assessment is more reliable; tenting suggests fluid deficit.
5. Which intervention best prevents orthostatic hypotension in an older adult?
A. Encouraging rapid position changes
B. Limiting fluid intake
C. Rising slowly and dangle legs before standing
D. Wearing tight knee-high socks
Answer: C
Rationale: Slow positional changes allow baroreceptors time to adjust, reducing dizziness
and fall risk.
6. An 88-year-old has a new onset of confusion. The nurse’s priority action is to:
A. Reorient the patient to time and place
B. Assess for a urinary tract infection
C. Request a psychiatric consult
D. Administer PRN haloperidol
Answer: B
Rationale: Delirium in older adults is often due to infection (UTI, pneumonia), dehydration,
or medications. Treat underlying cause first.
7. Which symptom is characteristic of sarcopenia?
A. Involuntary weight gain
B. Loss of muscle mass and strength
C. Increased handgrip strength
D. Bone density increase
Answer: B
Rationale: Sarcopenia is age-related loss of skeletal muscle mass and function, leading to
weakness and falls.
8. A nurse teaches an older adult about preventing constipation. Which statement indicates
understanding?
A. “I will take a laxative every day.”
B. “I should drink at least 6–8 glasses of water daily.”
C. “I need to avoid all fiber.”
D. “I will stay in bed to rest my bowels.”
, Answer: B
Rationale: Adequate hydration, fiber, and mobility prevent constipation. Daily laxatives can
cause dependence.
9. An older man reports urinary frequency and nocturia. The most likely age-related cause is:
A. Prostate cancer
B. Benign prostatic hyperplasia
C. Bladder stones
D. Neurogenic bladder
Answer: B
Rationale: BPH is common in aging men, causing obstructive and irritative voiding
symptoms.
10. Which finding indicates possible dehydration in an older adult?
A. Moist mucous membranes
B. Bounding pulse
C. Dry axilla and sunken eyes
D. Jugular vein distension
Answer: C
Rationale: Dry mucous membranes, sunken eyes, and poor skin turgor are signs of
dehydration. Axilla dryness is a sensitive sign in elders.
11. A nurse notes a new tremor in an 82-year-old at rest that improves with movement. This
suggests:
A. Essential tremor
B. Parkinsonian tremor
C. Cerebellar tremor
D. Physiologic tremor
Answer: B
Rationale: Rest tremor that improves with action is classic for Parkinson’s disease. Essential
tremor is worse with movement.
12. To reduce risk of aspiration in an older adult with dysphagia, the nurse should:
A. Thin all liquids
B. Place food on the weaker side of the mouth
C. Tuck chin down when swallowing
D. Rush meals to reduce fatigue
Answer: C
Rationale: Chin-tuck maneuver protects airway. Thickened liquids, slower pace, and placing
food on stronger side are safer.
