NU176 | NU 176 Geriatric Nursing Midterm v3 |
Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. Which physiological change of aging is considered a normal part of the
integumentary system’s decline?
A. Increased subcutaneous fat distribution
B. Increased sebum production
C. Decreased skin elasticity and thinning of the dermis
D. Faster rate of epidermal cell replacement
Correct Answer: C
Expert Explanation: As the body ages, the skin naturally loses collagen and elastin,
which leads to reduced elasticity and a thinner appearance. This makes the older
adult more susceptible to skin tears, pressure ulcers, and bruising. Nurses should
prioritize gentle handling and frequent skin assessments for this population.
2. When assessing an older adult for delirium, which characteristic most clearly
distinguishes it from dementia?
A. A slow, progressive decline in memory
B. Irreversible damage to the brain tissue
C. An acute and sudden onset of confusion
,D. Intact level of consciousness throughout the day
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid change in mental status
that occurs over hours or days, whereas dementia is typically a slow, chronic
progression. Delirium is often caused by an underlying medical condition, such as an
infection or medication toxicity, and is potentially reversible. It is critical for nurses
to identify the root cause of delirium immediately to prevent further complications.
3. According to the Beers Criteria, which medication class should be used with
extreme caution in older adults due to the risk of falls and confusion?
A. Anticholinergics
B. ACE inhibitors
C. Statins
D. Stool softeners
Correct Answer: A
Expert Explanation: Anticholinergic medications can cause side effects such as
blurred vision, urinary retention, and cognitive impairment in older adults. These
effects significantly increase the risk of falls and delirium in the geriatric population.
The Beers Criteria serves as a guide for clinicians to avoid potentially inappropriate
medications for older patients.
,4. An older adult is diagnosed with presbycusis. What is the primary characteristic of
this condition?
A. Loss of low-frequency sound perception
B. Total deafness in one ear
C. Continuous ringing in the ears
D. Inability to hear high-pitched sounds
Correct Answer: D
Expert Explanation: Presbycusis is a type of sensorineural hearing loss that
commonly occurs with aging, specifically affecting the ability to hear high-frequency
sounds. Patients often have difficulty understanding speech, especially in noisy
environments or when talking to people with higher-pitched voices. Nurses should
speak clearly and face the patient directly to improve communication.
5. Which of the following is classified as an Instrumental Activity of Daily Living (IADL)?
A. Managing finances
B. Bathing
C. Dressing
D. Toileting
Correct Answer: A
, Expert Explanation: IADLs involve more complex tasks that are necessary for
independent living within a community, such as managing money, shopping, and
preparing meals. In contrast, basic ADLs refer to fundamental self-care tasks like
eating, bathing, and dressing. Assessing IADLs helps determine if an older adult
requires assistance with household management or transition to an assisted living
facility.
6. What is the most common atypical presentation of an infection, such as a UTI, in an
older adult?
A. High-grade fever
B. Severe leukocytosis
C. Intense localized pain
D. Acute confusion or altered mental status
Correct Answer: D
Expert Explanation: Older adults often do not exhibit typical signs of infection like
a high fever because of a blunted immune response. Instead, they frequently present
with ‘atypical’ symptoms such as sudden confusion, lethargy, or falls. Nurses must
monitor for subtle changes in behavior as these may be the first indicators of a
serious underlying illness.
Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. Which physiological change of aging is considered a normal part of the
integumentary system’s decline?
A. Increased subcutaneous fat distribution
B. Increased sebum production
C. Decreased skin elasticity and thinning of the dermis
D. Faster rate of epidermal cell replacement
Correct Answer: C
Expert Explanation: As the body ages, the skin naturally loses collagen and elastin,
which leads to reduced elasticity and a thinner appearance. This makes the older
adult more susceptible to skin tears, pressure ulcers, and bruising. Nurses should
prioritize gentle handling and frequent skin assessments for this population.
2. When assessing an older adult for delirium, which characteristic most clearly
distinguishes it from dementia?
A. A slow, progressive decline in memory
B. Irreversible damage to the brain tissue
C. An acute and sudden onset of confusion
,D. Intact level of consciousness throughout the day
Correct Answer: C
Expert Explanation: Delirium is characterized by a rapid change in mental status
that occurs over hours or days, whereas dementia is typically a slow, chronic
progression. Delirium is often caused by an underlying medical condition, such as an
infection or medication toxicity, and is potentially reversible. It is critical for nurses
to identify the root cause of delirium immediately to prevent further complications.
3. According to the Beers Criteria, which medication class should be used with
extreme caution in older adults due to the risk of falls and confusion?
A. Anticholinergics
B. ACE inhibitors
C. Statins
D. Stool softeners
Correct Answer: A
Expert Explanation: Anticholinergic medications can cause side effects such as
blurred vision, urinary retention, and cognitive impairment in older adults. These
effects significantly increase the risk of falls and delirium in the geriatric population.
The Beers Criteria serves as a guide for clinicians to avoid potentially inappropriate
medications for older patients.
,4. An older adult is diagnosed with presbycusis. What is the primary characteristic of
this condition?
A. Loss of low-frequency sound perception
B. Total deafness in one ear
C. Continuous ringing in the ears
D. Inability to hear high-pitched sounds
Correct Answer: D
Expert Explanation: Presbycusis is a type of sensorineural hearing loss that
commonly occurs with aging, specifically affecting the ability to hear high-frequency
sounds. Patients often have difficulty understanding speech, especially in noisy
environments or when talking to people with higher-pitched voices. Nurses should
speak clearly and face the patient directly to improve communication.
5. Which of the following is classified as an Instrumental Activity of Daily Living (IADL)?
A. Managing finances
B. Bathing
C. Dressing
D. Toileting
Correct Answer: A
, Expert Explanation: IADLs involve more complex tasks that are necessary for
independent living within a community, such as managing money, shopping, and
preparing meals. In contrast, basic ADLs refer to fundamental self-care tasks like
eating, bathing, and dressing. Assessing IADLs helps determine if an older adult
requires assistance with household management or transition to an assisted living
facility.
6. What is the most common atypical presentation of an infection, such as a UTI, in an
older adult?
A. High-grade fever
B. Severe leukocytosis
C. Intense localized pain
D. Acute confusion or altered mental status
Correct Answer: D
Expert Explanation: Older adults often do not exhibit typical signs of infection like
a high fever because of a blunted immune response. Instead, they frequently present
with ‘atypical’ symptoms such as sudden confusion, lethargy, or falls. Nurses must
monitor for subtle changes in behavior as these may be the first indicators of a
serious underlying illness.
