NU176 | NU 176 Geriatric Nursing Exam 2 v1 |
Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is assessing an older adult patient who shows signs of acute confusion and a
fluctuating level of consciousness. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depression
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute onset and fluctuating
levels of consciousness, often triggered by an underlying medical issue like
infection. In contrast, dementia is a slow, progressive decline that does not typically
include a fluctuating level of consciousness. The nurse must identify and treat the
root cause of delirium to prevent permanent cognitive damage or death.
2. According to the Beers Criteria, which medication should be avoided in the elderly
due to the risk of confusion, falls, and sedation?
A. Diphenhydramine
B. Acetaminophen
,C. Lisinopril
D. Metformin
Correct Answer: A
Expert Explanation: Diphenhydramine is a first-generation antihistamine with
strong anticholinergic properties that significantly increase the risk of falls and
delirium in older adults. The Beers Criteria list this drug as potentially inappropriate
for seniors because safer alternatives for sleep or allergies are available. Nursing
care should focus on educating the patient about non-pharmacological sleep aids to
avoid these risks.
3. An elderly patient reports leaking urine whenever they cough, sneeze, or lift heavy
objects. Which type of incontinence is the patient experiencing?
A. Urge Incontinence
B. Overflow Incontinence
C. Functional Incontinence
D. Stress Incontinence
Correct Answer: D
Expert Explanation: Stress incontinence occurs when physical movement or
activity puts pressure on the bladder, causing leakage. It is commonly caused by
,weakened pelvic floor muscles, which can be strengthened through Kegel exercises.
Distinguishing between types of incontinence is essential for developing an
effective, non-invasive treatment plan for the elderly.
4. Which assessment finding is a hallmark sign of physical elder abuse that requires
mandatory reporting?
A. Presence of skin tears on the forearms
B. Dry mucous membranes and poor skin turgor
C. Multiple bruises in various stages of healing on the trunk
D. A single stage 1 pressure ulcer on the coccyx
Correct Answer: C
Expert Explanation: Bruises on the trunk or upper arms in various stages of
healing are highly suggestive of repeated physical abuse rather than accidental falls.
Skin tears are common in the elderly due to fragile skin and are not necessarily
indicative of abuse. Nurses are mandated reporters and must follow facility protocol
to report any suspicion of neglect or physical harm to protective services.
5. What is the primary goal of palliative care for a patient with a terminal illness?
A. To cure the underlying disease process
B. To provide 24-hour skilled nursing in a facility
, C. To hasten the dying process through sedation
D. To improve quality of life and manage symptoms
Correct Answer: D
Expert Explanation: Palliative care focuses on symptom management and
psychological support to enhance the quality of life for patients with serious
illnesses. It can be provided at any stage of a disease, unlike hospice, which is
specifically for those with a prognosis of six months or less. This holistic approach
involves an interdisciplinary team to address the physical, emotional, and spiritual
needs of the patient.
6. An older adult is diagnosed with Vitamin B12 deficiency. What age-related change
most likely contributes to this condition?
A. Increased gastric motility
B. Reduced surface area of the colon
C. Increased acidity of the stomach
D. Decreased production of intrinsic factor
Correct Answer: D
Expert Explanation: Age-related atrophic gastritis leads to a decrease in intrinsic
factor, which is necessary for the absorption of Vitamin B12 in the small intestine.
Questions with Correct Answers and Expert
Explanation for Each Question | Galen
1. A nurse is assessing an older adult patient who shows signs of acute confusion and a
fluctuating level of consciousness. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depression
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute onset and fluctuating
levels of consciousness, often triggered by an underlying medical issue like
infection. In contrast, dementia is a slow, progressive decline that does not typically
include a fluctuating level of consciousness. The nurse must identify and treat the
root cause of delirium to prevent permanent cognitive damage or death.
2. According to the Beers Criteria, which medication should be avoided in the elderly
due to the risk of confusion, falls, and sedation?
A. Diphenhydramine
B. Acetaminophen
,C. Lisinopril
D. Metformin
Correct Answer: A
Expert Explanation: Diphenhydramine is a first-generation antihistamine with
strong anticholinergic properties that significantly increase the risk of falls and
delirium in older adults. The Beers Criteria list this drug as potentially inappropriate
for seniors because safer alternatives for sleep or allergies are available. Nursing
care should focus on educating the patient about non-pharmacological sleep aids to
avoid these risks.
3. An elderly patient reports leaking urine whenever they cough, sneeze, or lift heavy
objects. Which type of incontinence is the patient experiencing?
A. Urge Incontinence
B. Overflow Incontinence
C. Functional Incontinence
D. Stress Incontinence
Correct Answer: D
Expert Explanation: Stress incontinence occurs when physical movement or
activity puts pressure on the bladder, causing leakage. It is commonly caused by
,weakened pelvic floor muscles, which can be strengthened through Kegel exercises.
Distinguishing between types of incontinence is essential for developing an
effective, non-invasive treatment plan for the elderly.
4. Which assessment finding is a hallmark sign of physical elder abuse that requires
mandatory reporting?
A. Presence of skin tears on the forearms
B. Dry mucous membranes and poor skin turgor
C. Multiple bruises in various stages of healing on the trunk
D. A single stage 1 pressure ulcer on the coccyx
Correct Answer: C
Expert Explanation: Bruises on the trunk or upper arms in various stages of
healing are highly suggestive of repeated physical abuse rather than accidental falls.
Skin tears are common in the elderly due to fragile skin and are not necessarily
indicative of abuse. Nurses are mandated reporters and must follow facility protocol
to report any suspicion of neglect or physical harm to protective services.
5. What is the primary goal of palliative care for a patient with a terminal illness?
A. To cure the underlying disease process
B. To provide 24-hour skilled nursing in a facility
, C. To hasten the dying process through sedation
D. To improve quality of life and manage symptoms
Correct Answer: D
Expert Explanation: Palliative care focuses on symptom management and
psychological support to enhance the quality of life for patients with serious
illnesses. It can be provided at any stage of a disease, unlike hospice, which is
specifically for those with a prognosis of six months or less. This holistic approach
involves an interdisciplinary team to address the physical, emotional, and spiritual
needs of the patient.
6. An older adult is diagnosed with Vitamin B12 deficiency. What age-related change
most likely contributes to this condition?
A. Increased gastric motility
B. Reduced surface area of the colon
C. Increased acidity of the stomach
D. Decreased production of intrinsic factor
Correct Answer: D
Expert Explanation: Age-related atrophic gastritis leads to a decrease in intrinsic
factor, which is necessary for the absorption of Vitamin B12 in the small intestine.
