VATI GREENLIGHT GERONTOLOGY & OLDER ADULT
NURSING EXAM (PN) QUESTIONS WITH 100%
CORRECT ANSWERS AND DETAILED RATIONALE
1. A nurse is caring for an 80-year-old client who has a new diagnosis of
pneumonia. Which of the following atypical findings is common in older adults
with pneumonia?
Confusion and lethargy without fever
High fever and productive cough
Chest pain and hemoptysis
Tachycardia and tachypnea only
Correct Answer: Confusion and lethargy without fever
Rationale: Older adults often present with atypical signs of infection such as
confusion, lethargy, or falls, rather than fever and cough. This is called atypical
presentation of illness.
2. A nurse is reinforcing teaching with an older adult client about fall prevention
in the home. Which of the following instructions should the nurse include?
Remove throw rugs from the floor
Use a step stool to reach high shelves
Wear smooth-soled socks when walking indoors
Keep the home dimly lit to reduce glare
Correct Answer: Remove throw rugs from the floor
,Rationale: Throw rugs are a common fall hazard. The home should have good
lighting, non-slip flooring, and grab bars. Smooth-soled socks increase fall risk.
3. A nurse is collecting data from an older adult client who is taking multiple
medications. Which of the following findings should indicate to the nurse that
the client may be experiencing polypharmacy-related complications?
Dizziness, confusion, and falls
Weight gain and increased appetite
Improved memory and energy
Decreased blood pressure only
Correct Answer: Dizziness, confusion, and falls
Rationale: Polypharmacy (taking multiple medications) increases the risk of
adverse drug reactions, drug interactions, dizziness, confusion, falls, and cognitive
impairment in older adults.
4. A nurse is caring for an older adult client who has a urinary tract infection.
Which of the following findings is the client most likely to exhibit?
Acute confusion and change in mental status
Dysuria and hematuria
Fever and chills
Flank pain and nausea
Correct Answer: Acute confusion and change in mental status
Rationale: Older adults with urinary tract infections often present with new or
worsening confusion (delirium) rather than classic urinary symptoms like dysuria
or fever.
5. A nurse is reinforcing teaching with an older adult client about age-related
changes in the gastrointestinal system. Which of the following changes should
the nurse include in the teaching?
,Decreased gastric motility and increased risk of constipation
Increased gastric acid production
Increased nutrient absorption
Faster gastric emptying time
Correct Answer: Decreased gastric motility and increased risk of constipation
Rationale: Age-related changes include decreased gastric motility, slower
peristalsis, decreased gastric acid, and increased risk of constipation. Fiber and
fluids are important.
6. A nurse is collecting data from an older adult client who has osteoporosis.
Which of the following findings should the nurse expect?
Loss of height and a stooped posture
Weight gain and edema
Increased range of motion in the spine
Bowing of the lower extremities
Correct Answer: Loss of height and a stooped posture
Rationale: Osteoporosis causes vertebral compression fractures, leading to loss of
height, kyphosis (stooped posture, dowager's hump), and back pain.
7. A nurse is caring for an older adult client who has a new prescription for
digoxin. Which of the following age-related changes increases the client's risk for
digoxin toxicity?
Decreased renal function
Increased liver metabolism
Increased cardiac output
Decreased body fat percentage
Correct Answer: Decreased renal function
, Rationale: Digoxin is excreted by the kidneys. Age-related decreased renal
function leads to reduced drug clearance and increased risk of toxicity. Dosage
adjustment is often needed.
8. A nurse is reinforcing teaching with an older adult client about preventing
pressure injuries. Which of the following instructions should the nurse include?
Change position every 2 hours while awake
Use a donut-shaped cushion for sitting
Stay in one position for as long as comfortable
Apply lotion between skin folds to reduce friction
Correct Answer: Change position every 2 hours while awake
Rationale: Frequent repositioning (every 2 hours) relieves pressure on bony
prominences and prevents pressure injuries. Donut cushions are not
recommended.
9. A nurse is collecting data from an older adult client who reports difficulty
sleeping. Which of the following age-related sleep changes should the nurse
expect?
Decreased time spent in deep (Stage 3) sleep
Increased rapid eye movement (REM) sleep
Longer periods of uninterrupted sleep
Earlier morning awakening is not normal
Correct Answer: Decreased time spent in deep (Stage 3) sleep
Rationale: Older adults spend less time in deep sleep (Stage 3 NREM) and more
time in lighter sleep stages, leading to more frequent awakenings and difficulty
staying asleep.
NURSING EXAM (PN) QUESTIONS WITH 100%
CORRECT ANSWERS AND DETAILED RATIONALE
1. A nurse is caring for an 80-year-old client who has a new diagnosis of
pneumonia. Which of the following atypical findings is common in older adults
with pneumonia?
Confusion and lethargy without fever
High fever and productive cough
Chest pain and hemoptysis
Tachycardia and tachypnea only
Correct Answer: Confusion and lethargy without fever
Rationale: Older adults often present with atypical signs of infection such as
confusion, lethargy, or falls, rather than fever and cough. This is called atypical
presentation of illness.
2. A nurse is reinforcing teaching with an older adult client about fall prevention
in the home. Which of the following instructions should the nurse include?
Remove throw rugs from the floor
Use a step stool to reach high shelves
Wear smooth-soled socks when walking indoors
Keep the home dimly lit to reduce glare
Correct Answer: Remove throw rugs from the floor
,Rationale: Throw rugs are a common fall hazard. The home should have good
lighting, non-slip flooring, and grab bars. Smooth-soled socks increase fall risk.
3. A nurse is collecting data from an older adult client who is taking multiple
medications. Which of the following findings should indicate to the nurse that
the client may be experiencing polypharmacy-related complications?
Dizziness, confusion, and falls
Weight gain and increased appetite
Improved memory and energy
Decreased blood pressure only
Correct Answer: Dizziness, confusion, and falls
Rationale: Polypharmacy (taking multiple medications) increases the risk of
adverse drug reactions, drug interactions, dizziness, confusion, falls, and cognitive
impairment in older adults.
4. A nurse is caring for an older adult client who has a urinary tract infection.
Which of the following findings is the client most likely to exhibit?
Acute confusion and change in mental status
Dysuria and hematuria
Fever and chills
Flank pain and nausea
Correct Answer: Acute confusion and change in mental status
Rationale: Older adults with urinary tract infections often present with new or
worsening confusion (delirium) rather than classic urinary symptoms like dysuria
or fever.
5. A nurse is reinforcing teaching with an older adult client about age-related
changes in the gastrointestinal system. Which of the following changes should
the nurse include in the teaching?
,Decreased gastric motility and increased risk of constipation
Increased gastric acid production
Increased nutrient absorption
Faster gastric emptying time
Correct Answer: Decreased gastric motility and increased risk of constipation
Rationale: Age-related changes include decreased gastric motility, slower
peristalsis, decreased gastric acid, and increased risk of constipation. Fiber and
fluids are important.
6. A nurse is collecting data from an older adult client who has osteoporosis.
Which of the following findings should the nurse expect?
Loss of height and a stooped posture
Weight gain and edema
Increased range of motion in the spine
Bowing of the lower extremities
Correct Answer: Loss of height and a stooped posture
Rationale: Osteoporosis causes vertebral compression fractures, leading to loss of
height, kyphosis (stooped posture, dowager's hump), and back pain.
7. A nurse is caring for an older adult client who has a new prescription for
digoxin. Which of the following age-related changes increases the client's risk for
digoxin toxicity?
Decreased renal function
Increased liver metabolism
Increased cardiac output
Decreased body fat percentage
Correct Answer: Decreased renal function
, Rationale: Digoxin is excreted by the kidneys. Age-related decreased renal
function leads to reduced drug clearance and increased risk of toxicity. Dosage
adjustment is often needed.
8. A nurse is reinforcing teaching with an older adult client about preventing
pressure injuries. Which of the following instructions should the nurse include?
Change position every 2 hours while awake
Use a donut-shaped cushion for sitting
Stay in one position for as long as comfortable
Apply lotion between skin folds to reduce friction
Correct Answer: Change position every 2 hours while awake
Rationale: Frequent repositioning (every 2 hours) relieves pressure on bony
prominences and prevents pressure injuries. Donut cushions are not
recommended.
9. A nurse is collecting data from an older adult client who reports difficulty
sleeping. Which of the following age-related sleep changes should the nurse
expect?
Decreased time spent in deep (Stage 3) sleep
Increased rapid eye movement (REM) sleep
Longer periods of uninterrupted sleep
Earlier morning awakening is not normal
Correct Answer: Decreased time spent in deep (Stage 3) sleep
Rationale: Older adults spend less time in deep sleep (Stage 3 NREM) and more
time in lighter sleep stages, leading to more frequent awakenings and difficulty
staying asleep.
