PNR 108/PNR108 Exam 3 V1 |
Gerontological Nursing Q&A with
Rationale | Fortis College
1. A nurse is assessing an older adult client for delirium. Which clinical manifestation should
the nurse identify as a primary indicator of this condition?
A. Gradual and progressive cognitive decline over several years
B. Normal aging process that does not require medical intervention
C. Permanent loss of long-term memory and personality changes
D. Sudden onset of confusion and fluctuating levels of consciousness
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute or sudden change in mental
status that often fluctuates throughout the day. Unlike dementia, delirium is typically
reversible once the underlying cause, such as an infection or electrolyte imbalance, is
treated. The nurse must prioritize this assessment because delirium is considered a
medical emergency in the geriatric population.
2. The nurse is planning care for an older adult with Alzheimer’s disease who experiences
sun-downing. Which intervention is most appropriate?
A. Increase the noise level in the hallway to keep the client alert
B. Provide a vigorous exercise routine late in the evening
,C. Keep the client’s room dark during the afternoon hours
D. Maintain a consistent routine and provide a calm environment
Correct Answer: D
Expert Explanation: Consistency in routines helps reduce the anxiety and confusion often
associated with sun-downing in dementia patients. Creating a calm, well-lit environment in
the evening can help reorient the client and minimize agitation. The nurse should also limit
caffeine and heavy activity late in the day to promote better rest.
3. Which of the following findings should the nurse prioritize when assessing an older adult
client’s medication list for polypharmacy?
A. Occasional use of acetaminophen for mild joint pain
B. Taking one daily multivitamin and a calcium supplement
C. The client using one pharmacy for all prescriptions
D. The use of multiple medications for the same condition
Correct Answer: D
Expert Explanation: Polypharmacy often involves the use of multiple medications that
may have duplicate effects or interact negatively with one another. This increases the risk
for adverse drug reactions, falls, and cognitive impairment in older adults. The nurse
should advocate for a medication reconciliation to ensure all prescribed drugs are
necessary and safe.
, 4. An older adult client is diagnosed with presbycusis. Which communication technique
should the nurse employ?
A. Shout loudly into the client’s ear to be heard
B. Speak clearly and slowly while facing the client directly
C. Stand behind the client while speaking to avoid distraction
D. Speak in a high-pitched voice for better clarity
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Facing the client allows them to use visual cues and
lip-reading to supplement their hearing. Shouting is often ineffective because it can distort
the sound and increase the pitch, which the client cannot hear.
5. A nurse is teaching a group of older adults about skin integrity. Which age-related change
increases the risk for pressure ulcers?
A. Increased vascularity of the dermis
B. Thinning of the subcutaneous fat layer
C. Increased elasticity of the skin tissue
D. Higher production of sebum and sweat
Correct Answer: B
Gerontological Nursing Q&A with
Rationale | Fortis College
1. A nurse is assessing an older adult client for delirium. Which clinical manifestation should
the nurse identify as a primary indicator of this condition?
A. Gradual and progressive cognitive decline over several years
B. Normal aging process that does not require medical intervention
C. Permanent loss of long-term memory and personality changes
D. Sudden onset of confusion and fluctuating levels of consciousness
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute or sudden change in mental
status that often fluctuates throughout the day. Unlike dementia, delirium is typically
reversible once the underlying cause, such as an infection or electrolyte imbalance, is
treated. The nurse must prioritize this assessment because delirium is considered a
medical emergency in the geriatric population.
2. The nurse is planning care for an older adult with Alzheimer’s disease who experiences
sun-downing. Which intervention is most appropriate?
A. Increase the noise level in the hallway to keep the client alert
B. Provide a vigorous exercise routine late in the evening
,C. Keep the client’s room dark during the afternoon hours
D. Maintain a consistent routine and provide a calm environment
Correct Answer: D
Expert Explanation: Consistency in routines helps reduce the anxiety and confusion often
associated with sun-downing in dementia patients. Creating a calm, well-lit environment in
the evening can help reorient the client and minimize agitation. The nurse should also limit
caffeine and heavy activity late in the day to promote better rest.
3. Which of the following findings should the nurse prioritize when assessing an older adult
client’s medication list for polypharmacy?
A. Occasional use of acetaminophen for mild joint pain
B. Taking one daily multivitamin and a calcium supplement
C. The client using one pharmacy for all prescriptions
D. The use of multiple medications for the same condition
Correct Answer: D
Expert Explanation: Polypharmacy often involves the use of multiple medications that
may have duplicate effects or interact negatively with one another. This increases the risk
for adverse drug reactions, falls, and cognitive impairment in older adults. The nurse
should advocate for a medication reconciliation to ensure all prescribed drugs are
necessary and safe.
, 4. An older adult client is diagnosed with presbycusis. Which communication technique
should the nurse employ?
A. Shout loudly into the client’s ear to be heard
B. Speak clearly and slowly while facing the client directly
C. Stand behind the client while speaking to avoid distraction
D. Speak in a high-pitched voice for better clarity
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Facing the client allows them to use visual cues and
lip-reading to supplement their hearing. Shouting is often ineffective because it can distort
the sound and increase the pitch, which the client cannot hear.
5. A nurse is teaching a group of older adults about skin integrity. Which age-related change
increases the risk for pressure ulcers?
A. Increased vascularity of the dermis
B. Thinning of the subcutaneous fat layer
C. Increased elasticity of the skin tissue
D. Higher production of sebum and sweat
Correct Answer: B
