PNR 108/PNR108 Exam 2 V1 |
Gerontological Nursing Q&A with
Rationale | Fortis College
1. A nurse is assessing an older adult client for delirium. Which finding is most characteristic
of this condition?
A. Gradual loss of cognitive function over several years
B. Stable personality changes throughout the day
C. Irreversible decline in memory and judgment
D. Sudden onset of confusion and altered level of consciousness
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute and sudden onset of confusion,
which is often reversible if the underlying cause is treated. Unlike dementia, which is a slow
and progressive decline, delirium fluctuates throughout the day and affects the level of
consciousness. Nurses must prioritize identifying the physiological trigger, such as a
urinary tract infection or medication toxicity.
2. Which age-related change in the integumentary system increases the risk of pressure
injuries in the elderly?
A. Increased subcutaneous fat over bony prominences
B. Thinning of the epidermal layer and loss of subcutaneous tissue
,C. Increased elasticity of the dermis
D. Enhanced vascularity and blood flow to the skin
Correct Answer: B
Expert Explanation: The thinning of the epidermis and the loss of subcutaneous fat reduce
the cushioning over bony prominences, making the skin more fragile. This physiological
change decreases the skin’s ability to withstand pressure and shear forces. Consequently,
older adults require frequent repositioning and meticulous skin care to prevent
breakdown.
3. An older adult patient reports frequent nighttime awakenings and feeling unrefreshed in
the morning. Which statement about sleep in the elderly is true?
A. Older adults require more hours of sleep than younger adults
B. The amount of time spent in deep sleep (Stage 4) increases with age
C. Sleep becomes more fragmented with more frequent arousals
D. REM sleep constitutes the majority of the sleep cycle in seniors
Correct Answer: C
Expert Explanation: Aging is associated with changes in sleep architecture, specifically a
decrease in deep, restorative sleep and more frequent nighttime awakenings. Older adults
often experience a shift in their circadian rhythm, leading to earlier bedtimes and earlier
wake times. Education on sleep hygiene, such as avoiding caffeine and daytime napping, is
essential for this population.
, 4. When administering medications to an 80-year-old patient, the nurse should be aware that
which physiological change affects drug metabolism?
A. Decreased renal filtration and blood flow
B. Increased hepatic blood flow
C. Increased total body water
D. Decreased percentage of body fat
Correct Answer: A
Expert Explanation: Reduced renal blood flow and a decreased glomerular filtration rate
(GFR) lead to a slower excretion of medications in older adults. This physiological decline
increases the risk of drug toxicity and prolonged half-lives of medications. Nurses must
monitor lab values such as serum creatinine and BUN closely to ensure safe dosing.
5. A client is diagnosed with Presbycusis. Which communication technique is most effective
for the nurse to use?
A. Shouting directly into the client’s ear
B. Using a high-pitched tone of voice
C. Speaking clearly in a low-pitched, normal volume
D. Covering the mouth to prevent distraction while speaking
Correct Answer: C
Gerontological Nursing Q&A with
Rationale | Fortis College
1. A nurse is assessing an older adult client for delirium. Which finding is most characteristic
of this condition?
A. Gradual loss of cognitive function over several years
B. Stable personality changes throughout the day
C. Irreversible decline in memory and judgment
D. Sudden onset of confusion and altered level of consciousness
Correct Answer: D
Expert Explanation: Delirium is characterized by an acute and sudden onset of confusion,
which is often reversible if the underlying cause is treated. Unlike dementia, which is a slow
and progressive decline, delirium fluctuates throughout the day and affects the level of
consciousness. Nurses must prioritize identifying the physiological trigger, such as a
urinary tract infection or medication toxicity.
2. Which age-related change in the integumentary system increases the risk of pressure
injuries in the elderly?
A. Increased subcutaneous fat over bony prominences
B. Thinning of the epidermal layer and loss of subcutaneous tissue
,C. Increased elasticity of the dermis
D. Enhanced vascularity and blood flow to the skin
Correct Answer: B
Expert Explanation: The thinning of the epidermis and the loss of subcutaneous fat reduce
the cushioning over bony prominences, making the skin more fragile. This physiological
change decreases the skin’s ability to withstand pressure and shear forces. Consequently,
older adults require frequent repositioning and meticulous skin care to prevent
breakdown.
3. An older adult patient reports frequent nighttime awakenings and feeling unrefreshed in
the morning. Which statement about sleep in the elderly is true?
A. Older adults require more hours of sleep than younger adults
B. The amount of time spent in deep sleep (Stage 4) increases with age
C. Sleep becomes more fragmented with more frequent arousals
D. REM sleep constitutes the majority of the sleep cycle in seniors
Correct Answer: C
Expert Explanation: Aging is associated with changes in sleep architecture, specifically a
decrease in deep, restorative sleep and more frequent nighttime awakenings. Older adults
often experience a shift in their circadian rhythm, leading to earlier bedtimes and earlier
wake times. Education on sleep hygiene, such as avoiding caffeine and daytime napping, is
essential for this population.
, 4. When administering medications to an 80-year-old patient, the nurse should be aware that
which physiological change affects drug metabolism?
A. Decreased renal filtration and blood flow
B. Increased hepatic blood flow
C. Increased total body water
D. Decreased percentage of body fat
Correct Answer: A
Expert Explanation: Reduced renal blood flow and a decreased glomerular filtration rate
(GFR) lead to a slower excretion of medications in older adults. This physiological decline
increases the risk of drug toxicity and prolonged half-lives of medications. Nurses must
monitor lab values such as serum creatinine and BUN closely to ensure safe dosing.
5. A client is diagnosed with Presbycusis. Which communication technique is most effective
for the nurse to use?
A. Shouting directly into the client’s ear
B. Using a high-pitched tone of voice
C. Speaking clearly in a low-pitched, normal volume
D. Covering the mouth to prevent distraction while speaking
Correct Answer: C
