PNR 108/PNR108 Exam 2 V3 |
Gerontological Nursing Q&A with
Rationale | Fortis College
1. An older adult patient presents with a sudden onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depressive Disorder
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute, rapid onset of confusion and
altered consciousness, often triggered by underlying medical issues such as infection or
medication toxicity. Unlike dementia, which is a slow and progressive decline, delirium is
typically reversible once the primary cause is addressed. The nurse must prioritize
identifying the physiological stressor to prevent further cognitive decline.
2. According to Erikson’s stages of psychosocial development, what is the primary
developmental task for the older adult?
A. Generativity vs. Stagnation
B. Ego Integrity vs. Despair
,C. Intimacy vs. Isolation
D. Autonomy vs. Shame and Doubt
Correct Answer: B
Expert Explanation: Ego Integrity vs. Despair is the final stage of Erikson’s theory,
occurring in late adulthood. In this stage, individuals reflect on their life achievements and
search for a sense of fulfillment and meaning. Successful resolution leads to wisdom, while
failure leads to regret and bitterness about the past.
3. A nurse is educating an older adult about age-related changes in the cardiovascular system.
Which change should the nurse include?
A. Increased cardiac output
B. Decreased peripheral vascular resistance
C. Increased arterial wall stiffness
D. Increased heart rate response to stress
Correct Answer: C
Expert Explanation: Arterial wall stiffness increases with age due to the loss of elastin and
the buildup of collagen and calcium. This change leads to increased systolic blood pressure
and places a higher workload on the heart. It is a significant factor in the development of
hypertension and other cardiovascular diseases in the elderly.
, 4. Which assessment finding is considered an atypical presentation of infection in an older
adult?
A. High-grade fever
B. Elevated white blood cell count
C. Productive cough with yellow sputum
D. New-onset confusion and lethargy
Correct Answer: D
Expert Explanation: Older adults often present with atypical symptoms of infection, such
as confusion, falls, or decreased functional status, rather than a classic fever. This is largely
due to age-related changes in the immune system and thermoregulation. Nurses must
remain vigilant for subtle behavioral changes that may signal a serious systemic infection.
5. A nurse is reviewing a list of medications for an 80-year-old patient. Based on the Beers
Criteria, which medication should be used with caution or avoided?
A. Diphenhydramine
B. Acetaminophen
C. Lisinopril
D. Metformin
Correct Answer: A
Gerontological Nursing Q&A with
Rationale | Fortis College
1. An older adult patient presents with a sudden onset of confusion, fluctuating levels of
consciousness, and visual hallucinations. Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Delirium
C. Vascular Dementia
D. Major Depressive Disorder
Correct Answer: B
Expert Explanation: Delirium is characterized by an acute, rapid onset of confusion and
altered consciousness, often triggered by underlying medical issues such as infection or
medication toxicity. Unlike dementia, which is a slow and progressive decline, delirium is
typically reversible once the primary cause is addressed. The nurse must prioritize
identifying the physiological stressor to prevent further cognitive decline.
2. According to Erikson’s stages of psychosocial development, what is the primary
developmental task for the older adult?
A. Generativity vs. Stagnation
B. Ego Integrity vs. Despair
,C. Intimacy vs. Isolation
D. Autonomy vs. Shame and Doubt
Correct Answer: B
Expert Explanation: Ego Integrity vs. Despair is the final stage of Erikson’s theory,
occurring in late adulthood. In this stage, individuals reflect on their life achievements and
search for a sense of fulfillment and meaning. Successful resolution leads to wisdom, while
failure leads to regret and bitterness about the past.
3. A nurse is educating an older adult about age-related changes in the cardiovascular system.
Which change should the nurse include?
A. Increased cardiac output
B. Decreased peripheral vascular resistance
C. Increased arterial wall stiffness
D. Increased heart rate response to stress
Correct Answer: C
Expert Explanation: Arterial wall stiffness increases with age due to the loss of elastin and
the buildup of collagen and calcium. This change leads to increased systolic blood pressure
and places a higher workload on the heart. It is a significant factor in the development of
hypertension and other cardiovascular diseases in the elderly.
, 4. Which assessment finding is considered an atypical presentation of infection in an older
adult?
A. High-grade fever
B. Elevated white blood cell count
C. Productive cough with yellow sputum
D. New-onset confusion and lethargy
Correct Answer: D
Expert Explanation: Older adults often present with atypical symptoms of infection, such
as confusion, falls, or decreased functional status, rather than a classic fever. This is largely
due to age-related changes in the immune system and thermoregulation. Nurses must
remain vigilant for subtle behavioral changes that may signal a serious systemic infection.
5. A nurse is reviewing a list of medications for an 80-year-old patient. Based on the Beers
Criteria, which medication should be used with caution or avoided?
A. Diphenhydramine
B. Acetaminophen
C. Lisinopril
D. Metformin
Correct Answer: A
