PNR 108/PNR108 Exam 4 V2 |
Gerontological Nursing Q&A with
Rationale | Fortis College
1. According to Erikson’s stages of psychosocial development, which task is specific to the
older adult population?
A. Autonomy vs. Shame and Doubt
B. Ego Integrity vs. Despair
C. Generativity vs. Stagnation
D. Identity vs. Role Confusion
Correct Answer: B
Expert Explanation: The stage of Ego Integrity vs. Despair involves the older adult
reflecting on their life and feeling a sense of satisfaction. If the individual views their life as
a series of failures, they may experience despair. Nurses play a crucial role in assisting
patients with life reviews to achieve integrity.
2. A nurse is assessing an older adult for polypharmacy. Which situation best defines this
term?
A. The use of five or more medications or the use of multiple medications for the same
condition.
B. The use of multiple pharmacies to fill the same prescription.
,C. Strict adherence to a complex medication schedule provided by one doctor.
D. Taking over-the-counter vitamins without a physician’s approval.
Correct Answer: A
Expert Explanation: Polypharmacy is commonly defined as the concurrent use of five or
more medications, including prescription and over-the-counter drugs. It significantly
increases the risk of adverse drug reactions and drug-drug interactions in the elderly
population. Nurses must regularly review the medication list to ensure all drugs are
necessary and safe.
3. Which physiological change associated with aging affects the metabolism of medications in
the older adult?
A. Decreased liver blood flow and mass
B. Increased total body water
C. Increased renal excretion
D. Decreased adipose tissue
Correct Answer: A
Expert Explanation: The liver is the primary organ responsible for drug metabolism, and
aging reduces its blood flow and mass. This reduction can lead to a prolonged half-life of
medications and an increased risk of toxicity. Nurses should monitor liver function tests
and observe for cumulative drug effects.
, 4. An older adult patient is diagnosed with presbycusis. What is the most appropriate nursing
intervention for communication?
A. Speak loudly and at a high pitch into the patient’s ear.
B. Speak in a clear, low-pitched voice while facing the patient.
C. Exaggerate mouth movements so the patient can lip-read.
D. Provide all instructions only in written format.
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Speaking in a lower-pitched, clear tone while
maintaining eye contact improves the patient’s ability to understand. Avoid shouting, as
this can distort sounds and may be perceived as aggressive.
5. Which assessment finding is a hallmark symptom of delirium in an older adult?
A. Gradual decline in memory over several years.
B. Acute onset of confusion and fluctuating levels of consciousness.
C. Consistent ability to focus on a single task.
D. Permanent loss of language skills.
Correct Answer: B
Expert Explanation: Delirium is characterized by a rapid, acute onset of confusion that
often fluctuates throughout the day. Unlike dementia, delirium is frequently reversible if
Gerontological Nursing Q&A with
Rationale | Fortis College
1. According to Erikson’s stages of psychosocial development, which task is specific to the
older adult population?
A. Autonomy vs. Shame and Doubt
B. Ego Integrity vs. Despair
C. Generativity vs. Stagnation
D. Identity vs. Role Confusion
Correct Answer: B
Expert Explanation: The stage of Ego Integrity vs. Despair involves the older adult
reflecting on their life and feeling a sense of satisfaction. If the individual views their life as
a series of failures, they may experience despair. Nurses play a crucial role in assisting
patients with life reviews to achieve integrity.
2. A nurse is assessing an older adult for polypharmacy. Which situation best defines this
term?
A. The use of five or more medications or the use of multiple medications for the same
condition.
B. The use of multiple pharmacies to fill the same prescription.
,C. Strict adherence to a complex medication schedule provided by one doctor.
D. Taking over-the-counter vitamins without a physician’s approval.
Correct Answer: A
Expert Explanation: Polypharmacy is commonly defined as the concurrent use of five or
more medications, including prescription and over-the-counter drugs. It significantly
increases the risk of adverse drug reactions and drug-drug interactions in the elderly
population. Nurses must regularly review the medication list to ensure all drugs are
necessary and safe.
3. Which physiological change associated with aging affects the metabolism of medications in
the older adult?
A. Decreased liver blood flow and mass
B. Increased total body water
C. Increased renal excretion
D. Decreased adipose tissue
Correct Answer: A
Expert Explanation: The liver is the primary organ responsible for drug metabolism, and
aging reduces its blood flow and mass. This reduction can lead to a prolonged half-life of
medications and an increased risk of toxicity. Nurses should monitor liver function tests
and observe for cumulative drug effects.
, 4. An older adult patient is diagnosed with presbycusis. What is the most appropriate nursing
intervention for communication?
A. Speak loudly and at a high pitch into the patient’s ear.
B. Speak in a clear, low-pitched voice while facing the patient.
C. Exaggerate mouth movements so the patient can lip-read.
D. Provide all instructions only in written format.
Correct Answer: B
Expert Explanation: Presbycusis is age-related hearing loss that typically affects the
ability to hear high-frequency sounds. Speaking in a lower-pitched, clear tone while
maintaining eye contact improves the patient’s ability to understand. Avoid shouting, as
this can distort sounds and may be perceived as aggressive.
5. Which assessment finding is a hallmark symptom of delirium in an older adult?
A. Gradual decline in memory over several years.
B. Acute onset of confusion and fluctuating levels of consciousness.
C. Consistent ability to focus on a single task.
D. Permanent loss of language skills.
Correct Answer: B
Expert Explanation: Delirium is characterized by a rapid, acute onset of confusion that
often fluctuates throughout the day. Unlike dementia, delirium is frequently reversible if
