NUR163/NUR 163 Exam 4 V2 | Concepts of
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for an elderly patient who is in the final stages of terminal lung cancer.
The family asks about the primary goal of hospice care. Which response by the nurse is most
appropriate?
A. Hospice care focuses on providing aggressive treatment to prolong life.
B. It is a specialized form of care designed to reverse the disease process.
C. Hospice is only for patients who have no family support at home.
D. The focus is on providing comfort and quality of life rather than a cure.
Correct Answer: D
Rationale: Hospice care is specifically designed to provide comfort and support to patients
who are nearing the end of life. Unlike traditional medical models, it prioritizes palliative
measures over curative treatments. This approach addresses the physical, emotional, and
spiritual needs of both the patient and their family members.
2. The nurse notes that an elderly patient has been experiencing a gradual loss of peripheral
vision, often described as ‘tunnel vision.’ Which condition should the nurse suspect?
A. Cataracts
,B. Macular degeneration
C. Glaucoma
D. Presbyopia
Correct Answer: C
Rationale: Glaucoma is characterized by increased intraocular pressure which leads to
damage of the optic nerve and peripheral vision loss. Patients often do not notice the
change until it has progressed significantly into tunnel vision. Early detection through
regular eye exams is critical to prevent permanent blindness in the elderly population.
3. Which legal document allows a patient to appoint a specific person to make healthcare
decisions on their behalf if they become incapacitated?
A. A Living Will
B. Durable Power of Attorney for Healthcare
C. A Do Not Resuscitate (DNR) order
D. The Patient’s Bill of Rights
Correct Answer: B
Rationale: The Durable Power of Attorney for Healthcare is a legal instrument that
designates a health care proxy. This individual is authorized to make medical decisions
only when the patient is unable to do so themselves. It provides a more flexible approach to
decision-making than a static living will, which only covers specific scenarios.
,4. An elderly patient is admitted with sudden confusion, restlessness, and incoherent speech.
The nurse recognizes these symptoms as being most indicative of which condition?
A. Dementia
B. Depression
C. Delirium
D. Normal age-related memory loss
Correct Answer: C
Rationale: Delirium is characterized by an acute, rapid onset of confusion and altered
consciousness, often triggered by an underlying medical issue like an infection. In contrast,
dementia involves a slow, progressive decline in cognitive function over years. Identifying
and treating the physiological cause of delirium is a priority for the nursing staff to ensure
patient safety.
5. While assessing an 80-year-old patient, the nurse observes multiple bruises in various
stages of healing on the back and upper arms. What is the nurse’s first priority action?
A. Ask the family how the bruises occurred.
B. Assume the patient is clumsy and prone to falling.
C. Apply cold compresses to the newest bruises.
D. Document the findings and report to the supervisor or authorities.
Correct Answer: D
, Rationale: Nurses are mandatory reporters of suspected elder abuse, and bruises in non-
typical areas like the back are significant red flags. The nurse must document the physical
findings accurately and follow facility policy for reporting to Adult Protective Services. It is
not the nurse’s role to investigate the cause, but rather to ensure the patient’s safety
through proper reporting channels.
6. A patient is experiencing ‘anticipatory grief’ following a terminal diagnosis. How should the
nurse best support this patient?
A. Provide opportunities for the patient to express their feelings and fears.
B. Encourage the patient to avoid thinking about the future.
C. Tell the patient that everything will be fine to maintain hope.
D. Suggest that the patient should remain busy to distract themselves.
Correct Answer: A
Rationale: Anticipatory grief occurs before the actual loss happens and is a normal part of
the process for terminally ill patients. The nurse should provide a therapeutic environment
that allows for open communication and emotional expression. Validating the patient’s
feelings helps them process the upcoming transition and reduces feelings of isolation.
7. The nurse is providing post-mortem care. Which action is appropriate when preparing the
body for the family to view?
A. Remove all jewelry and give it to the first available staff member.
B. Leave the patient’s eyes open to appear more natural.
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for an elderly patient who is in the final stages of terminal lung cancer.
The family asks about the primary goal of hospice care. Which response by the nurse is most
appropriate?
A. Hospice care focuses on providing aggressive treatment to prolong life.
B. It is a specialized form of care designed to reverse the disease process.
C. Hospice is only for patients who have no family support at home.
D. The focus is on providing comfort and quality of life rather than a cure.
Correct Answer: D
Rationale: Hospice care is specifically designed to provide comfort and support to patients
who are nearing the end of life. Unlike traditional medical models, it prioritizes palliative
measures over curative treatments. This approach addresses the physical, emotional, and
spiritual needs of both the patient and their family members.
2. The nurse notes that an elderly patient has been experiencing a gradual loss of peripheral
vision, often described as ‘tunnel vision.’ Which condition should the nurse suspect?
A. Cataracts
,B. Macular degeneration
C. Glaucoma
D. Presbyopia
Correct Answer: C
Rationale: Glaucoma is characterized by increased intraocular pressure which leads to
damage of the optic nerve and peripheral vision loss. Patients often do not notice the
change until it has progressed significantly into tunnel vision. Early detection through
regular eye exams is critical to prevent permanent blindness in the elderly population.
3. Which legal document allows a patient to appoint a specific person to make healthcare
decisions on their behalf if they become incapacitated?
A. A Living Will
B. Durable Power of Attorney for Healthcare
C. A Do Not Resuscitate (DNR) order
D. The Patient’s Bill of Rights
Correct Answer: B
Rationale: The Durable Power of Attorney for Healthcare is a legal instrument that
designates a health care proxy. This individual is authorized to make medical decisions
only when the patient is unable to do so themselves. It provides a more flexible approach to
decision-making than a static living will, which only covers specific scenarios.
,4. An elderly patient is admitted with sudden confusion, restlessness, and incoherent speech.
The nurse recognizes these symptoms as being most indicative of which condition?
A. Dementia
B. Depression
C. Delirium
D. Normal age-related memory loss
Correct Answer: C
Rationale: Delirium is characterized by an acute, rapid onset of confusion and altered
consciousness, often triggered by an underlying medical issue like an infection. In contrast,
dementia involves a slow, progressive decline in cognitive function over years. Identifying
and treating the physiological cause of delirium is a priority for the nursing staff to ensure
patient safety.
5. While assessing an 80-year-old patient, the nurse observes multiple bruises in various
stages of healing on the back and upper arms. What is the nurse’s first priority action?
A. Ask the family how the bruises occurred.
B. Assume the patient is clumsy and prone to falling.
C. Apply cold compresses to the newest bruises.
D. Document the findings and report to the supervisor or authorities.
Correct Answer: D
, Rationale: Nurses are mandatory reporters of suspected elder abuse, and bruises in non-
typical areas like the back are significant red flags. The nurse must document the physical
findings accurately and follow facility policy for reporting to Adult Protective Services. It is
not the nurse’s role to investigate the cause, but rather to ensure the patient’s safety
through proper reporting channels.
6. A patient is experiencing ‘anticipatory grief’ following a terminal diagnosis. How should the
nurse best support this patient?
A. Provide opportunities for the patient to express their feelings and fears.
B. Encourage the patient to avoid thinking about the future.
C. Tell the patient that everything will be fine to maintain hope.
D. Suggest that the patient should remain busy to distract themselves.
Correct Answer: A
Rationale: Anticipatory grief occurs before the actual loss happens and is a normal part of
the process for terminally ill patients. The nurse should provide a therapeutic environment
that allows for open communication and emotional expression. Validating the patient’s
feelings helps them process the upcoming transition and reduces feelings of isolation.
7. The nurse is providing post-mortem care. Which action is appropriate when preparing the
body for the family to view?
A. Remove all jewelry and give it to the first available staff member.
B. Leave the patient’s eyes open to appear more natural.
