NUR163/NUR 163 Exam 4 V1 | Concepts of
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is assessing an 80-year-old patient who reports difficulty hearing high-pitched
sounds. Which condition should the nurse document in the medical record?
A. Presbycusis
B. Otosclerosis
C. Tinnitus
D. Otitis Media
Correct Answer: A
Rationale: Presbycusis is the most common form of sensorineural hearing loss associated
with the aging process. It typically involves the gradual loss of the ability to hear high-
frequency sounds such as the voices of women and children. The nurse should
communicate by speaking in a lower-pitched, clear tone while facing the patient directly.
2. An elderly patient is admitted to the hospital with sudden onset confusion and irritability.
Which laboratory test should the nurse anticipate the provider will order first?
A. Urinalysis and culture
B. Chest X-ray
,C. Serum electrolyte panel
D. Brain Computed Tomography (CT) scan
Correct Answer: A
Rationale: In older adults, the primary symptom of a urinary tract infection (UTI) is often
an acute change in mental status or delirium rather than a fever. Because physiological
responses are blunted in the elderly, classic signs like dysuria or urgency may be absent.
The nurse must prioritize screening for infection as a reversible cause of confusion.
3. When teaching an older adult about the risk of polypharmacy, which statement by the
patient indicates a need for further teaching?
A. I will bring a list of all my medications to every doctor visit.
B. I use one pharmacy to fill all my prescriptions.
C. I should ask my doctor if I still need to take every medication I am currently on.
D. I take an over-the-counter herbal supplement to help me sleep at night.
Correct Answer: D
Rationale: Polypharmacy increases the risk of adverse drug reactions and falls in the
elderly population. Patients often fail to realize that herbal supplements can interact
dangerously with prescribed medications such as anticoagulants or antihypertensives. The
nurse must emphasize that all over-the-counter substances should be cleared by a
healthcare provider.
, 4. A nurse is evaluating an elderly patient for orthostatic hypotension. Which finding would
confirm this diagnosis?
A. A systolic blood pressure drop of 10 mmHg when standing.
B. A pulse rate increase of 5 beats per minute upon sitting.
C. An increase in systolic blood pressure of 20 mmHg when moving from supine to
standing.
D. A diastolic blood pressure drop of 10 mmHg within 3 minutes of standing.
Correct Answer: D
Rationale: Orthostatic hypotension is defined as a drop in systolic blood pressure of at
least 20 mmHg or a diastolic drop of at least 10 mmHg within three minutes of standing.
This condition is common in the elderly due to decreased baroreceptor sensitivity and
venous return. Nurses should instruct patients to change positions slowly and dangle their
feet at the bedside before standing.
5. Which exercise should the nurse recommend to an elderly patient to help prevent the
progression of osteoporosis?
A. Swimming laps for 30 minutes
B. Tai Chi for balance improvement
C. Brisk walking on a flat surface
D. Gentle stretching and yoga
Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is assessing an 80-year-old patient who reports difficulty hearing high-pitched
sounds. Which condition should the nurse document in the medical record?
A. Presbycusis
B. Otosclerosis
C. Tinnitus
D. Otitis Media
Correct Answer: A
Rationale: Presbycusis is the most common form of sensorineural hearing loss associated
with the aging process. It typically involves the gradual loss of the ability to hear high-
frequency sounds such as the voices of women and children. The nurse should
communicate by speaking in a lower-pitched, clear tone while facing the patient directly.
2. An elderly patient is admitted to the hospital with sudden onset confusion and irritability.
Which laboratory test should the nurse anticipate the provider will order first?
A. Urinalysis and culture
B. Chest X-ray
,C. Serum electrolyte panel
D. Brain Computed Tomography (CT) scan
Correct Answer: A
Rationale: In older adults, the primary symptom of a urinary tract infection (UTI) is often
an acute change in mental status or delirium rather than a fever. Because physiological
responses are blunted in the elderly, classic signs like dysuria or urgency may be absent.
The nurse must prioritize screening for infection as a reversible cause of confusion.
3. When teaching an older adult about the risk of polypharmacy, which statement by the
patient indicates a need for further teaching?
A. I will bring a list of all my medications to every doctor visit.
B. I use one pharmacy to fill all my prescriptions.
C. I should ask my doctor if I still need to take every medication I am currently on.
D. I take an over-the-counter herbal supplement to help me sleep at night.
Correct Answer: D
Rationale: Polypharmacy increases the risk of adverse drug reactions and falls in the
elderly population. Patients often fail to realize that herbal supplements can interact
dangerously with prescribed medications such as anticoagulants or antihypertensives. The
nurse must emphasize that all over-the-counter substances should be cleared by a
healthcare provider.
, 4. A nurse is evaluating an elderly patient for orthostatic hypotension. Which finding would
confirm this diagnosis?
A. A systolic blood pressure drop of 10 mmHg when standing.
B. A pulse rate increase of 5 beats per minute upon sitting.
C. An increase in systolic blood pressure of 20 mmHg when moving from supine to
standing.
D. A diastolic blood pressure drop of 10 mmHg within 3 minutes of standing.
Correct Answer: D
Rationale: Orthostatic hypotension is defined as a drop in systolic blood pressure of at
least 20 mmHg or a diastolic drop of at least 10 mmHg within three minutes of standing.
This condition is common in the elderly due to decreased baroreceptor sensitivity and
venous return. Nurses should instruct patients to change positions slowly and dangle their
feet at the bedside before standing.
5. Which exercise should the nurse recommend to an elderly patient to help prevent the
progression of osteoporosis?
A. Swimming laps for 30 minutes
B. Tai Chi for balance improvement
C. Brisk walking on a flat surface
D. Gentle stretching and yoga
