Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. An elderly patient presents with a sudden onset of confusion and visual hallucinations.
Which condition should the nurse suspect first?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Depression
Correct Answer: C
Rationale: Delirium is characterized by an acute, sudden onset of confusion and is often
reversible. In contrast, Alzheimer’s and vascular dementia have a slow, progressive onset
over several years. The nurse must identify the underlying cause of delirium, such as
infection or medication toxicity, to provide appropriate care.
2. Which factor is the primary cause of age-related changes in drug metabolism in the
elderly?
A. Increased gastric acidity
B. Decreased hepatic blood flow
,C. Increased total body water
D. Increased glomerular filtration rate
Correct Answer: B
Rationale: As people age, hepatic blood flow decreases, which significantly impacts the
liver’s ability to metabolize drugs. This reduction in metabolism can lead to increased drug
levels in the bloodstream and a higher risk of toxicity. Nurses must monitor elderly
patients closely for adverse drug reactions due to these physiological changes.
3. A nurse is teaching a family about the ‘Sundowning’ phenomenon. Which statement is
most accurate?
A. It occurs only in patients with late-stage Parkinson’s disease.
B. It is a normal part of aging and requires no intervention.
C. It is characterized by increased agitation and confusion in the late afternoon.
D. It can be cured with high doses of sedative medications.
Correct Answer: C
Rationale: Sundowning involves increased confusion and restlessness that occurs as
daylight fades into the evening. It is common in patients with dementia and can be
triggered by fatigue or low light levels. Creating a calm environment and maintaining a
consistent routine can help minimize these symptoms for the patient.
, 4. Which screening tool is most appropriate for assessing the risk of pressure ulcers in an
elderly patient?
A. Braden Scale
B. Morse Fall Scale
C. Glasgow Coma Scale
D. Mini-Mental State Exam
Correct Answer: A
Rationale: The Braden Scale is a standardized tool used to assess a patient’s risk for
developing pressure ulcers based on factors like moisture and mobility. Regular
assessment allows nurses to implement preventive measures early for high-risk
individuals. Using this tool is a standard of care in geriatric nursing to maintain skin
integrity.
5. When communicating with a patient who has presbycusis, which action should the nurse
take?
A. Shout directly into the patient’s ear.
B. Face the patient and speak in a lower tone.
C. Speak in a high-pitched voice.
D. Avoid using hand gestures to prevent distraction.
Correct Answer: B