NUR163/NUR 163 Final Exam V2 |
Concepts of Practical Nursing in the Care
of Elderly Patients Q&A with Rationale |
Hondros College of Nursing
1. A nurse is reviewing the pharmacological changes associated with aging. Which
physiological change significantly impacts the distribution of lipid-soluble medications in
elderly patients?
A. Increase in adipose tissue percentage
B. Increase in total body water
C. Decrease in total body fat
D. Decrease in hepatic blood flow
Correct Answer: A
Rationale: As a part of the aging process, the percentage of adipose tissue increases while
total body water decreases. This leads to a larger volume of distribution for lipid-soluble
drugs, potentially causing them to stay in the body longer and reach toxic levels. The nurse
must monitor for prolonged effects or delayed toxicity when these medications are
prescribed.
2. When assessing an 82-year-old patient for delirium, which clinical manifestation should the
nurse prioritize as a hallmark of this condition?
A. Slow, progressive memory loss over several years
,B. Stable cognitive impairment throughout the day
C. Flat affect and loss of interest in social activities
D. Acute change in mental status with fluctuating consciousness
Correct Answer: D
Rationale: Delirium is characterized by a rapid, acute onset of confusion and fluctuating
levels of consciousness. Unlike dementia, which is chronic and progressive, delirium is
often reversible and triggered by an underlying medical condition or medication side effect.
Prompt identification is critical to address the root cause and ensure patient safety.
3. An elderly patient is diagnosed with age-related macular degeneration (AMD). Which
visual impairment should the nurse expect the patient to report?
A. Loss of peripheral vision (tunnel vision)
B. Blurred vision with halos around lights
C. Loss of central vision and difficulty seeing faces
D. Total blindness in both eyes
Correct Answer: C
Rationale: Age-related macular degeneration specifically affects the macula, which is
responsible for central and detailed vision. Patients often report a dark or blurry spot in
the center of their field of vision, making it hard to read or recognize faces. Peripheral
vision usually remains intact in the early to middle stages of this condition.
, 4. Which intervention is most effective for a nurse to implement to prevent skin breakdown
in a bedbound geriatric patient?
A. Massaging bony prominences every four hours
B. Applying cornstarch to high-friction areas
C. Using a donut-shaped cushion for seating
D. Repositioning the patient at least every two hours
Correct Answer: D
Rationale: Frequent repositioning reduces prolonged pressure on bony prominences,
which is the primary cause of pressure injuries. Massaging reddened areas can actually
cause more tissue damage, and donut cushions restrict blood flow. Keeping the skin clean
and dry while offloading pressure is the standard of care.
5. A nurse is caring for an older adult with presbycusis. Which communication technique is
most appropriate?
A. Speaking in a high-pitched, loud voice
B. Standing behind the patient while speaking
C. Speaking clearly in a low-pitched tone while facing the patient
D. Exaggerating lip movements to help with lip-reading
Correct Answer: C
Concepts of Practical Nursing in the Care
of Elderly Patients Q&A with Rationale |
Hondros College of Nursing
1. A nurse is reviewing the pharmacological changes associated with aging. Which
physiological change significantly impacts the distribution of lipid-soluble medications in
elderly patients?
A. Increase in adipose tissue percentage
B. Increase in total body water
C. Decrease in total body fat
D. Decrease in hepatic blood flow
Correct Answer: A
Rationale: As a part of the aging process, the percentage of adipose tissue increases while
total body water decreases. This leads to a larger volume of distribution for lipid-soluble
drugs, potentially causing them to stay in the body longer and reach toxic levels. The nurse
must monitor for prolonged effects or delayed toxicity when these medications are
prescribed.
2. When assessing an 82-year-old patient for delirium, which clinical manifestation should the
nurse prioritize as a hallmark of this condition?
A. Slow, progressive memory loss over several years
,B. Stable cognitive impairment throughout the day
C. Flat affect and loss of interest in social activities
D. Acute change in mental status with fluctuating consciousness
Correct Answer: D
Rationale: Delirium is characterized by a rapid, acute onset of confusion and fluctuating
levels of consciousness. Unlike dementia, which is chronic and progressive, delirium is
often reversible and triggered by an underlying medical condition or medication side effect.
Prompt identification is critical to address the root cause and ensure patient safety.
3. An elderly patient is diagnosed with age-related macular degeneration (AMD). Which
visual impairment should the nurse expect the patient to report?
A. Loss of peripheral vision (tunnel vision)
B. Blurred vision with halos around lights
C. Loss of central vision and difficulty seeing faces
D. Total blindness in both eyes
Correct Answer: C
Rationale: Age-related macular degeneration specifically affects the macula, which is
responsible for central and detailed vision. Patients often report a dark or blurry spot in
the center of their field of vision, making it hard to read or recognize faces. Peripheral
vision usually remains intact in the early to middle stages of this condition.
, 4. Which intervention is most effective for a nurse to implement to prevent skin breakdown
in a bedbound geriatric patient?
A. Massaging bony prominences every four hours
B. Applying cornstarch to high-friction areas
C. Using a donut-shaped cushion for seating
D. Repositioning the patient at least every two hours
Correct Answer: D
Rationale: Frequent repositioning reduces prolonged pressure on bony prominences,
which is the primary cause of pressure injuries. Massaging reddened areas can actually
cause more tissue damage, and donut cushions restrict blood flow. Keeping the skin clean
and dry while offloading pressure is the standard of care.
5. A nurse is caring for an older adult with presbycusis. Which communication technique is
most appropriate?
A. Speaking in a high-pitched, loud voice
B. Standing behind the patient while speaking
C. Speaking clearly in a low-pitched tone while facing the patient
D. Exaggerating lip movements to help with lip-reading
Correct Answer: C
