NUR163/NUR 163 Exam 3 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 older adult who has been diagnosed with presbycusis. Which action
should the nurse take to facilitate communication?
A. Face the patient and speak clearly at a moderate pace.
B. Speak in a high-pitched, loud voice.
C. Over-articulate words to ensure lip reading is possible.
D. Shout directly into the patient’s better-hearing ear.
Correct Answer: A
Rationale: Presbycusis involves the loss of high-frequency hearing, so speaking in a lower
pitch is more effective than shouting. Facing the patient allows them to use visual cues and
lip-reading to supplement what they hear. Shouting or using a high-pitched voice can
actually distort sounds and make communication more difficult for the geriatric patient.
2. Which clinical finding is most characteristic of delirium in an elderly patient rather than
dementia?
A. Gradual onset over several years.
B. Irreversible cognitive decline.
,C. Intact short-term memory with lost long-term memory.
D. Acute onset with fluctuating levels of consciousness.
Correct Answer: D
Rationale: Delirium is characterized by a rapid, acute onset that is often reversible once
the underlying cause, such as infection or medication, is treated. Unlike dementia, which is
progressive and stable, delirium features fluctuations in alertness throughout the day.
Recognizing the sudden change in mental status is critical for the practical nurse to initiate
immediate medical assessment.
3. A patient is in the ‘Anger’ stage of Kübler-Ross’s five stages of grief. What is the most
appropriate nursing response?
A. Explain that their anger is misplaced and hurtful to staff.
B. Allow the patient to express their feelings without taking it personally.
C. Reassure the patient that everything will be fine.
D. Refer the patient to a psychiatrist immediately for mood stabilization.
Correct Answer: B
Rationale: Anger is a normal reaction to loss and serves as a defense mechanism for the
patient. The nurse should provide a safe environment for the patient to vent their
frustrations without becoming defensive or judgmental. Attempting to suppress this stage
or offering false reassurances can hinder the patient’s progression through the grieving
process.
, 4. An older adult patient is admitted with a suspected Urinary Tract Infection (UTI). Which
symptom should the nurse expect as a common atypical presentation in this population?
A. Acute confusion or mental status changes.
B. Severe flank pain.
C. High fever and chills.
D. Urinary frequency and burning.
Correct Answer: A
Rationale: Geriatric patients often do not present with classic signs of infection like fever
or localized pain due to age-related changes in the immune system. Acute confusion, often
referred to as delirium, is a hallmark sign of systemic issues like UTIs in the elderly. The
nurse must monitor for behavioral changes as a primary indicator of physical illness in this
demographic.
5. The nurse is discussing palliative care with a family. Which statement best describes the
goal of palliative care?
A. It is only provided when a patient has less than 6 months to live.
B. It focuses on symptom management and quality of life at any stage of illness.
C. It focuses on curative treatments for chronic illnesses.
D. It requires the patient to stop all life-sustaining medications.
Correct Answer: B
of Practical Nursing in the Care of Elderly
Patients Q&A with Rationale | Hondros
College of Nursing
1. A nurse is caring for an older adult who has been diagnosed with presbycusis. Which action
should the nurse take to facilitate communication?
A. Face the patient and speak clearly at a moderate pace.
B. Speak in a high-pitched, loud voice.
C. Over-articulate words to ensure lip reading is possible.
D. Shout directly into the patient’s better-hearing ear.
Correct Answer: A
Rationale: Presbycusis involves the loss of high-frequency hearing, so speaking in a lower
pitch is more effective than shouting. Facing the patient allows them to use visual cues and
lip-reading to supplement what they hear. Shouting or using a high-pitched voice can
actually distort sounds and make communication more difficult for the geriatric patient.
2. Which clinical finding is most characteristic of delirium in an elderly patient rather than
dementia?
A. Gradual onset over several years.
B. Irreversible cognitive decline.
,C. Intact short-term memory with lost long-term memory.
D. Acute onset with fluctuating levels of consciousness.
Correct Answer: D
Rationale: Delirium is characterized by a rapid, acute onset that is often reversible once
the underlying cause, such as infection or medication, is treated. Unlike dementia, which is
progressive and stable, delirium features fluctuations in alertness throughout the day.
Recognizing the sudden change in mental status is critical for the practical nurse to initiate
immediate medical assessment.
3. A patient is in the ‘Anger’ stage of Kübler-Ross’s five stages of grief. What is the most
appropriate nursing response?
A. Explain that their anger is misplaced and hurtful to staff.
B. Allow the patient to express their feelings without taking it personally.
C. Reassure the patient that everything will be fine.
D. Refer the patient to a psychiatrist immediately for mood stabilization.
Correct Answer: B
Rationale: Anger is a normal reaction to loss and serves as a defense mechanism for the
patient. The nurse should provide a safe environment for the patient to vent their
frustrations without becoming defensive or judgmental. Attempting to suppress this stage
or offering false reassurances can hinder the patient’s progression through the grieving
process.
, 4. An older adult patient is admitted with a suspected Urinary Tract Infection (UTI). Which
symptom should the nurse expect as a common atypical presentation in this population?
A. Acute confusion or mental status changes.
B. Severe flank pain.
C. High fever and chills.
D. Urinary frequency and burning.
Correct Answer: A
Rationale: Geriatric patients often do not present with classic signs of infection like fever
or localized pain due to age-related changes in the immune system. Acute confusion, often
referred to as delirium, is a hallmark sign of systemic issues like UTIs in the elderly. The
nurse must monitor for behavioral changes as a primary indicator of physical illness in this
demographic.
5. The nurse is discussing palliative care with a family. Which statement best describes the
goal of palliative care?
A. It is only provided when a patient has less than 6 months to live.
B. It focuses on symptom management and quality of life at any stage of illness.
C. It focuses on curative treatments for chronic illnesses.
D. It requires the patient to stop all life-sustaining medications.
Correct Answer: B
