Chapter 8 Caring for the Older Adult Fundamentals of Nursing 11th Edition (Potter & Perry) 50 NCLEX-Style Exam Questions with Detailed Rationales

1. A nurse is caring for an 82-year-old patient admitted for pneumonia. Which normal age-related change may affect the patient's ability to clear secretions effectively? A. Increased lung elasticity B. Decreased cough reflex C. Increased ciliary function D. Decreased alveolar surface tension Correct Answer: B Rationale: Aging leads to a decreased cough reflex, which impairs the older adult’s ability to clear respiratory secretions effectively. ________________________________________ 2. Which intervention should the nurse prioritize to prevent falls in an older adult with impaired vision? A. Encourage the use of dark rugs to improve contrast B. Leave lights off at night to promote sleep C. Keep frequently used items within reach D. Recommend the use of cane only during outdoor walking Correct Answer: C Rationale: Keeping frequently used items within reach reduces the need for movement and helps prevent falls, especially in patients with impaired vision. ________________________________________ 3. A nurse plans care for an older adult who is confused and wanders at night. What is the most appropriate nursing intervention? A. Apply physical restraints B. Place the patient in a room far from the nurse’s station C. Encourage the use of a sedative at bedtime D. Use a bed alarm and maintain a low-stimulus environment Correct Answer: D Rationale: Using a bed alarm and creating a calm environment are appropriate non-pharmacologic interventions for managing nocturnal wandering in confused older adults. ________________________________________ 4. What is the most common cause of medication errors in older adults? A. Polypharmacy B. Memory loss C. Caregiver neglect D. Decreased renal function Correct Answer: A Rationale: Polypharmacy—taking multiple medications—significantly increases the risk of adverse drug events and errors in older adults. ________________________________________ 5. The nurse is teaching a group of older adults about preventing constipation. Which statement indicates understanding? A. “I will limit my fluid intake to avoid frequent urination.” B. “I should increase my intake of cheese and bananas.” C. “I will walk for 30 minutes each day.” D. “Laxatives are the best solution if I feel bloated.” Correct Answer: C Rationale: Regular physical activity like walking promotes bowel motility and is effective in preventing constipation in older adults. ________________________________________ 6. An older adult patient has lost 10 pounds in the past month. What is the most appropriate initial nursing action? A. Consult the dietitian B. Document the weight loss C. Encourage more frequent meals D. Assess the patient’s oral health and appetite Correct Answer: D Rationale: Assessment is the first step in the nursing process. The nurse should first determine the cause of the weight loss. ________________________________________ 7. Which age-related physiological change contributes most to increased drug sensitivity in older adults? A. Increased hepatic metabolism B. Increased renal clearance C. Decreased body fat D. Decreased glomerular filtration rate Correct Answer: D Rationale: A decreased glomerular filtration rate in older adults reduces renal drug excretion, increasing the risk of drug toxicity. ________________________________________ 8. The nurse is caring for an older adult with dementia. Which approach is most appropriate when communicating? A. Speak loudly and use medical jargon B. Use simple, short sentences and give one instruction at a time C. Use complex instructions to stimulate memory D. Avoid eye contact to minimize agitation Correct Answer: B Rationale: Communication should be clear, calm, and simple when interacting with patients with cognitive impairment. ________________________________________ 9. What is the primary goal of the nurse when promoting health in older adults? A. Encouraging dependence to ensure safety B. Managing chronic diseases through hospitalization C. Promoting functional independence and quality of life D. Preventing all forms of aging-related decline Correct Answer: C Rationale: The primary nursing goal in gerontological care is to support older adults in maintaining independence and a high quality of life. ________________________________________ 10. Which assessment finding in an older adult requires immediate nursing intervention? A. Senile lentigines on the skin B. Slight decrease in short-term memory C. New onset of urinary incontinence D. Occasional forgetfulness Correct Answer: C Rationale: New onset of incontinence may signal an acute issue such as a urinary tract infection and requires immediate assessment and intervention. ________________________________________ 11. A nurse suspects elder abuse in a confused patient admitted with bruises. What is the most appropriate action? A. Document findings and report to adult protective services B. Ask the caregiver to explain the bruises C. Tell the patient to report future abuse D. Ignore the signs until proof is obtained Correct Answer: A Rationale: Nurses are mandated reporters. Suspected abuse must be documented and reported per facility policy and legal requirements. ________________________________________ 12. Which is the best indicator of dehydration in an older adult? A. Skin turgor on the hand B. Concentrated urine output C. Sunken eyes D. Elevated blood pressure Correct Answer: B Rationale: Older adults may not show classic signs of dehydration. Urine concentration is a reliable early indicator. ________________________________________ 13. The nurse is developing a discharge plan for an older adult who lives alone. What is the best intervention to promote medication adherence? A. Use of color-coded bottles B. Provide a complex medication schedule C. Recommend family administer all medications D. Use a pill organizer with clear labeling Correct Answer: D Rationale: Pill organizers are effective tools to enhance medication adherence, especially for older adults with mild cognitive impairment. ________________________________________ 14. Which factor is most likely to increase an older adult’s risk for social isolation? A. Retirement B. Grandparenting C. Increased mobility D. Access to transportation Correct Answer: A Rationale: Retirement can reduce social interaction and may increase feelings of isolation, especially if there’s limited support. ________________________________________ 15. The nurse is providing teaching to a group of older adults. Which topic is most important to include? A. Anti-aging skin treatments B. Fall prevention strategies C. Internet use for seniors D. Local entertainment options Correct Answer: B Rationale: Fall prevention is a high-priority safety concern in the aging population due to the risk of injury and hospitalization. ________________________________________