NUR2214 Nursing Care of the Older Adult
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1:
Mrs. Thompson is an 82‐year‐old female with a history of hypertension,
diabetes, and chronic heart failure. During a routine assessment, she is
found to be acutely confused and mildly febrile. Which of the following is
the most likely precipitant of her sudden change in mental status?
A. Adverse effects from polypharmacy
B. Hypoglycemia
C. Urinary tract infection
D. Sleep deprivation
Correct ANS: C. Urinary tract infection
Rationale: In older adults, infections (particularly UTIs) often present
atypically and are a common trigger for delirium. Although polypharmacy
and hypoglycemia can also cause confusion, the presence of a fever
raises suspicion for an underlying infection that should be ruled out.
---
Question 2:
Mr. Garcia, a 79‐year‐old male with osteoarthritis and limited mobility, is
at risk for skin breakdown. Which nursing intervention is most effective
in preventing pressure injuries in this patient?
A. Repositioning every 2 hours
B. Using intermittent pneumatic compression devices
C. Applying barrier creams only when redness is noted
D. Relying solely on specialized mattresses to prevent pressure injury
Correct ANS: A. Repositioning every 2 hours
Rationale: Regular repositioning is the cornerstone of pressure injury
prevention in older adults. While specialized mattresses and adjunctive
therapies may help, repositioning every 2 hours actively relieves pressure
on vulnerable areas and reduces the risk of ulceration.
©2025
, ---
Question 3:
Mrs. Lee is an 85‐year‐old resident with moderate dementia who
frequently wanders. Which intervention is the most appropriate and
evidence‐based strategy for safely managing her wandering behavior?
A. Restraining her movement physically
B. Increasing sedative medications
C. Implementing environmental modifications and an interdisciplinary
care plan
D. Isolating her in a locked unit
Correct ANS: C. Implementing environmental modifications and an
interdisciplinary care plan
Rationale: Nonpharmacologic interventions such as adapting the
environment, engaging her in familiar activities, and involving an
interdisciplinary team are recommended to safely manage wandering.
Physical restraints or excessive sedation may increase the risk of injury
and further diminish quality of life.
---
Question 4:
Mr. Rogers, a 90‐year‐old male residing in a long‐term care facility, has
difficulty swallowing and coughing during meals. Which assessment is
most critical to determine his risk for aspiration?
A. Ordering a modified barium swallow study immediately
B. Continuous pulse oximetry during feeding
C. A comprehensive bedside swallow evaluation observing for coughing
or choking
D. Assessing lung auscultation after meals
Correct ANS: C. A comprehensive bedside swallow evaluation
observing for coughing or choking
Rationale: A bedside swallow evaluation is the first step to assess for
©2025
Midterm Exam Review
(Questions & Solutions)
2025
©2025
, Question 1:
Mrs. Thompson is an 82‐year‐old female with a history of hypertension,
diabetes, and chronic heart failure. During a routine assessment, she is
found to be acutely confused and mildly febrile. Which of the following is
the most likely precipitant of her sudden change in mental status?
A. Adverse effects from polypharmacy
B. Hypoglycemia
C. Urinary tract infection
D. Sleep deprivation
Correct ANS: C. Urinary tract infection
Rationale: In older adults, infections (particularly UTIs) often present
atypically and are a common trigger for delirium. Although polypharmacy
and hypoglycemia can also cause confusion, the presence of a fever
raises suspicion for an underlying infection that should be ruled out.
---
Question 2:
Mr. Garcia, a 79‐year‐old male with osteoarthritis and limited mobility, is
at risk for skin breakdown. Which nursing intervention is most effective
in preventing pressure injuries in this patient?
A. Repositioning every 2 hours
B. Using intermittent pneumatic compression devices
C. Applying barrier creams only when redness is noted
D. Relying solely on specialized mattresses to prevent pressure injury
Correct ANS: A. Repositioning every 2 hours
Rationale: Regular repositioning is the cornerstone of pressure injury
prevention in older adults. While specialized mattresses and adjunctive
therapies may help, repositioning every 2 hours actively relieves pressure
on vulnerable areas and reduces the risk of ulceration.
©2025
, ---
Question 3:
Mrs. Lee is an 85‐year‐old resident with moderate dementia who
frequently wanders. Which intervention is the most appropriate and
evidence‐based strategy for safely managing her wandering behavior?
A. Restraining her movement physically
B. Increasing sedative medications
C. Implementing environmental modifications and an interdisciplinary
care plan
D. Isolating her in a locked unit
Correct ANS: C. Implementing environmental modifications and an
interdisciplinary care plan
Rationale: Nonpharmacologic interventions such as adapting the
environment, engaging her in familiar activities, and involving an
interdisciplinary team are recommended to safely manage wandering.
Physical restraints or excessive sedation may increase the risk of injury
and further diminish quality of life.
---
Question 4:
Mr. Rogers, a 90‐year‐old male residing in a long‐term care facility, has
difficulty swallowing and coughing during meals. Which assessment is
most critical to determine his risk for aspiration?
A. Ordering a modified barium swallow study immediately
B. Continuous pulse oximetry during feeding
C. A comprehensive bedside swallow evaluation observing for coughing
or choking
D. Assessing lung auscultation after meals
Correct ANS: C. A comprehensive bedside swallow evaluation
observing for coughing or choking
Rationale: A bedside swallow evaluation is the first step to assess for
©2025
