NYU Adult and Elder 1 Final| 162
QUESTIONS| WITH COMPLETE SOLUTIONS
Course
NYU Adult and Elder
1. Question: Polypharmacy Risk
Q: A 78-year-old patient is admitted with confusion, dizziness, and frequent falls. The patient is
on eight different medications. What is the most appropriate nursing intervention?
A. Notify the prescriber for a medication review.
B. Increase fluid intake.
C. Encourage more physical activity.
D. Administer medications as prescribed.
Answer: A
Rationale: Polypharmacy is common in older adults and can lead to adverse drug reactions,
confusion, and falls. A medication review is a priority to prevent harm.
2. Question: Delirium vs. Dementia
Q: Which of the following is a hallmark feature of delirium but not dementia?
A. Gradual onset
B. Memory loss
C. Fluctuating levels of consciousness
D. Poor judgment
Answer: C
Rationale: Delirium presents with an acute onset and fluctuating consciousness, while dementia
typically has a gradual onset with steady cognitive decline.
3. Question: Pressure Ulcer Staging
Q: A patient has a full-thickness skin loss with visible subcutaneous fat but no exposed bone or
muscle. What is the correct stage of the pressure ulcer?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
,Answer: C
Rationale: Stage 3 pressure ulcers involve full-thickness skin loss with visible fat. Bone, tendon,
or muscle exposure indicates Stage 4.
4. Question: Fall Prevention
Q: Which of the following nursing interventions is most effective in preventing falls in
hospitalized older adults?
A. Use of physical restraints
B. Hourly rounding and toileting schedule
C. Administering sedatives at bedtime
D. Keeping the bed in a high position
Answer: B
Rationale: Hourly rounding and regular toileting reduce fall risk by addressing common causes
of unassisted ambulation.
5. Question: Age-Related Changes
Q: Which physiological change is normal in the elderly population?
A. Increased renal clearance
B. Decreased gastric pH
C. Increased elasticity of arteries
D. Decreased lung compliance
Answer: D
Rationale: Aging leads to reduced lung compliance, affecting respiratory function. Other
options are incorrect or pathologic.
6. Question: Depression in Older Adults
Q: A nurse suspects depression in an 82-year-old patient. What is the most appropriate initial
nursing action?
A. Refer to a psychiatrist immediately.
B. Document the observation and continue care.
C. Administer a depression screening tool like the Geriatric Depression Scale.
D. Encourage the patient to talk to family.
,Answer: C
Rationale: Use of validated screening tools is essential for early detection of depression in the
elderly before proceeding to referral.
7. Question: Ethical Decision-Making
Q: A patient with advanced dementia has a DNR (Do Not Resuscitate) order. During lunch, the
patient begins choking. What is the nurse’s appropriate action?
A. Begin CPR immediately
B. Perform the Heimlich maneuver
C. Call the physician before taking action
D. Do nothing due to the DNR
Answer: B
Rationale: DNR applies to cardiac or respiratory arrest. Choking is a reversible airway
obstruction; Heimlich is appropriate.
8. Question: Osteoporosis Education
Q: Which statement by a patient with osteoporosis indicates a need for further education?
A. "I should do weight-bearing exercises regularly."
B. "I’ll take calcium and vitamin D as prescribed."
C. "I will increase my intake of caffeine."
D. "I will use handrails and avoid slippery surfaces."
Answer: C
Rationale: Caffeine can reduce calcium absorption. This statement indicates a misunderstanding
and a need for further teaching.
9. Question: Pharmacokinetics in the Elderly
Q: How does aging affect drug metabolism and excretion?
A. Increases liver enzyme activity
B. Enhances kidney filtration rate
C. Slows hepatic metabolism and renal excretion
D. Increases drug absorption
, Answer: C
Rationale: Aging decreases liver and kidney function, reducing drug clearance and increasing
the risk of toxicity.
10. Question: End-of-Life Care
Q: Which nursing action demonstrates culturally competent care at the end of life?
A. Providing the same care plan to all dying patients
B. Avoiding discussions of death to prevent distress
C. Asking about spiritual and cultural practices regarding death
D. Limiting family presence to reduce confusion
Answer: C
Rationale: Cultural competence includes respecting and incorporating patients’ beliefs and
preferences about dying and death into care.
11. Question: Urinary Incontinence Types
Q: A patient complains of involuntary urine leakage when sneezing or coughing. What type of
urinary incontinence is this?
A. Urge incontinence
B. Overflow incontinence
C. Functional incontinence
D. Stress incontinence
Answer: D
Rationale: Stress incontinence is caused by increased intra-abdominal pressure during activities
like sneezing or coughing.
12. Question: Sensory Changes
Q: Which age-related sensory change is most likely to affect medication adherence?
A. Loss of taste
B. Decreased sense of smell
C. Presbyopia
D. Hearing loss
Answer: C
Rationale: Presbyopia (difficulty reading close objects) may prevent older adults from reading
medication labels properly.
QUESTIONS| WITH COMPLETE SOLUTIONS
Course
NYU Adult and Elder
1. Question: Polypharmacy Risk
Q: A 78-year-old patient is admitted with confusion, dizziness, and frequent falls. The patient is
on eight different medications. What is the most appropriate nursing intervention?
A. Notify the prescriber for a medication review.
B. Increase fluid intake.
C. Encourage more physical activity.
D. Administer medications as prescribed.
Answer: A
Rationale: Polypharmacy is common in older adults and can lead to adverse drug reactions,
confusion, and falls. A medication review is a priority to prevent harm.
2. Question: Delirium vs. Dementia
Q: Which of the following is a hallmark feature of delirium but not dementia?
A. Gradual onset
B. Memory loss
C. Fluctuating levels of consciousness
D. Poor judgment
Answer: C
Rationale: Delirium presents with an acute onset and fluctuating consciousness, while dementia
typically has a gradual onset with steady cognitive decline.
3. Question: Pressure Ulcer Staging
Q: A patient has a full-thickness skin loss with visible subcutaneous fat but no exposed bone or
muscle. What is the correct stage of the pressure ulcer?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
,Answer: C
Rationale: Stage 3 pressure ulcers involve full-thickness skin loss with visible fat. Bone, tendon,
or muscle exposure indicates Stage 4.
4. Question: Fall Prevention
Q: Which of the following nursing interventions is most effective in preventing falls in
hospitalized older adults?
A. Use of physical restraints
B. Hourly rounding and toileting schedule
C. Administering sedatives at bedtime
D. Keeping the bed in a high position
Answer: B
Rationale: Hourly rounding and regular toileting reduce fall risk by addressing common causes
of unassisted ambulation.
5. Question: Age-Related Changes
Q: Which physiological change is normal in the elderly population?
A. Increased renal clearance
B. Decreased gastric pH
C. Increased elasticity of arteries
D. Decreased lung compliance
Answer: D
Rationale: Aging leads to reduced lung compliance, affecting respiratory function. Other
options are incorrect or pathologic.
6. Question: Depression in Older Adults
Q: A nurse suspects depression in an 82-year-old patient. What is the most appropriate initial
nursing action?
A. Refer to a psychiatrist immediately.
B. Document the observation and continue care.
C. Administer a depression screening tool like the Geriatric Depression Scale.
D. Encourage the patient to talk to family.
,Answer: C
Rationale: Use of validated screening tools is essential for early detection of depression in the
elderly before proceeding to referral.
7. Question: Ethical Decision-Making
Q: A patient with advanced dementia has a DNR (Do Not Resuscitate) order. During lunch, the
patient begins choking. What is the nurse’s appropriate action?
A. Begin CPR immediately
B. Perform the Heimlich maneuver
C. Call the physician before taking action
D. Do nothing due to the DNR
Answer: B
Rationale: DNR applies to cardiac or respiratory arrest. Choking is a reversible airway
obstruction; Heimlich is appropriate.
8. Question: Osteoporosis Education
Q: Which statement by a patient with osteoporosis indicates a need for further education?
A. "I should do weight-bearing exercises regularly."
B. "I’ll take calcium and vitamin D as prescribed."
C. "I will increase my intake of caffeine."
D. "I will use handrails and avoid slippery surfaces."
Answer: C
Rationale: Caffeine can reduce calcium absorption. This statement indicates a misunderstanding
and a need for further teaching.
9. Question: Pharmacokinetics in the Elderly
Q: How does aging affect drug metabolism and excretion?
A. Increases liver enzyme activity
B. Enhances kidney filtration rate
C. Slows hepatic metabolism and renal excretion
D. Increases drug absorption
, Answer: C
Rationale: Aging decreases liver and kidney function, reducing drug clearance and increasing
the risk of toxicity.
10. Question: End-of-Life Care
Q: Which nursing action demonstrates culturally competent care at the end of life?
A. Providing the same care plan to all dying patients
B. Avoiding discussions of death to prevent distress
C. Asking about spiritual and cultural practices regarding death
D. Limiting family presence to reduce confusion
Answer: C
Rationale: Cultural competence includes respecting and incorporating patients’ beliefs and
preferences about dying and death into care.
11. Question: Urinary Incontinence Types
Q: A patient complains of involuntary urine leakage when sneezing or coughing. What type of
urinary incontinence is this?
A. Urge incontinence
B. Overflow incontinence
C. Functional incontinence
D. Stress incontinence
Answer: D
Rationale: Stress incontinence is caused by increased intra-abdominal pressure during activities
like sneezing or coughing.
12. Question: Sensory Changes
Q: Which age-related sensory change is most likely to affect medication adherence?
A. Loss of taste
B. Decreased sense of smell
C. Presbyopia
D. Hearing loss
Answer: C
Rationale: Presbyopia (difficulty reading close objects) may prevent older adults from reading
medication labels properly.
