Older Adult Nclex questions

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1. The nurse is setting up an education session with an 85-year-old patient
who will be going home on anticoagulant therapy. Which strategy would reflect
consideration of aging changes that may exist with this patient?

A. Show a colorful video about anticoagulation therapy.

B. Present all the information in one session just before discharge.
C. Give the patient pamphlets about the medications to read at home.
D. Develop large-print handouts that reflect the verbal information presented.-
: D. Develop large-print handouts that reflect the verbal information presented.

Rationale: Option D addresses altered perception in two ways. First, by using visual
aids to reinforce verbal instructions, one addresses the possibility of decreased
ability to hear high-frequency sounds. By developing the handouts in large print,
one addresses the possibility of decreased visual acuity. Option A does not allow
discussion of the information; furthermore, the text and print may be small and
difficult to read and understand.
2. When developing the plan of care for an older adult who is hospitalized for
an acute illness, the nurse should

A. use a standardized geriatric nursing care plan.

B. plan for likely long-term-care transfer to allow additional time for recovery.
C. consider the preadmission functional abilities when setting patient goals.
D. minimize activity level during hospitalization.: C. consider the preadmission
functional abilities when setting patient goals.

Rationale: The plan of care for older adults should be individualized and based on
the patients current functional abilities. A standardized geriatric nursing care plan
is unlikely to address individual patient needs and strengths. A patients need for
discharge to a long-term-care facility is variable. Activity level should be designed
to allow the patient to retain functional abilities while hospitalized and also to allow
any additional rest needed for recovery from the acute process.
3. Which information obtained by the home health nurse when making a visit
to an 88-year-old with mild forgetfulness is of the most concern?

A. The patient's son uses a marked pillbox to set up the patient's medications
weekly.
B. The patient has lost 10 pounds (4.5 kg) during the last month.
C. The patient is cared for by a daughter during the day and stays with a son
at night.
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D. The patient tells the nurse that a close friend recently died.: B. The patient
has lost 10 pounds (4.5 kg) during the last month.

Rationale: A 10-pound weight loss may be an indication of elder neglect or depres-

sion and requires further assessment by the nurse.
4. A 70-year-old client asks the nurse to explain to her about hypertension.
An appropriate response by the nurse as to why older clients often have
hypertension is due to:

A. Myocardial muscle damage

B. Reduction in physical activity
C. Ingestion of foods high in sodium
D. Accumulation of plaque on arterial walls: D. Accumulation of plaque on arterial
walls
5. In reviewing changes in the older adult, the nurse recognizes that which of
the following statements related to cognitive functioning in the older client is
true?

A. Delirium is usually easily distinguished from irreversible dementia.

B. Therapeutic drug intoxication is a common cause of senile dementia.
C. Reversible systemic disorders are often implicated as a cause of delirium.
D. Cognitive deterioration is an inevitable outcome of the human aging
process.: C. Reversible systemic disorders are often implicated as a cause of
delirium.

Rationale: Delirium is a potentially reversible cognitive impairment that is often

due to a physiological cause such as an electrolyte imbalance, cerebral anoxia,
hypoglycemia, medications, tumors, cerebrovascular infection, or hemorrhage.
6. Which of the following interventions should be taken to help an older client
to prevent osteoporosis?

A. Decrease dietary calcium intake.

B. Increase sedentary lifestyles
C. Increase dietary protein intake.
D. Encourage regular exercise.: D. Encourage regular exercise.

Rationale: Key word in question is prevent

Weight-bearing exercises helps to fight off degeneration of bone in osteoporosis

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7. Which of the following statements accurately reflects data that the nurse
should use in planning care to meet the needs of the older adult?

A. 50% of older adults have two chronic health problems.

B. Cancer is the most common cause of death among older adults.
C. Nutritional needs for both younger and older adults are essentially the
same.
D. Adults older than 65 years of age are the greatest users of prescription
medications.: D. Adults older than 65 years of age are the greatest users of
prescription medications.

Rationale: Approximately two thirds of older adults use prescription and nonprescrip-
tion drugs with one third of all prescriptions being written for older adults
8. The nurse is aware that the majority of older adults:

A. Live alone
B. Live in institutional settings
C. Are unable to care for themselves
D. Are actively involved in their community: D. Are actively involved in their
community
9. The nurse works with elderly clients in a wellness screening clinic on a
weekly basis. Which of the following statements made by the nurse is the most
therapeutic regarding their mobility?

A. "Your shoulder pain is normal for your age."

B. "Continue to exercise your joints regularly to your tolerance level."
C. "Why don't you begin walking 3 to 4 miles a day, and we'll evaluate how you
feel next week."
D. "Don't worry about taking that combination of medications since your
doctor has prescribed them.": B. "Continue to exercise your joints regularly to your
tolerance level."
10. A long-term care facility sponsors a discussion group on the administra-
tion of medications. The participants have a number of questions concerning
their medications. The nurse responds most appropriately by saying:

A. "Don't worry about the medication's name if you can identify it by its color
and shape."
B. "Unless you have severe side affects, don't worry about the minor changes
in the way you feel."
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C. "Feel free to ask your physician why you are receiving the medications that
are prescribed for you."
D. "Remember that the hepatic system is primarily responsible for the phar-
macotherapeutics of your medications.": C. "Feel free to ask your physician why
you are receiving the medications that are prescribed for you."

Rationale: The nurse should encourage the older adult to question the physician
and/or pharmacist about all prescribed drugs and over-the-counter drugs. The older
adult should be taught the names of all drugs being taken, when and how to take
them, and the desirable and undesirable effects of the drugs.
11. In performing a physical assessment for an older adult, the nurse antici-
pates finding which of the following normal physiological changes of aging?

A. Increased perspiration
B. Increased airway resistance
C. Increased salivary secretions
D. Increased pitch discrimination: B. Increased airway resistance

Rational: Normal physiological changes of aging include increased airway resis-

tance in the older adult. The older adult would be expected to have decreased
perspiration and drier skin as they experience glandular atrophy (oil, moisture, sweat
glands) in the integumentary system. The older adult would be expected to have
a decrease in saliva. A normal physiological change of the older adult related to
hearing is a loss of acuity for high-frequency tones (presbycusis).
12. There are factors that influence the musculoskeletal system associated
with aging. The nurse recognizes that with age:

A. Men have the greatest incidence of osteoporosis

B. Muscle fibers increase in size and become tighter
C. Weight-bearing exercise reduces the loss of bone mass
D. Muscle strength does not diminish as much as muscle mass: C. Weight-bear-
ing exercise reduces the loss of bone mass
13. Which of the following statements, made by the daughter of an older adult
client concerning bringing her mother home to live with her family, presents
the greatest concern for the nurse?

A. "If this doesn't work out, she can always go to live with my sister."
B. "I don't think she will react very well to me making decisions for her."
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C. "I'm afraid that mom will be depressed and miss her home."
D. "My children will just have to adjust to having their grandmother with
us.": B. "I don't think she will react very well to me making decisions for her."
14. The nurse, preparing to discharge an 81-year-old client from the hospital,
recognizes that the majority of older adults:

A. Require institutional care

B. Have no social or family support
C. Are unable to afford any medical treatment
D. Are capable of taking charge of their own lives: D. Are capable of taking
charge of their own lives
15. Which of the following responses by an older-adult client is most reflective
of a need for further education by the nurse regarding the physiological
changes associated with the older adult?

A. "I call a cab if I want to go out after dark."

B. "I can't help worrying about becoming forgetful."
C. "I have my eyes checked regularly. Can't afford to fall."
D. "I really enjoy eating good vanilla ice cream, but I have cut way down."
0%: B. "I can't help worrying about becoming forgetful."
16. Which of the following statements made by a family member of a client
recently diagnosed with early stages of Alzheimer's disease is most reflective
of an understanding of this disease process?

A. "Dad has always been a fighter; he'll fight this too. He won't give up."
B. "We have an appointment with his care provider to see about medication
therapy."
C. "Good thing we found out about this early so we can prevent this from
getting worse."
D. "We have a made arrangements to discuss nursing home placement for
dad.": B. "We have an appointment with his care provider to see about medication
therapy."
17. The nurse is planning client education for an older adult being prepared
for discharge home after hospitalization for a cardiac problem. Which nursing
action addresses the most commonly determined need for this age-group?

A. Suggest that he purchase an emergency in-home alert system.

B. Arrange for the client to receive meals delivered to his home daily.
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C. Encourage the client to use a compartmentalized pill storage container for
his daily medications.
D. Provide only written document describing the medications the client is cur-
rently prescribed.: Encourage the client to use a compartmentalized pill storage
container for his daily medications.
18. An assisted living facility has provided its clients with an educational
program on safe administration of prescribed medications. Which statement
made by an older-adult client reflects the best understanding of safe self-ad-
ministration of medications?

A. "I don't seem to have problems with side effects, but I'll let my doctor know
if something happens."
B. "I'm lucky since my daughter is really good about keeping up with my
medications."
C. "I'll be sure to read the inserts and ask the pharmacist if I don't understand
something."
D. "It shouldn't be too hard to keep it straight since I don't have any really
serious health issues.": C. "I'll be sure to read the inserts and ask the pharmacist
if I don't understand something."
19. Which of the following client statements regarding self-medication admin-
istration by an older-adult client requires follow-up teaching by the nurse?

A. "I take all the pills ordered once a day at bedtime, so I'm less likely to forget
them."
B. "I have one pill that needs cut in half. I am going to ask the pharmacist to
do that for me."
C. "The pharmacist said to keep my pills away from the sunlight, so I put them
inside the kitchen cabinet."
D. "My daughter comes over each morning and puts my pills into a container
that sorts them by the time they are due.": A. "I take all the pills ordered once a
day at bedtime, so I'm less likely to forget them."
20. Which of the following statements made by an older-adult client poses
the greatest concern for the nurse conducting an assessment regarding the
clients adjustment to the aging process?

A. "I use to enjoy dancing and jogging so much, but now I have arthritis in my
knees so that it's hard to even walk."
B. "I've given my grandchildren money for college so they can live a better life
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than I had."
C. "Growing old certainly presents all sorts of challenges. I wish I knew then
what I know now."
D. "As I age I've found its harder to do the things I love doing, but I guess it
will all be over soon enough.": D. "As I age I've found its harder to do the things I
love doing, but I guess it will all be over soon enough."
21. Of the following options, which is the greatest barrier to providing quality
health care to the older-adult client?

A. Poor client compliance resulting from generalized diminished capacity

B. Inadequate health insurance coverage for the group as a whole
C. Insufficient research to provide a basis for effective geriatric health care
D. Preconceived assumptions regarding the lifestyles and attitudes of this
group: D. Preconceived assumptions regarding the lifestyles and attitudes of this
group
22. A patient is taking delayed-release omeprazole (Prilosec) capsules for the
treatment of gastroesophageal reflux disease (GERD). Which statement will
the nurse include in the teaching plan about this medication?

A. "Take this medication once a day after breakfast."

B. "You will only have to be on this medication for 2 weeks for a life long
treatment of the reflux disease."
C. "The medication may be dissolved in a liquid for better absorption."
D. "The entire capsule should be taken whole, not crushed, chewed, or
opened.": D. "The entire capsule should be taken whole, not crushed, chewed, or
opened."
23. The nurse defines ageism most accurately as:

A. The undervaluing of individuals based on their age.

B. Perception of a person's worth based on productivity
C. Biases directed towards individuals considered aged
D. Discrimination based on an individual's increasing age: D. Discrimination
based on an individual's increasing age
24. A nurse is caring for an older adult client preparing for discharge to
a nursing center after having hip surgery. Which of the following nursing
responses is most therapeutic with a client's concern that she, will never go
back home?
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A. "What makes you think that this transfer to the nursing center will be
permanent?"
B. "The reason for this transfer is only to support you while you continue to
recuperate."
C. "The decision to stay in the nursing center is yours to make. When you want
to leave no one will stop you."
D. "The nursing center is a lovely place with a wonderful staff of caring people.
Just give it a chance. You may like it.": A. "What makes you think that this transfer
to the nursing center will be permanent?"
25. A nurse caring for older adults in an assistive living facility recognizes that
a clients quality of life needs are best determined by:

A. Excellent physical, social, and emotional nursing assessments

B. A working knowledge of this age-group's developmental needs
C. A therapeutic nurse-client relationship that facilitates communication
D. The client's need for complete physical, emotional, and cognitive care: C. A
therapeutic nurse-client relationship that facilitates communication
26. Which of the following statements made by a nurse reflects the best under-
standing of the health value of conducting a blood pressure (BP) screening at
a senior citizens centers health fair?

A. "This is a high risk group, so assessing BP allows us to identify clients at

risk and send them for treatment."
B. "Older adults enjoy health fairs, so it's a good place to screen substantial
numbers of clients for hypertension."
C. "Hypertension doesn't present symptoms early on, so screening elder
adults is a wonderful preventive measure."
D. "Blood pressure problems are common among this group, so it's a good
way to monitor the effectiveness of their medications.": B. "Older adults enjoy
health fairs, so it's a good place to screen substantial numbers of clients for hyper-
tension."
27. The three common conditions affecting cognition in the older adults are:

A. Stroke, MI, Cancer

B. Cancer, Alzheimer's disease, Stroke
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C. Delirium, Depression, Dementia
D. Blindness, Hearing loss, Stroke: C. Delirium, Depression, Dementia
28. A client has been recently diagnosed with Alzheimer's disease. When
teaching the family about the prognosis, the nurse must explain that:

A. Diet and exercise can slow the process considerably

B. It usually progresses gradually with a deterioration of function
C. Many individuals can be cured if the diagnosis is made early
D. Few clients live more than 3 years after the diagnosis: B. It usually progresses
gradually with a deterioration of function
29. An overall, general assessment of an older adult patient is best performed
in which setting?

A. During a meal.
B. During assessment of vital signs.
C. While assisting a patient with a bath.
D. When assisting a patient during a walk.: C. While assisting a patient with a
bath.
30. When caring for the older adult, it is important to:

Student Response Value Correct Answer Feedback

A. Repeat oneself often because older adults are forgetful.
B. Treat the client as an individual with a unique history of his or her own.
C. Be aware that older adults are no longer interested in sex.
D. Disregard the older adult's experiences because older people are too
old-fashioned to be of value today.: B. Treat the client as an individual with a
unique history of his or her own.
31. When administering a mental status examination to a patient with delirium,
the nurse should

A. give the examination when the patient is well-rested.

B. choose a place without distracting environmental stimuli.
C. reorient the patient as needed during the examination.
D. medicate the patient first to reduce anxiety.: B. choose a place without dis-
tracting environmental stimuli.
32. When performing a comprehensive geriatric assessment of an older adult,
focus of the nursing assessment is on the patient's:

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A. Physical signs of aging.
B. Immunological function.
C. Functional abilities.
D. Chronic illness.: C. Functional abilities.
33. Of the following, which describes dementia?

A. Quick onset, irreversible

B. Slow onset, chronic
C. Acute onset, reversible
D. Progressive, terminal: B. Slow onset, chronic
34. When a fall results in injury and hospitalization, a cycle of disuse may
occur over time. When establishing a care plan for the patient and family to
prevent this, it is important to remember disuse is most likely a result of:

A. Decreasing muscle strength.

B. Decreased joint mobility.
C. Fear of repeated falls.
D. Changes in sensory perception.: C. Fear of repeated falls.
35. What is the best resource (of those listed below) for identifying information
regarding an older adult's current functional ability?

A. Psychological tests and related exams

B. Diagnostic x-rays and lab tests
C. Family members who visit occasionally and call weekly
D. Neighbor who visits daily and helps the person to the store weekly.: D.
Neighbor who visits daily and helps the person to the store weekly.
36. When caring for an older adult patient, the nurse uses the following inter-
ventions to accommodate visual changes with age:

A. Eye glasses in the bedside table.

B. Adequate lighting and uncluttered walkways.
C. Draw drapes in room to prevent glare.
D. Keep bedside rails down.: B. Adequate lighting and uncluttered walkways.
37. The primary reason an older adult client is more likely to develop a pres-
sure ulcer on the elbow as compared to a middle-age adult is:

A. A reduced skin elasticity is common in the older adult

B. The attachment between the epidermis and dermis is weaker
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C. The older client has less subcutaneous padding on the elbows
D. Older adults have a poor diet that increases risk for pressure ulcers: C. The
older client has less subcutaneous padding on the elbows
38. While bathing an elderly client who has limited abilities for self-care, the
nurse notices several patches of dry skin on the clients heels, elbows, and
coccyx. The nurse cleans and dries all the areas well and applies a moisturiz-
ing lotion. The most appropriate immediate follow-up by the nurse to ensure
appropriate nursing care for this clients skin is to:

A. Revise the client's care plan to show the need for the application of
moisturizing lotion
B. Assume personal responsibility to apply the moisturizing lotion daily to the
client's skin
C. Encourage the client to tell whomever bathes her to apply the moisturizing
lotion to her areas of dry skin
D. Inform the staff that the client's skin is showing signs of breakdown and
moisturizing lotion needs to be applied daily: A. Revise the client's care plan to
show the need for the application of moisturizing lotion
39. A 76-year-old adult female is brought to a neighborhood client after being
found wandering around the local park. The client appears disheveled and re-
ports being hungry. Which of the following assessment and interview findings
would cause the nurse to suspect elder abuse? (Select all that apply.)

A. Falls asleep in the examination room

B. Repeatedly states, "Don't hurt me."
C. Chafing around wrists and ankles
D. Bruises in various stages of healing: B. Repeatedly states, "Don't hurt me."
C. Chafing around wrists and ankles
D. Bruises in various stages of healing
40. One reason for medication problems in the elderly is that

1. Regular use of laxatives increases absorption of medications

2. Decreased renal function slows excretion of drugs
3. Enhanced sense of taste of medications
4. Increased perception of pain from injections: 2. Decreased renal function
slows excretion of drugs

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41. You are caring for a 78 year-old female cardiac patient. In preconference,
your clinical instructor asks you what is an age-related change in the cardiac
system of the older adult? Your best response would be

Student Response Value Correct Answer Feedback

1. Decreased blood pressure
2. Decreased cardiac output
3. Increase ability to respond to stress
4. Increased heart recovery rate: 2. Decreased cardiac output
42. The most common affective or mood disorder of old age is

1. dementia.
2. depression.
3. delirium.
4. Alzheimer's.: 2. depression.
43. Your patient assigned to you has pneumonia. You are reviewing the age-re-
lated changed involved with the older adult. Select all age-related changes of
the respiratory system that apply.

1. Decreased in residual lung volume

2. Decreased gas exchange
3. Decreased cough efficiency
4. Increased gas exchange: 2. Decreased gas exchange
3. Decreased cough efficiency
44. The leading cause of injury and preventable source of mortality and mor-
bidity in older adults is

1. presbycusis.
2. car accidents.
3. pneumonia.
4. falls.: 4. falls.
45. Which medication prevents the breakdown of a brain chemical important
for memory and thinking and may slow the progress of Alzheimer's disease.

1. memantine (Namenda)
2. ozazepam (Serax)
3. donepezil (Aricept)
4. citalopram (Celexa): 3. donepezil (Aricept)
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