CPNRE - Canadian Practical Nurse Registration Examination Gerontological and Palliative Care Questions and Answers Flashcards

A 78-year-old client is prescribed multiple medications. Which age-related pharmacokinetic change most increases the risk of drug toxicity in older adults?

Answer: Decreased renal clearance

Declining glomerular filtration rate reduces renal clearance, causing drug accumulation and elevated risk of toxicity in older adults.

When using the PAINAD scale to assess pain in a non-verbal client with advanced dementia, the nurse observes rigid body posture and clenched fists but no facial grimacing or vocalization. The nurse should:

Answer: Score body language and consult the care team about analgesic management

Body language indicators on the PAINAD scale are valid pain indicators; rigid posture and clenched fists indicate discomfort requiring attention.

Which dietary modification is most appropriate for an older adult with dysphagia at risk for aspiration?

Answer: Provide minced or pureed foods and thickened liquids as per SLP recommendation

A speech-language pathologist-guided texture-modified diet reduces aspiration risk while preserving oral nutrition.

An older adult residing in a long-term care facility refuses a bath for the third consecutive day. The nurse's best response is to:

Answer: Explore the reason for refusal and offer alternative hygiene options

Exploring barriers and offering choices respects autonomy while addressing hygiene needs through person-centred care.

A palliative client on high-dose morphine develops myoclonus. This symptom most likely indicates:

Answer: Opioid-induced neurotoxicity potentially requiring opioid rotation

Myoclonus is a sign of opioid-induced neurotoxicity; opioid rotation to a different opioid may be needed.

Which principle of palliative care best describes treating the whole person — physical, emotional, social, and spiritual dimensions — rather than only the disease?

Answer: Holistic care

Holistic care addresses all dimensions of suffering and is a foundational principle of palliative nursing.

A frail older adult is admitted with dehydration. Which assessment finding best supports a nursing diagnosis of fluid volume deficit in this population?

Answer: Dry oral mucous membranes and elevated serum sodium

Dry mucous membranes combined with elevated serum sodium are reliable indicators of fluid volume deficit in older adults.