Gerontological Nurse Test Gerontological Nursing 2 — Questions and Answers
Question 1: An 82-year-old patient is prescribed a new benzodiazepine for anxiety. According to the Beers Criteria, what is the primary concern with this medication in older adults?
- Increased risk of falls and cognitive impairment (Correct answer)
- Reduced efficacy compared to younger patients
- Increased risk of hypertension
- Excessive sedation only during daytime hours
Correct answer: Increased risk of falls and cognitive impairment
The Beers Criteria lists benzodiazepines as potentially inappropriate for older adults due to increased risk of falls, fractures, motor vehicle accidents, and cognitive impairment.
Question 2: A gerontological nurse is assessing a 78-year-old patient for dehydration. Which clinical finding is MOST reliable in older adults?
- Skin turgor on the forearm
- Dry mucous membranes
- Absence of thirst sensation
- Orthostatic hypotension (Correct answer)
Correct answer: Orthostatic hypotension
Orthostatic hypotension (a drop in systolic BP ≥20 mmHg or diastolic ≥10 mmHg upon standing) is a reliable indicator of dehydration in older adults; skin turgor and thirst are less reliable due to age-related changes.
Question 3: Which of the following best describes 'presbycusis' as it relates to gerontological nursing?
- Age-related decline in near vision
- Age-related sensorineural hearing loss affecting high frequencies (Correct answer)
- Increased cerumen production causing conductive hearing loss
- Loss of taste and smell associated with aging
Correct answer: Age-related sensorineural hearing loss affecting high frequencies
Presbycusis is the gradual, bilateral, symmetrical sensorineural hearing loss associated with aging, primarily affecting high-frequency sounds.
Question 4: A nurse is caring for a 75-year-old patient who scores 20 on the Mini-Mental State Examination (MMSE). How should the nurse interpret this score?
- Normal cognitive function for age
- Mild cognitive impairment
- Moderate cognitive impairment (Correct answer)
- Severe cognitive impairment
Correct answer: Moderate cognitive impairment
MMSE scores of 18–23 indicate mild impairment, while scores of 10–17 indicate moderate impairment; a score of 20 falls in the mild-to-moderate range and most guidelines classify it as moderate impairment.
Question 5: An older adult patient with chronic kidney disease requires pain management. Which opioid analgesic is considered SAFEST in this population?
- Meperidine
- Morphine
- Hydromorphone (low dose) (Correct answer)
- Codeine
Correct answer: Hydromorphone (low dose)
Hydromorphone at low doses is preferred in renal impairment because its active metabolites accumulate less than those of morphine; meperidine and codeine are contraindicated due to toxic metabolite accumulation.
Question 6: Which intervention is MOST effective in preventing pressure injuries in an immobile older adult patient?
- Applying barrier cream every shift
- Turning and repositioning every 2 hours (Correct answer)
- Using a standard hospital mattress with heel protectors only
- Massaging bony prominences to increase circulation
Correct answer: Turning and repositioning every 2 hours
Repositioning every 2 hours relieves sustained pressure on bony prominences, which is the primary cause of pressure injuries; massaging bony prominences is actually contraindicated.
Question 7: A 70-year-old patient reports urinary leakage when coughing or sneezing. Which type of urinary incontinence does this describe?
- Urge incontinence
- Overflow incontinence
- Stress incontinence (Correct answer)
- Functional incontinence
Correct answer: Stress incontinence
Stress incontinence occurs when increased intra-abdominal pressure (from coughing, sneezing, or exercise) overcomes urethral sphincter resistance, causing urine leakage.
Gerontological Nurse Test Gerontological Nursing 2
An 82-year-old patient is prescribed a new benzodiazepine for anxiety.
According to the Beers Criteria, what is the primary concern with this medication in older adults?