Gerontological Nurse Test Nutrition and Hydration in the Elderly 2 — Questions and Answers
Question 1: Which clinical sign is most reliable for assessing dehydration in older adults when skin turgor is unreliable due to normal age-related changes?
- Decreased urine output
- Dry axillae (Correct answer)
- Pitting edema
- Increased respiratory rate
Correct answer: Dry axillae
Dry axillae (armpits) is a more reliable indicator of dehydration in elderly patients than skin turgor because axillary skin is less affected by age-related elasticity loss.
Question 2: A 78-year-old patient with advanced dementia cannot take adequate oral nutrition. What is the most important factor when considering enteral tube feeding?
- The patient's weight loss percentage
- The patient's advance directives and goals of care (Correct answer)
- The current serum albumin level
- The patient's family preference alone
Correct answer: The patient's advance directives and goals of care
Advance directives and established goals of care take ethical and legal precedence when making decisions about artificial nutrition for patients with advanced dementia who lack decision-making capacity.
Question 3: Which medication class most commonly causes xerostomia (dry mouth) that contributes to nutritional problems in older adults?
- ACE inhibitors
- Anticholinergic medications (Correct answer)
- Beta-blockers
- Statins
Correct answer: Anticholinergic medications
Anticholinergic medications reduce parasympathetic stimulation of salivary glands, causing dry mouth that impairs chewing, swallowing, and appetite.
Question 4: Sarcopenia in older adults is best described as:
- Increased fat mass with decreased bone density
- Progressive loss of skeletal muscle mass and strength with aging (Correct answer)
- Inflammation of the sarcomeres in cardiac muscle
- Excessive protein accumulation in muscle tissue
Correct answer: Progressive loss of skeletal muscle mass and strength with aging
Sarcopenia is the progressive, age-related loss of skeletal muscle mass and strength that contributes to functional decline, increased fall risk, and malnutrition.
Question 5: What is the standard minimum daily fluid requirement for a healthy 70 kg older adult?
- 500–700 mL
- 1,000–1,200 mL
- 1,500–2,000 mL (Correct answer)
- 3,000–4,000 mL
Correct answer: 1,500–2,000 mL
The standard recommendation of approximately 30 mL/kg/day places a 70 kg adult at about 2,100 mL; the practical clinical range is 1,500–2,000 mL minimum for most elderly patients.
Question 6: Which nursing intervention is most effective for promoting adequate nutrition in a hospitalized older adult with poor appetite?
- Inserting a nasogastric tube immediately
- Offering small, frequent meals with preferred foods (Correct answer)
- Providing high-calorie protein shakes exclusively
- Restricting meals to scheduled times only
Correct answer: Offering small, frequent meals with preferred foods
Small, frequent meals of preferred foods improve palatability, reduce feelings of early satiety, and increase overall caloric and protein intake in elderly patients with poor appetite.
Question 7: In the DETERMINE nutritional risk checklist used with older adults, the letter 'D' stands for which risk factor?
- Dehydration
- Dental problems
- Disease (Correct answer)
- Decreased mobility
Correct answer: Disease
In the DETERMINE checklist, 'D' stands for Disease — any illness or condition that changes the kind or amount of food eaten is a primary nutritional risk factor.
Gerontological Nurse Test Nutrition and Hydration in the Elderly 2
Which clinical sign is most reliable for assessing dehydration in older adults when skin turgor is unreliable due to normal age-related changes?