A nurse is completing a wellness visit for a 79-year-old client who lives alone. Which information from the client is most important for the nurse to follow up?
"I need a brighter lamp and I hold the newspaper farther away to read it."
"In a noisy restaurant I have trouble making out high-pitched voices."
"I have fallen twice at home in the past 6 months, but I was not hurt."
"The skin on my hands is thinner and drier, and it bruises more easily."
Show the answer and explanation
Answer: C. "I have fallen twice at home in the past 6 months, but I was not hurt."
Topic: normal aging vs findings to report; falls
Falls are not a normal part of aging. A history of falls is one of the strongest predictors of another fall and calls for a full assessment of gait, balance, medications, vision, blood pressure on standing and the home. The other statements describe expected age-related changes in vision, hearing and skin.
Why the others are wrong
A – Presbyopia and a need for more light are expected lens and pupil changes of aging; they are managed with correction and lighting, not treated as a warning sign.
B – Loss of high-frequency hearing that is worse with background noise (presbycusis) is an expected change.
D – Thinner, drier skin and fragile capillaries are expected skin changes of aging.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
2Question
An 82-year-old client takes 11 prescribed medications ordered by three different prescribers and reports using over-the-counter diphenhydramine most nights for sleep. Which actions should the nurse take?
Select all that apply.
Tell the client that over-the-counter products and supplements do not need to be on the medication list.
Ask the client to bring every medication, supplement and over-the-counter product in its container to each visit.
Advise the client to stop any medication that seems to cause a side effect until the next appointment.
Encourage the client to have all prescriptions filled at one pharmacy.
Discuss the nightly diphenhydramine with the health care provider.
Show the answers and explanation
Answers: B, D and E.
B – Ask the client to bring every medication, supplement and over-the-counter product in its container to each visit.
D – Encourage the client to have all prescriptions filled at one pharmacy.
E – Discuss the nightly diphenhydramine with the health care provider.
Topic: polypharmacy
Polypharmacy raises the risk of interactions, duplication and adverse drug events in older adults. A complete review of everything the client takes, one pharmacy that can screen for interactions, and questioning a strongly anticholinergic sleep aid, which is listed as potentially inappropriate for older adults because of confusion, urinary retention and falls, all reduce that risk.
Why the others are wrong
A – Over-the-counter products and supplements interact with prescribed drugs and must be on the list; here one of them is the main concern.
C – Stopping medications without advice can be dangerous, for example with beta-blockers or anticonvulsants; the client should report the effect and be advised.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
3Question
An 84-year-old client is 2 days postoperative after hip repair. Overnight the client became restless, could not follow a conversation and pulled at the IV line; this morning the client is drowsy but answers appropriately. The daughter says, "Last week my father was completely sharp." Which action should the nurse take first?
Check oxygen saturation, pain, bladder distension and bowel status, and review the medications given in the last 24 hours.
Request a prescription for soft wrist restraints to protect the IV line at night.
Explain to the daughter that surgery often brings out dementia that was already developing.
Request a prescription for a sedative to be given at bedtime.
Show the answer and explanation
Answer: A. Check oxygen saturation, pain, bladder distension and bowel status, and review the medications given in the last 24 hours.
Topic: delirium vs dementia
An abrupt change in attention that fluctuates over hours in a client who was at baseline days ago is delirium until proven otherwise. Delirium is a medical emergency with a treatable cause, commonly hypoxia, pain, infection, urinary retention, constipation, dehydration or a medication, so the first step is to assess for those causes.
Why the others are wrong
B – Restraints are a last resort and increase agitation, injury and delirium; the cause has not yet been assessed.
C – Dementia develops over months to years and does not fluctuate over hours; labelling this as dementia would delay finding a treatable cause.
D – Sedatives can deepen or prolong delirium and raise fall risk; they do not address why it started.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
4Question
A nurse is preparing discharge teaching for a 77-year-old client with age-related hearing loss who wears no hearing aid. Which approaches should the nurse use?
Select all that apply.
Sit facing the client at eye level with the light on the nurse's face.
Speak loudly into the client's better ear.
Use a lower-pitched voice at a normal to slightly slower pace.
Turn off the television and close the door before starting.
Exaggerate lip movements so the words are easier to read.
Rephrase a sentence the client did not catch instead of repeating the same words.
Show the answers and explanation
Answers: A, C, D and F.
A – Sit facing the client at eye level with the light on the nurse's face.
C – Use a lower-pitched voice at a normal to slightly slower pace.
D – Turn off the television and close the door before starting.
F – Rephrase a sentence the client did not catch instead of repeating the same words.
Topic: sensory changes and communication
Age-related hearing loss affects high-pitched sounds first and is made worse by background noise. Facing the client in good light supports speech reading, a lower pitch falls in the range the client hears best, a quiet room removes competing sound, and different words may contain sounds that are easier to hear.
Why the others are wrong
B – Shouting raises the pitch of the voice, distorts the words and can be uncomfortable; clarity, not volume, is the problem.
E – Exaggerated lip movements change the normal shape of words and make speech reading harder.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
5Question
A 76-year-old client says, "I wake up at 5 in the morning and I never feel like I slept deeply." After teaching about sleep in older adults, which statement by the client shows that the teaching was effective?
"A glass of wine at bedtime will help me stay asleep until morning."
"I will get up at the same time every day and keep any nap short and early in the afternoon."
"I will take an over-the-counter sleep aid every night so I get a full night."
"I will stay in bed a few extra hours each morning to make up the sleep I lost."
Show the answer and explanation
Answer: B. "I will get up at the same time every day and keep any nap short and early in the afternoon."
Topic: sleep in older adults
With aging, sleep becomes lighter and more broken and the sleep period tends to move earlier. Sleep hygiene is the first-line approach: a regular rising time, daytime light and activity, and limited, early naps protect the drive to sleep at night.
Why the others are wrong
A – Alcohol may shorten the time to fall asleep but fragments later sleep and adds fall risk.
C – Nonprescription sleep aids are sedating antihistamines with anticholinergic effects that cause confusion, urinary retention and falls in older adults.
D – Long periods awake in bed worsen insomnia and reduce the drive to sleep the next night.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
6Question
An 81-year-old client who lives alone has lost 4.5 kg (10 lb) over 3 months without trying and says, "Food just does not interest me anymore." Which action should the nurse take first?
Recommend a liquid nutritional supplement between meals.
Arrange for home-delivered meals.
Explain that appetite and weight normally decline with age.
Ask about chewing and denture fit, mood, medications, and the ability to shop and cook.
Show the answer and explanation
Answer: D. Ask about chewing and denture fit, mood, medications, and the ability to shop and cook.
Topic: nutrition in older adults
Unintentional weight loss in an older adult is a warning sign, not an expected change. Causes include poor dentition, depression, medications that alter taste or appetite, illness, isolation, and limited money or ability to obtain food, and the right intervention depends on which is present.
Why the others are wrong
A – A supplement may be part of the plan but does not help if the problem is depression, pain on chewing or a medication effect; the cause is not yet known.
B – Meal delivery addresses access to food only; it is chosen after assessment shows access is the problem.
C – Taste and thirst sensation may lessen with age, but unintentional weight loss of this size is not normal and needs evaluation.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
7Question
A nurse is evaluating teaching with a 51-year-old client whose menstrual periods have become irregular and who has hot flashes and vaginal dryness. Which statements by the client show correct understanding?
Select all that apply.
"Walking and other weight-bearing exercise, with enough calcium and vitamin D, will help protect my bones."
"Now that my periods are irregular, I can stop using birth control."
"A water-based lubricant can make intercourse more comfortable."
"Having hot flashes means that I must start hormone therapy."
"If I bleed after I have gone a full year without a period, I need to report it."
Show the answers and explanation
Answers: A, C and E.
A – "Walking and other weight-bearing exercise, with enough calcium and vitamin D, will help protect my bones."
C – "A water-based lubricant can make intercourse more comfortable."
E – "If I bleed after I have gone a full year without a period, I need to report it."
Topic: menopause teaching
Falling estrogen speeds bone loss and thins vaginal tissue, so weight-bearing exercise, calcium and vitamin D, and lubricants are taught. Menopause is confirmed after 12 months without menses; any bleeding after that must be investigated for endometrial cancer, and pregnancy remains possible until then.
Why the others are wrong
B – Ovulation still occurs unpredictably in perimenopause; contraception is continued until menopause is confirmed.
D – Hot flashes are expected; many clients manage with layered clothing, a cool room and avoiding triggers, and hormone therapy is an individual decision with the provider.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
8Question
During a heat wave, an older client asks why the body stays near its usual temperature while the air outside is much hotter. Which explanation should the nurse give?
The body stores the extra heat in fat and releases it at night.
The skin blocks heat from entering, so no adjustment is needed.
Body temperature rises and falls with the air to save energy.
Feedback systems such as sweating and wider skin vessels release heat.
Show the answer and explanation
Answer: D. Feedback systems such as sweating and wider skin vessels release heat.
Topic: homeostasis and temperature regulation
Homeostasis keeps internal conditions steady through feedback loops. When heat load rises, the hypothalamus triggers sweating and dilation of skin blood vessels so that heat is lost, keeping core temperature near its normal range. Older adults respond more slowly, so they need extra caution in hot weather.
Why the others are wrong
A – Fat does not store and later release excess environmental heat in this way.
B – Skin does not block heat entirely; the body must actively release heat.
C – Core temperature is regulated within a narrow range and does not follow the air temperature.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
9Question
A nurse at a senior center is selecting an evidence-based fall-prevention activity. Which program is most appropriate?
Group classes that build balance and leg strength, such as tai chi
A seated craft program held three mornings each week at the center
A lecture on national fall statistics given once at the start of the season
Advice for everyone to limit walking and stay indoors to avoid tripping
Show the answer and explanation
Answer: A. Group classes that build balance and leg strength, such as tai chi
Topic: community fall prevention
Exercise that improves balance, strength and gait is among the most effective ways to prevent falls in older adults. Tai chi and similar programs are recommended by public health agencies.
Why the others are wrong
B – This is social activity but does not improve balance or strength.
C – Information alone does not reduce falls.
D – Reduced activity weakens muscles and increases fall risk.
Written for the Medical Exam YouTube channel and answered blind by a second AI model before publication.
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