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A
Complete loss of short-term memory
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B
Decreased skin turgor, slower wound healing, reduced visual acuity, and longer reaction times — these are normal aging changes
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C
New-onset urinary incontinence
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D
Severe confusion and disorientation at all times
Why this is the answer
Distinguishing NORMAL AGING from PATHOLOGY is essential nursing knowledge. NORMAL PHYSIOLOGICAL CHANGES OF AGING include: SKIN — decreased turgor (pinch test not reliable for dehydration in elderly), thinning, dryness, increased bruising, slower wound healing, age spots (lentigines), decreased subcutaneous fat; VISION — presbyopia (difficulty focusing on close objects, requiring reading glasses), reduced dark adaptation, increased sensitivity to glare, reduced peripheral vision, smaller pupil size; HEARING — presbycusis (high-frequency hearing loss), difficulty distinguishing speech in background noise; NEUROLOGICAL — slower reaction times, longer time to process information, some reduction in word retrieval (but NOT memory loss significant enough to impair daily life); RESPIRATORY — decreased lung elasticity, reduced maximum breathing capacity; CARDIOVASCULAR — stiffening of vessels (increased systolic BP), slowed heart rate response; RENAL — decreased GFR, reduced drug clearance; GI — slowed gastric motility (constipation tendency), reduced taste/smell; MUSCULOSKELETAL — sarcopenia (muscle loss), osteoporosis risk, joint changes, decreased height. NOT NORMAL AGING: severe short-term memory loss, confusion (delirium or dementia must be evaluated), new incontinence (may indicate UTI, pelvic floor dysfunction, etc.), chest pain, significant dyspnea, sudden vision changes, falls without explanation. PN ROLE: differentiate normal from pathological; adapt assessments and care to older adults (e.g., slower pace, larger font, brighter lighting, fall precautions, medication management for polypharmacy).
Source: NCLEX-PN Test Plan: Health Promotion — Aging