BSN425: GERONTOLOGICAL NURSING Final
Exam , with Guide Practice Questions & Verified
Answers 2026/ 2027 Updated A+ Grade Guaranteed
Pass
Question 1:
An 82-year-old patient is admitted to the medical unit. Which
physiological change of aging is most likely to affect drug distribution
for digoxin (a hydrophilic drug)?
A. Increased total body fat
B. Decreased total body water
C. Increased serum albumin
D. Decreased liver mass
Rationale: Correct answer: B. Digoxin is hydrophilic (water-soluble).
Aging decreases total body water by 10-15%, so hydrophilic drugs have
a smaller volume of distribution, leading to higher serum concentrations
and increased toxicity risk. Increased total body fat (A) affects lipophilic
drugs. Serum albumin decreases (not increases - C). Liver mass
decreases (D) affects metabolism, not distribution.
Question 2:
A 78-year-old patient reports dizziness when standing up from a seated
position. The nurse checks orthostatic vital signs. Which finding defines
orthostatic hypotension in an older adult?
,
A. Decrease in systolic BP of 10 mmHg or more within 3 minutes of
standing
B. Decrease in systolic BP of 20 mmHg or more (or diastolic 10 mmHg)
within 3 minutes of standing
C. Decrease in heart rate of 20 beats per minute upon standing
D. Increase in systolic BP of 20 mmHg upon standing
Rationale: Correct answer: B. Orthostatic hypotension is defined as a
decrease in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3
minutes of standing. This is common in older adults (baroreceptor
dysfunction, medications). Option A is too low. Heart rate normally
increases (not decreases - C). Increase in BP (D) is not orthostatic
hypotension.
Question 3:
An 85-year-old patient with dementia is started on donepezil (Aricept)
5mg at bedtime. The patient reports vivid nightmares. What is the most
appropriate nursing action?
A. Discontinue donepezil immediately
B. Suggest switching donepezil to morning dosing
C. Increase donepezil to 10mg
D. Add prazosin for nightmares
Rationale: Correct answer: B. Donepezil (cholinesterase inhibitor)
causes vivid dreams/nightmares due to cholinergic activation. Switching
to morning dosing often resolves this (instead of bedtime). Do not
,
discontinue (A) if otherwise tolerated. Increasing dose (C) may worsen.
Prazosin (D) is for PTSD-related nightmares, not needed here.
Question 4:
A 76-year-old patient is on long-term omeprazole (Prilosec) 40mg daily
for GERD. The nurse should monitor for which long-term complication?
A. Hypertension
B. Vitamin B12 deficiency
C. Hypercalcemia
D. Hyperglycemia
Rationale: Correct answer: B. Long-term PPI use (>1-2 years) reduces
gastric acid, which is required to release vitamin B12 from food proteins,
leading to B12 deficiency (neuropathy, anemia). Also associated with C.
diff, hypomagnesemia, fractures, CKD, and iron deficiency.
Hypertension (A), hypercalcemia (C), and hyperglycemia (D) are not
associated.
Question 5:
An 80-year-old patient has a history of falls. The nurse performs a Timed
Up & Go (TUG) test. The patient takes 15 seconds to complete the test.
What does this indicate?
A. Low fall risk (normal)
B. High fall risk (abnormal)
C. Normal for age
D. Requires assistance with walking
,
Rationale: Correct answer: B. Timed Up & Go (TUG) >12 seconds
indicates high fall risk (sensitivity and specificity for falls). Older adults
should complete in <12 seconds. 15 seconds = increased fall risk. The
nurse should implement fall precautions.
Question 6:
An 83-year-old patient with type 2 diabetes has A1c 7.8% on metformin
and glipizide. The patient has mild cognitive impairment and lives alone.
Which A1c target is most appropriate?
A. <6.5%
B. 7.0-7.5%
C. 7.5-8.0%
D. >8.5%
Rationale: Correct answer: C. For older adults with moderate
comorbidity (mild cognitive impairment, multiple chronic conditions,
fall risk), A1c target is 7.5-8.0% to avoid hypoglycemia. Tight control
(A, B) increases hypoglycemia risk (falls, confusion, hospitalization).
>8.5% (D) for frail, advanced dementia, limited life expectancy.
Question 7:
A 79-year-old patient is prescribed amitriptyline (Elavil) 25mg at
bedtime for neuropathic pain. The nurse notes that the patient has
become confused and constipated. What is the most likely cause?
A. Normal aging changes
B. Amitriptyline (anticholinergic side effects)
Exam , with Guide Practice Questions & Verified
Answers 2026/ 2027 Updated A+ Grade Guaranteed
Pass
Question 1:
An 82-year-old patient is admitted to the medical unit. Which
physiological change of aging is most likely to affect drug distribution
for digoxin (a hydrophilic drug)?
A. Increased total body fat
B. Decreased total body water
C. Increased serum albumin
D. Decreased liver mass
Rationale: Correct answer: B. Digoxin is hydrophilic (water-soluble).
Aging decreases total body water by 10-15%, so hydrophilic drugs have
a smaller volume of distribution, leading to higher serum concentrations
and increased toxicity risk. Increased total body fat (A) affects lipophilic
drugs. Serum albumin decreases (not increases - C). Liver mass
decreases (D) affects metabolism, not distribution.
Question 2:
A 78-year-old patient reports dizziness when standing up from a seated
position. The nurse checks orthostatic vital signs. Which finding defines
orthostatic hypotension in an older adult?
,
A. Decrease in systolic BP of 10 mmHg or more within 3 minutes of
standing
B. Decrease in systolic BP of 20 mmHg or more (or diastolic 10 mmHg)
within 3 minutes of standing
C. Decrease in heart rate of 20 beats per minute upon standing
D. Increase in systolic BP of 20 mmHg upon standing
Rationale: Correct answer: B. Orthostatic hypotension is defined as a
decrease in systolic BP ≥20 mmHg or diastolic BP ≥10 mmHg within 3
minutes of standing. This is common in older adults (baroreceptor
dysfunction, medications). Option A is too low. Heart rate normally
increases (not decreases - C). Increase in BP (D) is not orthostatic
hypotension.
Question 3:
An 85-year-old patient with dementia is started on donepezil (Aricept)
5mg at bedtime. The patient reports vivid nightmares. What is the most
appropriate nursing action?
A. Discontinue donepezil immediately
B. Suggest switching donepezil to morning dosing
C. Increase donepezil to 10mg
D. Add prazosin for nightmares
Rationale: Correct answer: B. Donepezil (cholinesterase inhibitor)
causes vivid dreams/nightmares due to cholinergic activation. Switching
to morning dosing often resolves this (instead of bedtime). Do not
,
discontinue (A) if otherwise tolerated. Increasing dose (C) may worsen.
Prazosin (D) is for PTSD-related nightmares, not needed here.
Question 4:
A 76-year-old patient is on long-term omeprazole (Prilosec) 40mg daily
for GERD. The nurse should monitor for which long-term complication?
A. Hypertension
B. Vitamin B12 deficiency
C. Hypercalcemia
D. Hyperglycemia
Rationale: Correct answer: B. Long-term PPI use (>1-2 years) reduces
gastric acid, which is required to release vitamin B12 from food proteins,
leading to B12 deficiency (neuropathy, anemia). Also associated with C.
diff, hypomagnesemia, fractures, CKD, and iron deficiency.
Hypertension (A), hypercalcemia (C), and hyperglycemia (D) are not
associated.
Question 5:
An 80-year-old patient has a history of falls. The nurse performs a Timed
Up & Go (TUG) test. The patient takes 15 seconds to complete the test.
What does this indicate?
A. Low fall risk (normal)
B. High fall risk (abnormal)
C. Normal for age
D. Requires assistance with walking
,
Rationale: Correct answer: B. Timed Up & Go (TUG) >12 seconds
indicates high fall risk (sensitivity and specificity for falls). Older adults
should complete in <12 seconds. 15 seconds = increased fall risk. The
nurse should implement fall precautions.
Question 6:
An 83-year-old patient with type 2 diabetes has A1c 7.8% on metformin
and glipizide. The patient has mild cognitive impairment and lives alone.
Which A1c target is most appropriate?
A. <6.5%
B. 7.0-7.5%
C. 7.5-8.0%
D. >8.5%
Rationale: Correct answer: C. For older adults with moderate
comorbidity (mild cognitive impairment, multiple chronic conditions,
fall risk), A1c target is 7.5-8.0% to avoid hypoglycemia. Tight control
(A, B) increases hypoglycemia risk (falls, confusion, hospitalization).
>8.5% (D) for frail, advanced dementia, limited life expectancy.
Question 7:
A 79-year-old patient is prescribed amitriptyline (Elavil) 25mg at
bedtime for neuropathic pain. The nurse notes that the patient has
become confused and constipated. What is the most likely cause?
A. Normal aging changes
B. Amitriptyline (anticholinergic side effects)
