NU 176 Exam 4 | Geriatric Nursing
NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) An 82-year-old client is admitted with acute confusion and a urinary tract infection. Which condition
should the nurse suspect?
A. Alzheimer's Disease
B. Delirium
C. Depression
D. Normal age-related decline
CORRECT ANSWER: B
Clinical Rationale: Delirium is characterized by an acute, sudden onset of confusion, often triggered by an
underlying medical condition like an infection (UTI) or medication side effects. It is usually reversible.
(2) Which is a priority nursing intervention for a client with advanced dementia who frequently wanders
at night?
A. Administer a sedative at bedtime.
B. Place the client in soft wrist restraints.
C. Provide a safe, well-lit path for wandering.
D. Keep the client's room door locked.
CORRECT ANSWER: C
Clinical Rationale: Safety is the priority. Providing a safe environment for wandering is a non-pharmacological,
least-restrictive intervention. Restraints and locked doors increase agitation and risk of injury.
(3) The nurse is reviewing the 'Beers Criteria' list. What is the primary purpose of this list in geriatric
nursing?
A. To identify medications that are potentially inappropriate for older adults.
B. To list mandatory immunizations for the elderly.
C. To provide a guide for nutritional supplements.
D. To categorize various stages of dementia.
CORRECT ANSWER: A
Clinical Rationale: The Beers Criteria is a guide for healthcare professionals to identify medications that pose a
higher risk of adverse effects in older adults due to physiological changes of aging.
,(4) Which physiological change of aging increases the risk of drug toxicity in older adults?
A. Increased total body water.
B. Increased glomerular filtration rate (GFR).
C. Decreased hepatic blood flow and renal function.
D. Decreased percentage of body fat.
CORRECT ANSWER: C
Clinical Rationale: Aging leads to decreased liver and kidney function, which slows the metabolism and excretion
of drugs, leading to higher blood levels and increased risk of toxicity.
(5) A client has a 'DNR' (Do Not Resuscitate) order. The nurse finds the client unresponsive and without a
pulse. Which action should the nurse take?
A. Call a Code Blue.
B. Begin chest compressions.
C. Provide comfort measures and notify the family and provider.
D. Intubate the client immediately.
CORRECT ANSWER: C
Clinical Rationale: A DNR order means that no CPR or life-sustaining measures should be started if the heart or
breathing stops. The nurse should allow a natural death while providing comfort.
(6) A nurse is providing palliative care to a terminally ill client. What is the primary goal of this type of
care?
A. To cure the underlying disease.
B. To provide aggressive life-prolonging treatment.
C. To improve the quality of life and manage symptoms.
D. To assist with funeral arrangements.
CORRECT ANSWER: C
Clinical Rationale: Palliative care focuses on symptom management (pain, dyspnea) and psychosocial support to
improve the quality of life for clients with serious illnesses, regardless of life expectancy.
,(7) A nurse notes multiple bruises in various stages of healing on an elderly client's back and arms. What
is the nurse's legal responsibility?
A. Confront the family members immediately.
B. Document the findings and report to Adult Protective Services (APS).
C. Wait for the client to confirm abuse before reporting.
D. Apply ice packs to the bruised areas.
CORRECT ANSWER: B
Clinical Rationale: Nurses are mandated reporters. Any suspicion of elder abuse or neglect must be reported to
the appropriate authorities (like APS) according to state law and facility policy.
(8) An older adult client reports difficulty hearing high-pitched sounds. The nurse recognizes this as a
common age-related change known as:
A. Otosclerosis
B. Tinnitus
C. Presbycusis
D. Meniere's Disease
CORRECT ANSWER: C
Clinical Rationale: Presbycusis is the age-related sensorineural hearing loss that typically affects the ability to
hear high-pitched sounds and distinguish speech in noisy environments.
(9) Which is the most common cause of vision loss in older adults that results in a loss of central vision?
A. Glaucoma
B. Cataracts
C. Age-related macular degeneration (AMD)
D. Diabetic retinopathy
CORRECT ANSWER: C
Clinical Rationale: Macular degeneration affects the central part of the retina (macula), leading to blurred or
lost central vision, which is essential for reading and driving.
, (10) An elderly client is at risk for constipation. Which recommendation should the nurse include in the
teaching?
A. Limit fluid intake to 1 liter per day.
B. Increase dietary fiber and daily physical activity.
C. Take a stimulant laxative every morning.
D. Stay on bed rest as much as possible.
CORRECT ANSWER: B
Clinical Rationale: Non-pharmacological interventions like increasing fiber (fruits, vegetables, whole grains),
increasing fluids, and regular movement are the first-line treatments for constipation in the elderly.
(11) An 82-year-old client is admitted with acute confusion and a urinary tract infection. Which condition
should the nurse suspect?
A. Alzheimer's Disease
B. Delirium
C. Depression
D. Normal age-related decline
CORRECT ANSWER: B
Clinical Rationale: Delirium is characterized by an acute, sudden onset of confusion, often triggered by an
underlying medical condition like an infection (UTI) or medication side effects. It is usually reversible.
(12) Which is a priority nursing intervention for a client with advanced dementia who frequently wanders
at night?
A. Administer a sedative at bedtime.
B. Place the client in soft wrist restraints.
C. Provide a safe, well-lit path for wandering.
D. Keep the client's room door locked.
CORRECT ANSWER: C
Clinical Rationale: Safety is the priority. Providing a safe environment for wandering is a non-pharmacological,
least-restrictive intervention. Restraints and locked doors increase agitation and risk of injury.
NURSING PRACTICE EXAM (2026/2027) - GALEN COLLEGE
(1) An 82-year-old client is admitted with acute confusion and a urinary tract infection. Which condition
should the nurse suspect?
A. Alzheimer's Disease
B. Delirium
C. Depression
D. Normal age-related decline
CORRECT ANSWER: B
Clinical Rationale: Delirium is characterized by an acute, sudden onset of confusion, often triggered by an
underlying medical condition like an infection (UTI) or medication side effects. It is usually reversible.
(2) Which is a priority nursing intervention for a client with advanced dementia who frequently wanders
at night?
A. Administer a sedative at bedtime.
B. Place the client in soft wrist restraints.
C. Provide a safe, well-lit path for wandering.
D. Keep the client's room door locked.
CORRECT ANSWER: C
Clinical Rationale: Safety is the priority. Providing a safe environment for wandering is a non-pharmacological,
least-restrictive intervention. Restraints and locked doors increase agitation and risk of injury.
(3) The nurse is reviewing the 'Beers Criteria' list. What is the primary purpose of this list in geriatric
nursing?
A. To identify medications that are potentially inappropriate for older adults.
B. To list mandatory immunizations for the elderly.
C. To provide a guide for nutritional supplements.
D. To categorize various stages of dementia.
CORRECT ANSWER: A
Clinical Rationale: The Beers Criteria is a guide for healthcare professionals to identify medications that pose a
higher risk of adverse effects in older adults due to physiological changes of aging.
,(4) Which physiological change of aging increases the risk of drug toxicity in older adults?
A. Increased total body water.
B. Increased glomerular filtration rate (GFR).
C. Decreased hepatic blood flow and renal function.
D. Decreased percentage of body fat.
CORRECT ANSWER: C
Clinical Rationale: Aging leads to decreased liver and kidney function, which slows the metabolism and excretion
of drugs, leading to higher blood levels and increased risk of toxicity.
(5) A client has a 'DNR' (Do Not Resuscitate) order. The nurse finds the client unresponsive and without a
pulse. Which action should the nurse take?
A. Call a Code Blue.
B. Begin chest compressions.
C. Provide comfort measures and notify the family and provider.
D. Intubate the client immediately.
CORRECT ANSWER: C
Clinical Rationale: A DNR order means that no CPR or life-sustaining measures should be started if the heart or
breathing stops. The nurse should allow a natural death while providing comfort.
(6) A nurse is providing palliative care to a terminally ill client. What is the primary goal of this type of
care?
A. To cure the underlying disease.
B. To provide aggressive life-prolonging treatment.
C. To improve the quality of life and manage symptoms.
D. To assist with funeral arrangements.
CORRECT ANSWER: C
Clinical Rationale: Palliative care focuses on symptom management (pain, dyspnea) and psychosocial support to
improve the quality of life for clients with serious illnesses, regardless of life expectancy.
,(7) A nurse notes multiple bruises in various stages of healing on an elderly client's back and arms. What
is the nurse's legal responsibility?
A. Confront the family members immediately.
B. Document the findings and report to Adult Protective Services (APS).
C. Wait for the client to confirm abuse before reporting.
D. Apply ice packs to the bruised areas.
CORRECT ANSWER: B
Clinical Rationale: Nurses are mandated reporters. Any suspicion of elder abuse or neglect must be reported to
the appropriate authorities (like APS) according to state law and facility policy.
(8) An older adult client reports difficulty hearing high-pitched sounds. The nurse recognizes this as a
common age-related change known as:
A. Otosclerosis
B. Tinnitus
C. Presbycusis
D. Meniere's Disease
CORRECT ANSWER: C
Clinical Rationale: Presbycusis is the age-related sensorineural hearing loss that typically affects the ability to
hear high-pitched sounds and distinguish speech in noisy environments.
(9) Which is the most common cause of vision loss in older adults that results in a loss of central vision?
A. Glaucoma
B. Cataracts
C. Age-related macular degeneration (AMD)
D. Diabetic retinopathy
CORRECT ANSWER: C
Clinical Rationale: Macular degeneration affects the central part of the retina (macula), leading to blurred or
lost central vision, which is essential for reading and driving.
, (10) An elderly client is at risk for constipation. Which recommendation should the nurse include in the
teaching?
A. Limit fluid intake to 1 liter per day.
B. Increase dietary fiber and daily physical activity.
C. Take a stimulant laxative every morning.
D. Stay on bed rest as much as possible.
CORRECT ANSWER: B
Clinical Rationale: Non-pharmacological interventions like increasing fiber (fruits, vegetables, whole grains),
increasing fluids, and regular movement are the first-line treatments for constipation in the elderly.
(11) An 82-year-old client is admitted with acute confusion and a urinary tract infection. Which condition
should the nurse suspect?
A. Alzheimer's Disease
B. Delirium
C. Depression
D. Normal age-related decline
CORRECT ANSWER: B
Clinical Rationale: Delirium is characterized by an acute, sudden onset of confusion, often triggered by an
underlying medical condition like an infection (UTI) or medication side effects. It is usually reversible.
(12) Which is a priority nursing intervention for a client with advanced dementia who frequently wanders
at night?
A. Administer a sedative at bedtime.
B. Place the client in soft wrist restraints.
C. Provide a safe, well-lit path for wandering.
D. Keep the client's room door locked.
CORRECT ANSWER: C
Clinical Rationale: Safety is the priority. Providing a safe environment for wandering is a non-pharmacological,
least-restrictive intervention. Restraints and locked doors increase agitation and risk of injury.
