GERONTOLOGICAL NURSING/LONG TERM CARE EXAM –
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE
Core Domains
Physiological Integrity and Aging
Pharmacokinetics and Pharmacodynamics in Older Adults
Geriatric Syndromes and Common Pathologies
Cognitive Impairment, Dementia, and Delirium
Palliative and End-of-Life Care
Legal, Ethical, and Regulatory Standards in Long-Term Care
Interdisciplinary Team Collaboration and Care Coordination
Introduction
The purpose of this comprehensive examination is to evaluate the
advanced clinical competency, specialized knowledge, and critical
decision-making skills required of professional nurses practicing in
gerontological and long-term care environments. This assessment
measures foundational nursing theory, applied clinical interventions,
pharmacotherapy management, and ethical considerations unique to
aging populations. Featuring a rigorous blend of direct multiple-choice
inquiries and complex clinical scenarios, the test emphasizes real-
world application, safety advocacy, and evidence-based practice.
Candidates are tested on their ability to manage complex
multimorbidity, navigate regulatory frameworks, and champion person-
centered care across diverse residential and community settings.
Section One: Questions 1–100
An 82-year-old resident in a long-term care facility exhibits a
sudden onset of acute confusion, fluctuating levels of
consciousness, and visual hallucinations over the past 24 hours.
Which initial nursing intervention is most appropriate?
,A. Administer a prescribed as-needed antipsychotic medication.
B. Restrict fluid intake to prevent potential bladder
overdistension.
C. Assess for physiological triggers such as urinary tract infection
or hypoxia.
D. Reorient the resident to time and place every fifteen minutes.
🟢 C. Assess for physiological triggers such as urinary tract
infection or hypoxia.
🔴 Explanation: Acute onset of confusion and fluctuating
consciousness strongly indicates delirium rather than dementia.
The nurse must first investigate and address underlying medical
triggers such as infection, hypoxia, electrolyte imbalance, or
medication side effects.
Which age-related physiological change in the gastrointestinal
system places an older adult at increased risk for constipation?
A. Decreased gastric acid secretion
B. Reduced peristalsis in the large intestine
C. Increased liver mass and blood flow
D. Hypertrophy of the intestinal villi
🟢 B. Reduced peristalsis in the large intestine
🔴 Explanation: Age-related slowing of gastrointestinal motility,
combined with decreased colonic peristalsis, significantly
contributes to a higher prevalence of constipation among older
adults.
A nurse is evaluating an 88-year-old patient's risk for pressure
injuries using the Braden Scale. Which subscale assesses the
patient's ability to change and control body position?
A. Sensory perception
B. Moisture
C. Mobility
D. Friction and shear
🟢 C. Mobility
🔴 Explanation: The mobility subscale of the Braden Scale
evaluates the patient's ability to successfully change and control
their body position independently or with minimal assistance.
,Which pharmacological principle is primarily altered in older
adults due to a decrease in total body water and an increase in
adipose tissue?
A. First-pass metabolism is completely bypassed.
B. Water-soluble drugs have a smaller volume of distribution,
leading to higher peak plasma concentrations.
C. Protein binding of highly acidic drugs is universally eliminated.
D. Renal clearance of all drug metabolites accelerates rapidly.
🟢 B. Water-soluble drugs have a smaller volume of distribution,
leading to higher peak plasma concentrations.
🔴 Explanation: Aging is associated with decreased total body
water and lean muscle mass, which decreases the volume of
distribution for water-soluble drugs, resulting in higher serum
concentrations and increased toxicity risks.
A nurse observes an older adult resident demonstrating repetitive
vocalizations and pacing throughout the secured memory care
unit late in the afternoon. This behavioral pattern is best identified
as:
A. Sundowning syndrome
B. Catastrophic reaction
C. Agnosia
D. Apraxia
🟢 A. Sundowning syndrome
🔴 Explanation: Sundowning refers to a pattern of increased
confusion, agitation, and pacing that commonly occurs in
individuals with dementia during the late afternoon and early
evening hours.
Which laboratory value should the nurse monitor closely when an
older adult is prescribed chronic nonsteroidal anti-inflammatory
drug (NSAID) therapy?
A. Serum creatinine and blood urea nitrogen (BUN)
B. Total serum cholesterol
C. Fasting blood glucose
D. Serum ionized calcium
🟢 A. Serum creatinine and blood urea nitrogen (BUN)
🔴 Explanation: Chronic NSAID use in older adults poses a
, significant risk for nephrotoxicity and gastrointestinal bleeding.
Monitoring renal function markers such as serum creatinine and
BUN is essential.
An 86-year-old patient with osteoarthritis reports chronic, bilateral
knee pain that worsens with activity and improves with rest.
Which classification of medication is typically prescribed first-line
for this condition?
A. Oral corticosteroids
B. Acetaminophen
C. Strong opioid analgesics
D. Disease-modifying antirheumatic drugs (DMARDs)
🟢 B. Acetaminophen
🔴 Explanation: Acetaminophen is recommended as the initial
first-line pharmacological treatment for mild-to-moderate
osteoarthritis pain due to its favorable safety profile compared to
NSAIDs and opioids.
Which clinical finding is characteristic of normal age-related
visual changes in an older adult?
A. Complete loss of central vision
B. Decreased ability to adapt to changes in light and glare
C. Rapidly progressive bilateral clouding of the cornea
D. Persistent unilateral ocular pain and halos around lights
🟢 B. Decreased ability to adapt to changes in light and glare
🔴 Explanation: Normal age-related ocular changes include
reduced pupil size, diminished pupillary reactivity, and yellowing
of the lens, which impair dark adaptation, depth perception, and
tolerance to glare.
A nurse is planning care for an older adult patient admitted with
severe dehydration and hypernatremia. Which IV fluid is typically
initiated initially for volume resuscitation in this patient?
A. 0.9% Sodium Chloride (Normal Saline)
B. 5% Dextrose in Water (D5W)
C. 0.45% Sodium Chloride (Half-Normal Saline)
D. 3% Sodium Chloride
🟢 A. 0.9% Sodium Chloride (Normal Saline)
🔴 Explanation: Initial volume resuscitation for severe
QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED
ANSWERS | PLUS RATIONALES | GUARANTEED PASS | LATEST
EXAM UPDATE
Core Domains
Physiological Integrity and Aging
Pharmacokinetics and Pharmacodynamics in Older Adults
Geriatric Syndromes and Common Pathologies
Cognitive Impairment, Dementia, and Delirium
Palliative and End-of-Life Care
Legal, Ethical, and Regulatory Standards in Long-Term Care
Interdisciplinary Team Collaboration and Care Coordination
Introduction
The purpose of this comprehensive examination is to evaluate the
advanced clinical competency, specialized knowledge, and critical
decision-making skills required of professional nurses practicing in
gerontological and long-term care environments. This assessment
measures foundational nursing theory, applied clinical interventions,
pharmacotherapy management, and ethical considerations unique to
aging populations. Featuring a rigorous blend of direct multiple-choice
inquiries and complex clinical scenarios, the test emphasizes real-
world application, safety advocacy, and evidence-based practice.
Candidates are tested on their ability to manage complex
multimorbidity, navigate regulatory frameworks, and champion person-
centered care across diverse residential and community settings.
Section One: Questions 1–100
An 82-year-old resident in a long-term care facility exhibits a
sudden onset of acute confusion, fluctuating levels of
consciousness, and visual hallucinations over the past 24 hours.
Which initial nursing intervention is most appropriate?
,A. Administer a prescribed as-needed antipsychotic medication.
B. Restrict fluid intake to prevent potential bladder
overdistension.
C. Assess for physiological triggers such as urinary tract infection
or hypoxia.
D. Reorient the resident to time and place every fifteen minutes.
🟢 C. Assess for physiological triggers such as urinary tract
infection or hypoxia.
🔴 Explanation: Acute onset of confusion and fluctuating
consciousness strongly indicates delirium rather than dementia.
The nurse must first investigate and address underlying medical
triggers such as infection, hypoxia, electrolyte imbalance, or
medication side effects.
Which age-related physiological change in the gastrointestinal
system places an older adult at increased risk for constipation?
A. Decreased gastric acid secretion
B. Reduced peristalsis in the large intestine
C. Increased liver mass and blood flow
D. Hypertrophy of the intestinal villi
🟢 B. Reduced peristalsis in the large intestine
🔴 Explanation: Age-related slowing of gastrointestinal motility,
combined with decreased colonic peristalsis, significantly
contributes to a higher prevalence of constipation among older
adults.
A nurse is evaluating an 88-year-old patient's risk for pressure
injuries using the Braden Scale. Which subscale assesses the
patient's ability to change and control body position?
A. Sensory perception
B. Moisture
C. Mobility
D. Friction and shear
🟢 C. Mobility
🔴 Explanation: The mobility subscale of the Braden Scale
evaluates the patient's ability to successfully change and control
their body position independently or with minimal assistance.
,Which pharmacological principle is primarily altered in older
adults due to a decrease in total body water and an increase in
adipose tissue?
A. First-pass metabolism is completely bypassed.
B. Water-soluble drugs have a smaller volume of distribution,
leading to higher peak plasma concentrations.
C. Protein binding of highly acidic drugs is universally eliminated.
D. Renal clearance of all drug metabolites accelerates rapidly.
🟢 B. Water-soluble drugs have a smaller volume of distribution,
leading to higher peak plasma concentrations.
🔴 Explanation: Aging is associated with decreased total body
water and lean muscle mass, which decreases the volume of
distribution for water-soluble drugs, resulting in higher serum
concentrations and increased toxicity risks.
A nurse observes an older adult resident demonstrating repetitive
vocalizations and pacing throughout the secured memory care
unit late in the afternoon. This behavioral pattern is best identified
as:
A. Sundowning syndrome
B. Catastrophic reaction
C. Agnosia
D. Apraxia
🟢 A. Sundowning syndrome
🔴 Explanation: Sundowning refers to a pattern of increased
confusion, agitation, and pacing that commonly occurs in
individuals with dementia during the late afternoon and early
evening hours.
Which laboratory value should the nurse monitor closely when an
older adult is prescribed chronic nonsteroidal anti-inflammatory
drug (NSAID) therapy?
A. Serum creatinine and blood urea nitrogen (BUN)
B. Total serum cholesterol
C. Fasting blood glucose
D. Serum ionized calcium
🟢 A. Serum creatinine and blood urea nitrogen (BUN)
🔴 Explanation: Chronic NSAID use in older adults poses a
, significant risk for nephrotoxicity and gastrointestinal bleeding.
Monitoring renal function markers such as serum creatinine and
BUN is essential.
An 86-year-old patient with osteoarthritis reports chronic, bilateral
knee pain that worsens with activity and improves with rest.
Which classification of medication is typically prescribed first-line
for this condition?
A. Oral corticosteroids
B. Acetaminophen
C. Strong opioid analgesics
D. Disease-modifying antirheumatic drugs (DMARDs)
🟢 B. Acetaminophen
🔴 Explanation: Acetaminophen is recommended as the initial
first-line pharmacological treatment for mild-to-moderate
osteoarthritis pain due to its favorable safety profile compared to
NSAIDs and opioids.
Which clinical finding is characteristic of normal age-related
visual changes in an older adult?
A. Complete loss of central vision
B. Decreased ability to adapt to changes in light and glare
C. Rapidly progressive bilateral clouding of the cornea
D. Persistent unilateral ocular pain and halos around lights
🟢 B. Decreased ability to adapt to changes in light and glare
🔴 Explanation: Normal age-related ocular changes include
reduced pupil size, diminished pupillary reactivity, and yellowing
of the lens, which impair dark adaptation, depth perception, and
tolerance to glare.
A nurse is planning care for an older adult patient admitted with
severe dehydration and hypernatremia. Which IV fluid is typically
initiated initially for volume resuscitation in this patient?
A. 0.9% Sodium Chloride (Normal Saline)
B. 5% Dextrose in Water (D5W)
C. 0.45% Sodium Chloride (Half-Normal Saline)
D. 3% Sodium Chloride
🟢 A. 0.9% Sodium Chloride (Normal Saline)
🔴 Explanation: Initial volume resuscitation for severe
