Basic Geriatric Nursing 2026/2027 | 9th Edition by Patricia A. Williams
Study Guide, Geriatric Nursing Exam Prep, Practice Questions with Answers
& Rationales, Aging Theories, Physiologic Changes, Health Assessment,
Medication Administration, Fluid & Nutrition, Safety, Cognition, End-of-Life
Care, Chronic Illness, Gerontological Nursing & NCLEX-PN Prep
Question 1: Which of the following physiologic changes of aging most directly
increases the risk of dehydration in older adults?
A. Decreased glomerular filtration rate
B. Decreased thirst sensation
C. Decreased gastric motility
D. Decreased bone density
CORRECT ANSWER: B. Decreased thirst sensation
Rationale: Aging reduces the sensitivity of the thirst mechanism, so older adults
may not feel thirsty even when fluid intake is inadequate, predisposing them to
dehydration. While decreased glomerular filtration rate affects fluid balance, the
blunted thirst sensation is the most direct cause of reduced voluntary fluid intake.
Question 2: An older adult is prescribed a diuretic. Which laboratory value
should the nurse monitor most closely to detect a common adverse effect?
A. Serum calcium
B. Serum potassium
C. Serum albumin
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Diuretics, especially thiazide and loop diuretics, commonly cause
potassium depletion (hypokalemia), which can lead to cardiac dysrhythmias and
muscle weakness in older adults. Monitoring serum potassium is essential for safe
medication management.
Question 3: Which of the following is the leading cause of injury-related death
in adults over age 65?
A. Motor vehicle accidents
B. Falls
,C. Burns
D. Poisoning
CORRECT ANSWER: B. Falls
Rationale: Falls are the leading cause of injury-related morbidity and mortality in
older adults. Age-related changes in balance, vision, muscle strength, and
medication effects contribute to fall risk. Fall prevention is a core geriatric nursing
priority.
Question 4: A nurse is assessing an older adult for dementia. Which finding is
most consistent with dementia rather than delirium?
A. Acute onset with fluctuating course
B. Insidious onset with gradual decline
C. Impaired attention as the primary deficit
D. Reversibility with treatment of underlying cause
CORRECT ANSWER: B. Insidious onset with gradual decline
Rationale: Dementia is characterized by a slow, progressive, and insidious decline
in cognitive function, whereas delirium has an acute onset with fluctuating
consciousness and attention deficits. Differentiating the two is critical for
appropriate intervention.
Question 5: Which age-related change in the respiratory system increases an
older adult's risk for pneumonia?
A. Increased chest wall compliance
B. Decreased cough reflex and mucociliary clearance
C. Increased vital capacity
D. Decreased residual volume
CORRECT ANSWER: B. Decreased cough reflex and mucociliary clearance
Rationale: Aging weakens the cough reflex and slows mucociliary clearance,
allowing secretions and pathogens to accumulate in the airways, which increases
the risk of pneumonia and respiratory infections.
Question 6: An older adult reports constipation. Which nursing intervention is
most appropriate as a first-line measure?
,A. Administer a daily stimulant laxative
B. Increase dietary fiber and fluid intake
C. Recommend bed rest to conserve energy
D. Restrict physical activity
CORRECT ANSWER: B. Increase dietary fiber and fluid intake
Rationale: Constipation in older adults is often related to low fiber intake,
inadequate fluids, and decreased mobility. First-line management includes
increasing dietary fiber and fluids, along with activity, before resorting to
pharmacologic agents.
Question 7: Which of the following best describes polypharmacy in geriatric
nursing?
A. Taking any prescription medication daily
B. The concurrent use of multiple medications, often five or more
C. Taking vitamins only
D. Using herbal supplements exclusively
CORRECT ANSWER: B. The concurrent use of multiple medications, often five or
more
Rationale: Polypharmacy refers to the use of multiple medications concurrently,
commonly defined as five or more. It increases the risk of drug interactions,
adverse effects, and nonadherence in older adults.
Question 8: A nurse notes that an older adult has a decreased sense of taste and
smell. Which nutritional risk is most directly associated with this change?
A. Increased appetite
B. Decreased food intake and poor nutrition
C. Increased thirst
D. Enhanced digestion
CORRECT ANSWER: B. Decreased food intake and poor nutrition
Rationale: Reduced taste and smell can make food less appealing, leading to
decreased food intake and inadequate nutrition. Nurses should monitor weight
and nutritional status in older adults with sensory losses.
, Question 9: Which skin change is a normal age-related finding in older adults?
A. Increased subcutaneous fat
B. Decreased skin turgor and thinning
C. Increased sweat gland activity
D. Enhanced wound healing
CORRECT ANSWER: B. Decreased skin turgor and thinning
Rationale: Aging causes thinning of the epidermis and dermis, loss of
subcutaneous fat, and decreased elasticity, resulting in decreased skin turgor. This
makes older adults more prone to skin tears and pressure injuries.
Question 10: An older adult is at risk for pressure ulcers. Which nursing action is
most effective in prevention?
A. Massaging reddened bony prominences
B. Repositioning the patient at least every two hours
C. Keeping the head of the bed elevated at 90 degrees
D. Restricting fluid intake
CORRECT ANSWER: B. Repositioning the patient at least every two hours
Rationale: Frequent repositioning relieves pressure on bony prominences and is a
cornerstone of pressure ulcer prevention. Massaging reddened areas can damage
tissue, and high Fowler's position increases shear and pressure.
Question 11: Which of the following is a common cause of urinary incontinence
in older women?
A. Enlarged prostate
B. Weak pelvic floor muscles
C. Kidney stones
D. Urethral obstruction
CORRECT ANSWER: B. Weak pelvic floor muscles
Rationale: Weakening of the pelvic floor muscles, often from childbirth and aging,
contributes to stress and urge incontinence in older women. Pelvic floor exercises
(Kegel exercises) are a common intervention.
Study Guide, Geriatric Nursing Exam Prep, Practice Questions with Answers
& Rationales, Aging Theories, Physiologic Changes, Health Assessment,
Medication Administration, Fluid & Nutrition, Safety, Cognition, End-of-Life
Care, Chronic Illness, Gerontological Nursing & NCLEX-PN Prep
Question 1: Which of the following physiologic changes of aging most directly
increases the risk of dehydration in older adults?
A. Decreased glomerular filtration rate
B. Decreased thirst sensation
C. Decreased gastric motility
D. Decreased bone density
CORRECT ANSWER: B. Decreased thirst sensation
Rationale: Aging reduces the sensitivity of the thirst mechanism, so older adults
may not feel thirsty even when fluid intake is inadequate, predisposing them to
dehydration. While decreased glomerular filtration rate affects fluid balance, the
blunted thirst sensation is the most direct cause of reduced voluntary fluid intake.
Question 2: An older adult is prescribed a diuretic. Which laboratory value
should the nurse monitor most closely to detect a common adverse effect?
A. Serum calcium
B. Serum potassium
C. Serum albumin
D. Serum magnesium
CORRECT ANSWER: B. Serum potassium
Rationale: Diuretics, especially thiazide and loop diuretics, commonly cause
potassium depletion (hypokalemia), which can lead to cardiac dysrhythmias and
muscle weakness in older adults. Monitoring serum potassium is essential for safe
medication management.
Question 3: Which of the following is the leading cause of injury-related death
in adults over age 65?
A. Motor vehicle accidents
B. Falls
,C. Burns
D. Poisoning
CORRECT ANSWER: B. Falls
Rationale: Falls are the leading cause of injury-related morbidity and mortality in
older adults. Age-related changes in balance, vision, muscle strength, and
medication effects contribute to fall risk. Fall prevention is a core geriatric nursing
priority.
Question 4: A nurse is assessing an older adult for dementia. Which finding is
most consistent with dementia rather than delirium?
A. Acute onset with fluctuating course
B. Insidious onset with gradual decline
C. Impaired attention as the primary deficit
D. Reversibility with treatment of underlying cause
CORRECT ANSWER: B. Insidious onset with gradual decline
Rationale: Dementia is characterized by a slow, progressive, and insidious decline
in cognitive function, whereas delirium has an acute onset with fluctuating
consciousness and attention deficits. Differentiating the two is critical for
appropriate intervention.
Question 5: Which age-related change in the respiratory system increases an
older adult's risk for pneumonia?
A. Increased chest wall compliance
B. Decreased cough reflex and mucociliary clearance
C. Increased vital capacity
D. Decreased residual volume
CORRECT ANSWER: B. Decreased cough reflex and mucociliary clearance
Rationale: Aging weakens the cough reflex and slows mucociliary clearance,
allowing secretions and pathogens to accumulate in the airways, which increases
the risk of pneumonia and respiratory infections.
Question 6: An older adult reports constipation. Which nursing intervention is
most appropriate as a first-line measure?
,A. Administer a daily stimulant laxative
B. Increase dietary fiber and fluid intake
C. Recommend bed rest to conserve energy
D. Restrict physical activity
CORRECT ANSWER: B. Increase dietary fiber and fluid intake
Rationale: Constipation in older adults is often related to low fiber intake,
inadequate fluids, and decreased mobility. First-line management includes
increasing dietary fiber and fluids, along with activity, before resorting to
pharmacologic agents.
Question 7: Which of the following best describes polypharmacy in geriatric
nursing?
A. Taking any prescription medication daily
B. The concurrent use of multiple medications, often five or more
C. Taking vitamins only
D. Using herbal supplements exclusively
CORRECT ANSWER: B. The concurrent use of multiple medications, often five or
more
Rationale: Polypharmacy refers to the use of multiple medications concurrently,
commonly defined as five or more. It increases the risk of drug interactions,
adverse effects, and nonadherence in older adults.
Question 8: A nurse notes that an older adult has a decreased sense of taste and
smell. Which nutritional risk is most directly associated with this change?
A. Increased appetite
B. Decreased food intake and poor nutrition
C. Increased thirst
D. Enhanced digestion
CORRECT ANSWER: B. Decreased food intake and poor nutrition
Rationale: Reduced taste and smell can make food less appealing, leading to
decreased food intake and inadequate nutrition. Nurses should monitor weight
and nutritional status in older adults with sensory losses.
, Question 9: Which skin change is a normal age-related finding in older adults?
A. Increased subcutaneous fat
B. Decreased skin turgor and thinning
C. Increased sweat gland activity
D. Enhanced wound healing
CORRECT ANSWER: B. Decreased skin turgor and thinning
Rationale: Aging causes thinning of the epidermis and dermis, loss of
subcutaneous fat, and decreased elasticity, resulting in decreased skin turgor. This
makes older adults more prone to skin tears and pressure injuries.
Question 10: An older adult is at risk for pressure ulcers. Which nursing action is
most effective in prevention?
A. Massaging reddened bony prominences
B. Repositioning the patient at least every two hours
C. Keeping the head of the bed elevated at 90 degrees
D. Restricting fluid intake
CORRECT ANSWER: B. Repositioning the patient at least every two hours
Rationale: Frequent repositioning relieves pressure on bony prominences and is a
cornerstone of pressure ulcer prevention. Massaging reddened areas can damage
tissue, and high Fowler's position increases shear and pressure.
Question 11: Which of the following is a common cause of urinary incontinence
in older women?
A. Enlarged prostate
B. Weak pelvic floor muscles
C. Kidney stones
D. Urethral obstruction
CORRECT ANSWER: B. Weak pelvic floor muscles
Rationale: Weakening of the pelvic floor muscles, often from childbirth and aging,
contributes to stress and urge incontinence in older women. Pelvic floor exercises
(Kegel exercises) are a common intervention.
