Adult-Gerontology Clinical Nurse Specialist
AGCNS- Actual Questions with Verified Answers
| New 2025/2026 Update | 100% Correct.
1. An older adult patient is prescribed a new medication. Which
age-related change most increases the risk of adverse drug
reactions?
A. Increased gastric motility
B. Decreased glomerular filtration rate
C. Increased hepatic blood flow
D. Increased total body water
Answer: B
Rationale: Decreased glomerular filtration rate reduces renal
clearance of drugs, prolonging half-life and increasing the risk of
toxicity. Aging also decreases hepatic blood flow and total body
water while increasing body fat.
2. Which assessment finding is most concerning in an 80-year-
old patient with pneumonia?
A. Temperature of 101.2 F
B. New onset confusion
,C. Productive cough
D. Respiratory rate of 22
Answer: B
Rationale: Older adults often present atypically with infection.
Acute confusion may be the only sign of pneumonia or urinary
tract infection because immune and inflammatory responses
are blunted.
3. A patient with advanced dementia is no longer eating. Which
action by the clinical nurse specialist best supports ethical
practice?
A. Recommend placement of a feeding tube
B. Initiate a goals-of-care discussion with the family
C. Restrict family visits
D. Increase antipsychotic medication
Answer: B
Rationale: Goals-of-care conversations align treatment with
patient values and preferences. Artificial nutrition in advanced
dementia has not been shown to improve survival or quality of
life.
,4. Which screening is recommended for all adults age 65 and
older?
A. Annual colonoscopy
B. Annual influenza vaccination
C. Annual chest X-ray
D. Annual stress test
Answer: B
Rationale: Annual influenza vaccination is recommended for all
adults 65 and older. Colonoscopy is generally recommended
until age 75. Routine chest X-rays and stress tests are not
recommended for asymptomatic adults.
5. A patient reports falling twice in the past month. Which
intervention should the clinical nurse specialist implement first?
A. Restrict ambulation
B. Conduct a comprehensive falls assessment
C. Prescribe a walker
D. Order a head CT
Answer: B
Rationale: A comprehensive falls assessment identifies
modifiable risk factors such as medications, vision, gait,
, orthostatic hypotension, and environmental hazards. Restricting
ambulation increases weakness and fall risk.
6. Which medication class is most associated with orthostatic
hypotension in older adults?
A. Antihistamines
B. Alpha-blockers
C. Proton pump inhibitors
D. Inhaled corticosteroids
Answer: B
Rationale: Alpha-blockers cause vasodilation and are strongly
associated with orthostatic hypotension and falls.
Antihypertensives, diuretics, and tricyclic antidepressants also
contribute.
7. The clinical nurse specialist is leading a project to reduce
catheter-associated urinary tract infections. Which action is
most effective?
A. Increasing antibiotic prophylaxis
B. Implementing nurse-driven removal protocols
C. Changing catheters every 48 hours
AGCNS- Actual Questions with Verified Answers
| New 2025/2026 Update | 100% Correct.
1. An older adult patient is prescribed a new medication. Which
age-related change most increases the risk of adverse drug
reactions?
A. Increased gastric motility
B. Decreased glomerular filtration rate
C. Increased hepatic blood flow
D. Increased total body water
Answer: B
Rationale: Decreased glomerular filtration rate reduces renal
clearance of drugs, prolonging half-life and increasing the risk of
toxicity. Aging also decreases hepatic blood flow and total body
water while increasing body fat.
2. Which assessment finding is most concerning in an 80-year-
old patient with pneumonia?
A. Temperature of 101.2 F
B. New onset confusion
,C. Productive cough
D. Respiratory rate of 22
Answer: B
Rationale: Older adults often present atypically with infection.
Acute confusion may be the only sign of pneumonia or urinary
tract infection because immune and inflammatory responses
are blunted.
3. A patient with advanced dementia is no longer eating. Which
action by the clinical nurse specialist best supports ethical
practice?
A. Recommend placement of a feeding tube
B. Initiate a goals-of-care discussion with the family
C. Restrict family visits
D. Increase antipsychotic medication
Answer: B
Rationale: Goals-of-care conversations align treatment with
patient values and preferences. Artificial nutrition in advanced
dementia has not been shown to improve survival or quality of
life.
,4. Which screening is recommended for all adults age 65 and
older?
A. Annual colonoscopy
B. Annual influenza vaccination
C. Annual chest X-ray
D. Annual stress test
Answer: B
Rationale: Annual influenza vaccination is recommended for all
adults 65 and older. Colonoscopy is generally recommended
until age 75. Routine chest X-rays and stress tests are not
recommended for asymptomatic adults.
5. A patient reports falling twice in the past month. Which
intervention should the clinical nurse specialist implement first?
A. Restrict ambulation
B. Conduct a comprehensive falls assessment
C. Prescribe a walker
D. Order a head CT
Answer: B
Rationale: A comprehensive falls assessment identifies
modifiable risk factors such as medications, vision, gait,
, orthostatic hypotension, and environmental hazards. Restricting
ambulation increases weakness and fall risk.
6. Which medication class is most associated with orthostatic
hypotension in older adults?
A. Antihistamines
B. Alpha-blockers
C. Proton pump inhibitors
D. Inhaled corticosteroids
Answer: B
Rationale: Alpha-blockers cause vasodilation and are strongly
associated with orthostatic hypotension and falls.
Antihypertensives, diuretics, and tricyclic antidepressants also
contribute.
7. The clinical nurse specialist is leading a project to reduce
catheter-associated urinary tract infections. Which action is
most effective?
A. Increasing antibiotic prophylaxis
B. Implementing nurse-driven removal protocols
C. Changing catheters every 48 hours
