NRNP 6540 Care of the Older Adult Final 2026 | Practice Questions, Answers & Detailed Rationales -
DIVERSE VARIED
600 TRULY DIVERSE CONCEPTS + VARIED STEMS - NOT SAME 'What is X?' - CLEAN - NO EXAM NAME
1. What would you do first when older adult shows falls and geriatric syndromes frailty sarcopenia failure to thrive
A. No sarcopenia geriatric syndromes
B. Single factor geriatric syndromes
C. No frailty geriatric syndromes
D. Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
Answer: D
Rationale: Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
2. Priority for older adult with weight loss: Cognitive screening MMSE 24 cutoff MoCA 26 clock drawing
A. MMSE 24 MoCA 26 clock drawing cognitive screening
B. No MoCA cognitive
C. No cutoff MMSE
D. No clock cognitive
Answer: A
Rationale: MMSE 24 MoCA 26 clock drawing cognitive screening
3. Why does aging cause depression? Polypharmacy Beers criteria older adult avoid anticholinergics benzodiazepines
A. Give Beers polypharmacy older
B. No criteria polypharmacy
C. Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
D. All meds safe polypharmacy older
Answer: C
Rationale: Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
4. Lab: albumin 2.8. Depression vs dementia pseudodementia older adult PHQ-9 GDS
A. Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
B. No anhedonia depression older
C. No PHQ depression older
D. No sleep depression older
Answer: A
Rationale: Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
5. Older adult presents: Pressure injury older adult skin changes Braden nutrition reposition Assessment shows dementia.
A. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
B. No reposition pressure older
C. No nutrition pressure older
D. No Braden pressure older
Answer: A
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
6. What would you do first when older adult shows confusion and elder abuse screening mandatory reporting
A. No reporting elder abuse
B. Ignore elder abuse
C. Elder abuse physical emotional financial neglect screening mandatory report
D. No screening elder abuse
Answer: C
Rationale: Elder abuse physical emotional financial neglect screening mandatory report
7. A 65-year-old older adult with new confusion: What is priority for geriatric safety 7554?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
8. A 87-year-old older adult with new falls: What is priority for geriatric safety 5877?
A. No assessment
B. Ignore safety
C. Assess geriatric syndromes function cognition safety polypharmacy
D. Only meds
Answer: C
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
9. A 73-year-old older adult with new falls: What is priority for geriatric safety 6342?
, A. Only meds
B. Ignore safety
C. No assessment
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
10. A 86-year-old older adult with new weight loss: What is priority for geriatric safety 8516?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. Only meds
D. No assessment
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
11. A 70-year-old older adult with new falls: What is priority for geriatric safety 4938?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
12. A 95-year-old older adult with new confusion: What is priority for geriatric safety 6990?
A. Ignore safety
B. Only meds
C. No assessment
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
13. A 89-year-old older adult with new weight loss: What is priority for geriatric safety 2165?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
14. You are caring for older adult with dementia. Cognitive screening MMSE 24 cutoff MoCA 26 clock drawing
A. No MoCA cognitive
B. No cutoff MMSE
C. No clock cognitive
D. MMSE 24 MoCA 26 clock drawing cognitive screening
Answer: D
Rationale: MMSE 24 MoCA 26 clock drawing cognitive screening
15. Lab: albumin 2.8. Osteoporosis screening DEXA T-score -2.5 calcium vitamin D bisphosphonate
A. No DEXA osteoporosis
B. No calcium osteoporosis
C. T -1 osteoporosis
D. Osteoporosis DEXA T -2.5 calcium vitamin D bisphosphonate fall prevention
Answer: D
Rationale: Osteoporosis DEXA T -2.5 calcium vitamin D bisphosphonate fall prevention
16. Older adult presents: Sleep changes older adult melatonin sleep hygiene Assessment shows pressure injury.
A. Increased deep sleep older sleep
B. Sleep older decreased deep sleep early awakening melatonin hygiene
C. No melatonin older sleep
D. No hygiene older sleep
Answer: B
Rationale: Sleep older decreased deep sleep early awakening melatonin hygiene
17. You are caring for older adult with pressure injury. Depression vs dementia pseudodementia older adult PHQ-9 GDS
A. No anhedonia depression older
B. No PHQ depression older
C. No sleep depression older
D. Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
Answer: D
Rationale: Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
,18. Why does aging cause incontinence? Hypertension older adult isolated systolic treatment
A. No isolated systolic HTN older
B. No stiffness HTN older
C. No orthostasis HTN older
D. HTN older isolated systolic stiff arteries treat <130/80 if tolerated orthostasis
Answer: D
Rationale: HTN older isolated systolic stiff arteries treat <130/80 if tolerated orthostasis
19. A 75-year-old with confusion: Urinary incontinence types stress urge overflow functional older
A. No overflow incontinence older
B. Incontinence stress cough urge urgency overflow retention functional mobility
C. Only stress incontinence older
D. No urge incontinence older
Answer: B
Rationale: Incontinence stress cough urge urgency overflow retention functional mobility
20. A 78-year-old with incontinence: Hospice palliative criteria older adult
A. Hospice prognosis <6 months palliative symptom management goals
B. Only curative hospice
C. No prognosis hospice
D. No symptom hospice
Answer: A
Rationale: Hospice prognosis <6 months palliative symptom management goals
21. Priority for older adult with pressure injury: Dementia Alzheimer progressive memory loss MMSE MoCA functional decline
chronic
A. Acute dementia
B. Dementia Alzheimer progressive memory functional decline chronic MMSE MoCA
C. Fluctuating dementia reversible
D. No memory dementia
Answer: B
Rationale: Dementia Alzheimer progressive memory functional decline chronic MMSE MoCA
22. What would you do first when older adult shows polypharmacy and diabetes older adult a1c goal less strict hypoglycemia
avoidance
A. Diabetes older A1c <7.5-8 less strict avoid hypoglycemia
B. No hypoglycemia diabetes older
C. Strict diabetes older always
D. A1c <6 diabetes older
Answer: A
Rationale: Diabetes older A1c <7.5-8 less strict avoid hypoglycemia
23. Priority for older adult with pressure injury: Geriatric syndromes frailty sarcopenia failure to thrive
A. Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
B. Single factor geriatric syndromes
C. No frailty geriatric syndromes
D. No sarcopenia geriatric syndromes
Answer: A
Rationale: Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
24. Priority for older adult with polypharmacy: Pressure injury older adult skin changes Braden nutrition reposition
A. No nutrition pressure older
B. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
C. No reposition pressure older
D. No Braden pressure older
Answer: B
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
25. Based on geriatric assessment, pressure injury older adult skin changes braden nutrition reposition
A. No nutrition pressure older
B. No Braden pressure older
C. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
D. No reposition pressure older
Answer: C
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
26. A 72-year-old with depression: Polypharmacy Beers criteria older adult avoid anticholinergics benzodiazepines
A. Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
B. Give Beers polypharmacy older
C. No criteria polypharmacy
, D. All meds safe polypharmacy older
Answer: A
Rationale: Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
27. A 85-year-old older adult with new weight loss: What is priority for geriatric safety 2179?
A. No assessment
B. Only meds
C. Assess geriatric syndromes function cognition safety polypharmacy
D. Ignore safety
Answer: C
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
28. Which indicates worsening in older adult with dementia? Delirium acute confusion fluctuating attention infection meds
dehydration reversible workup CAM
A. Irreversible delirium
B. No fluctuation delirium
C. Chronic delirium
D. Delirium acute fluctuating inattention infection meds dehydration reversible CAM assessment
Answer: D
Rationale: Delirium acute fluctuating inattention infection meds dehydration reversible CAM assessment
29. Select correct intervention for older adult: Caregiver burden Zarit scale respite
A. No burden caregiver older
B. No respite caregiver older
C. No Zarit caregiver older
D. Caregiver burden Zarit respite support
Answer: D
Rationale: Caregiver burden Zarit respite support
30. Older adult presents: Infection older adult atypical presentation no fever confusion Assessment shows weight loss.
A. No confusion infection older
B. Typical infection older always
C. Infection older atypical no fever confusion functional decline
D. Fever always infection older
Answer: C
Rationale: Infection older atypical no fever confusion functional decline
31. You are caring for older adult with incontinence. Sleep changes older adult melatonin sleep hygiene
A. No melatonin older sleep
B. Increased deep sleep older sleep
C. Sleep older decreased deep sleep early awakening melatonin hygiene
D. No hygiene older sleep
Answer: C
Rationale: Sleep older decreased deep sleep early awakening melatonin hygiene
32. A 76-year-old older adult with new confusion: What is priority for geriatric safety 7155?
A. Ignore safety
B. No assessment
C. Only meds
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
33. A 75-year-old older adult with new weight loss: What is priority for geriatric safety 3770?
A. Only meds
B. Assess geriatric syndromes function cognition safety polypharmacy
C. Ignore safety
D. No assessment
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
34. Which indicates worsening in older adult with incontinence? Nutrition older adult anorexia weight loss albumin
A. High albumin nutrition older low
B. No anorexia nutrition older
C. Nutrition older anorexia weight loss albumin 3.5 social dentition
D. No dentition nutrition older
Answer: C
Rationale: Nutrition older anorexia weight loss albumin 3.5 social dentition
35. A 72-year-old older adult with new confusion: What is priority for geriatric safety 3568?
DIVERSE VARIED
600 TRULY DIVERSE CONCEPTS + VARIED STEMS - NOT SAME 'What is X?' - CLEAN - NO EXAM NAME
1. What would you do first when older adult shows falls and geriatric syndromes frailty sarcopenia failure to thrive
A. No sarcopenia geriatric syndromes
B. Single factor geriatric syndromes
C. No frailty geriatric syndromes
D. Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
Answer: D
Rationale: Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
2. Priority for older adult with weight loss: Cognitive screening MMSE 24 cutoff MoCA 26 clock drawing
A. MMSE 24 MoCA 26 clock drawing cognitive screening
B. No MoCA cognitive
C. No cutoff MMSE
D. No clock cognitive
Answer: A
Rationale: MMSE 24 MoCA 26 clock drawing cognitive screening
3. Why does aging cause depression? Polypharmacy Beers criteria older adult avoid anticholinergics benzodiazepines
A. Give Beers polypharmacy older
B. No criteria polypharmacy
C. Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
D. All meds safe polypharmacy older
Answer: C
Rationale: Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
4. Lab: albumin 2.8. Depression vs dementia pseudodementia older adult PHQ-9 GDS
A. Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
B. No anhedonia depression older
C. No PHQ depression older
D. No sleep depression older
Answer: A
Rationale: Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
5. Older adult presents: Pressure injury older adult skin changes Braden nutrition reposition Assessment shows dementia.
A. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
B. No reposition pressure older
C. No nutrition pressure older
D. No Braden pressure older
Answer: A
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
6. What would you do first when older adult shows confusion and elder abuse screening mandatory reporting
A. No reporting elder abuse
B. Ignore elder abuse
C. Elder abuse physical emotional financial neglect screening mandatory report
D. No screening elder abuse
Answer: C
Rationale: Elder abuse physical emotional financial neglect screening mandatory report
7. A 65-year-old older adult with new confusion: What is priority for geriatric safety 7554?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
8. A 87-year-old older adult with new falls: What is priority for geriatric safety 5877?
A. No assessment
B. Ignore safety
C. Assess geriatric syndromes function cognition safety polypharmacy
D. Only meds
Answer: C
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
9. A 73-year-old older adult with new falls: What is priority for geriatric safety 6342?
, A. Only meds
B. Ignore safety
C. No assessment
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
10. A 86-year-old older adult with new weight loss: What is priority for geriatric safety 8516?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. Only meds
D. No assessment
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
11. A 70-year-old older adult with new falls: What is priority for geriatric safety 4938?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
12. A 95-year-old older adult with new confusion: What is priority for geriatric safety 6990?
A. Ignore safety
B. Only meds
C. No assessment
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
13. A 89-year-old older adult with new weight loss: What is priority for geriatric safety 2165?
A. Ignore safety
B. Assess geriatric syndromes function cognition safety polypharmacy
C. No assessment
D. Only meds
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
14. You are caring for older adult with dementia. Cognitive screening MMSE 24 cutoff MoCA 26 clock drawing
A. No MoCA cognitive
B. No cutoff MMSE
C. No clock cognitive
D. MMSE 24 MoCA 26 clock drawing cognitive screening
Answer: D
Rationale: MMSE 24 MoCA 26 clock drawing cognitive screening
15. Lab: albumin 2.8. Osteoporosis screening DEXA T-score -2.5 calcium vitamin D bisphosphonate
A. No DEXA osteoporosis
B. No calcium osteoporosis
C. T -1 osteoporosis
D. Osteoporosis DEXA T -2.5 calcium vitamin D bisphosphonate fall prevention
Answer: D
Rationale: Osteoporosis DEXA T -2.5 calcium vitamin D bisphosphonate fall prevention
16. Older adult presents: Sleep changes older adult melatonin sleep hygiene Assessment shows pressure injury.
A. Increased deep sleep older sleep
B. Sleep older decreased deep sleep early awakening melatonin hygiene
C. No melatonin older sleep
D. No hygiene older sleep
Answer: B
Rationale: Sleep older decreased deep sleep early awakening melatonin hygiene
17. You are caring for older adult with pressure injury. Depression vs dementia pseudodementia older adult PHQ-9 GDS
A. No anhedonia depression older
B. No PHQ depression older
C. No sleep depression older
D. Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
Answer: D
Rationale: Depression older adult anhedonia weight change sleep PHQ-9 GDS pseudodementia treatable
,18. Why does aging cause incontinence? Hypertension older adult isolated systolic treatment
A. No isolated systolic HTN older
B. No stiffness HTN older
C. No orthostasis HTN older
D. HTN older isolated systolic stiff arteries treat <130/80 if tolerated orthostasis
Answer: D
Rationale: HTN older isolated systolic stiff arteries treat <130/80 if tolerated orthostasis
19. A 75-year-old with confusion: Urinary incontinence types stress urge overflow functional older
A. No overflow incontinence older
B. Incontinence stress cough urge urgency overflow retention functional mobility
C. Only stress incontinence older
D. No urge incontinence older
Answer: B
Rationale: Incontinence stress cough urge urgency overflow retention functional mobility
20. A 78-year-old with incontinence: Hospice palliative criteria older adult
A. Hospice prognosis <6 months palliative symptom management goals
B. Only curative hospice
C. No prognosis hospice
D. No symptom hospice
Answer: A
Rationale: Hospice prognosis <6 months palliative symptom management goals
21. Priority for older adult with pressure injury: Dementia Alzheimer progressive memory loss MMSE MoCA functional decline
chronic
A. Acute dementia
B. Dementia Alzheimer progressive memory functional decline chronic MMSE MoCA
C. Fluctuating dementia reversible
D. No memory dementia
Answer: B
Rationale: Dementia Alzheimer progressive memory functional decline chronic MMSE MoCA
22. What would you do first when older adult shows polypharmacy and diabetes older adult a1c goal less strict hypoglycemia
avoidance
A. Diabetes older A1c <7.5-8 less strict avoid hypoglycemia
B. No hypoglycemia diabetes older
C. Strict diabetes older always
D. A1c <6 diabetes older
Answer: A
Rationale: Diabetes older A1c <7.5-8 less strict avoid hypoglycemia
23. Priority for older adult with pressure injury: Geriatric syndromes frailty sarcopenia failure to thrive
A. Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
B. Single factor geriatric syndromes
C. No frailty geriatric syndromes
D. No sarcopenia geriatric syndromes
Answer: A
Rationale: Geriatric syndromes frailty sarcopenia anorexia failure to thrive multifactorial
24. Priority for older adult with polypharmacy: Pressure injury older adult skin changes Braden nutrition reposition
A. No nutrition pressure older
B. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
C. No reposition pressure older
D. No Braden pressure older
Answer: B
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
25. Based on geriatric assessment, pressure injury older adult skin changes braden nutrition reposition
A. No nutrition pressure older
B. No Braden pressure older
C. Pressure injury older skin thin less elastic Braden nutrition reposition moisture
D. No reposition pressure older
Answer: C
Rationale: Pressure injury older skin thin less elastic Braden nutrition reposition moisture
26. A 72-year-old with depression: Polypharmacy Beers criteria older adult avoid anticholinergics benzodiazepines
A. Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
B. Give Beers polypharmacy older
C. No criteria polypharmacy
, D. All meds safe polypharmacy older
Answer: A
Rationale: Polypharmacy Beers criteria avoid anticholinergics benzos NSAIDs renal dosing
27. A 85-year-old older adult with new weight loss: What is priority for geriatric safety 2179?
A. No assessment
B. Only meds
C. Assess geriatric syndromes function cognition safety polypharmacy
D. Ignore safety
Answer: C
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
28. Which indicates worsening in older adult with dementia? Delirium acute confusion fluctuating attention infection meds
dehydration reversible workup CAM
A. Irreversible delirium
B. No fluctuation delirium
C. Chronic delirium
D. Delirium acute fluctuating inattention infection meds dehydration reversible CAM assessment
Answer: D
Rationale: Delirium acute fluctuating inattention infection meds dehydration reversible CAM assessment
29. Select correct intervention for older adult: Caregiver burden Zarit scale respite
A. No burden caregiver older
B. No respite caregiver older
C. No Zarit caregiver older
D. Caregiver burden Zarit respite support
Answer: D
Rationale: Caregiver burden Zarit respite support
30. Older adult presents: Infection older adult atypical presentation no fever confusion Assessment shows weight loss.
A. No confusion infection older
B. Typical infection older always
C. Infection older atypical no fever confusion functional decline
D. Fever always infection older
Answer: C
Rationale: Infection older atypical no fever confusion functional decline
31. You are caring for older adult with incontinence. Sleep changes older adult melatonin sleep hygiene
A. No melatonin older sleep
B. Increased deep sleep older sleep
C. Sleep older decreased deep sleep early awakening melatonin hygiene
D. No hygiene older sleep
Answer: C
Rationale: Sleep older decreased deep sleep early awakening melatonin hygiene
32. A 76-year-old older adult with new confusion: What is priority for geriatric safety 7155?
A. Ignore safety
B. No assessment
C. Only meds
D. Assess geriatric syndromes function cognition safety polypharmacy
Answer: D
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
33. A 75-year-old older adult with new weight loss: What is priority for geriatric safety 3770?
A. Only meds
B. Assess geriatric syndromes function cognition safety polypharmacy
C. Ignore safety
D. No assessment
Answer: B
Rationale: Assess geriatric syndromes function cognition safety polypharmacy
34. Which indicates worsening in older adult with incontinence? Nutrition older adult anorexia weight loss albumin
A. High albumin nutrition older low
B. No anorexia nutrition older
C. Nutrition older anorexia weight loss albumin 3.5 social dentition
D. No dentition nutrition older
Answer: C
Rationale: Nutrition older anorexia weight loss albumin 3.5 social dentition
35. A 72-year-old older adult with new confusion: What is priority for geriatric safety 3568?
