Advanced Geriatric Care Competency Assessment
for AGNPs (150Qs And Answers)
2025/2026
1. A 78-year-old patient presents with new-onset confusion,
agitation, and hallucinations. Which is the most likely cause?
A. Dementia
B. Depression
C. Delirium
D. Parkinson’s disease
_Rationale: Delirium is characterized by an acute onset of
confusion, fluctuating course, and often hallucinations, whereas
dementia develops slowly and progressively.**
2. Which of the following vaccines is recommended annually for
older adults?
A. Hepatitis B
B. MMR
C. Influenza
D. Varicella
_Rationale: The influenza vaccine is recommended yearly for
adults ≥65 due to higher risk of complications.**
3. A 72-year-old female presents with progressive shortness of
breath and lower extremity edema. Which diagnostic test is most
appropriate to evaluate heart failure?
A. Chest X-ray
B. EKG
C. Echocardiogram
D. Pulmonary function tests
, _Rationale: Echocardiography is the gold standard to assess
cardiac function and confirm heart failure.**
4. Which cognitive screening tool is most appropriate for routine
geriatric assessment?
A. Beck Depression Inventory
B. Mini Nutritional Assessment
C. Mini-Mental State Examination (MMSE)
D. Montreal Cognitive Assessment (MoCA)
_Rationale: MMSE is widely used for initial cognitive screening in
older adults.**
5. An 80-year-old patient is experiencing urinary incontinence.
Which is the first-line management strategy?
A. Surgery
B. Anticholinergic medications
C. Behavioral interventions (bladder training, scheduled voiding)
D. Indwelling catheter placement
_Rationale: Behavioral interventions are first-line management to
reduce incontinence episodes safely.**
6. Which medication class increases the risk of falls in the elderly?
A. Beta-blockers
B. ACE inhibitors
C. Benzodiazepines
D. Statins
_Rationale: Benzodiazepines can cause sedation, impaired
coordination, and increase fall risk in older adults.**
7. A 76-year-old male with chronic kidney disease presents with
fatigue and pallor. Labs show low hemoglobin. The most common
cause of anemia in this patient is:
A. Iron deficiency
, B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Hemolytic anemia
_Rationale: Anemia of chronic disease is common in elderly
patients with CKD due to reduced erythropoietin production.**
8. Which dietary recommendation is most important to prevent
osteoporosis in older adults?
A. Low sodium diet
B. High protein diet
C. Adequate calcium and vitamin D intake
D. Gluten-free diet
_Rationale: Calcium and vitamin D are crucial for bone health and
reducing fracture risk.**
9. Which of the following is considered a geriatric syndrome?
A. Hypertension
B. Frailty
C. Diabetes mellitus
D. Hyperlipidemia
_Rationale: Frailty is a geriatric syndrome characterized by
decreased physiologic reserve and increased vulnerability.**
10. A 79-year-old patient presents with severe arthritis pain
limiting mobility. Which intervention is preferred for chronic pain
management?
A. Long-term opioid therapy
B. NSAIDs without monitoring
C. Acetaminophen and non-pharmacologic interventions
D. Corticosteroid injections every month
_Rationale: Acetaminophen is first-line for osteoarthritis pain in
older adults; NSAIDs have higher risk for adverse effects.**
, 11. Which of the following best describes polypharmacy?
A. Taking herbal supplements
B. Taking a single high-dose medication
C. Use of multiple medications simultaneously, often ≥5
D. Occasional use of over-the-counter drugs
_Rationale: Polypharmacy increases the risk of adverse drug
events, drug interactions, and functional decline in the elderly.**
12. In evaluating an older adult with depression, which
symptom is most common?
A. Hyperactivity
B. Hallucinations
C. Anhedonia and low energy
D. Euphoria
_Rationale: Older adults often present with apathy, fatigue, and
loss of interest rather than overt sadness.**
13. Which intervention is most effective in preventing falls in
elderly patients?
A. Vitamin B12 supplementation
B. Daily aspirin
C. Exercise programs focusing on balance and strength
D. Restriction of physical activity
_Rationale: Strength and balance training reduces fall risk in
community-dwelling older adults.**
14. Which lab abnormality is most commonly associated with
dehydration in older adults?
A. Hypokalemia
B. Elevated BUN-to-creatinine ratio
C. Hypoglycemia
D. Hyponatremia
for AGNPs (150Qs And Answers)
2025/2026
1. A 78-year-old patient presents with new-onset confusion,
agitation, and hallucinations. Which is the most likely cause?
A. Dementia
B. Depression
C. Delirium
D. Parkinson’s disease
_Rationale: Delirium is characterized by an acute onset of
confusion, fluctuating course, and often hallucinations, whereas
dementia develops slowly and progressively.**
2. Which of the following vaccines is recommended annually for
older adults?
A. Hepatitis B
B. MMR
C. Influenza
D. Varicella
_Rationale: The influenza vaccine is recommended yearly for
adults ≥65 due to higher risk of complications.**
3. A 72-year-old female presents with progressive shortness of
breath and lower extremity edema. Which diagnostic test is most
appropriate to evaluate heart failure?
A. Chest X-ray
B. EKG
C. Echocardiogram
D. Pulmonary function tests
, _Rationale: Echocardiography is the gold standard to assess
cardiac function and confirm heart failure.**
4. Which cognitive screening tool is most appropriate for routine
geriatric assessment?
A. Beck Depression Inventory
B. Mini Nutritional Assessment
C. Mini-Mental State Examination (MMSE)
D. Montreal Cognitive Assessment (MoCA)
_Rationale: MMSE is widely used for initial cognitive screening in
older adults.**
5. An 80-year-old patient is experiencing urinary incontinence.
Which is the first-line management strategy?
A. Surgery
B. Anticholinergic medications
C. Behavioral interventions (bladder training, scheduled voiding)
D. Indwelling catheter placement
_Rationale: Behavioral interventions are first-line management to
reduce incontinence episodes safely.**
6. Which medication class increases the risk of falls in the elderly?
A. Beta-blockers
B. ACE inhibitors
C. Benzodiazepines
D. Statins
_Rationale: Benzodiazepines can cause sedation, impaired
coordination, and increase fall risk in older adults.**
7. A 76-year-old male with chronic kidney disease presents with
fatigue and pallor. Labs show low hemoglobin. The most common
cause of anemia in this patient is:
A. Iron deficiency
, B. Vitamin B12 deficiency
C. Anemia of chronic disease
D. Hemolytic anemia
_Rationale: Anemia of chronic disease is common in elderly
patients with CKD due to reduced erythropoietin production.**
8. Which dietary recommendation is most important to prevent
osteoporosis in older adults?
A. Low sodium diet
B. High protein diet
C. Adequate calcium and vitamin D intake
D. Gluten-free diet
_Rationale: Calcium and vitamin D are crucial for bone health and
reducing fracture risk.**
9. Which of the following is considered a geriatric syndrome?
A. Hypertension
B. Frailty
C. Diabetes mellitus
D. Hyperlipidemia
_Rationale: Frailty is a geriatric syndrome characterized by
decreased physiologic reserve and increased vulnerability.**
10. A 79-year-old patient presents with severe arthritis pain
limiting mobility. Which intervention is preferred for chronic pain
management?
A. Long-term opioid therapy
B. NSAIDs without monitoring
C. Acetaminophen and non-pharmacologic interventions
D. Corticosteroid injections every month
_Rationale: Acetaminophen is first-line for osteoarthritis pain in
older adults; NSAIDs have higher risk for adverse effects.**
, 11. Which of the following best describes polypharmacy?
A. Taking herbal supplements
B. Taking a single high-dose medication
C. Use of multiple medications simultaneously, often ≥5
D. Occasional use of over-the-counter drugs
_Rationale: Polypharmacy increases the risk of adverse drug
events, drug interactions, and functional decline in the elderly.**
12. In evaluating an older adult with depression, which
symptom is most common?
A. Hyperactivity
B. Hallucinations
C. Anhedonia and low energy
D. Euphoria
_Rationale: Older adults often present with apathy, fatigue, and
loss of interest rather than overt sadness.**
13. Which intervention is most effective in preventing falls in
elderly patients?
A. Vitamin B12 supplementation
B. Daily aspirin
C. Exercise programs focusing on balance and strength
D. Restriction of physical activity
_Rationale: Strength and balance training reduces fall risk in
community-dwelling older adults.**
14. Which lab abnormality is most commonly associated with
dehydration in older adults?
A. Hypokalemia
B. Elevated BUN-to-creatinine ratio
C. Hypoglycemia
D. Hyponatremia
