NUR 198 – Fundamentals of Nursing Exam 4
Comprehensive Study Guide 2026 – Geriatrics,
Polypharmacy, Renal & Fluids, Electrolytes,
Infection Control, Medication Safety, and Basic
Assessment with 100 Practice Questions and
Detailed Rationales
(Topics: geriatrics, polypharmacy, renal & fluids/electrolytes, anemia & epoetin, infection
control, safety, med fundamentals, basic assessment & ethics.)
SECTION 1 – Geriatrics & Polypharmacy (Q1–25)
Q1. An older adult takes 7 prescriptions plus 4 OTC products and reports dizziness. Which
factor most increases risk?
A. Young age
B. Polypharmacy and drug interactions
C. High protein diet
D. Regular exercise
E. No risk
B. Polypharmacy and drug interactions
Multiple meds increase adverse effects and falls.
Q2. Which assessment is priority for an older adult with new confusion?
A. Skin turgor only
B. Medication review, infection screen, hydration, and electrolytes
C. No assessment
D. Vision only
E. Hearing only
,B. Medication review, infection screen, hydration, and electrolytes
Delirium is often multifactorial.
Q3. A patient with dementia becomes agitated during bathing. Best initial action?
A. Restrain immediately
B. Stop, assess pain/fear, use calm approach, and try again later
C. Force completion
D. Sedate routinely
E. Ignore
B. Stop, assess pain/fear, use calm approach, and try again later
Nonpharmacologic first.
Q4. Which finding suggests depression in an older adult?
A. Increased energy
B. Anhedonia, sleep/appetite changes, and hopelessness
C. No symptoms
D. Only weight gain
E. Only insomnia
B. Anhedonia, sleep/appetite changes, and hopelessness
Depression indicators.
Q5. Which intervention best reduces fall risk at home?
A. Throw rugs everywhere
B. Remove loose rugs, add grab bars, and improve lighting
C. No changes
D. Avoid all walking
E. No assistive devices
B. Remove loose rugs, add grab bars, and improve lighting
Environmental modifications.
,Q6. An older adult reports constipation. Which first-line intervention is appropriate?
A. No fiber
B. Increase fluids, fiber, activity; review constipating meds
C. Avoid fluids
D. No activity
E. No changes
B. Increase fluids, fiber, activity; review constipating meds
Basic bowel regimen.
Q7. Which sign suggests orthostatic hypotension?
A. BP increases when standing
B. Dizziness and BP drop upon standing
C. No change
D. Only bradycardia
E. No symptoms
B. Dizziness and BP drop upon standing
Orthostatic change.
Q8. A patient with hearing loss struggles to understand instructions. Best approach?
A. Shout loudly
B. Face patient, speak slowly, reduce noise, and use written materials
C. No teaching
D. Avoid visuals
E. No assistance
B. Face patient, speak slowly, reduce noise, and use written materials
Effective communication.
Q9. Which finding is an atypical infection presentation in older adults?
A. High fever only
B. Confusion, functional decline, and falls with or without fever
C. No symptoms
, D. Only rash
E. Only cough
B. Confusion, functional decline, and falls with or without fever
Older adults may not mount classic fever.
Q10. Which instruction helps prevent aspiration in dysphagia?
A. Supine feeding
B. Upright positioning, small bites, and chin-tuck as directed
C. Large bites
D. No monitoring
E. No teaching
B. Upright positioning, small bites, and chin-tuck as directed
Swallowing safety.
Q11. An older adult has difficulty reading medication labels. Which aid helps most?
A. No changes
B. Large-print labels and a daily pill organizer
C. Avoid labels
D. No teaching
E. No assistance
B. Large-print labels and a daily pill organizer
Supports adherence.
Q12. Which finding suggests possible elder neglect?
A. Well-groomed appearance
B. Poor hygiene, malnutrition, and unexplained injuries
C. No issues
D. Regular follow-up
E. No concerns
B. Poor hygiene, malnutrition, and unexplained injuries
Neglect indicators.
Comprehensive Study Guide 2026 – Geriatrics,
Polypharmacy, Renal & Fluids, Electrolytes,
Infection Control, Medication Safety, and Basic
Assessment with 100 Practice Questions and
Detailed Rationales
(Topics: geriatrics, polypharmacy, renal & fluids/electrolytes, anemia & epoetin, infection
control, safety, med fundamentals, basic assessment & ethics.)
SECTION 1 – Geriatrics & Polypharmacy (Q1–25)
Q1. An older adult takes 7 prescriptions plus 4 OTC products and reports dizziness. Which
factor most increases risk?
A. Young age
B. Polypharmacy and drug interactions
C. High protein diet
D. Regular exercise
E. No risk
B. Polypharmacy and drug interactions
Multiple meds increase adverse effects and falls.
Q2. Which assessment is priority for an older adult with new confusion?
A. Skin turgor only
B. Medication review, infection screen, hydration, and electrolytes
C. No assessment
D. Vision only
E. Hearing only
,B. Medication review, infection screen, hydration, and electrolytes
Delirium is often multifactorial.
Q3. A patient with dementia becomes agitated during bathing. Best initial action?
A. Restrain immediately
B. Stop, assess pain/fear, use calm approach, and try again later
C. Force completion
D. Sedate routinely
E. Ignore
B. Stop, assess pain/fear, use calm approach, and try again later
Nonpharmacologic first.
Q4. Which finding suggests depression in an older adult?
A. Increased energy
B. Anhedonia, sleep/appetite changes, and hopelessness
C. No symptoms
D. Only weight gain
E. Only insomnia
B. Anhedonia, sleep/appetite changes, and hopelessness
Depression indicators.
Q5. Which intervention best reduces fall risk at home?
A. Throw rugs everywhere
B. Remove loose rugs, add grab bars, and improve lighting
C. No changes
D. Avoid all walking
E. No assistive devices
B. Remove loose rugs, add grab bars, and improve lighting
Environmental modifications.
,Q6. An older adult reports constipation. Which first-line intervention is appropriate?
A. No fiber
B. Increase fluids, fiber, activity; review constipating meds
C. Avoid fluids
D. No activity
E. No changes
B. Increase fluids, fiber, activity; review constipating meds
Basic bowel regimen.
Q7. Which sign suggests orthostatic hypotension?
A. BP increases when standing
B. Dizziness and BP drop upon standing
C. No change
D. Only bradycardia
E. No symptoms
B. Dizziness and BP drop upon standing
Orthostatic change.
Q8. A patient with hearing loss struggles to understand instructions. Best approach?
A. Shout loudly
B. Face patient, speak slowly, reduce noise, and use written materials
C. No teaching
D. Avoid visuals
E. No assistance
B. Face patient, speak slowly, reduce noise, and use written materials
Effective communication.
Q9. Which finding is an atypical infection presentation in older adults?
A. High fever only
B. Confusion, functional decline, and falls with or without fever
C. No symptoms
, D. Only rash
E. Only cough
B. Confusion, functional decline, and falls with or without fever
Older adults may not mount classic fever.
Q10. Which instruction helps prevent aspiration in dysphagia?
A. Supine feeding
B. Upright positioning, small bites, and chin-tuck as directed
C. Large bites
D. No monitoring
E. No teaching
B. Upright positioning, small bites, and chin-tuck as directed
Swallowing safety.
Q11. An older adult has difficulty reading medication labels. Which aid helps most?
A. No changes
B. Large-print labels and a daily pill organizer
C. Avoid labels
D. No teaching
E. No assistance
B. Large-print labels and a daily pill organizer
Supports adherence.
Q12. Which finding suggests possible elder neglect?
A. Well-groomed appearance
B. Poor hygiene, malnutrition, and unexplained injuries
C. No issues
D. Regular follow-up
E. No concerns
B. Poor hygiene, malnutrition, and unexplained injuries
Neglect indicators.
