GERONTOLOGICAL NURSING COMPREHENSIVE EXAM REVIEW 2026 /
COMPLETE OLDER ADULT NURSING STUDY GUIDE WITH PRACTICE
QUESTIONS AND RATIONALES
1. An 82-year-old hospitalized adult reports difficulty hearing the nurse during
medication teaching, particularly when several people are speaking at once.
Which nursing intervention would best promote effective communication
while respecting normal age-related sensory changes?
A. Speak rapidly so the client does not lose concentration
B. Use a louder voice with a high-pitched tone
C. Face the client, reduce background noise, speak clearly in a lower-pitched
voice, and allow time for responses
D. Avoid verbal communication and provide all information in writing
Answer: C
2. An older adult who has been independent at home is admitted after
developing pneumonia. The nurse notices that the client is suddenly
confused, inattentive, and unable to identify the hospital location. Which
condition should the nurse suspect?
A. Delirium
B. Normal aging
C. Chronic dementia
D. Depression
Answer: A
3. A 79-year-old client becomes acutely disoriented several hours after surgery
and alternates between periods of agitation and lethargy. The nurse reviews
the record and finds that the client's cognition was normal before
admission. Which intervention is most appropriate?
A. Assume the behavior is an expected consequence of aging
B. Restrict all family visits
C. Keep the client awake throughout the night
D. Assess for reversible causes such as infection, medications, hypoxia, pain,
pg. 1
, and metabolic abnormalities
Answer: D
4. An older adult with progressive memory loss has difficulty managing
finances, preparing meals, and remembering familiar routes but remains
physically stable. Which finding would most strongly distinguish dementia
from delirium?
A. Symptoms fluctuate dramatically over several hours
B. Cognitive decline has developed gradually and progressively
C. Attention changes suddenly after medication administration
D. Consciousness changes repeatedly during the same day
Answer: B
5. A nurse is assessing an older adult who reports urinary urgency and
occasional leakage when unable to reach the bathroom in time. Which type
of urinary incontinence is most consistent with this description?
A. Stress incontinence
B. Overflow incontinence
C. Urge incontinence
D. Functional incontinence
Answer: C
6. An 86-year-old client reports urine leakage when coughing, laughing, or
sneezing but denies urgency before the leakage occurs. Which type of
incontinence should the nurse identify?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: A
7. An older adult with severe arthritis is continent but repeatedly has urine
accidents because the bathroom is far from the bedroom and the client
cannot walk quickly. Which type of incontinence is most likely?
A. Overflow
pg. 2
, B. Stress
C. Urge
D. Functional
Answer: D
8. A nurse is assessing an 81-year-old client for fall risk. Which finding should
receive the greatest attention when developing an individualized fall-
prevention plan?
A. Preference for reading before bedtime
B. Multiple medications associated with dizziness and orthostatic
hypotension
C. Preference for sleeping eight hours nightly
D. Occasional participation in social activities
Answer: B
9. An older adult becomes dizzy when standing from a chair. Blood pressure
decreases substantially after standing. Which nursing intervention should
be prioritized?
A. Encourage rapid position changes to improve circulation
B. Restrict all oral fluids
C. Teach the client to change positions slowly and assess contributing
medications and hydration
D. Encourage prolonged bed rest
Answer: C
10. An 88-year-old client has experienced two falls during the past month. The
client uses several medications, reports blurred vision, and has loose rugs
throughout the home. Which nursing action should occur first?
A. Perform a comprehensive fall-risk assessment and identify modifiable
hazards
B. Recommend permanent institutionalization
C. Tell the client to stop all prescribed medications
D. Encourage the client to remain in bed
Answer: A
pg. 3
, 11. A nurse is educating an older adult about medication safety. Which
statement by the client demonstrates the greatest understanding of
polypharmacy risk?
A. “If a medication is prescribed, it cannot interact with my other
medicines.”
B. “I should keep an updated list of all prescription, over-the-counter, and
herbal products.”
C. “I can stop medications whenever I feel better.”
D. “My medications do not need review if I have taken them for several
years.”
Answer: B
12. An older adult takes eight prescribed medications and several over-the-
counter products. Which nursing action is most appropriate during
medication reconciliation?
A. Ask the client to bring or provide information about every medication,
including dose, frequency, and nonprescription products
B. Review only medications prescribed by the current provider
C. Ignore herbal supplements because they are natural
D. Assume medications taken for years remain appropriate indefinitely
Answer: A
13. A nurse is reviewing pharmacokinetics in older adults. Which physiological
change can contribute to increased serum concentrations of some water-
soluble medications?
A. Increased total body water
B. Increased renal clearance
C. Decreased renal function
D. Increased hepatic blood flow
Answer: C
14. An older adult has reduced kidney function and is prescribed a medication
primarily eliminated through the kidneys. Which nursing consideration is
most important?
pg. 4
COMPLETE OLDER ADULT NURSING STUDY GUIDE WITH PRACTICE
QUESTIONS AND RATIONALES
1. An 82-year-old hospitalized adult reports difficulty hearing the nurse during
medication teaching, particularly when several people are speaking at once.
Which nursing intervention would best promote effective communication
while respecting normal age-related sensory changes?
A. Speak rapidly so the client does not lose concentration
B. Use a louder voice with a high-pitched tone
C. Face the client, reduce background noise, speak clearly in a lower-pitched
voice, and allow time for responses
D. Avoid verbal communication and provide all information in writing
Answer: C
2. An older adult who has been independent at home is admitted after
developing pneumonia. The nurse notices that the client is suddenly
confused, inattentive, and unable to identify the hospital location. Which
condition should the nurse suspect?
A. Delirium
B. Normal aging
C. Chronic dementia
D. Depression
Answer: A
3. A 79-year-old client becomes acutely disoriented several hours after surgery
and alternates between periods of agitation and lethargy. The nurse reviews
the record and finds that the client's cognition was normal before
admission. Which intervention is most appropriate?
A. Assume the behavior is an expected consequence of aging
B. Restrict all family visits
C. Keep the client awake throughout the night
D. Assess for reversible causes such as infection, medications, hypoxia, pain,
pg. 1
, and metabolic abnormalities
Answer: D
4. An older adult with progressive memory loss has difficulty managing
finances, preparing meals, and remembering familiar routes but remains
physically stable. Which finding would most strongly distinguish dementia
from delirium?
A. Symptoms fluctuate dramatically over several hours
B. Cognitive decline has developed gradually and progressively
C. Attention changes suddenly after medication administration
D. Consciousness changes repeatedly during the same day
Answer: B
5. A nurse is assessing an older adult who reports urinary urgency and
occasional leakage when unable to reach the bathroom in time. Which type
of urinary incontinence is most consistent with this description?
A. Stress incontinence
B. Overflow incontinence
C. Urge incontinence
D. Functional incontinence
Answer: C
6. An 86-year-old client reports urine leakage when coughing, laughing, or
sneezing but denies urgency before the leakage occurs. Which type of
incontinence should the nurse identify?
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: A
7. An older adult with severe arthritis is continent but repeatedly has urine
accidents because the bathroom is far from the bedroom and the client
cannot walk quickly. Which type of incontinence is most likely?
A. Overflow
pg. 2
, B. Stress
C. Urge
D. Functional
Answer: D
8. A nurse is assessing an 81-year-old client for fall risk. Which finding should
receive the greatest attention when developing an individualized fall-
prevention plan?
A. Preference for reading before bedtime
B. Multiple medications associated with dizziness and orthostatic
hypotension
C. Preference for sleeping eight hours nightly
D. Occasional participation in social activities
Answer: B
9. An older adult becomes dizzy when standing from a chair. Blood pressure
decreases substantially after standing. Which nursing intervention should
be prioritized?
A. Encourage rapid position changes to improve circulation
B. Restrict all oral fluids
C. Teach the client to change positions slowly and assess contributing
medications and hydration
D. Encourage prolonged bed rest
Answer: C
10. An 88-year-old client has experienced two falls during the past month. The
client uses several medications, reports blurred vision, and has loose rugs
throughout the home. Which nursing action should occur first?
A. Perform a comprehensive fall-risk assessment and identify modifiable
hazards
B. Recommend permanent institutionalization
C. Tell the client to stop all prescribed medications
D. Encourage the client to remain in bed
Answer: A
pg. 3
, 11. A nurse is educating an older adult about medication safety. Which
statement by the client demonstrates the greatest understanding of
polypharmacy risk?
A. “If a medication is prescribed, it cannot interact with my other
medicines.”
B. “I should keep an updated list of all prescription, over-the-counter, and
herbal products.”
C. “I can stop medications whenever I feel better.”
D. “My medications do not need review if I have taken them for several
years.”
Answer: B
12. An older adult takes eight prescribed medications and several over-the-
counter products. Which nursing action is most appropriate during
medication reconciliation?
A. Ask the client to bring or provide information about every medication,
including dose, frequency, and nonprescription products
B. Review only medications prescribed by the current provider
C. Ignore herbal supplements because they are natural
D. Assume medications taken for years remain appropriate indefinitely
Answer: A
13. A nurse is reviewing pharmacokinetics in older adults. Which physiological
change can contribute to increased serum concentrations of some water-
soluble medications?
A. Increased total body water
B. Increased renal clearance
C. Decreased renal function
D. Increased hepatic blood flow
Answer: C
14. An older adult has reduced kidney function and is prescribed a medication
primarily eliminated through the kidneys. Which nursing consideration is
most important?
pg. 4
