CORRECT ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES 2026 Q&A |
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Core Domains
Pharmacokinetics and Pharmacodynamics in the Elderly
Cognitive Impairment, Dementia, and Delirium Management
Palliative and End-of-Life Care Coordination
Geriatric Syndromes: Falls, Incontinence, and Frailty
Legal and Ethical Issues in Aged Care
Health Promotion and Disease Prevention
Multidisciplinary Care Planning and Transitions
Physical Assessment and Diagnostic Reasoning
Introduction
This comprehensive assessment is designed to evaluate the advanced proficiency of
nursing professionals specializing in geriatric care. The exam focuses on the
integration of clinical expertise, ethical decision-making, and evidence-based practice
to address the complex needs of the aging population. Candidates are assessed on
,their ability to manage chronic conditions, interpret diagnostic findings, and
implement patient-centered interventions within a multidisciplinary framework.
Utilizing a blend of foundational theory and scenario-based questions, the exam
emphasizes critical thinking and real-world application. Each question is structured to
challenge the practitioner’s judgment in high-stakes environments, ensuring high
standards of safety and care quality for older adults.
SECTION ONE
1. An 82-year-old patient presents with a sudden onset of confusion and visual
hallucinations. The nurse notes a history of mild cognitive impairment. Which of
the following should be the priority assessment?
A. Assessment for chronic dementia progression
B. Evaluation for urinary tract infection or electrolyte imbalance
C. Mini-Mental State Examination (MMSE)
D. Review of family history for psychiatric disorders
🟢 B. Evaluation for urinary tract infection or electrolyte imbalance
🔴 RATIONALE: Acute onset of confusion and hallucinations in the elderly is a
hallmark of delirium, often caused by underlying physiological triggers such as
,infections or metabolic disturbances.
2. When prescribing a new medication for a 90-year-old patient, which
physiological change is most significant regarding drug toxicity?
A. Increased total body water
B. Increased hepatic blood flow
C. Reduced glomerular filtration rate
D. Decreased body fat percentage
🟢 C. Reduced glomerular filtration rate
🔴 RATIONALE: Aging is associated with a decline in renal function (GFR), which
reduces the clearance of water-soluble drugs, significantly increasing the risk of
toxicity.
3. Which of the following is the most appropriate initial intervention for an older
adult experiencing urge incontinence?
A. Immediate catheterization
B. Scheduled bladder retraining and pelvic floor exercises
C. Administration of high-dose anticholinergics
D. Fluid restriction to less than 500mL per day
, 🟢 B. Scheduled bladder retraining and pelvic floor exercises
🔴 RATIONALE: Behavioral interventions like bladder retraining are first-line
treatments for urge incontinence before moving to pharmacological or invasive
measures.
4. A patient with advanced Alzheimer’s disease has been losing weight despite
adequate intake. What is the most appropriate nursing action?
A. Insert a nasogastric tube for supplemental feeding
B. Prescribe high-calorie meal replacements and finger foods
C. Initiate a high-protein, low-carbohydrate diet
D. Restrict the patient to a bed-bound status to conserve energy
🟢 B. Prescribe high-calorie meal replacements and finger foods
🔴 RATIONALE: Finger foods allow patients with dementia to maintain autonomy
and increase caloric intake in a way that accommodates their pacing or restlessness.
5. According to the Beers Criteria, which of the following medications should be
avoided in older adults due to high risk of falls?