GERONTOLOGICAL NURSING CERTIFICATION (GERO-BC) QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES | LATEST VERSION PDF
Section One: Questions 1–100
Which physiological change associated with aging primarily contributes to the increased risk of
medication toxicity?
A. Decreased gastric pH
B. Increased lean body mass
C. Decreased glomerular filtration rate
D. Increased hepatic blood flow
🟢C
🔴 RATIONALE: The glomerular filtration rate (GFR) declines with age, leading to reduced renal
clearance of drugs, which increases the half-life and risk of accumulation for many medications.
A 78-year-old patient presents with acute confusion, fever, and dysuria. Which condition should the
nurse prioritize in the assessment?
A. Sundowning syndrome
B. Urinary tract infection
C. Early-stage Alzheimer’s disease
D. Normal pressure hydrocephalus
🟢B
🔴 RATIONALE: In older adults, delirium is often the primary manifestation of an infection,
particularly a urinary tract infection, rather than typical systemic symptoms.
When assessing an older adult for depression, which tool is specifically designed for the geriatric
population?
A. PHQ-9
B. Geriatric Depression Scale (GDS)
,C. Hamilton Depression Rating Scale
D. Beck Depression Inventory
🟢B
🔴 RATIONALE: The Geriatric Depression Scale is specifically validated for older adults and
excludes somatic symptoms that may be confused with physical comorbidities.
Which of the following is a core principle of the Beers Criteria?
A. Identifying medications to avoid in patients with stage 4 CKD
B. Listing potentially inappropriate medications for older adults
C. Providing guidelines for polypharmacy management in palliative care
D. Standardization of intravenous fluid administration for the elderly
🟢B
🔴 RATIONALE: The Beers Criteria provides a list of medications that are generally considered
inappropriate for older adults due to risks that outweigh benefits.
An older adult patient has a pressure ulcer on the sacrum that presents as a shallow, open ulcer
with a red-pink wound bed. How should the nurse classify this stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
🟢B
🔴 RATIONALE: A Stage 2 pressure ulcer involves partial-thickness loss of skin with an exposed
dermis, appearing as a shallow, open ulcer.
Which assessment finding is most indicative of elder neglect by a caregiver?
A. Unexplained bruises on the upper arms
,B. Frequent requests for pain medication
C. Poor hygiene and malnourishment
D. Agitation during physical therapy
🟢C
🔴 RATIONALE: Neglect involves the failure of a caregiver to provide basic necessities, such as
adequate nutrition, hygiene, or safety, often resulting in physical deterioration.
What is the most common cause of reversible dementia-like symptoms in older adults?
A. Vitamin B12 deficiency
B. Normal pressure hydrocephalus
C. Chronic subdural hematoma
D. Hypothyroidism
🟢A
🔴 RATIONALE: Vitamin B12 deficiency is a common, reversible cause of cognitive impairment
and neurological symptoms in older adults.
According to the Morse Fall Scale, which factor is a high-risk indicator for falls?
A. Age over 65
B. History of a recent fall
C. Taking one antihypertensive medication
D. Living alone
🟢B
🔴 RATIONALE: A documented history of a recent fall is the most significant predictor of future
falls in the geriatric population.
An older patient expresses concerns about "giving up driving." Which nursing intervention is most
appropriate?
, A. Advise the patient to drive only during daylight hours.
B. Recommend an Occupational Therapist for a driving evaluation.
C. Inform the patient that they must surrender their license immediately.
D. Suggest that a family member drive for them at all times.
🟢B
🔴 RATIONALE: An Occupational Therapist specializing in driving rehabilitation can objectively
assess physical and cognitive capabilities to determine driving safety.
Which medication is most associated with an increased risk of falls due to orthostatic hypotension?
A. Metformin
B. Lisinopril
C. Levothyroxine
D. Atorvastatin
🟢B
🔴 RATIONALE: ACE inhibitors like lisinopril can cause orthostatic hypotension, especially in older
adults, increasing the risk of falls and syncopal episodes.
What is the goal of "Age-Friendly Health Systems" using the 4Ms framework?
A. Reducing the number of specialists involved in care
B. Focusing on What Matters, Medication, Mentation, and Mobility
C. Increasing the use of advanced technology in home care
D. Minimizing the cost of geriatric long-term care
🟢B
🔴 RATIONALE: The 4Ms framework (What Matters, Medication, Mentation, and Mobility) is the
evidence-based core of the Age-Friendly Health Systems initiative.
ANSWERS WITH DETAILED RATIONALES | LATEST VERSION PDF
Section One: Questions 1–100
Which physiological change associated with aging primarily contributes to the increased risk of
medication toxicity?
A. Decreased gastric pH
B. Increased lean body mass
C. Decreased glomerular filtration rate
D. Increased hepatic blood flow
🟢C
🔴 RATIONALE: The glomerular filtration rate (GFR) declines with age, leading to reduced renal
clearance of drugs, which increases the half-life and risk of accumulation for many medications.
A 78-year-old patient presents with acute confusion, fever, and dysuria. Which condition should the
nurse prioritize in the assessment?
A. Sundowning syndrome
B. Urinary tract infection
C. Early-stage Alzheimer’s disease
D. Normal pressure hydrocephalus
🟢B
🔴 RATIONALE: In older adults, delirium is often the primary manifestation of an infection,
particularly a urinary tract infection, rather than typical systemic symptoms.
When assessing an older adult for depression, which tool is specifically designed for the geriatric
population?
A. PHQ-9
B. Geriatric Depression Scale (GDS)
,C. Hamilton Depression Rating Scale
D. Beck Depression Inventory
🟢B
🔴 RATIONALE: The Geriatric Depression Scale is specifically validated for older adults and
excludes somatic symptoms that may be confused with physical comorbidities.
Which of the following is a core principle of the Beers Criteria?
A. Identifying medications to avoid in patients with stage 4 CKD
B. Listing potentially inappropriate medications for older adults
C. Providing guidelines for polypharmacy management in palliative care
D. Standardization of intravenous fluid administration for the elderly
🟢B
🔴 RATIONALE: The Beers Criteria provides a list of medications that are generally considered
inappropriate for older adults due to risks that outweigh benefits.
An older adult patient has a pressure ulcer on the sacrum that presents as a shallow, open ulcer
with a red-pink wound bed. How should the nurse classify this stage?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
🟢B
🔴 RATIONALE: A Stage 2 pressure ulcer involves partial-thickness loss of skin with an exposed
dermis, appearing as a shallow, open ulcer.
Which assessment finding is most indicative of elder neglect by a caregiver?
A. Unexplained bruises on the upper arms
,B. Frequent requests for pain medication
C. Poor hygiene and malnourishment
D. Agitation during physical therapy
🟢C
🔴 RATIONALE: Neglect involves the failure of a caregiver to provide basic necessities, such as
adequate nutrition, hygiene, or safety, often resulting in physical deterioration.
What is the most common cause of reversible dementia-like symptoms in older adults?
A. Vitamin B12 deficiency
B. Normal pressure hydrocephalus
C. Chronic subdural hematoma
D. Hypothyroidism
🟢A
🔴 RATIONALE: Vitamin B12 deficiency is a common, reversible cause of cognitive impairment
and neurological symptoms in older adults.
According to the Morse Fall Scale, which factor is a high-risk indicator for falls?
A. Age over 65
B. History of a recent fall
C. Taking one antihypertensive medication
D. Living alone
🟢B
🔴 RATIONALE: A documented history of a recent fall is the most significant predictor of future
falls in the geriatric population.
An older patient expresses concerns about "giving up driving." Which nursing intervention is most
appropriate?
, A. Advise the patient to drive only during daylight hours.
B. Recommend an Occupational Therapist for a driving evaluation.
C. Inform the patient that they must surrender their license immediately.
D. Suggest that a family member drive for them at all times.
🟢B
🔴 RATIONALE: An Occupational Therapist specializing in driving rehabilitation can objectively
assess physical and cognitive capabilities to determine driving safety.
Which medication is most associated with an increased risk of falls due to orthostatic hypotension?
A. Metformin
B. Lisinopril
C. Levothyroxine
D. Atorvastatin
🟢B
🔴 RATIONALE: ACE inhibitors like lisinopril can cause orthostatic hypotension, especially in older
adults, increasing the risk of falls and syncopal episodes.
What is the goal of "Age-Friendly Health Systems" using the 4Ms framework?
A. Reducing the number of specialists involved in care
B. Focusing on What Matters, Medication, Mentation, and Mobility
C. Increasing the use of advanced technology in home care
D. Minimizing the cost of geriatric long-term care
🟢B
🔴 RATIONALE: The 4Ms framework (What Matters, Medication, Mentation, and Mobility) is the
evidence-based core of the Age-Friendly Health Systems initiative.
