Geriatric Nursing Exam Questions And
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
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1. Which physiological change is commonly associated with normal aging?
A. Increased total body water
B. Increased renal blood flow
C. Decreased skin elasticity
D. Increased cardiac reserve
Answer: C. Decreased skin elasticity
Rationale: Decreased skin elasticity is a normal age-related change caused by
reductions in collagen, elastin, subcutaneous tissue, and skin hydration. Older
adults also commonly experience decreased total body water, reduced renal blood
flow, and diminished cardiac reserve. These changes can increase vulnerability to
dehydration, medication accumulation, and physiologic stress.
2. An older adult reports difficulty seeing objects in dim lighting. Which age-
related visual change most likely contributes to this problem?
A. Increased pupil size
B. Increased lens transparency
C. Decreased ability of the pupil to dilate
D. Increased retinal sensitivity
Answer: C. Decreased ability of the pupil to dilate
Rationale: Aging is associated with reduced pupil dilation and decreased retinal
illumination, making it more difficult for older adults to adapt to darkness. The lens
also becomes less flexible and less transparent with age. Nurses should provide
,adequate lighting and allow older adults additional time to adjust when moving
between areas with different levels of illumination.
3. Which intervention is most appropriate when communicating with an older
adult who has presbycusis?
A. Speak loudly directly into the patient's ear
B. Speak clearly while facing the patient
C. Use a high-pitched voice
D. Avoid using visual cues
Answer: B. Speak clearly while facing the patient
Rationale: Presbycusis is age-related hearing loss, particularly involving high-
frequency sounds. The nurse should face the patient, maintain eye contact, speak
clearly at a moderate pace, and use a lower-pitched voice when appropriate.
Shouting can distort speech and make understanding more difficult.
4. Which age-related change places an older adult at increased risk for
dehydration?
A. Increased total body water
B. Increased thirst sensation
C. Reduced renal concentrating ability
D. Increased aldosterone production
Answer: C. Reduced renal concentrating ability
Rationale: Aging reduces the kidneys' ability to concentrate urine and conserve
water. Older adults may also have a diminished thirst response, decreased total
body water, and reduced renal reserve. These changes make dehydration more
likely, especially during illness, hot weather, or periods of poor fluid intake.
5. Which finding should the nurse recognize as most suggestive of delirium
rather than dementia?
A. Gradual decline in memory over several years
B. Stable impairment in cognitive function
,C. Acute onset with fluctuating attention
D. Progressive difficulty performing complex tasks
Answer: C. Acute onset with fluctuating attention
Rationale: Delirium usually develops rapidly and is characterized by an acute
change in attention, awareness, and cognition that may fluctuate during the day.
Dementia generally has a gradual, progressive course. Delirium should be treated
as a potentially urgent condition because it is frequently caused by an underlying
medical problem, medication effect, infection, metabolic disturbance, or
environmental stressor.
6. An older hospitalized patient suddenly becomes confused and attempts to
climb out of bed. What should the nurse do first?
A. Apply physical restraints
B. Determine the patient's baseline cognitive status and assess for causes
C. Administer a sedative immediately
D. Tell the patient to return to bed
Answer: B. Determine the patient's baseline cognitive status and assess for causes
Rationale: Sudden confusion in an older adult should prompt assessment for
delirium and potentially reversible causes such as infection, hypoxia, dehydration,
pain, medication effects, urinary retention, constipation, or metabolic
abnormalities. Restraints and sedatives should not be used as automatic responses
because they may worsen agitation and increase complications.
7. Which finding is most characteristic of Alzheimer's disease in its early stage?
A. Sudden onset of severe confusion
B. Progressive short-term memory impairment
C. Complete loss of consciousness
D. Acute unilateral weakness
Answer: B. Progressive short-term memory impairment
, Rationale: Early Alzheimer's disease commonly presents with gradual impairment
of recent memory, difficulty learning new information, and problems with complex
activities. The disease progresses over time and eventually affects language,
judgment, orientation, mobility, and activities of daily living. Sudden confusion is
more characteristic of delirium.
8. Which nursing intervention is appropriate for an older adult with dementia?
A. Frequently change the patient's daily routine
B. Provide complex instructions all at once
C. Maintain a consistent routine
D. Correct every inaccurate statement immediately
Answer: C. Maintain a consistent routine
Rationale: Consistency and familiarity help reduce anxiety and confusion in people
with dementia. The nurse should use simple instructions, establish predictable
routines, reduce environmental overstimulation, and promote independence
whenever safely possible. Constant correction may increase frustration without
improving functioning.
9. Which assessment finding is most concerning for elder abuse?
A. A healed surgical scar
B. Multiple bruises in different stages of healing
C. Mild age-related hearing loss
D. Dry skin on the lower legs
Answer: B. Multiple bruises in different stages of healing
Rationale: Multiple unexplained injuries, injuries in different stages of healing,
inconsistent explanations, fearfulness, poor hygiene, malnutrition, and sudden
changes in financial circumstances can be warning signs of abuse or neglect.
Nurses have a responsibility to assess safety and follow applicable reporting
requirements when abuse is suspected.
10.Which statement best describes frailty in an older adult?
Correct Answers (Verified Answers)
Plus Rationales 2026 Q&A | Instant
Download Pdf
1. Which physiological change is commonly associated with normal aging?
A. Increased total body water
B. Increased renal blood flow
C. Decreased skin elasticity
D. Increased cardiac reserve
Answer: C. Decreased skin elasticity
Rationale: Decreased skin elasticity is a normal age-related change caused by
reductions in collagen, elastin, subcutaneous tissue, and skin hydration. Older
adults also commonly experience decreased total body water, reduced renal blood
flow, and diminished cardiac reserve. These changes can increase vulnerability to
dehydration, medication accumulation, and physiologic stress.
2. An older adult reports difficulty seeing objects in dim lighting. Which age-
related visual change most likely contributes to this problem?
A. Increased pupil size
B. Increased lens transparency
C. Decreased ability of the pupil to dilate
D. Increased retinal sensitivity
Answer: C. Decreased ability of the pupil to dilate
Rationale: Aging is associated with reduced pupil dilation and decreased retinal
illumination, making it more difficult for older adults to adapt to darkness. The lens
also becomes less flexible and less transparent with age. Nurses should provide
,adequate lighting and allow older adults additional time to adjust when moving
between areas with different levels of illumination.
3. Which intervention is most appropriate when communicating with an older
adult who has presbycusis?
A. Speak loudly directly into the patient's ear
B. Speak clearly while facing the patient
C. Use a high-pitched voice
D. Avoid using visual cues
Answer: B. Speak clearly while facing the patient
Rationale: Presbycusis is age-related hearing loss, particularly involving high-
frequency sounds. The nurse should face the patient, maintain eye contact, speak
clearly at a moderate pace, and use a lower-pitched voice when appropriate.
Shouting can distort speech and make understanding more difficult.
4. Which age-related change places an older adult at increased risk for
dehydration?
A. Increased total body water
B. Increased thirst sensation
C. Reduced renal concentrating ability
D. Increased aldosterone production
Answer: C. Reduced renal concentrating ability
Rationale: Aging reduces the kidneys' ability to concentrate urine and conserve
water. Older adults may also have a diminished thirst response, decreased total
body water, and reduced renal reserve. These changes make dehydration more
likely, especially during illness, hot weather, or periods of poor fluid intake.
5. Which finding should the nurse recognize as most suggestive of delirium
rather than dementia?
A. Gradual decline in memory over several years
B. Stable impairment in cognitive function
,C. Acute onset with fluctuating attention
D. Progressive difficulty performing complex tasks
Answer: C. Acute onset with fluctuating attention
Rationale: Delirium usually develops rapidly and is characterized by an acute
change in attention, awareness, and cognition that may fluctuate during the day.
Dementia generally has a gradual, progressive course. Delirium should be treated
as a potentially urgent condition because it is frequently caused by an underlying
medical problem, medication effect, infection, metabolic disturbance, or
environmental stressor.
6. An older hospitalized patient suddenly becomes confused and attempts to
climb out of bed. What should the nurse do first?
A. Apply physical restraints
B. Determine the patient's baseline cognitive status and assess for causes
C. Administer a sedative immediately
D. Tell the patient to return to bed
Answer: B. Determine the patient's baseline cognitive status and assess for causes
Rationale: Sudden confusion in an older adult should prompt assessment for
delirium and potentially reversible causes such as infection, hypoxia, dehydration,
pain, medication effects, urinary retention, constipation, or metabolic
abnormalities. Restraints and sedatives should not be used as automatic responses
because they may worsen agitation and increase complications.
7. Which finding is most characteristic of Alzheimer's disease in its early stage?
A. Sudden onset of severe confusion
B. Progressive short-term memory impairment
C. Complete loss of consciousness
D. Acute unilateral weakness
Answer: B. Progressive short-term memory impairment
, Rationale: Early Alzheimer's disease commonly presents with gradual impairment
of recent memory, difficulty learning new information, and problems with complex
activities. The disease progresses over time and eventually affects language,
judgment, orientation, mobility, and activities of daily living. Sudden confusion is
more characteristic of delirium.
8. Which nursing intervention is appropriate for an older adult with dementia?
A. Frequently change the patient's daily routine
B. Provide complex instructions all at once
C. Maintain a consistent routine
D. Correct every inaccurate statement immediately
Answer: C. Maintain a consistent routine
Rationale: Consistency and familiarity help reduce anxiety and confusion in people
with dementia. The nurse should use simple instructions, establish predictable
routines, reduce environmental overstimulation, and promote independence
whenever safely possible. Constant correction may increase frustration without
improving functioning.
9. Which assessment finding is most concerning for elder abuse?
A. A healed surgical scar
B. Multiple bruises in different stages of healing
C. Mild age-related hearing loss
D. Dry skin on the lower legs
Answer: B. Multiple bruises in different stages of healing
Rationale: Multiple unexplained injuries, injuries in different stages of healing,
inconsistent explanations, fearfulness, poor hygiene, malnutrition, and sudden
changes in financial circumstances can be warning signs of abuse or neglect.
Nurses have a responsibility to assess safety and follow applicable reporting
requirements when abuse is suspected.
10.Which statement best describes frailty in an older adult?
