NUR 257 EXAM 1-4 GERRATRIC NCLEX EXAM – QUESTIONS AND ANSWERS |
EXAM TESTBANK WITH VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
Pharmacology and Polypharmacy in Older Adults
Age-Related Physiological Changes and Their Impact
Cognitive and Psychological Disorders of Aging
Legal and Ethical Issues in Geriatric Care
Functional Assessment and Mobility
Nutritional and Metabolic Considerations
Palliative and End-of-Life Care
Chronic Disease Management in the Elderly
Health Promotion and Disease Prevention
Sensory and Communication Changes with Aging
Introduction
This comprehensive examination has been developed to assess the essential
knowledge, critical thinking, and clinical judgment required for the safe and
effective nursing care of the geriatric population. It is designed to evaluate the
student's understanding of foundational gerontological nursing principles, including
the physiological, psychological, and socio-cultural aspects of aging. The exam
emphasizes the application of evidence-based practice to complex clinical scenarios,
particularly in the areas of medication management, functional decline, cognitive
impairment, and end-of-life care. Through a series of multiple-choice questions, the
student will be challenged to prioritize care, identify potential complications, and
make sound ethical decisions, reflecting the depth of knowledge necessary for
successful NCLEX-RN preparation and professional nursing practice.
,SECTION ONE: QUESTIONS 1 – 50
1.
An 82-year-old patient is admitted with dehydration and mild confusion. The
nurse reviews the patient's home medication list, which includes metoprolol,
furosemide, and digoxin. Which laboratory value is most critical for the nurse to
monitor closely in this patient?
A. Serum sodium
B. Serum potassium
C. Serum creatinine
D. Serum calcium
🟢 Correct Answer: B. Serum potassium
🔴 Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. Hypokalemia can precipitate digoxin toxicity, which is a serious risk in older
adults. While all labs are important, monitoring potassium is most critical given
the combined risk of furosemide-induced hypokalemia and digoxin therapy.
2.
A frail 88-year-old patient who recently moved to a long-term care facility is
refusing to participate in group activities and prefers to stay in her room. The
nurse should initially implement which intervention?
A. Tell the patient she must join the group activities to meet her social needs.
B. Allow the patient to stay in her room but check on her frequently.
C. Ask the patient why she does not want to participate and what activities she
would enjoy.
D. Ask the patient's family to talk to her about the benefits of participating.
,🟢 Correct Answer: C. Ask the patient why she does not want to participate and
what activities she would enjoy.
🔴 Explanation: A new environment is a significant stressor for an older adult. The
nurse must first assess the patient's individual preferences, fears, and needs. This
person-centered approach respects the patient's autonomy and allows for a
tailored plan to promote socialization, rather than forcing participation or
delegating the issue to family.
3.
The nurse is caring for an 80-year-old patient with a diagnosis of Alzheimer's
disease. The patient is becoming increasingly agitated and is pacing the hallways.
What is the nurse's priority intervention at this time?
A. Restrain the patient in a chair for safety.
B. Administer a PRN dose of haloperidol.
C. Redirect the patient to a quiet, calm environment with a familiar object.
D. Call the physician to request a new order for a sedative.
🟢 Correct Answer: C. Redirect the patient to a quiet, calm environment with a
familiar object.
🔴 Explanation: The priority for managing agitation in a patient with dementia is
to use non-pharmacological interventions first. Restraint use and antipsychotics
like haloperidol carry significant risks for older adults (e.g., falls, stroke) and
should be a last resort. Redirection to a calm environment is a safe and effective
initial strategy to de-escalate the situation.
4.
A patient is recovering from a hip fracture repair. The nurse is providing
education on fall prevention strategies for when the patient returns home. Which
statement by the patient indicates a need for further teaching?
, A. "I will install grab bars in my bathroom."
B. "I will have my vision checked regularly."
C. "I will place area rugs over my hardwood floors to cushion a fall."
D. "I will use a walker until my doctor says I can stop."
🟢 Correct Answer: C. "I will place area rugs over my hardwood floors to cushion
a fall."
🔴 Explanation: Area rugs are a significant fall hazard in the home environment.
They can easily cause tripping. The patient should be taught to remove any throw
rugs or ensure they are securely fastened with non-slip backing. The other
statements are all appropriate and safe fall prevention strategies.
5.
A nurse is assessing an older adult's skin and notes a deep, crater-like wound
over the coccyx with visible subcutaneous fat and a small area of necrotic tissue.
How should the nurse accurately stage this pressure injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
🟢 Correct Answer: C. Stage 3
🔴 Explanation: A Stage 3 pressure injury involves full-thickness skin loss with
visible subcutaneous fat but without bone, tendon, or muscle exposure. The
description of a deep crater with fat and some necrotic tissue fits this stage. A
Stage 4 injury would expose bone, tendon, or muscle.
6.
The family of an 85-year-old patient with severe, end-stage dementia asks the
nurse about placing a percutaneous endoscopic gastrostomy (PEG) tube for
EXAM TESTBANK WITH VERIFIED AND WELL DETAILED ANSWERS | PLUS
RATIONALES | DOWNLOAD AND PASS | LATEST EXAM UPDATE 2026/2027
Core Domains:
Pharmacology and Polypharmacy in Older Adults
Age-Related Physiological Changes and Their Impact
Cognitive and Psychological Disorders of Aging
Legal and Ethical Issues in Geriatric Care
Functional Assessment and Mobility
Nutritional and Metabolic Considerations
Palliative and End-of-Life Care
Chronic Disease Management in the Elderly
Health Promotion and Disease Prevention
Sensory and Communication Changes with Aging
Introduction
This comprehensive examination has been developed to assess the essential
knowledge, critical thinking, and clinical judgment required for the safe and
effective nursing care of the geriatric population. It is designed to evaluate the
student's understanding of foundational gerontological nursing principles, including
the physiological, psychological, and socio-cultural aspects of aging. The exam
emphasizes the application of evidence-based practice to complex clinical scenarios,
particularly in the areas of medication management, functional decline, cognitive
impairment, and end-of-life care. Through a series of multiple-choice questions, the
student will be challenged to prioritize care, identify potential complications, and
make sound ethical decisions, reflecting the depth of knowledge necessary for
successful NCLEX-RN preparation and professional nursing practice.
,SECTION ONE: QUESTIONS 1 – 50
1.
An 82-year-old patient is admitted with dehydration and mild confusion. The
nurse reviews the patient's home medication list, which includes metoprolol,
furosemide, and digoxin. Which laboratory value is most critical for the nurse to
monitor closely in this patient?
A. Serum sodium
B. Serum potassium
C. Serum creatinine
D. Serum calcium
🟢 Correct Answer: B. Serum potassium
🔴 Explanation: Furosemide is a loop diuretic that causes significant potassium
loss. Hypokalemia can precipitate digoxin toxicity, which is a serious risk in older
adults. While all labs are important, monitoring potassium is most critical given
the combined risk of furosemide-induced hypokalemia and digoxin therapy.
2.
A frail 88-year-old patient who recently moved to a long-term care facility is
refusing to participate in group activities and prefers to stay in her room. The
nurse should initially implement which intervention?
A. Tell the patient she must join the group activities to meet her social needs.
B. Allow the patient to stay in her room but check on her frequently.
C. Ask the patient why she does not want to participate and what activities she
would enjoy.
D. Ask the patient's family to talk to her about the benefits of participating.
,🟢 Correct Answer: C. Ask the patient why she does not want to participate and
what activities she would enjoy.
🔴 Explanation: A new environment is a significant stressor for an older adult. The
nurse must first assess the patient's individual preferences, fears, and needs. This
person-centered approach respects the patient's autonomy and allows for a
tailored plan to promote socialization, rather than forcing participation or
delegating the issue to family.
3.
The nurse is caring for an 80-year-old patient with a diagnosis of Alzheimer's
disease. The patient is becoming increasingly agitated and is pacing the hallways.
What is the nurse's priority intervention at this time?
A. Restrain the patient in a chair for safety.
B. Administer a PRN dose of haloperidol.
C. Redirect the patient to a quiet, calm environment with a familiar object.
D. Call the physician to request a new order for a sedative.
🟢 Correct Answer: C. Redirect the patient to a quiet, calm environment with a
familiar object.
🔴 Explanation: The priority for managing agitation in a patient with dementia is
to use non-pharmacological interventions first. Restraint use and antipsychotics
like haloperidol carry significant risks for older adults (e.g., falls, stroke) and
should be a last resort. Redirection to a calm environment is a safe and effective
initial strategy to de-escalate the situation.
4.
A patient is recovering from a hip fracture repair. The nurse is providing
education on fall prevention strategies for when the patient returns home. Which
statement by the patient indicates a need for further teaching?
, A. "I will install grab bars in my bathroom."
B. "I will have my vision checked regularly."
C. "I will place area rugs over my hardwood floors to cushion a fall."
D. "I will use a walker until my doctor says I can stop."
🟢 Correct Answer: C. "I will place area rugs over my hardwood floors to cushion
a fall."
🔴 Explanation: Area rugs are a significant fall hazard in the home environment.
They can easily cause tripping. The patient should be taught to remove any throw
rugs or ensure they are securely fastened with non-slip backing. The other
statements are all appropriate and safe fall prevention strategies.
5.
A nurse is assessing an older adult's skin and notes a deep, crater-like wound
over the coccyx with visible subcutaneous fat and a small area of necrotic tissue.
How should the nurse accurately stage this pressure injury?
A. Stage 1
B. Stage 2
C. Stage 3
D. Stage 4
🟢 Correct Answer: C. Stage 3
🔴 Explanation: A Stage 3 pressure injury involves full-thickness skin loss with
visible subcutaneous fat but without bone, tendon, or muscle exposure. The
description of a deep crater with fat and some necrotic tissue fits this stage. A
Stage 4 injury would expose bone, tendon, or muscle.
6.
The family of an 85-year-old patient with severe, end-stage dementia asks the
nurse about placing a percutaneous endoscopic gastrostomy (PEG) tube for
