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Nursing for Wellness in Older Adults (Miller, 9th Ed.) – Complete
Practice Test (2026)
Unit 1: Foundations of Gerontological Nursing (Chapters 1-4)
1. A nurse is caring for a 78-year-old patient who is hospitalized for a hip
fracture. The patient asks, "Why is my body breaking down so fast?" Which of
the following responses by the nurse best reflects the current understanding of
aging?
A) "Aging is a predictable, genetically programmed process that causes all organs
to fail at the same rate."
B) "Aging is a complex process influenced by genetics, lifestyle, environment, and
disease; it does not necessarily mean inevitable decline."
C) "Your body is breaking down because you didn't take good care of yourself
when you were younger."
D) "All older adults experience the same physical changes, and there is nothing
you can do to slow it down."
Answer: B
Rationale: The contemporary view of aging (geroscience) recognizes that aging is
a multifactorial process. While genetics play a role, lifestyle, environment, and
disease interactions significantly influence how an individual ages. The nurse
should validate the patient's concern while providing a hopeful, evidence-based
perspective that does not equate aging with inevitable disability.
2. A nurse is teaching a group of nursing students about the demography of
aging. Which of the following statements by a student indicates a correct
understanding of the older adult population in the United States?
A) "The population aged 65 and older is shrinking."
B) "The fastest-growing segment of the older adult population is the 'oldest-old'
(age 85 and over)."
C) "Most older adults live in nursing homes."
D) "The majority of older adults are non-Hispanic Black individuals."
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Answer: B
Rationale: The "oldest-old" (85 years and older) is the fastest-growing segment of
the U.S. population. This group has unique healthcare needs, including increased
frailty, multiple chronic conditions, and higher rates of institutionalization. The
majority of older adults live in the community, not nursing homes.
3. According to Erik Erikson's theory of psychosocial development, the primary
developmental task of the older adult (age 65+) is:
A) Generativity vs. Stagnation
B) Integrity vs. Despair
C) Intimacy vs. Isolation
D) Industry vs. Inferiority
Answer: B
Rationale: Erikson’s final stage of psychosocial development is Integrity vs.
Despair. The older adult reflects on their life and either feels a sense of
accomplishment and meaning (integrity) or regrets and dissatisfaction (despair).
The nurse can support this process by encouraging life review and reminiscence
therapy.
4. A nurse is conducting a health history on an 82-year-old patient. Which of the
following is a key principle of effective communication with the older adult?
A) Speak in a loud voice, regardless of the patient's hearing status.
B) Face the patient, speak clearly and slowly, and minimize background noise.
C) Use complex medical terminology to demonstrate expertise.
D) Assume the patient has cognitive impairment if they are slow to respond.
Answer: B
Rationale: Effective communication with older adults includes: facing the patient,
speaking clearly and slowly (not necessarily loudly), using simple language,
minimizing background noise, and allowing extra time for response. The nurse
should not assume cognitive impairment based on a delayed response.
5. A nurse is evaluating an older adult patient for age-related changes in the
integumentary system. Which of the following is a normal, expected age-related
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change?
A) Increased thickness of the dermis
B) Decreased sebaceous and sweat gland activity, leading to dry, fragile skin
C) Increased elasticity of the skin
D) Increased production of melanin, causing hyperpigmentation
Answer: B
Rationale: Normal age-related changes in the skin include: thinning of the dermis
and epidermis, decreased sebaceous and sweat gland activity (leading to dry,
pruritic skin), decreased elasticity (wrinkling), and thinning of subcutaneous fat.
Sun exposure contributes to hyperpigmentation (age spots), but this is not a
normal physiological change.
Unit 2: Health Assessment & Wellness (Chapters 5-9)
6. A nurse is performing a comprehensive geriatric assessment (CGA) on a 76-
year-old patient. Which of the following is a core component of the CGA?
A) A single, focused physical exam
B) A multidisciplinary evaluation of medical, functional, cognitive, and
psychosocial domains
C) A review of only the patient's current medications
D) A one-time assessment of blood pressure and heart rate
Answer: B
Rationale: A Comprehensive Geriatric Assessment (CGA) is a multidisciplinary,
multidimensional process that evaluates the older adult's medical, functional,
cognitive, and psychosocial status. It is used to develop a comprehensive care plan
and is a cornerstone of geriatric nursing.
7. The nurse is assessing a 74-year-old patient's functional status using the Katz
Index of Activities of Daily Living (ADLs). Which of the following is an ADL?
A) Using the telephone
B) Managing finances
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C) Bathing and dressing
D) Shopping for groceries
Answer: C
Rationale: The Katz Index assesses basic Activities of Daily Living (ADLs), which
include: bathing, dressing, toileting, transferring, continence, and feeding.
Instrumental Activities of Daily Living (IADLs) include: using the telephone,
managing finances, shopping, and preparing meals.
8. A nurse is teaching an 82-year-old patient about nutrition. Which of the
following is a normal age-related change that affects nutritional status?
A) Increased sense of taste and smell
B) Decreased gastric motility and delayed gastric emptying
C) Increased stomach acid production
D) Increased calcium absorption
Answer: B
Rationale: Normal age-related changes affecting nutrition include: decreased
sense of taste and smell, decreased gastric motility (delayed emptying), decreased
stomach acid (hypochlorhydria), decreased saliva production, and decreased
absorption of nutrients like calcium and B12.
9. A nurse is screening an 80-year-old patient for fall risk. Which of the following
is the most significant risk factor for falls in the older adult?
A) A history of previous falls
B) Living in a single-story home
C) Wearing bifocal glasses
D) Having a pet in the home
Answer: A
Rationale: A history of previous falls is one of the strongest predictors of future
falls. The presence of multiple risk factors (gait instability, medications,
environmental hazards, sensory deficits) compounds the risk. The nurse should
perform a Timed Up and Go (TUG) test and a fall risk assessment.
Nursing for Wellness in Older Adults (Miller, 9th Ed.) – Complete
Practice Test (2026)
Unit 1: Foundations of Gerontological Nursing (Chapters 1-4)
1. A nurse is caring for a 78-year-old patient who is hospitalized for a hip
fracture. The patient asks, "Why is my body breaking down so fast?" Which of
the following responses by the nurse best reflects the current understanding of
aging?
A) "Aging is a predictable, genetically programmed process that causes all organs
to fail at the same rate."
B) "Aging is a complex process influenced by genetics, lifestyle, environment, and
disease; it does not necessarily mean inevitable decline."
C) "Your body is breaking down because you didn't take good care of yourself
when you were younger."
D) "All older adults experience the same physical changes, and there is nothing
you can do to slow it down."
Answer: B
Rationale: The contemporary view of aging (geroscience) recognizes that aging is
a multifactorial process. While genetics play a role, lifestyle, environment, and
disease interactions significantly influence how an individual ages. The nurse
should validate the patient's concern while providing a hopeful, evidence-based
perspective that does not equate aging with inevitable disability.
2. A nurse is teaching a group of nursing students about the demography of
aging. Which of the following statements by a student indicates a correct
understanding of the older adult population in the United States?
A) "The population aged 65 and older is shrinking."
B) "The fastest-growing segment of the older adult population is the 'oldest-old'
(age 85 and over)."
C) "Most older adults live in nursing homes."
D) "The majority of older adults are non-Hispanic Black individuals."
, Page |2
Answer: B
Rationale: The "oldest-old" (85 years and older) is the fastest-growing segment of
the U.S. population. This group has unique healthcare needs, including increased
frailty, multiple chronic conditions, and higher rates of institutionalization. The
majority of older adults live in the community, not nursing homes.
3. According to Erik Erikson's theory of psychosocial development, the primary
developmental task of the older adult (age 65+) is:
A) Generativity vs. Stagnation
B) Integrity vs. Despair
C) Intimacy vs. Isolation
D) Industry vs. Inferiority
Answer: B
Rationale: Erikson’s final stage of psychosocial development is Integrity vs.
Despair. The older adult reflects on their life and either feels a sense of
accomplishment and meaning (integrity) or regrets and dissatisfaction (despair).
The nurse can support this process by encouraging life review and reminiscence
therapy.
4. A nurse is conducting a health history on an 82-year-old patient. Which of the
following is a key principle of effective communication with the older adult?
A) Speak in a loud voice, regardless of the patient's hearing status.
B) Face the patient, speak clearly and slowly, and minimize background noise.
C) Use complex medical terminology to demonstrate expertise.
D) Assume the patient has cognitive impairment if they are slow to respond.
Answer: B
Rationale: Effective communication with older adults includes: facing the patient,
speaking clearly and slowly (not necessarily loudly), using simple language,
minimizing background noise, and allowing extra time for response. The nurse
should not assume cognitive impairment based on a delayed response.
5. A nurse is evaluating an older adult patient for age-related changes in the
integumentary system. Which of the following is a normal, expected age-related
, Page |3
change?
A) Increased thickness of the dermis
B) Decreased sebaceous and sweat gland activity, leading to dry, fragile skin
C) Increased elasticity of the skin
D) Increased production of melanin, causing hyperpigmentation
Answer: B
Rationale: Normal age-related changes in the skin include: thinning of the dermis
and epidermis, decreased sebaceous and sweat gland activity (leading to dry,
pruritic skin), decreased elasticity (wrinkling), and thinning of subcutaneous fat.
Sun exposure contributes to hyperpigmentation (age spots), but this is not a
normal physiological change.
Unit 2: Health Assessment & Wellness (Chapters 5-9)
6. A nurse is performing a comprehensive geriatric assessment (CGA) on a 76-
year-old patient. Which of the following is a core component of the CGA?
A) A single, focused physical exam
B) A multidisciplinary evaluation of medical, functional, cognitive, and
psychosocial domains
C) A review of only the patient's current medications
D) A one-time assessment of blood pressure and heart rate
Answer: B
Rationale: A Comprehensive Geriatric Assessment (CGA) is a multidisciplinary,
multidimensional process that evaluates the older adult's medical, functional,
cognitive, and psychosocial status. It is used to develop a comprehensive care plan
and is a cornerstone of geriatric nursing.
7. The nurse is assessing a 74-year-old patient's functional status using the Katz
Index of Activities of Daily Living (ADLs). Which of the following is an ADL?
A) Using the telephone
B) Managing finances
, Page |4
C) Bathing and dressing
D) Shopping for groceries
Answer: C
Rationale: The Katz Index assesses basic Activities of Daily Living (ADLs), which
include: bathing, dressing, toileting, transferring, continence, and feeding.
Instrumental Activities of Daily Living (IADLs) include: using the telephone,
managing finances, shopping, and preparing meals.
8. A nurse is teaching an 82-year-old patient about nutrition. Which of the
following is a normal age-related change that affects nutritional status?
A) Increased sense of taste and smell
B) Decreased gastric motility and delayed gastric emptying
C) Increased stomach acid production
D) Increased calcium absorption
Answer: B
Rationale: Normal age-related changes affecting nutrition include: decreased
sense of taste and smell, decreased gastric motility (delayed emptying), decreased
stomach acid (hypochlorhydria), decreased saliva production, and decreased
absorption of nutrients like calcium and B12.
9. A nurse is screening an 80-year-old patient for fall risk. Which of the following
is the most significant risk factor for falls in the older adult?
A) A history of previous falls
B) Living in a single-story home
C) Wearing bifocal glasses
D) Having a pet in the home
Answer: A
Rationale: A history of previous falls is one of the strongest predictors of future
falls. The presence of multiple risk factors (gait instability, medications,
environmental hazards, sensory deficits) compounds the risk. The nurse should
perform a Timed Up and Go (TUG) test and a fall risk assessment.
