LPN/LVN Geriatric Nursing Competency
Exam — Code: LPN-GERO-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An 82-year-old resident with heart failure has gained 2.2 lb (1 kg) overnight
and reports increasing fatigue. Which finding requires the LPN/LVN to act
first?
A. Mild bilateral ankle edema
B. Weight gain of 2.2 lb
C. New dyspnea while resting
D. Decreased appetite
Answer: New dyspnea while resting
,Rationale: New dyspnea at rest may indicate worsening pulmonary congestion
and impaired oxygenation. Airway and breathing take priority, while the rapid
weight gain is also an important indicator of fluid retention.
2. An older adult taking digoxin reports nausea, anorexia, and seeing yellow-
green halos around lights. What is the nurse's priority action?
A. Administer the next dose with food
B. Encourage increased fluid intake
C. Hold the medication and notify the provider
D. Document the findings as expected adverse effects
Answer: Hold the medication and notify the provider
Rationale: Nausea, anorexia, and visual disturbances are classic manifestations
of possible digoxin toxicity. The medication should be withheld and the provider
notified for further evaluation.
3. An 88-year-old patient becomes acutely confused and agitated two days
after admission for pneumonia. Which condition should the nurse suspect
first?
A. Dementia
B. Delirium
C. Depression
D. Normal aging
Answer: Delirium
Rationale: Acute, fluctuating confusion with a recent medical trigger is
characteristic of delirium. Dementia generally develops gradually and is not an
acute change from baseline.
4. Which intervention is most appropriate for preventing pressure injuries in a
frail older adult with limited mobility?
A. Massage reddened bony prominences
B. Reposition the patient regularly and offload pressure
,C. Keep the head of bed elevated continuously
D. Apply powder to all skin folds
Answer: Reposition the patient regularly and offload pressure
Rationale: Frequent repositioning and pressure redistribution reduce tissue
ischemia. Massaging reddened areas can further damage vulnerable tissue and
should be avoided.
5. An older adult taking warfarin has an INR of 5.8 and reports new bruising.
What should the LPN/LVN do?
A. Administer warfarin as prescribed
B. Encourage foods high in vitamin K immediately
C. Hold the medication and notify the provider
D. Give aspirin for discomfort
Answer: Hold the medication and notify the provider
Rationale: A markedly elevated INR with active bleeding manifestations
increases the risk for serious hemorrhage. Warfarin should be withheld and the
abnormal result promptly reported.
6. A 79-year-old patient with Parkinson disease has difficulty swallowing
medications. Which intervention is safest?
A. Crush all medications together
B. Ask the pharmacist whether medications may be crushed or converted to
another formulation
C. Mix medications into a large amount of food
D. Give medications while the patient is lying flat
Answer: Ask the pharmacist whether medications may be crushed or converted
to another formulation
Rationale: Some medications should never be crushed because doing so can
alter absorption or cause toxicity. Dysphagia requires medication-specific
evaluation and aspiration precautions.
, 7. An older adult with dementia repeatedly attempts to leave the unit. Which
intervention should the nurse implement first?
A. Apply wrist restraints
B. Place the patient in seclusion
C. Identify triggers and provide structured, supervised activity
D. Administer a sedative without further assessment
Answer: Identify triggers and provide structured, supervised activity
Rationale: Nonpharmacologic interventions are preferred for behavioral
symptoms associated with dementia. Identifying unmet needs, triggers, and
environmental factors may reduce wandering.
8. Which assessment finding in an older adult is most suggestive of
dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Orthostatic blood pressure changes
D. Jugular venous distention
Answer: Orthostatic blood pressure changes
Rationale: Orthostatic hypotension can occur with reduced circulating volume
and is particularly important in older adults because it increases fall risk.
9. An older adult with osteoporosis asks how to reduce fracture risk. Which
recommendation is most appropriate?
A. Avoid all physical activity
B. Perform weight-bearing activity as tolerated and maintain adequate calcium
and vitamin D intake
C. Remain on bed rest during periods of discomfort
D. Avoid sunlight completely
Answer: Perform weight-bearing activity as tolerated and maintain adequate
calcium and vitamin D intake
Exam — Code: LPN-GERO-COMP | 100-
Question Advanced Practice Exam 2026
| Questions & Answers with Detailed
Rationales | Complete Exam Prep &
Study Guide
1. An 82-year-old resident with heart failure has gained 2.2 lb (1 kg) overnight
and reports increasing fatigue. Which finding requires the LPN/LVN to act
first?
A. Mild bilateral ankle edema
B. Weight gain of 2.2 lb
C. New dyspnea while resting
D. Decreased appetite
Answer: New dyspnea while resting
,Rationale: New dyspnea at rest may indicate worsening pulmonary congestion
and impaired oxygenation. Airway and breathing take priority, while the rapid
weight gain is also an important indicator of fluid retention.
2. An older adult taking digoxin reports nausea, anorexia, and seeing yellow-
green halos around lights. What is the nurse's priority action?
A. Administer the next dose with food
B. Encourage increased fluid intake
C. Hold the medication and notify the provider
D. Document the findings as expected adverse effects
Answer: Hold the medication and notify the provider
Rationale: Nausea, anorexia, and visual disturbances are classic manifestations
of possible digoxin toxicity. The medication should be withheld and the provider
notified for further evaluation.
3. An 88-year-old patient becomes acutely confused and agitated two days
after admission for pneumonia. Which condition should the nurse suspect
first?
A. Dementia
B. Delirium
C. Depression
D. Normal aging
Answer: Delirium
Rationale: Acute, fluctuating confusion with a recent medical trigger is
characteristic of delirium. Dementia generally develops gradually and is not an
acute change from baseline.
4. Which intervention is most appropriate for preventing pressure injuries in a
frail older adult with limited mobility?
A. Massage reddened bony prominences
B. Reposition the patient regularly and offload pressure
,C. Keep the head of bed elevated continuously
D. Apply powder to all skin folds
Answer: Reposition the patient regularly and offload pressure
Rationale: Frequent repositioning and pressure redistribution reduce tissue
ischemia. Massaging reddened areas can further damage vulnerable tissue and
should be avoided.
5. An older adult taking warfarin has an INR of 5.8 and reports new bruising.
What should the LPN/LVN do?
A. Administer warfarin as prescribed
B. Encourage foods high in vitamin K immediately
C. Hold the medication and notify the provider
D. Give aspirin for discomfort
Answer: Hold the medication and notify the provider
Rationale: A markedly elevated INR with active bleeding manifestations
increases the risk for serious hemorrhage. Warfarin should be withheld and the
abnormal result promptly reported.
6. A 79-year-old patient with Parkinson disease has difficulty swallowing
medications. Which intervention is safest?
A. Crush all medications together
B. Ask the pharmacist whether medications may be crushed or converted to
another formulation
C. Mix medications into a large amount of food
D. Give medications while the patient is lying flat
Answer: Ask the pharmacist whether medications may be crushed or converted
to another formulation
Rationale: Some medications should never be crushed because doing so can
alter absorption or cause toxicity. Dysphagia requires medication-specific
evaluation and aspiration precautions.
, 7. An older adult with dementia repeatedly attempts to leave the unit. Which
intervention should the nurse implement first?
A. Apply wrist restraints
B. Place the patient in seclusion
C. Identify triggers and provide structured, supervised activity
D. Administer a sedative without further assessment
Answer: Identify triggers and provide structured, supervised activity
Rationale: Nonpharmacologic interventions are preferred for behavioral
symptoms associated with dementia. Identifying unmet needs, triggers, and
environmental factors may reduce wandering.
8. Which assessment finding in an older adult is most suggestive of
dehydration?
A. Bounding pulse
B. Moist mucous membranes
C. Orthostatic blood pressure changes
D. Jugular venous distention
Answer: Orthostatic blood pressure changes
Rationale: Orthostatic hypotension can occur with reduced circulating volume
and is particularly important in older adults because it increases fall risk.
9. An older adult with osteoporosis asks how to reduce fracture risk. Which
recommendation is most appropriate?
A. Avoid all physical activity
B. Perform weight-bearing activity as tolerated and maintain adequate calcium
and vitamin D intake
C. Remain on bed rest during periods of discomfort
D. Avoid sunlight completely
Answer: Perform weight-bearing activity as tolerated and maintain adequate
calcium and vitamin D intake
