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NU 176 Geriatric Nursing Exam 4
– Galen College – 2026/2027
Study Guide
Prepare for NU 176 Geriatric Nursing Exam 4 at Galen College of
Nursing with this comprehensive Q&A study guide. Covers key
topics including dementia and delirium, end-of-life and palliative
care, fall prevention, polypharmacy, elder abuse, sensory changes,
and functional assessment. Each question includes detailed
rationales to strengthen clinical reasoning. Organized for efficient
review, this resource helps you focus on high-yield geriatric nursing
concepts. Ideal for exam preparation and concept reinforcement
What This Resource Covers
Based on the sample questions available in this documents, Exam 4 appears to focus
on these main areas:
End-of-Life and Palliative Care
Questions cover the differences between palliative and hospice care, signs that a
client is actively dying (such as incontinence and decreased consciousness), the role
of the hospice nurse, and how culture influences end-of-life decision-making and
practices.
Dementia, Delirium, and Cognitive Assessment
You may be tested on distinguishing delirium from dementia, appropriate
,2|Page
interventions for delirium (like reducing stimulation and limiting visitors), cognitive
assessment techniques (such as the Mini-Cog and orientation questions), and
managing challenging behaviors like inappropriate touching.
Grief, Loss, and Safety
This includes recognizing concerning statements from grieving clients (especially
those suggesting suicidal ideation, which requires immediate safety interventions),
supporting life review in dying clients, and understanding advance directives like
living wills.
Age-Related Changes and Medication Safety
Topics include normal aging changes across body systems, dehydration assessment
in older adults, and physiological changes that increase medication toxicity risk
(particularly decreased renal function and liver metabolism)
1. Which age-related change most affects an older adult's ability to regulate
body temperature?
A. Increased sweat gland activity
B. Decreased subcutaneous fat
C. Increased metabolic rate
D. Thickened dermis
B. Decreased subcutaneous fat
Rationale: Loss of subcutaneous fat reduces insulation, making older adults more
susceptible to hypothermia and temperature extremes.
2. A nurse is assessing an 80-year-old client. Which finding should the nurse
recognize as a normal age-related change?
A. Sudden onset of confusion
B. Decreased ability to hear high-pitched sounds
C. Unilateral vision loss
D. New-onset incontinence
B. Decreased ability to hear high-pitched sounds
Rationale: Presbycusis is a normal age-related hearing loss affecting high-frequency
sounds. Sudden confusion, unilateral vision loss, and new incontinence are abnormal
and require investigation.
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3. Which intervention best promotes safety for an older adult with presbyopia?
A. Encouraging the use of large-print materials
B. Restricting reading activities
C. Increasing room lighting to dim levels
D. Discouraging the use of glasses
A. Encouraging the use of large-print materials
Rationale: Presbyopia impairs near vision. Large print and adequate lighting improve
safety and function.
4. A nurse notices an older adult has a decreased sense of taste. Which nursing
action is most appropriate?
A. Add more salt to food
B. Offer highly seasoned, varied foods
C. Restrict all spices
D. Serve only bland foods
B. Offer highly seasoned, varied foods
Rationale: Taste bud atrophy reduces flavor perception. Enhancing food variety and
seasoning (within dietary limits) improves intake. Adding salt is not appropriate for
most older adults.
5. Which age-related skin change increases the risk of pressure injuries?
A. Increased dermal thickness
B. Decreased skin elasticity
C. Increased sebaceous gland activity
D. Increased collagen production
B. Decreased skin elasticity
Rationale: Reduced elasticity and thinning skin make older adults more prone to
breakdown and pressure injury.
6. A nurse is teaching an older adult about fall prevention. Which statement
indicates correct understanding?
A. "I should keep my walker across the room."
B. "I should wear socks without shoes indoors."
C. "I should use night lights in the hallway."
, 4|Page
D. "I should avoid using handrails on stairs."
C. "I should use night lights in the hallway."
Rationale: Night lights reduce fall risk during nighttime ambulation. Walkers should be
within reach, and nonskid footwear is preferred over socks alone.
7. Which assessment finding places an older adult at highest risk for falls?
A. Blood pressure 130/80 mmHg
B. History of a fall in the past year
C. Pulse rate of 72 beats per minute
D. Occasional forgetfulness
B. History of a fall in the past year
Rationale: A previous fall is one of the strongest predictors of future falls.
8. A nurse is caring for an older adult with osteoporosis. Which intervention is
most important?
A. Encourage weight-bearing exercise
B. Restrict all physical activity
C. Increase caffeine intake
D. Limit calcium in the diet
A. Encourage weight-bearing exercise
Rationale: Weight-bearing exercise helps maintain bone density. Restriction, caffeine,
and calcium limitation worsen bone loss.
9. Which finding should a nurse report immediately in an older adult after a
fall?
A. Mild bruising on the forearm
B. Shortened right leg with external rotation
C. Complaint of mild knee pain
D. Small abrasion on the elbow
B. Shortened right leg with external rotation
Rationale: This finding suggests a hip fracture and requires immediate intervention.
10. An older adult is prescribed a new medication. Which factor most increases
the risk of adverse drug reactions?
NU 176 Geriatric Nursing Exam 4
– Galen College – 2026/2027
Study Guide
Prepare for NU 176 Geriatric Nursing Exam 4 at Galen College of
Nursing with this comprehensive Q&A study guide. Covers key
topics including dementia and delirium, end-of-life and palliative
care, fall prevention, polypharmacy, elder abuse, sensory changes,
and functional assessment. Each question includes detailed
rationales to strengthen clinical reasoning. Organized for efficient
review, this resource helps you focus on high-yield geriatric nursing
concepts. Ideal for exam preparation and concept reinforcement
What This Resource Covers
Based on the sample questions available in this documents, Exam 4 appears to focus
on these main areas:
End-of-Life and Palliative Care
Questions cover the differences between palliative and hospice care, signs that a
client is actively dying (such as incontinence and decreased consciousness), the role
of the hospice nurse, and how culture influences end-of-life decision-making and
practices.
Dementia, Delirium, and Cognitive Assessment
You may be tested on distinguishing delirium from dementia, appropriate
,2|Page
interventions for delirium (like reducing stimulation and limiting visitors), cognitive
assessment techniques (such as the Mini-Cog and orientation questions), and
managing challenging behaviors like inappropriate touching.
Grief, Loss, and Safety
This includes recognizing concerning statements from grieving clients (especially
those suggesting suicidal ideation, which requires immediate safety interventions),
supporting life review in dying clients, and understanding advance directives like
living wills.
Age-Related Changes and Medication Safety
Topics include normal aging changes across body systems, dehydration assessment
in older adults, and physiological changes that increase medication toxicity risk
(particularly decreased renal function and liver metabolism)
1. Which age-related change most affects an older adult's ability to regulate
body temperature?
A. Increased sweat gland activity
B. Decreased subcutaneous fat
C. Increased metabolic rate
D. Thickened dermis
B. Decreased subcutaneous fat
Rationale: Loss of subcutaneous fat reduces insulation, making older adults more
susceptible to hypothermia and temperature extremes.
2. A nurse is assessing an 80-year-old client. Which finding should the nurse
recognize as a normal age-related change?
A. Sudden onset of confusion
B. Decreased ability to hear high-pitched sounds
C. Unilateral vision loss
D. New-onset incontinence
B. Decreased ability to hear high-pitched sounds
Rationale: Presbycusis is a normal age-related hearing loss affecting high-frequency
sounds. Sudden confusion, unilateral vision loss, and new incontinence are abnormal
and require investigation.
,3|Page
3. Which intervention best promotes safety for an older adult with presbyopia?
A. Encouraging the use of large-print materials
B. Restricting reading activities
C. Increasing room lighting to dim levels
D. Discouraging the use of glasses
A. Encouraging the use of large-print materials
Rationale: Presbyopia impairs near vision. Large print and adequate lighting improve
safety and function.
4. A nurse notices an older adult has a decreased sense of taste. Which nursing
action is most appropriate?
A. Add more salt to food
B. Offer highly seasoned, varied foods
C. Restrict all spices
D. Serve only bland foods
B. Offer highly seasoned, varied foods
Rationale: Taste bud atrophy reduces flavor perception. Enhancing food variety and
seasoning (within dietary limits) improves intake. Adding salt is not appropriate for
most older adults.
5. Which age-related skin change increases the risk of pressure injuries?
A. Increased dermal thickness
B. Decreased skin elasticity
C. Increased sebaceous gland activity
D. Increased collagen production
B. Decreased skin elasticity
Rationale: Reduced elasticity and thinning skin make older adults more prone to
breakdown and pressure injury.
6. A nurse is teaching an older adult about fall prevention. Which statement
indicates correct understanding?
A. "I should keep my walker across the room."
B. "I should wear socks without shoes indoors."
C. "I should use night lights in the hallway."
, 4|Page
D. "I should avoid using handrails on stairs."
C. "I should use night lights in the hallway."
Rationale: Night lights reduce fall risk during nighttime ambulation. Walkers should be
within reach, and nonskid footwear is preferred over socks alone.
7. Which assessment finding places an older adult at highest risk for falls?
A. Blood pressure 130/80 mmHg
B. History of a fall in the past year
C. Pulse rate of 72 beats per minute
D. Occasional forgetfulness
B. History of a fall in the past year
Rationale: A previous fall is one of the strongest predictors of future falls.
8. A nurse is caring for an older adult with osteoporosis. Which intervention is
most important?
A. Encourage weight-bearing exercise
B. Restrict all physical activity
C. Increase caffeine intake
D. Limit calcium in the diet
A. Encourage weight-bearing exercise
Rationale: Weight-bearing exercise helps maintain bone density. Restriction, caffeine,
and calcium limitation worsen bone loss.
9. Which finding should a nurse report immediately in an older adult after a
fall?
A. Mild bruising on the forearm
B. Shortened right leg with external rotation
C. Complaint of mild knee pain
D. Small abrasion on the elbow
B. Shortened right leg with external rotation
Rationale: This finding suggests a hip fracture and requires immediate intervention.
10. An older adult is prescribed a new medication. Which factor most increases
the risk of adverse drug reactions?
