AGNP Geriatric Care Mastery Exam – 150-Item
Verified Test Bank Answers And Rationale
Included (2025/2026)
1. A 78-year-old patient presents with increasing forgetfulness over the
past year. The patient is independent in ADLs. What is the most likely
diagnosis?
A. Delirium
B. Mild cognitive impairment
C. Dementia
D. Depression
Rationale: Mild cognitive impairment involves memory changes without
significant impact on daily functioning, unlike dementia.
2. Which vaccination is especially recommended annually for older
adults?
A. MMR
B. Varicella
C. Influenza
D. Hepatitis B
Rationale: Influenza vaccination reduces morbidity and mortality in
older adults and is recommended annually.
3. An 82-year-old male with chronic kidney disease stage 3 is on
multiple medications. Which lab should be monitored regularly?
A. Liver function tests
B. Serum creatinine and eGFR
C. Hemoglobin A1c
D. Lipid profile
,Rationale: CKD requires monitoring renal function to adjust medications
and prevent toxicity.
4. Which of the following is the most common cause of falls in older
adults?
A. Seizures
B. Stroke
C. Medication side effects
D. Visual impairment
Rationale: Polypharmacy and certain medications, like sedatives, are
major contributors to falls.
5. In geriatric patients, which symptom is often the earliest sign of
infection?
A. Fever
B. Chills
C. Confusion or delirium
D. Tachycardia
Rationale: Older adults may not mount a febrile response; acute
confusion is often the first sign.
6. A 76-year-old female has hypertension and osteoarthritis. Which
medication combination is preferred for both conditions?
A. NSAID and ACE inhibitor
B. ACE inhibitor and acetaminophen
C. Beta-blocker and NSAID
D. Calcium channel blocker and ibuprofen
Rationale: ACE inhibitors control hypertension, while acetaminophen
manages pain without risking renal compromise or hypertension
exacerbation.
7. What is the most sensitive screening tool for depression in older
adults?
,A. PHQ-2
B. Geriatric Depression Scale (GDS)
C. Beck Depression Inventory
D. Hamilton Rating Scale
Rationale: GDS is validated specifically for older adults and avoids
somatic items that can confound results.
8. A patient with Alzheimer’s disease is experiencing agitation in the
evening. What is the most likely explanation?
A. Medication noncompliance
B. Sundowning phenomenon
C. Hypoglycemia
D. Sleep apnea
Rationale: Sundowning refers to increased confusion and agitation in
the late afternoon or evening.
9. Which intervention is most effective for preventing pressure ulcers in
immobile older adults?
A. Frequent showers
B. Regular repositioning
C. Antibiotic ointments
D. High-protein diet alone
Rationale: Frequent repositioning reduces prolonged pressure on bony
prominences, preventing skin breakdown.
10. Which lab marker is most useful in diagnosing vitamin B12
deficiency in older adults?
A. Serum folate
B. Serum methylmalonic acid
C. Serum calcium
D. Serum iron
, Rationale: Methylmalonic acid is elevated early in B12 deficiency, even
if serum B12 is borderline.
11. Which symptom is most characteristic of Parkinson’s disease in the
elderly?
A. Spasticity
B. Bradykinesia
C. Weakness
D. Tremor in all limbs
Rationale: Bradykinesia, or slowness of movement, is a hallmark
symptom of Parkinson’s disease.
12. An 85-year-old female presents with new-onset urinary
incontinence. Which initial test is most appropriate?
A. Cystoscopy
B. Urinalysis and culture
C. MRI of the spine
D. Pelvic ultrasound
Rationale: Urinary tract infections are common reversible causes of
incontinence in older adults.
13. Which medication is most likely to cause orthostatic hypotension in
an older adult?
A. Acetaminophen
B. Alpha-blockers
C. Proton pump inhibitors
D. SSRIs
Rationale: Alpha-blockers can relax vascular smooth muscle, causing
orthostatic hypotension, particularly in the elderly.
14. For an older adult with chronic heart failure, which intervention has
the strongest evidence for reducing hospitalizations?
A. High-protein diet
Verified Test Bank Answers And Rationale
Included (2025/2026)
1. A 78-year-old patient presents with increasing forgetfulness over the
past year. The patient is independent in ADLs. What is the most likely
diagnosis?
A. Delirium
B. Mild cognitive impairment
C. Dementia
D. Depression
Rationale: Mild cognitive impairment involves memory changes without
significant impact on daily functioning, unlike dementia.
2. Which vaccination is especially recommended annually for older
adults?
A. MMR
B. Varicella
C. Influenza
D. Hepatitis B
Rationale: Influenza vaccination reduces morbidity and mortality in
older adults and is recommended annually.
3. An 82-year-old male with chronic kidney disease stage 3 is on
multiple medications. Which lab should be monitored regularly?
A. Liver function tests
B. Serum creatinine and eGFR
C. Hemoglobin A1c
D. Lipid profile
,Rationale: CKD requires monitoring renal function to adjust medications
and prevent toxicity.
4. Which of the following is the most common cause of falls in older
adults?
A. Seizures
B. Stroke
C. Medication side effects
D. Visual impairment
Rationale: Polypharmacy and certain medications, like sedatives, are
major contributors to falls.
5. In geriatric patients, which symptom is often the earliest sign of
infection?
A. Fever
B. Chills
C. Confusion or delirium
D. Tachycardia
Rationale: Older adults may not mount a febrile response; acute
confusion is often the first sign.
6. A 76-year-old female has hypertension and osteoarthritis. Which
medication combination is preferred for both conditions?
A. NSAID and ACE inhibitor
B. ACE inhibitor and acetaminophen
C. Beta-blocker and NSAID
D. Calcium channel blocker and ibuprofen
Rationale: ACE inhibitors control hypertension, while acetaminophen
manages pain without risking renal compromise or hypertension
exacerbation.
7. What is the most sensitive screening tool for depression in older
adults?
,A. PHQ-2
B. Geriatric Depression Scale (GDS)
C. Beck Depression Inventory
D. Hamilton Rating Scale
Rationale: GDS is validated specifically for older adults and avoids
somatic items that can confound results.
8. A patient with Alzheimer’s disease is experiencing agitation in the
evening. What is the most likely explanation?
A. Medication noncompliance
B. Sundowning phenomenon
C. Hypoglycemia
D. Sleep apnea
Rationale: Sundowning refers to increased confusion and agitation in
the late afternoon or evening.
9. Which intervention is most effective for preventing pressure ulcers in
immobile older adults?
A. Frequent showers
B. Regular repositioning
C. Antibiotic ointments
D. High-protein diet alone
Rationale: Frequent repositioning reduces prolonged pressure on bony
prominences, preventing skin breakdown.
10. Which lab marker is most useful in diagnosing vitamin B12
deficiency in older adults?
A. Serum folate
B. Serum methylmalonic acid
C. Serum calcium
D. Serum iron
, Rationale: Methylmalonic acid is elevated early in B12 deficiency, even
if serum B12 is borderline.
11. Which symptom is most characteristic of Parkinson’s disease in the
elderly?
A. Spasticity
B. Bradykinesia
C. Weakness
D. Tremor in all limbs
Rationale: Bradykinesia, or slowness of movement, is a hallmark
symptom of Parkinson’s disease.
12. An 85-year-old female presents with new-onset urinary
incontinence. Which initial test is most appropriate?
A. Cystoscopy
B. Urinalysis and culture
C. MRI of the spine
D. Pelvic ultrasound
Rationale: Urinary tract infections are common reversible causes of
incontinence in older adults.
13. Which medication is most likely to cause orthostatic hypotension in
an older adult?
A. Acetaminophen
B. Alpha-blockers
C. Proton pump inhibitors
D. SSRIs
Rationale: Alpha-blockers can relax vascular smooth muscle, causing
orthostatic hypotension, particularly in the elderly.
14. For an older adult with chronic heart failure, which intervention has
the strongest evidence for reducing hospitalizations?
A. High-protein diet
