NURS 5461 Adult Gerontology Final Exam 2026
| Practice Test + Verified Questions & Answers
| Complete Nursing Study Guide (Latest
Version)
NURS 5461 Adult Gerontology Final Exam 2026
Practice Test + Verified Questions & Answers | Complete Nursing Study Guide
(Latest Version)
Question 1 An 82-year-old patient presents with confusion, decreased urine output, and
dry mucous membranes. Which intervention is the nurse's priority?
A. Administer a diuretic as ordered
B. Encourage oral fluid intake
C. Assess hydration status and initiate IV fluids as ordered
D. Obtain a urine culture
E. Place the patient in Trendelenburg position
CORRECT ANSWER: C RATIONALE: Older adults are at high risk for dehydration
due to decreased thirst sensation and reduced kidney function. Confusion, decreased
urine output, and dry mucous membranes indicate dehydration. The priority is to assess
hydration status and restore fluid balance through IV hydration as ordered.
Question 2 Which age-related change contributes most to increased drug toxicity in
older adults?
A. Increased liver enzyme production
B. Enhanced gastrointestinal absorption
C. Decreased glomerular filtration rate (GFR)
D. Increased plasma protein binding
E. Increased total body water
CORRECT ANSWER: C RATIONALE: Decreased GFR with aging reduces renal drug
clearance, leading to drug accumulation and toxicity. This is especially important for
renally cleared medications such as digoxin, metformin, and aminoglycosides.
,Question 3 A gerontological nurse is assessing a 78-year-old using the Mini-Mental
State Examination (MMSE). A score of 18 indicates:
A. Normal cognitive function
B. Severe dementia
C. Mild to moderate cognitive impairment
D. Depression
E. No need for further assessment
CORRECT ANSWER: C RATIONALE: MMSE scores range from 0–30. A score of 18
falls in the mild to moderate impairment range (scores 10–20). Scores of 24–30 are
considered normal; below 10 suggests severe impairment.
Question 4 Which finding is most consistent with normal aging of the cardiovascular
system?
A. Decreased systolic blood pressure
B. Increased cardiac output at rest
C. Decreased arterial compliance leading to increased systolic blood pressure
D. Increased heart rate response to exercise
E. Decreased left ventricular wall thickness
CORRECT ANSWER: C RATIONALE: Normal aging causes arterial stiffening, which
reduces compliance and elevates systolic blood pressure. This leads to isolated systolic
hypertension, common in older adults. Cardiac output and heart rate response to stress
are generally reduced.
Question 5 A nurse is caring for an 80-year-old with a hip fracture post-surgery. Which
intervention best prevents delirium?
A. Administer benzodiazepines for sleep
B. Keep the room dark and quiet at all times
C. Reorient the patient frequently and promote sleep-wake cycles
,D. Restrict visitors to reduce stimulation
E. Administer opioids around the clock
CORRECT ANSWER: C RATIONALE: Non-pharmacological interventions including
frequent reorientation, maintaining normal sleep-wake cycles, early mobilization,
adequate hydration, and sensory aids are first-line strategies for preventing delirium in
older surgical patients.
Question 6 Which laboratory value change is an expected finding in a healthy older
adult?
A. Elevated serum albumin
B. Elevated hemoglobin
C. Slightly decreased creatinine clearance
D. Elevated fasting blood glucose above 126 mg/dL
E. Elevated serum potassium
CORRECT ANSWER: C RATIONALE: As adults age, muscle mass decreases,
lowering creatinine production, while GFR also declines. Together, these cause a mild
reduction in creatinine clearance even when serum creatinine appears normal, making
GFR estimation essential in older adults.
Question 7 An older adult reports difficulty falling asleep, frequent nighttime
awakenings, and early morning arousal. The nurse recognizes these as:
A. Signs of depression only
B. Signs of sleep apnea
C. Age-related changes in sleep architecture
D. Adverse effects of caffeine
E. Early signs of dementia
CORRECT ANSWER: C RATIONALE: Normal aging is associated with reduced slow-
wave sleep, more fragmented sleep, earlier sleep onset and arousal, and decreased
total sleep time. These changes reflect altered sleep architecture, not necessarily a
pathological condition.
, Question 8 A nurse administering warfarin to a 75-year-old patient should monitor for
which priority complication?
A. Hypertension
B. Hypoglycemia
C. Bleeding
D. Constipation
E. Hyponatremia
CORRECT ANSWER: C RATIONALE: Warfarin is an anticoagulant. Older adults are
at higher risk of bleeding due to polypharmacy, reduced vitamin K intake, and altered
drug metabolism. The nurse must monitor for signs of bleeding including bruising,
hematuria, and black tarry stools.
Question 9 Which tool is most appropriate to assess fall risk in a hospitalized older
adult?
A. Katz Index
B. Braden Scale
C. Morse Fall Scale
D. Mini Nutritional Assessment
E. Pittsburgh Sleep Quality Index
CORRECT ANSWER: C RATIONALE: The Morse Fall Scale is a validated tool used
in hospital settings to assess fall risk in adult patients. It evaluates history of falling,
secondary diagnoses, ambulatory aids, IV therapy, gait, and mental status.
Question 10 Which statement best describes presbycusis in older adults?
A. It is a conductive hearing loss caused by cerumen impaction
B. It primarily affects low-frequency sounds
C. It is a sensorineural hearing loss involving progressive high-frequency
sound loss
| Practice Test + Verified Questions & Answers
| Complete Nursing Study Guide (Latest
Version)
NURS 5461 Adult Gerontology Final Exam 2026
Practice Test + Verified Questions & Answers | Complete Nursing Study Guide
(Latest Version)
Question 1 An 82-year-old patient presents with confusion, decreased urine output, and
dry mucous membranes. Which intervention is the nurse's priority?
A. Administer a diuretic as ordered
B. Encourage oral fluid intake
C. Assess hydration status and initiate IV fluids as ordered
D. Obtain a urine culture
E. Place the patient in Trendelenburg position
CORRECT ANSWER: C RATIONALE: Older adults are at high risk for dehydration
due to decreased thirst sensation and reduced kidney function. Confusion, decreased
urine output, and dry mucous membranes indicate dehydration. The priority is to assess
hydration status and restore fluid balance through IV hydration as ordered.
Question 2 Which age-related change contributes most to increased drug toxicity in
older adults?
A. Increased liver enzyme production
B. Enhanced gastrointestinal absorption
C. Decreased glomerular filtration rate (GFR)
D. Increased plasma protein binding
E. Increased total body water
CORRECT ANSWER: C RATIONALE: Decreased GFR with aging reduces renal drug
clearance, leading to drug accumulation and toxicity. This is especially important for
renally cleared medications such as digoxin, metformin, and aminoglycosides.
,Question 3 A gerontological nurse is assessing a 78-year-old using the Mini-Mental
State Examination (MMSE). A score of 18 indicates:
A. Normal cognitive function
B. Severe dementia
C. Mild to moderate cognitive impairment
D. Depression
E. No need for further assessment
CORRECT ANSWER: C RATIONALE: MMSE scores range from 0–30. A score of 18
falls in the mild to moderate impairment range (scores 10–20). Scores of 24–30 are
considered normal; below 10 suggests severe impairment.
Question 4 Which finding is most consistent with normal aging of the cardiovascular
system?
A. Decreased systolic blood pressure
B. Increased cardiac output at rest
C. Decreased arterial compliance leading to increased systolic blood pressure
D. Increased heart rate response to exercise
E. Decreased left ventricular wall thickness
CORRECT ANSWER: C RATIONALE: Normal aging causes arterial stiffening, which
reduces compliance and elevates systolic blood pressure. This leads to isolated systolic
hypertension, common in older adults. Cardiac output and heart rate response to stress
are generally reduced.
Question 5 A nurse is caring for an 80-year-old with a hip fracture post-surgery. Which
intervention best prevents delirium?
A. Administer benzodiazepines for sleep
B. Keep the room dark and quiet at all times
C. Reorient the patient frequently and promote sleep-wake cycles
,D. Restrict visitors to reduce stimulation
E. Administer opioids around the clock
CORRECT ANSWER: C RATIONALE: Non-pharmacological interventions including
frequent reorientation, maintaining normal sleep-wake cycles, early mobilization,
adequate hydration, and sensory aids are first-line strategies for preventing delirium in
older surgical patients.
Question 6 Which laboratory value change is an expected finding in a healthy older
adult?
A. Elevated serum albumin
B. Elevated hemoglobin
C. Slightly decreased creatinine clearance
D. Elevated fasting blood glucose above 126 mg/dL
E. Elevated serum potassium
CORRECT ANSWER: C RATIONALE: As adults age, muscle mass decreases,
lowering creatinine production, while GFR also declines. Together, these cause a mild
reduction in creatinine clearance even when serum creatinine appears normal, making
GFR estimation essential in older adults.
Question 7 An older adult reports difficulty falling asleep, frequent nighttime
awakenings, and early morning arousal. The nurse recognizes these as:
A. Signs of depression only
B. Signs of sleep apnea
C. Age-related changes in sleep architecture
D. Adverse effects of caffeine
E. Early signs of dementia
CORRECT ANSWER: C RATIONALE: Normal aging is associated with reduced slow-
wave sleep, more fragmented sleep, earlier sleep onset and arousal, and decreased
total sleep time. These changes reflect altered sleep architecture, not necessarily a
pathological condition.
, Question 8 A nurse administering warfarin to a 75-year-old patient should monitor for
which priority complication?
A. Hypertension
B. Hypoglycemia
C. Bleeding
D. Constipation
E. Hyponatremia
CORRECT ANSWER: C RATIONALE: Warfarin is an anticoagulant. Older adults are
at higher risk of bleeding due to polypharmacy, reduced vitamin K intake, and altered
drug metabolism. The nurse must monitor for signs of bleeding including bruising,
hematuria, and black tarry stools.
Question 9 Which tool is most appropriate to assess fall risk in a hospitalized older
adult?
A. Katz Index
B. Braden Scale
C. Morse Fall Scale
D. Mini Nutritional Assessment
E. Pittsburgh Sleep Quality Index
CORRECT ANSWER: C RATIONALE: The Morse Fall Scale is a validated tool used
in hospital settings to assess fall risk in adult patients. It evaluates history of falling,
secondary diagnoses, ambulatory aids, IV therapy, gait, and mental status.
Question 10 Which statement best describes presbycusis in older adults?
A. It is a conductive hearing loss caused by cerumen impaction
B. It primarily affects low-frequency sounds
C. It is a sensorineural hearing loss involving progressive high-frequency
sound loss
