NUR 257 Exams 1–4 Complete Study Guide | 250 NCLEX-Style
Geriatric Nursing Practice Questions with Detailed Answers &
Rationales | Comprehensive Exam Review for Older Adult Health,
Dementia, Delirium, Polypharmacy, Fall Prevention, Chronic
Disease Management & Comprehensive Geriatric Assessment
(2026–2027 Edition) pdf
NUR 257 Exams 1–4 Complete Coverage
Exam 1 (Questions 1–60):
Fundamentals of Aging
Physiological Changes
Communication
Functional Assessment
Nutrition
Safety and Falls
Exam 2 (Questions 61–125):
Dementia and Alzheimer's Disease
Delirium
Polypharmacy
Elder Abuse and Neglect
Mobility and Pressure Injuries
Exam 3 (Questions 126–190):
Chronic Disease Management
Frailty Syndrome
Cardiovascular and Respiratory Disorders
Independence and Quality of Life
Exam 4 (Questions 191–250):
Comprehensive Geriatric Assessment
Advanced Dementia Care
Medication Safety
End-of-Life and Holistic Geriatric Nursing Concepts
, NCLEX-Style Comprehensive Review (2026/2027)
NUR 257 – Geriatric Nursing Exam 1
1. An 80-year-old patient reports increasing difficulty understanding conversations in
noisy restaurants despite having no history of ear infections. Which age-related
sensory change most likely explains this complaint?
A. Conductive hearing loss caused by cerumen impaction
B. Presbycusis resulting in impaired high-frequency hearing discrimination
C. Acute labyrinthitis causing vestibular dysfunction
D. Tympanic membrane perforation from chronic trauma
Answer: B. Presbycusis resulting in impaired high-frequency hearing discrimination
Explanation: Presbycusis is a common age-related sensorineural hearing loss affecting
high-frequency sounds and speech understanding.
2. A nurse is assessing an older adult who becomes acutely confused over several
hours following hospitalization for pneumonia. Which condition should the nurse
suspect first?
A. Alzheimer's disease
B. Delirium
C. Normal cognitive aging
D. Vascular dementia
Answer: B. Delirium
Explanation: Delirium develops suddenly and is often triggered by infection,
hospitalization, medications, or metabolic disturbances.
3. Which physiological change commonly occurs within the cardiovascular system
as part of the normal aging process?
A. Increased elasticity of major arteries
B. Reduced systolic blood pressure
,C. Increased arterial stiffness and reduced vascular compliance
D. Enhanced cardiac output reserve
Answer: C. Increased arterial stiffness and reduced vascular compliance
Explanation: Aging causes arterial stiffening, contributing to elevated systolic blood
pressure and increased cardiac workload.
4. An elderly patient living alone reports several recent falls within the home. Which
nursing intervention would most effectively reduce future fall risk?
A. Encourage prolonged bed rest throughout the day
B. Restrict physical activity whenever possible
C. Implement strength, balance, and home-safety interventions
D. Limit fluid intake after breakfast
Answer: C. Implement strength, balance, and home-safety interventions
Explanation: Fall prevention strategies include exercise, environmental modifications,
medication review, and assistive devices when needed.
5. Which age-related integumentary change contributes most significantly to
increased skin fragility in older adults?
A. Increased collagen production
B. Thickening of dermal layers
C. Loss of skin elasticity and thinning of the epidermis
D. Increased subcutaneous fat deposition
Answer: C. Loss of skin elasticity and thinning of the epidermis
Explanation: Aging skin becomes thinner, less elastic, and more vulnerable to injury
and pressure damage.
6. A nurse is educating family members about dementia. Which statement
demonstrates correct understanding?
, A. Dementia develops suddenly over several days.
B. Dementia always results from infection.
C. Dementia involves progressive cognitive decline affecting daily functioning.
D. Dementia is considered a normal part of aging.
Answer: C. Dementia involves progressive cognitive decline affecting daily
functioning.
Explanation: Dementia causes gradual impairment in memory, judgment, language,
and functional abilities.
7. Which assessment finding is most concerning in an older adult experiencing
dehydration?
A. Moist mucous membranes and strong pulses
B. Dry oral mucosa with tachycardia and concentrated urine
C. Increased urine output and warm skin
D. Elevated appetite and improved energy
Answer: B. Dry oral mucosa with tachycardia and concentrated urine
Explanation: Older adults frequently present with subtle signs of dehydration that can
rapidly progress to serious complications.
8. Which factor places older adults at increased risk for adverse medication events?
A. Polypharmacy involving multiple prescribed medications
B. Improved hepatic metabolism with age
C. Increased renal clearance of medications
D. Decreased medication sensitivity
Answer: A. Polypharmacy involving multiple prescribed medications
Explanation: Multiple medications increase the likelihood of interactions, side effects,
and medication errors.
9. An elderly patient reports difficulty rising from a chair and climbing stairs. Which
age-related condition most likely contributes to these symptoms?
Geriatric Nursing Practice Questions with Detailed Answers &
Rationales | Comprehensive Exam Review for Older Adult Health,
Dementia, Delirium, Polypharmacy, Fall Prevention, Chronic
Disease Management & Comprehensive Geriatric Assessment
(2026–2027 Edition) pdf
NUR 257 Exams 1–4 Complete Coverage
Exam 1 (Questions 1–60):
Fundamentals of Aging
Physiological Changes
Communication
Functional Assessment
Nutrition
Safety and Falls
Exam 2 (Questions 61–125):
Dementia and Alzheimer's Disease
Delirium
Polypharmacy
Elder Abuse and Neglect
Mobility and Pressure Injuries
Exam 3 (Questions 126–190):
Chronic Disease Management
Frailty Syndrome
Cardiovascular and Respiratory Disorders
Independence and Quality of Life
Exam 4 (Questions 191–250):
Comprehensive Geriatric Assessment
Advanced Dementia Care
Medication Safety
End-of-Life and Holistic Geriatric Nursing Concepts
, NCLEX-Style Comprehensive Review (2026/2027)
NUR 257 – Geriatric Nursing Exam 1
1. An 80-year-old patient reports increasing difficulty understanding conversations in
noisy restaurants despite having no history of ear infections. Which age-related
sensory change most likely explains this complaint?
A. Conductive hearing loss caused by cerumen impaction
B. Presbycusis resulting in impaired high-frequency hearing discrimination
C. Acute labyrinthitis causing vestibular dysfunction
D. Tympanic membrane perforation from chronic trauma
Answer: B. Presbycusis resulting in impaired high-frequency hearing discrimination
Explanation: Presbycusis is a common age-related sensorineural hearing loss affecting
high-frequency sounds and speech understanding.
2. A nurse is assessing an older adult who becomes acutely confused over several
hours following hospitalization for pneumonia. Which condition should the nurse
suspect first?
A. Alzheimer's disease
B. Delirium
C. Normal cognitive aging
D. Vascular dementia
Answer: B. Delirium
Explanation: Delirium develops suddenly and is often triggered by infection,
hospitalization, medications, or metabolic disturbances.
3. Which physiological change commonly occurs within the cardiovascular system
as part of the normal aging process?
A. Increased elasticity of major arteries
B. Reduced systolic blood pressure
,C. Increased arterial stiffness and reduced vascular compliance
D. Enhanced cardiac output reserve
Answer: C. Increased arterial stiffness and reduced vascular compliance
Explanation: Aging causes arterial stiffening, contributing to elevated systolic blood
pressure and increased cardiac workload.
4. An elderly patient living alone reports several recent falls within the home. Which
nursing intervention would most effectively reduce future fall risk?
A. Encourage prolonged bed rest throughout the day
B. Restrict physical activity whenever possible
C. Implement strength, balance, and home-safety interventions
D. Limit fluid intake after breakfast
Answer: C. Implement strength, balance, and home-safety interventions
Explanation: Fall prevention strategies include exercise, environmental modifications,
medication review, and assistive devices when needed.
5. Which age-related integumentary change contributes most significantly to
increased skin fragility in older adults?
A. Increased collagen production
B. Thickening of dermal layers
C. Loss of skin elasticity and thinning of the epidermis
D. Increased subcutaneous fat deposition
Answer: C. Loss of skin elasticity and thinning of the epidermis
Explanation: Aging skin becomes thinner, less elastic, and more vulnerable to injury
and pressure damage.
6. A nurse is educating family members about dementia. Which statement
demonstrates correct understanding?
, A. Dementia develops suddenly over several days.
B. Dementia always results from infection.
C. Dementia involves progressive cognitive decline affecting daily functioning.
D. Dementia is considered a normal part of aging.
Answer: C. Dementia involves progressive cognitive decline affecting daily
functioning.
Explanation: Dementia causes gradual impairment in memory, judgment, language,
and functional abilities.
7. Which assessment finding is most concerning in an older adult experiencing
dehydration?
A. Moist mucous membranes and strong pulses
B. Dry oral mucosa with tachycardia and concentrated urine
C. Increased urine output and warm skin
D. Elevated appetite and improved energy
Answer: B. Dry oral mucosa with tachycardia and concentrated urine
Explanation: Older adults frequently present with subtle signs of dehydration that can
rapidly progress to serious complications.
8. Which factor places older adults at increased risk for adverse medication events?
A. Polypharmacy involving multiple prescribed medications
B. Improved hepatic metabolism with age
C. Increased renal clearance of medications
D. Decreased medication sensitivity
Answer: A. Polypharmacy involving multiple prescribed medications
Explanation: Multiple medications increase the likelihood of interactions, side effects,
and medication errors.
9. An elderly patient reports difficulty rising from a chair and climbing stairs. Which
age-related condition most likely contributes to these symptoms?
