PART 1 of 5
This is Part 1 of the Geriatric Medicine
Fundamentals 10th Edition
Comprehensive Test Bank by Rockwood,
Hubbard, and Clegg.
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Comprehensive Geriatric Assessment and Frailty (Questions 1-10)
Chapter 2: Delirium (Questions 11-20)
Chapter 3: Dementia and Cognitive Impairment (Questions 21-30)
Chapter 4: Falls and Gait Disorders (Questions 31-40)
Chapter 5: Polypharmacy and Inappropriate Prescribing (Questions 41-50)
CHAPTER 1: COMPREHENSIVE GERIATRIC ASSESSMENT AND FRAILTY
Q1. An 82-year-old woman is admitted after a fall. She has lost 6 kg in 6 months, reports exhaustion,
and walks slowly. Grip strength is reduced. Which frailty phenotype criterion is she NOT
demonstrating?
A. Weight loss
B. Exhaustion
C. Low physical activity
D. Weakness
Correct Answer: Low physical activity ✅
Rationale: The correct answer is low physical activity, because the vignette describes weight
loss, exhaustion, slowness, and weakness but does not mention reduced activity level. The Fried
frailty phenotype requires three or more of five criteria: unintentional weight loss, self-reported
,exhaustion, slow gait, low grip strength, and low physical activity. Option A is wrong because the 6 kg
loss in 6 months meets the weight loss criterion. Option B is wrong because her reported exhaustion
meets that criterion. Option D is wrong because reduced grip strength meets the weakness criterion.
The governing concept is that frailty is a measurable syndrome, not a vague impression, and
identifying which criteria are present guides targeted intervention such as exercise, nutrition, and
medication review.
Q2. A 78-year-old man scores 8 seconds on the Timed Up and Go test. Which interpretation is most
appropriate?
A. Normal mobility for age
B. Borderline; reassess in 6 months
C. Impaired mobility with increased fall risk
D. Requires immediate wheelchair use
Correct Answer: Impaired mobility with increased fall risk ✅
Rationale: The correct answer is impaired mobility with increased fall risk. A Timed Up and Go
time of 8 seconds is generally considered normal, but values of 12 seconds or longer indicate
increased fall risk; 8 seconds sits near the upper normal range and warrants attention when
combined with other findings. Option A is wrong because labeling it simply normal misses the need
to interpret it in clinical context. Option B is wrong because deferring reassessment for 6 months
risks an avoidable fall. Option D is wrong because impaired mobility does not mandate wheelchair
use and would promote further deconditioning. The governing concept is that gait and balance
testing must be interpreted alongside history, medication review, and home hazards to guide fall
prevention.
Q3. An 85-year-old woman lives alone and has difficulty managing medications and finances. She
scores 26/30 on the Mini-Mental State Examination. Which domain of comprehensive geriatric
assessment is most directly affected?
A. Functional status
B. Instrumental activities of daily living
C. Basic activities of daily living
D. Nutritional status
,Correct Answer: Instrumental activities of daily living ✅
Rationale: The correct answer is instrumental activities of daily living. Managing medications
and finances are instrumental activities, which are more complex than basic self-care tasks and
typically decline earlier in cognitive impairment. Option A is wrong because functional status is a
broad umbrella that includes both basic and instrumental activities, making it less precise than the
specific domain asked about. Option C is wrong because basic activities such as bathing, dressing,
and toileting are not described as impaired. Option D is wrong because nutrition is not the domain
being tested by difficulty with medications and finances. The governing concept is that instrumental
activities of daily living are sensitive early markers of decline and should be assessed explicitly in any
geriatric evaluation.
Q4. An 80-year-old man is scheduled for elective hip surgery. Preoperative assessment reveals frailty
and a Clinical Frailty Scale score of 6. Which perioperative implication is most important?
A. Reduced risk of postoperative delirium
B. Increased risk of adverse outcomes and need for tailored care
C. No change in surgical risk compared with non-frail patients
D. Frailty is irrelevant to surgical planning
Correct Answer: Increased risk of adverse outcomes and need for tailored care ✅
Rationale: The correct answer is increased risk of adverse outcomes and need for tailored
care. Frailty independently predicts postoperative complications, delirium, functional decline, and
mortality, and a Clinical Frailty Scale score of 6 indicates moderate frailty that should trigger
preoperative optimization and individualized planning. Option A is wrong because frailty increases,
not reduces, delirium risk. Option C is wrong because frailty substantially modifies surgical risk and
cannot be ignored. Option D is wrong because frailty is one of the strongest predictors of
perioperative outcomes in older adults. The governing concept is that frailty assessment should be
part of preoperative evaluation because it changes both risk prediction and the plan of care.
Q5. A 76-year-old woman is being evaluated for unexplained weight loss. Which component of
comprehensive geriatric assessment is most likely to reveal the cause?
A. Cognitive testing alone
B. Multidimensional assessment including mood, function, and social factors
, C. Vision testing alone
D. Bone density measurement
Correct Answer: Multidimensional assessment including mood, function, and social factors ✅
Rationale: The correct answer is multidimensional assessment including mood, function, and
social factors. Unexplained weight loss in older adults frequently arises from depression, functional
limitations affecting shopping and cooking, medication effects, or social isolation, and only a
multidimensional assessment captures these contributors. Option A is wrong because cognitive
testing alone misses depression, function, and social determinants. Option C is wrong because vision
testing addresses only one possible contributor. Option D is wrong because bone density measures
skeletal health and does not explain weight loss. The governing concept is that weight loss in older
adults is usually multifactorial and requires assessment across medical, functional, psychological, and
social domains.
Q6. An 88-year-old man is admitted with pneumonia. He is bedbound at baseline and has a Braden
score of 14. Which action best reflects a comprehensive geriatric assessment approach?
A. Treat the pneumonia and discharge without further assessment
B. Address the acute illness while assessing function, cognition, and pressure injury risk
C. Order a head CT routinely
D. Restrict mobilization to prevent falls
Correct Answer: Address the acute illness while assessing function, cognition, and pressure injury risk
✅
Rationale: The correct answer is to address the acute illness while assessing function,
cognition, and pressure injury risk. Comprehensive geriatric assessment during acute illness identifies
reversible contributors to decline and prevents complications such as delirium, deconditioning, and
pressure injury. Option A is wrong because discharge without assessment misses opportunities to
prevent functional decline and readmission. Option C is wrong because routine head CT without
indication exposes the patient to unnecessary risk and cost. Option D is wrong because restricting
mobilization promotes deconditioning, delirium, and pressure injury. The governing concept is that
hospitalization is a high-risk period for older adults and structured assessment improves outcomes.
This is Part 1 of the Geriatric Medicine
Fundamentals 10th Edition
Comprehensive Test Bank by Rockwood,
Hubbard, and Clegg.
TABLE OF CONTENTS - PART 1 of 5
Chapter 1: Comprehensive Geriatric Assessment and Frailty (Questions 1-10)
Chapter 2: Delirium (Questions 11-20)
Chapter 3: Dementia and Cognitive Impairment (Questions 21-30)
Chapter 4: Falls and Gait Disorders (Questions 31-40)
Chapter 5: Polypharmacy and Inappropriate Prescribing (Questions 41-50)
CHAPTER 1: COMPREHENSIVE GERIATRIC ASSESSMENT AND FRAILTY
Q1. An 82-year-old woman is admitted after a fall. She has lost 6 kg in 6 months, reports exhaustion,
and walks slowly. Grip strength is reduced. Which frailty phenotype criterion is she NOT
demonstrating?
A. Weight loss
B. Exhaustion
C. Low physical activity
D. Weakness
Correct Answer: Low physical activity ✅
Rationale: The correct answer is low physical activity, because the vignette describes weight
loss, exhaustion, slowness, and weakness but does not mention reduced activity level. The Fried
frailty phenotype requires three or more of five criteria: unintentional weight loss, self-reported
,exhaustion, slow gait, low grip strength, and low physical activity. Option A is wrong because the 6 kg
loss in 6 months meets the weight loss criterion. Option B is wrong because her reported exhaustion
meets that criterion. Option D is wrong because reduced grip strength meets the weakness criterion.
The governing concept is that frailty is a measurable syndrome, not a vague impression, and
identifying which criteria are present guides targeted intervention such as exercise, nutrition, and
medication review.
Q2. A 78-year-old man scores 8 seconds on the Timed Up and Go test. Which interpretation is most
appropriate?
A. Normal mobility for age
B. Borderline; reassess in 6 months
C. Impaired mobility with increased fall risk
D. Requires immediate wheelchair use
Correct Answer: Impaired mobility with increased fall risk ✅
Rationale: The correct answer is impaired mobility with increased fall risk. A Timed Up and Go
time of 8 seconds is generally considered normal, but values of 12 seconds or longer indicate
increased fall risk; 8 seconds sits near the upper normal range and warrants attention when
combined with other findings. Option A is wrong because labeling it simply normal misses the need
to interpret it in clinical context. Option B is wrong because deferring reassessment for 6 months
risks an avoidable fall. Option D is wrong because impaired mobility does not mandate wheelchair
use and would promote further deconditioning. The governing concept is that gait and balance
testing must be interpreted alongside history, medication review, and home hazards to guide fall
prevention.
Q3. An 85-year-old woman lives alone and has difficulty managing medications and finances. She
scores 26/30 on the Mini-Mental State Examination. Which domain of comprehensive geriatric
assessment is most directly affected?
A. Functional status
B. Instrumental activities of daily living
C. Basic activities of daily living
D. Nutritional status
,Correct Answer: Instrumental activities of daily living ✅
Rationale: The correct answer is instrumental activities of daily living. Managing medications
and finances are instrumental activities, which are more complex than basic self-care tasks and
typically decline earlier in cognitive impairment. Option A is wrong because functional status is a
broad umbrella that includes both basic and instrumental activities, making it less precise than the
specific domain asked about. Option C is wrong because basic activities such as bathing, dressing,
and toileting are not described as impaired. Option D is wrong because nutrition is not the domain
being tested by difficulty with medications and finances. The governing concept is that instrumental
activities of daily living are sensitive early markers of decline and should be assessed explicitly in any
geriatric evaluation.
Q4. An 80-year-old man is scheduled for elective hip surgery. Preoperative assessment reveals frailty
and a Clinical Frailty Scale score of 6. Which perioperative implication is most important?
A. Reduced risk of postoperative delirium
B. Increased risk of adverse outcomes and need for tailored care
C. No change in surgical risk compared with non-frail patients
D. Frailty is irrelevant to surgical planning
Correct Answer: Increased risk of adverse outcomes and need for tailored care ✅
Rationale: The correct answer is increased risk of adverse outcomes and need for tailored
care. Frailty independently predicts postoperative complications, delirium, functional decline, and
mortality, and a Clinical Frailty Scale score of 6 indicates moderate frailty that should trigger
preoperative optimization and individualized planning. Option A is wrong because frailty increases,
not reduces, delirium risk. Option C is wrong because frailty substantially modifies surgical risk and
cannot be ignored. Option D is wrong because frailty is one of the strongest predictors of
perioperative outcomes in older adults. The governing concept is that frailty assessment should be
part of preoperative evaluation because it changes both risk prediction and the plan of care.
Q5. A 76-year-old woman is being evaluated for unexplained weight loss. Which component of
comprehensive geriatric assessment is most likely to reveal the cause?
A. Cognitive testing alone
B. Multidimensional assessment including mood, function, and social factors
, C. Vision testing alone
D. Bone density measurement
Correct Answer: Multidimensional assessment including mood, function, and social factors ✅
Rationale: The correct answer is multidimensional assessment including mood, function, and
social factors. Unexplained weight loss in older adults frequently arises from depression, functional
limitations affecting shopping and cooking, medication effects, or social isolation, and only a
multidimensional assessment captures these contributors. Option A is wrong because cognitive
testing alone misses depression, function, and social determinants. Option C is wrong because vision
testing addresses only one possible contributor. Option D is wrong because bone density measures
skeletal health and does not explain weight loss. The governing concept is that weight loss in older
adults is usually multifactorial and requires assessment across medical, functional, psychological, and
social domains.
Q6. An 88-year-old man is admitted with pneumonia. He is bedbound at baseline and has a Braden
score of 14. Which action best reflects a comprehensive geriatric assessment approach?
A. Treat the pneumonia and discharge without further assessment
B. Address the acute illness while assessing function, cognition, and pressure injury risk
C. Order a head CT routinely
D. Restrict mobilization to prevent falls
Correct Answer: Address the acute illness while assessing function, cognition, and pressure injury risk
✅
Rationale: The correct answer is to address the acute illness while assessing function,
cognition, and pressure injury risk. Comprehensive geriatric assessment during acute illness identifies
reversible contributors to decline and prevents complications such as delirium, deconditioning, and
pressure injury. Option A is wrong because discharge without assessment misses opportunities to
prevent functional decline and readmission. Option C is wrong because routine head CT without
indication exposes the patient to unnecessary risk and cost. Option D is wrong because restricting
mobilization promotes deconditioning, delirium, and pressure injury. The governing concept is that
hospitalization is a high-risk period for older adults and structured assessment improves outcomes.
