Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
Basic Geriatric Nursing, 8th Edition (Williams,
2023)
UNIT I OVERVIEW OF AGING
Chapter 1: Trends and Issues
1. The fastest-growing segment of the older adult population in the United States is which age group?
A. Young-old (65–74)
B. Middle-old (75–84)
C. Oldest-old (85 and over)
D. Baby boomers aged 60–65
✔ Answer: C — Oldest-old (85 and over)
Rationale: The oldest-old (85+) is the fastest-growing age group, driven by improvements in medical care and
public health.
2. A nurse explains ageism to a nursing student. Which statement BEST defines ageism?
A. Fear of the physical process of growing old
B. Discrimination against individuals solely on the basis of age
C. Cultural sensitivity toward the concerns of aging
D. Promotion of resources available to older adults
✔ Answer: B — Discrimination against individuals solely on the basis of age
Rationale: Ageism is a negative belief pattern that leads to discrimination against persons solely because of their
age.
3. An 80-year-old resident in a long-term care facility repeatedly refuses meals. The nurse recognizes
this behavior as MOST likely representing:
A. Early signs of Alzheimer disease
B. Dislike of the facility's food choices
C. An effort to retain independence and self-direction
D. A passive-aggressive attempt to gain attention
✔ Answer: C — An effort to retain independence and self-direction
Rationale: Loss of control is a significant concern for institutionalized elders; food refusal often represents one of
the few remaining areas of autonomous decision-making.
4. Medicare Part A PRIMARILY covers which type of health care costs?
A. 80% of physician fees
B. Inpatient hospital costs
C. Outpatient prescription drug expenses
D. Private insurance premiums for Medigap policies
✔ Answer: B — Inpatient hospital costs
Rationale: Medicare Part A pays for inpatient hospital care, skilled nursing facility care after hospitalization, hospice,
and some home health care.
Page 1 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
5. Which document legally transfers health care decision-making authority to a designated person when
a patient is unable to speak for themselves?
A. A living will
B. A 'Do Not Resuscitate' order
C. A durable power of attorney for health care
D. An advance beneficiary notice
✔ Answer: C — A durable power of attorney for health care
Rationale: A durable power of attorney for health care (DPAHC) designates another person to make health care
decisions when the patient loses decision-making capacity.
6. Under Medicare's DRG system, hospital stays are determined by:
A. The physician's estimate of recovery time
B. The patient's insurance policy limits
C. A preset number of days allotted based on the admitting diagnosis
D. The hospital's average length of stay statistics
✔ Answer: C — A preset number of days allotted based on the admitting diagnosis
Rationale: Diagnosis-Related Groups (DRGs) allocate a fixed reimbursement amount and typical length of stay
based on the admitting diagnosis to control Medicare costs.
7. A 75-year-old patient with diabetes and dementia requires ongoing skilled nursing care, physical
therapy, and wound care. Which care facility is MOST appropriate?
A. Assisted-living center
B. Government-subsidized senior housing
C. Skilled care facility
D. Adult day care center
✔ Answer: C — Skilled care facility
Rationale: Skilled care facilities provide nursing care by licensed professionals and rehabilitative services such as
PT, OT, and speech therapy.
8. Two physicians must agree in writing that the established criteria have been met before which
document takes effect?
A. A durable power of attorney for health care
B. A living will
C. An advance beneficiary notice
D. A Medicare assignment agreement
✔ Answer: B — A living will
Rationale: A living will requires written agreement by two physicians that the patient meets the criteria stated in the
document before it becomes operative.
9. The gerontological nurse is aware that preventive health care practices in the latter half of the 20th
century PRIMARILY contributed to which outcome?
A. Increased acute care hospitalizations in the young-old
B. Decreased chronic disease incidence in the oldest-old
C. Increased longevity and a larger older adult population
D. Decreased expenditure on Medicare and Medicaid
✔ Answer: C — Increased longevity and a larger older adult population
Rationale: Preventive health practices, disease control, and wellness focus helped people live longer, significantly
expanding the older adult population.
Chapter 2: Theories of Aging
10. The free radical theory of aging proposes that aging results from:
A. Programmed cell death encoded in DNA
B. Cumulative damage from unstable oxygen molecules that disrupt cell function
Page 2 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
C. Gradual cross-linking of collagen fibers limiting cellular flexibility
D. Accumulation of metabolic waste products in aging cells
✔ Answer: B — Cumulative damage from unstable oxygen molecules that disrupt cell function
Rationale: Free radicals are unstable oxygen molecules that cause cumulative oxidative cellular damage,
contributing to the aging process.
11. According to Erikson's psychosocial theory, the developmental task of later adulthood is:
A. Intimacy versus isolation
B. Industry versus inferiority
C. Integrity versus despair
D. Generativity versus stagnation
✔ Answer: C — Integrity versus despair
Rationale: Erikson's final stage — ego integrity vs. despair — involves reflecting on one's life with acceptance and
wisdom rather than regret.
12. The caloric restriction theory suggests that aging may be slowed by:
A. Supplementing the diet with fat-soluble vitamins A, D, E, and K
B. Consuming a high-nutrient, reduced-calorie diet
C. Eating organically grown foods to avoid chemical exposure
D. Increasing protein intake to maintain muscle mass
✔ Answer: B — Consuming a high-nutrient, reduced-calorie diet
Rationale: Caloric restriction theory links reduced caloric intake with slowed aging processes and extended life span
in various animal models.
13. A patient practices daily meditation and maintains close social connections as part of healthy aging.
This aligns MOST closely with which aging theory?
A. Free radical theory
B. Cross-linkage theory
C. Wear-and-tear theory
D. Activity theory
✔ Answer: D — Activity theory
Rationale: The activity theory proposes that older adults who remain active and engaged maintain higher life
satisfaction and more successful aging outcomes.
14. The nurse is teaching a class on biological theories of aging. The wear-and-tear theory would
support which nursing instruction?
A. Encouraging patients to engage in vigorous daily exercise regardless of pain
B. Teaching patients to balance activity with adequate rest and stress reduction
C. Advising patients that cellular aging is entirely genetically predetermined
D. Recommending high-antioxidant supplements to prevent cell damage
✔ Answer: B — Teaching patients to balance activity with adequate rest and stress reduction
Rationale: Wear-and-tear theory holds that repeated stress and use eventually damage tissues; balanced activity
and rest help minimize excessive cellular breakdown.
15. Disengagement theory in gerontology proposes that successful aging involves:
A. Remaining as active and engaged as possible throughout life
B. Mutual withdrawal between the aging individual and society
C. Finding new roles to replace those lost through retirement
D. Maintaining the same lifestyle and activities as in middle age
✔ Answer: B — Mutual withdrawal between the aging individual and society
Rationale: Disengagement theory holds that aging involves a natural, mutually beneficial withdrawal between the
older adult and society.
Page 3 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
16. Which dietary choices should the nurse recommend for a patient who wants to maximize
antioxidant intake to support the free radical theory of healthy aging?
A. Red meat and dairy products
B. Fruits and vegetables
C. Whole grains and legumes only
D. Omega-3 rich fish twice per week
✔ Answer: B — Fruits and vegetables
Rationale: Fruits and vegetables are rich in antioxidants such as vitamins C and E that neutralize free radicals and
reduce oxidative cellular damage.
17. A nurse performs a 'life review' with an 82-year-old patient. Which outcomes are considered positive
results of this process? Select the option that includes ONLY positive outcomes.
A. Comparing one's accomplishments with those of peers
B. Seeking validation from others regarding past decisions
C. Gaining wisdom, self-understanding, and acceptance of self
D. Focusing on missed opportunities and past regrets
✔ Answer: C — Gaining wisdom, self-understanding, and acceptance of self
Rationale: Positive outcomes of life review include wisdom, an integrated self-image, understanding of self and
relationships, and self-acceptance.
Chapter 3: Physiologic Changes
18. The nurse is performing a respiratory assessment on a 78-year-old patient. Which age-related
change is an expected finding?
A. Increased vital capacity and improved gas exchange
B. Decreased residual lung volume
C. Reduced cough reflex efficiency and decreased lung elasticity
D. Increased ciliary action improving mucus clearance
✔ Answer: C — Reduced cough reflex efficiency and decreased lung elasticity
Rationale: Normal aging causes decreased lung elasticity, reduced cough effectiveness, and diminished ciliary
action, increasing respiratory infection risk.
19. An older adult patient reports that food does not taste as good as it once did. The nurse recognizes
this as a normal age-related change caused by:
A. Decreased production of hydrochloric acid in the stomach
B. Reduction in the number of functioning taste buds
C. Diminished sense of smell due to olfactory nerve atrophy
D. Both B and C contribute to decreased taste perception
✔ Answer: D — Both B and C contribute to decreased taste perception
Rationale: Both decreased taste bud numbers and olfactory decline contribute to reduced taste perception in older
adults, which can impact nutritional intake.
20. Which age-related cardiovascular change MOST directly increases the older adult's risk for
orthostatic hypotension?
A. Increased heart rate response to positional change
B. Decreased baroreceptor sensitivity to positional changes
C. Thickening of the sinoatrial node with increased conduction velocity
D. Increased cardiac output at rest
✔ Answer: B — Decreased baroreceptor sensitivity to positional changes
Rationale: Decreased baroreceptor sensitivity with aging impairs the body's ability to rapidly compensate for blood
pressure changes with positional changes, causing orthostatic hypotension.
21. A 70-year-old patient's lab values show a slightly elevated serum creatinine despite no known
kidney disease. The nurse understands this MOST likely reflects:
Page 4 | Not for resale — Original educational content only
Basic Geriatric Nursing, 8th Edition (Williams,
2023)
UNIT I OVERVIEW OF AGING
Chapter 1: Trends and Issues
1. The fastest-growing segment of the older adult population in the United States is which age group?
A. Young-old (65–74)
B. Middle-old (75–84)
C. Oldest-old (85 and over)
D. Baby boomers aged 60–65
✔ Answer: C — Oldest-old (85 and over)
Rationale: The oldest-old (85+) is the fastest-growing age group, driven by improvements in medical care and
public health.
2. A nurse explains ageism to a nursing student. Which statement BEST defines ageism?
A. Fear of the physical process of growing old
B. Discrimination against individuals solely on the basis of age
C. Cultural sensitivity toward the concerns of aging
D. Promotion of resources available to older adults
✔ Answer: B — Discrimination against individuals solely on the basis of age
Rationale: Ageism is a negative belief pattern that leads to discrimination against persons solely because of their
age.
3. An 80-year-old resident in a long-term care facility repeatedly refuses meals. The nurse recognizes
this behavior as MOST likely representing:
A. Early signs of Alzheimer disease
B. Dislike of the facility's food choices
C. An effort to retain independence and self-direction
D. A passive-aggressive attempt to gain attention
✔ Answer: C — An effort to retain independence and self-direction
Rationale: Loss of control is a significant concern for institutionalized elders; food refusal often represents one of
the few remaining areas of autonomous decision-making.
4. Medicare Part A PRIMARILY covers which type of health care costs?
A. 80% of physician fees
B. Inpatient hospital costs
C. Outpatient prescription drug expenses
D. Private insurance premiums for Medigap policies
✔ Answer: B — Inpatient hospital costs
Rationale: Medicare Part A pays for inpatient hospital care, skilled nursing facility care after hospitalization, hospice,
and some home health care.
Page 1 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
5. Which document legally transfers health care decision-making authority to a designated person when
a patient is unable to speak for themselves?
A. A living will
B. A 'Do Not Resuscitate' order
C. A durable power of attorney for health care
D. An advance beneficiary notice
✔ Answer: C — A durable power of attorney for health care
Rationale: A durable power of attorney for health care (DPAHC) designates another person to make health care
decisions when the patient loses decision-making capacity.
6. Under Medicare's DRG system, hospital stays are determined by:
A. The physician's estimate of recovery time
B. The patient's insurance policy limits
C. A preset number of days allotted based on the admitting diagnosis
D. The hospital's average length of stay statistics
✔ Answer: C — A preset number of days allotted based on the admitting diagnosis
Rationale: Diagnosis-Related Groups (DRGs) allocate a fixed reimbursement amount and typical length of stay
based on the admitting diagnosis to control Medicare costs.
7. A 75-year-old patient with diabetes and dementia requires ongoing skilled nursing care, physical
therapy, and wound care. Which care facility is MOST appropriate?
A. Assisted-living center
B. Government-subsidized senior housing
C. Skilled care facility
D. Adult day care center
✔ Answer: C — Skilled care facility
Rationale: Skilled care facilities provide nursing care by licensed professionals and rehabilitative services such as
PT, OT, and speech therapy.
8. Two physicians must agree in writing that the established criteria have been met before which
document takes effect?
A. A durable power of attorney for health care
B. A living will
C. An advance beneficiary notice
D. A Medicare assignment agreement
✔ Answer: B — A living will
Rationale: A living will requires written agreement by two physicians that the patient meets the criteria stated in the
document before it becomes operative.
9. The gerontological nurse is aware that preventive health care practices in the latter half of the 20th
century PRIMARILY contributed to which outcome?
A. Increased acute care hospitalizations in the young-old
B. Decreased chronic disease incidence in the oldest-old
C. Increased longevity and a larger older adult population
D. Decreased expenditure on Medicare and Medicaid
✔ Answer: C — Increased longevity and a larger older adult population
Rationale: Preventive health practices, disease control, and wellness focus helped people live longer, significantly
expanding the older adult population.
Chapter 2: Theories of Aging
10. The free radical theory of aging proposes that aging results from:
A. Programmed cell death encoded in DNA
B. Cumulative damage from unstable oxygen molecules that disrupt cell function
Page 2 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
C. Gradual cross-linking of collagen fibers limiting cellular flexibility
D. Accumulation of metabolic waste products in aging cells
✔ Answer: B — Cumulative damage from unstable oxygen molecules that disrupt cell function
Rationale: Free radicals are unstable oxygen molecules that cause cumulative oxidative cellular damage,
contributing to the aging process.
11. According to Erikson's psychosocial theory, the developmental task of later adulthood is:
A. Intimacy versus isolation
B. Industry versus inferiority
C. Integrity versus despair
D. Generativity versus stagnation
✔ Answer: C — Integrity versus despair
Rationale: Erikson's final stage — ego integrity vs. despair — involves reflecting on one's life with acceptance and
wisdom rather than regret.
12. The caloric restriction theory suggests that aging may be slowed by:
A. Supplementing the diet with fat-soluble vitamins A, D, E, and K
B. Consuming a high-nutrient, reduced-calorie diet
C. Eating organically grown foods to avoid chemical exposure
D. Increasing protein intake to maintain muscle mass
✔ Answer: B — Consuming a high-nutrient, reduced-calorie diet
Rationale: Caloric restriction theory links reduced caloric intake with slowed aging processes and extended life span
in various animal models.
13. A patient practices daily meditation and maintains close social connections as part of healthy aging.
This aligns MOST closely with which aging theory?
A. Free radical theory
B. Cross-linkage theory
C. Wear-and-tear theory
D. Activity theory
✔ Answer: D — Activity theory
Rationale: The activity theory proposes that older adults who remain active and engaged maintain higher life
satisfaction and more successful aging outcomes.
14. The nurse is teaching a class on biological theories of aging. The wear-and-tear theory would
support which nursing instruction?
A. Encouraging patients to engage in vigorous daily exercise regardless of pain
B. Teaching patients to balance activity with adequate rest and stress reduction
C. Advising patients that cellular aging is entirely genetically predetermined
D. Recommending high-antioxidant supplements to prevent cell damage
✔ Answer: B — Teaching patients to balance activity with adequate rest and stress reduction
Rationale: Wear-and-tear theory holds that repeated stress and use eventually damage tissues; balanced activity
and rest help minimize excessive cellular breakdown.
15. Disengagement theory in gerontology proposes that successful aging involves:
A. Remaining as active and engaged as possible throughout life
B. Mutual withdrawal between the aging individual and society
C. Finding new roles to replace those lost through retirement
D. Maintaining the same lifestyle and activities as in middle age
✔ Answer: B — Mutual withdrawal between the aging individual and society
Rationale: Disengagement theory holds that aging involves a natural, mutually beneficial withdrawal between the
older adult and society.
Page 3 | Not for resale — Original educational content only
, Basic Geriatric Nursing 8e — Exam Prep | Original Practice Questions 2026 | Williams (Elsevier) Aligned
16. Which dietary choices should the nurse recommend for a patient who wants to maximize
antioxidant intake to support the free radical theory of healthy aging?
A. Red meat and dairy products
B. Fruits and vegetables
C. Whole grains and legumes only
D. Omega-3 rich fish twice per week
✔ Answer: B — Fruits and vegetables
Rationale: Fruits and vegetables are rich in antioxidants such as vitamins C and E that neutralize free radicals and
reduce oxidative cellular damage.
17. A nurse performs a 'life review' with an 82-year-old patient. Which outcomes are considered positive
results of this process? Select the option that includes ONLY positive outcomes.
A. Comparing one's accomplishments with those of peers
B. Seeking validation from others regarding past decisions
C. Gaining wisdom, self-understanding, and acceptance of self
D. Focusing on missed opportunities and past regrets
✔ Answer: C — Gaining wisdom, self-understanding, and acceptance of self
Rationale: Positive outcomes of life review include wisdom, an integrated self-image, understanding of self and
relationships, and self-acceptance.
Chapter 3: Physiologic Changes
18. The nurse is performing a respiratory assessment on a 78-year-old patient. Which age-related
change is an expected finding?
A. Increased vital capacity and improved gas exchange
B. Decreased residual lung volume
C. Reduced cough reflex efficiency and decreased lung elasticity
D. Increased ciliary action improving mucus clearance
✔ Answer: C — Reduced cough reflex efficiency and decreased lung elasticity
Rationale: Normal aging causes decreased lung elasticity, reduced cough effectiveness, and diminished ciliary
action, increasing respiratory infection risk.
19. An older adult patient reports that food does not taste as good as it once did. The nurse recognizes
this as a normal age-related change caused by:
A. Decreased production of hydrochloric acid in the stomach
B. Reduction in the number of functioning taste buds
C. Diminished sense of smell due to olfactory nerve atrophy
D. Both B and C contribute to decreased taste perception
✔ Answer: D — Both B and C contribute to decreased taste perception
Rationale: Both decreased taste bud numbers and olfactory decline contribute to reduced taste perception in older
adults, which can impact nutritional intake.
20. Which age-related cardiovascular change MOST directly increases the older adult's risk for
orthostatic hypotension?
A. Increased heart rate response to positional change
B. Decreased baroreceptor sensitivity to positional changes
C. Thickening of the sinoatrial node with increased conduction velocity
D. Increased cardiac output at rest
✔ Answer: B — Decreased baroreceptor sensitivity to positional changes
Rationale: Decreased baroreceptor sensitivity with aging impairs the body's ability to rapidly compensate for blood
pressure changes with positional changes, causing orthostatic hypotension.
21. A 70-year-old patient's lab values show a slightly elevated serum creatinine despite no known
kidney disease. The nurse understands this MOST likely reflects:
Page 4 | Not for resale — Original educational content only
