1
NCLEX RN Exam Bank on Geriatric
Assessment, Fall Risk, Nutrition &
Polypharmacy
Table of Contents
Subtopic 1: Fall Risk Identification and Prevention Strategies (Questions 1–20) ................. 2
Subtopic 2: Nutritional Needs and Malnutrition in Older Adults (Questions 21–40) .......... 10
Subtopic 3: Polypharmacy—Risks, Recognition & Interventions (Questions 41–60) .......... 19
Subtopic 4: Cognitive Impairment and Medication Safety in Older Adults (Questions 61–80)
.................................................................................................................................. 27
Subtopic 5: Nutritional Deficiencies in the Elderly—Identification and Nursing Interventions
.................................................................................................................................. 36
Subtopic 6: Geriatric Pharmacodynamics & Age-Related Drug Response (Q101–Q120) ... 45
Subtopic 7: Cognitive Decline and Functional Assessment in Older Adults...................... 53
Subtopic 8: Geriatric Mental Health, Cognitive Impairment, Depression, and Delirium..... 62
, 2
Subtopic 1: Fall Risk Identification and Prevention
Strategies (Questions 1–20)
Question 1
Which of the following is the most significant predictor of future falls in older adults?
A. Age over 85
B. History of previous falls
C. Polypharmacy
D. Use of a walker
Correct answer: B. History of previous falls
Rationale: A prior fall is the strongest predictor of future falls. It often indicates balance,
strength, or environmental issues that remain unresolved.
Question 2
Which intervention is most appropriate for a confused elderly patient at high risk for falls?
A. Assign the patient to a private room
B. Use all four bed rails
C. Implement a toileting schedule and hourly rounding
D. Restrain the patient in bed
Correct answer: C. Implement a toileting schedule and hourly rounding
Rationale: Proactive toileting and frequent monitoring reduce fall risk while promoting
safety and dignity without resorting to restraints.
Question 3
Which medication should raise a red flag in a fall-risk assessment for older adults?
, 3
A. Acetaminophen
B. Lorazepam
C. Atorvastatin
D. Metformin
Correct answer: B. Lorazepam
Rationale: Lorazepam, a benzodiazepine, increases fall risk due to its sedative and muscle-
relaxing effects, impairing coordination and alertness.
Question 4
A nurse finds a 78-year-old patient walking barefoot on a wet hospital floor. What is the
priority nursing intervention?
A. Educate the patient on infection risk
B. Ask the patient to go back to bed
C. Provide non-slip footwear immediately
D. Document the observation in the chart
Correct answer: C. Provide non-slip footwear immediately
Rationale: Addressing the immediate risk (wet floor + barefoot walking) with proper
footwear directly reduces the chance of falls.
Question 5
In assessing an older adult’s home for fall risks, which of the following requires immediate
modification?
A. Presence of a cat
B. Recliner chair
C. Throw rugs in the hallway
, 4
D. Use of a bedside lamp
Correct answer: C. Throw rugs in the hallway
Rationale: Throw rugs are a major tripping hazard, particularly in hallways where quick
ambulation may occur.
Question 6
Which physical assessment finding indicates increased fall risk in a geriatric patient?
A. BMI of 26
B. Positive Romberg test
C. BP 130/70 mmHg
D. Mild arthritis
Correct answer: B. Positive Romberg test
Rationale: A positive Romberg test suggests balance impairment, which increases the risk
of falling, especially in unassisted walking.
Question 7
Which of the following nursing actions best addresses fall risk for a newly admitted elderly
patient with orthostatic hypotension?
A. Start IV fluids
B. Educate to change positions slowly
C. Encourage frequent ambulation
D. Raise the head of the bed to 90 degrees
Correct answer: B. Educate to change positions slowly
NCLEX RN Exam Bank on Geriatric
Assessment, Fall Risk, Nutrition &
Polypharmacy
Table of Contents
Subtopic 1: Fall Risk Identification and Prevention Strategies (Questions 1–20) ................. 2
Subtopic 2: Nutritional Needs and Malnutrition in Older Adults (Questions 21–40) .......... 10
Subtopic 3: Polypharmacy—Risks, Recognition & Interventions (Questions 41–60) .......... 19
Subtopic 4: Cognitive Impairment and Medication Safety in Older Adults (Questions 61–80)
.................................................................................................................................. 27
Subtopic 5: Nutritional Deficiencies in the Elderly—Identification and Nursing Interventions
.................................................................................................................................. 36
Subtopic 6: Geriatric Pharmacodynamics & Age-Related Drug Response (Q101–Q120) ... 45
Subtopic 7: Cognitive Decline and Functional Assessment in Older Adults...................... 53
Subtopic 8: Geriatric Mental Health, Cognitive Impairment, Depression, and Delirium..... 62
, 2
Subtopic 1: Fall Risk Identification and Prevention
Strategies (Questions 1–20)
Question 1
Which of the following is the most significant predictor of future falls in older adults?
A. Age over 85
B. History of previous falls
C. Polypharmacy
D. Use of a walker
Correct answer: B. History of previous falls
Rationale: A prior fall is the strongest predictor of future falls. It often indicates balance,
strength, or environmental issues that remain unresolved.
Question 2
Which intervention is most appropriate for a confused elderly patient at high risk for falls?
A. Assign the patient to a private room
B. Use all four bed rails
C. Implement a toileting schedule and hourly rounding
D. Restrain the patient in bed
Correct answer: C. Implement a toileting schedule and hourly rounding
Rationale: Proactive toileting and frequent monitoring reduce fall risk while promoting
safety and dignity without resorting to restraints.
Question 3
Which medication should raise a red flag in a fall-risk assessment for older adults?
, 3
A. Acetaminophen
B. Lorazepam
C. Atorvastatin
D. Metformin
Correct answer: B. Lorazepam
Rationale: Lorazepam, a benzodiazepine, increases fall risk due to its sedative and muscle-
relaxing effects, impairing coordination and alertness.
Question 4
A nurse finds a 78-year-old patient walking barefoot on a wet hospital floor. What is the
priority nursing intervention?
A. Educate the patient on infection risk
B. Ask the patient to go back to bed
C. Provide non-slip footwear immediately
D. Document the observation in the chart
Correct answer: C. Provide non-slip footwear immediately
Rationale: Addressing the immediate risk (wet floor + barefoot walking) with proper
footwear directly reduces the chance of falls.
Question 5
In assessing an older adult’s home for fall risks, which of the following requires immediate
modification?
A. Presence of a cat
B. Recliner chair
C. Throw rugs in the hallway
, 4
D. Use of a bedside lamp
Correct answer: C. Throw rugs in the hallway
Rationale: Throw rugs are a major tripping hazard, particularly in hallways where quick
ambulation may occur.
Question 6
Which physical assessment finding indicates increased fall risk in a geriatric patient?
A. BMI of 26
B. Positive Romberg test
C. BP 130/70 mmHg
D. Mild arthritis
Correct answer: B. Positive Romberg test
Rationale: A positive Romberg test suggests balance impairment, which increases the risk
of falling, especially in unassisted walking.
Question 7
Which of the following nursing actions best addresses fall risk for a newly admitted elderly
patient with orthostatic hypotension?
A. Start IV fluids
B. Educate to change positions slowly
C. Encourage frequent ambulation
D. Raise the head of the bed to 90 degrees
Correct answer: B. Educate to change positions slowly
