NU 217
Gerontological Nursing
Proctored Midterm Exam
2026
(Questions & Answers)
1. A 78-year-old patient with mild cognitive impairment shows signs of medication non-adherence
related to complex regimen. What is the most appropriate nursing intervention? A) Simplify
medication regimen and use pill organizers B) Increase medication dosage to compensate C)
Ignore non-adherence if mild D) Refer immediately to psychiatry
Answer: A Rationale: Simplifying medication and using pill organizers helps improve adherence,
critical for older adults with cognitive challenges.
2. Which physiological change in older adults most affects thermoregulation? A) Increased sweat
gland activity B) Decreased peripheral vasodilation C) Reduced subcutaneous fat and impaired
vasoconstriction D) Enhanced shivering response
Answer: C Rationale: Aging reduces subcutaneous fat and impairs vasoconstriction, impairing heat
retention and temperature regulation.
3. A nurse is caring for a patient with advanced Parkinson’s disease. Which symptom is least likely to
be managed with dopaminergic medications? A) Bradykinesia B) Resting tremor C) Postural
instability D) Muscle rigidity
Answer: C Rationale: Postural instability often responds poorly to medication and usually requires
physical therapy.
4. In assessing an elderly patient’s risk for pressure ulcers, which factor is most critical? A) Cognitive
level B) Nutritional status C) Physical activity level D) History of smoking
Answer: B Rationale: Nutritional deficits impair skin integrity and wound healing, increasing ulcer
risk.
,5. What is the best method to assess pain in an elderly patient with moderate dementia? A) Self-report
using a numeric scale B) Ignoring verbal cues and relying on vital signs C) Using behavioral pain
scales like PAINAD D) Administering analgesics preemptively
Answer: C Rationale: Behavioral scales are validated for assessing pain in patients unable to self-
report reliably.
6. Which of the following vaccines are recommended specifically for all adults age 65 years and
older? A) Influenza and varicella B) Pneumococcal and shingles (herpes zoster) C) Hepatitis B
and HPV D) Meningococcal and measles
Answer: B Rationale: Pneumococcal and shingles vaccines are standard preventive measures for
older adults.
7. An elderly patient with congestive heart failure presents with sudden confusion and agitation. What
should the nurse suspect first? A) Acute myocardial infarction B) Delirium secondary to hypoxia
or fluid imbalance C) Stroke D) Anxiety disorder
Answer: B Rationale: Delirium caused by hypoxia or electrolyte/fluid imbalance is common in heart
failure.
8. Which factor contributes most to decreased renal clearance in elderly patients? A) Increased renal
blood flow B) Decreased glomerular filtration rate (GFR) C) Increased tubule function D)
Enlarged kidney size
Answer: B Rationale: Aging decreases GFR, reducing kidney clearance and requiring dose
adjustments for many drugs.
True/False Questions
9. Polypharmacy increases the risk of adverse drug reactions in elderly patients. Answer: True
Rationale: Multiple medications increase drug interactions and side effects in older adults.
10. Sarcopenia in older adults can be reversed fully with resistance training alone. Answer: False
Rationale: Resistance training helps but complete reversal depends on multiple factors including
nutrition and underlying disease.
11. Depression in older adults always presents with sadness and obvious emotional symptoms.
Answer: False Rationale: Depression often presents atypically with somatic complaints or
, apathy rather than overt sadness.
12. The risk of falls increases with age due to impaired balance, vision, and medication effects.
Answer: True Rationale: Multiple age-related factors contribute to fall risk.
13. Older adults have a decreased pain threshold compared to younger adults, so they feel pain more
intensely. Answer: False Rationale: Pain perception varies, but response to pain can be blunted,
sometimes leading to underreporting.
Short Answer Questions
14. List three common geriatric syndromes and their potential consequences. Answer:
• Falls → fractures, disability
• Delirium → longer hospital stays, cognitive decline
• Incontinence → skin infections, social isolation
Rationale: Recognizing syndromes helps prevent complications in older adults.
15. Explain why comprehensive geriatric assessment (CGA) is integral to care planning. Answer:
CGA evaluates medical, psychological, functional, and social aspects to create holistic,
individualized care plans.
Rationale: CGA is a multidimensional approach crucial for optimizing outcomes.
16. What is orthostatic hypotension and why is it common in elderly patients? Answer: A drop in
blood pressure upon standing due to impaired autonomic regulation, common due to aging
vascular and neurologic changes.
Rationale: Awareness helps prevent falls and syncope.
17. Provide two key nursing strategies for managing polypharmacy. Answer:
• Regular medication review and reconciliation
• Educating patients on medication purpose and side effects
, Rationale: These reduce adverse drug events.
18. Describe how sarcopenia can impact activities of daily living (ADLs) in elderly individuals.
Answer: Muscle loss leads to weakness, reduced mobility, decreased balance, and difficulty
performing ADLs like bathing or dressing.
Rationale: Understanding impact guides interventions.
Matching Questions
19–25. Match the geriatric syndrome (left) with the appropriate nursing intervention (right).
Geriatric Syndrome Nursing Intervention
1) Orientation and environmental
A) Delirium
modifications
B) Pressure ulcers 2) Pressure redistribution and skin care
C) Urinary
3) Bladder training and scheduled toileting
incontinence
4) Psychosocial support and possible
D) Depression
medication
5) Fall risk assessment and home safety
E) Falls
evaluation
6) Nutritional support and monitoring
F) Malnutrition
weight
G) Polypharmacy 7) Medication review and simplification
Answers: A-1 | B-2 | C-3 | D-4 | E-5 | F-6 | G-7
Rationale: Interventions align with commonly accepted management of geriatric syndromes.
Fill in the Blank
26. The term __________ describes age-related decline in cognitive function that interferes with daily
life. Answer: dementia Rationale: Distinguishes normal aging from pathological cognitive
decline.
Gerontological Nursing
Proctored Midterm Exam
2026
(Questions & Answers)
1. A 78-year-old patient with mild cognitive impairment shows signs of medication non-adherence
related to complex regimen. What is the most appropriate nursing intervention? A) Simplify
medication regimen and use pill organizers B) Increase medication dosage to compensate C)
Ignore non-adherence if mild D) Refer immediately to psychiatry
Answer: A Rationale: Simplifying medication and using pill organizers helps improve adherence,
critical for older adults with cognitive challenges.
2. Which physiological change in older adults most affects thermoregulation? A) Increased sweat
gland activity B) Decreased peripheral vasodilation C) Reduced subcutaneous fat and impaired
vasoconstriction D) Enhanced shivering response
Answer: C Rationale: Aging reduces subcutaneous fat and impairs vasoconstriction, impairing heat
retention and temperature regulation.
3. A nurse is caring for a patient with advanced Parkinson’s disease. Which symptom is least likely to
be managed with dopaminergic medications? A) Bradykinesia B) Resting tremor C) Postural
instability D) Muscle rigidity
Answer: C Rationale: Postural instability often responds poorly to medication and usually requires
physical therapy.
4. In assessing an elderly patient’s risk for pressure ulcers, which factor is most critical? A) Cognitive
level B) Nutritional status C) Physical activity level D) History of smoking
Answer: B Rationale: Nutritional deficits impair skin integrity and wound healing, increasing ulcer
risk.
,5. What is the best method to assess pain in an elderly patient with moderate dementia? A) Self-report
using a numeric scale B) Ignoring verbal cues and relying on vital signs C) Using behavioral pain
scales like PAINAD D) Administering analgesics preemptively
Answer: C Rationale: Behavioral scales are validated for assessing pain in patients unable to self-
report reliably.
6. Which of the following vaccines are recommended specifically for all adults age 65 years and
older? A) Influenza and varicella B) Pneumococcal and shingles (herpes zoster) C) Hepatitis B
and HPV D) Meningococcal and measles
Answer: B Rationale: Pneumococcal and shingles vaccines are standard preventive measures for
older adults.
7. An elderly patient with congestive heart failure presents with sudden confusion and agitation. What
should the nurse suspect first? A) Acute myocardial infarction B) Delirium secondary to hypoxia
or fluid imbalance C) Stroke D) Anxiety disorder
Answer: B Rationale: Delirium caused by hypoxia or electrolyte/fluid imbalance is common in heart
failure.
8. Which factor contributes most to decreased renal clearance in elderly patients? A) Increased renal
blood flow B) Decreased glomerular filtration rate (GFR) C) Increased tubule function D)
Enlarged kidney size
Answer: B Rationale: Aging decreases GFR, reducing kidney clearance and requiring dose
adjustments for many drugs.
True/False Questions
9. Polypharmacy increases the risk of adverse drug reactions in elderly patients. Answer: True
Rationale: Multiple medications increase drug interactions and side effects in older adults.
10. Sarcopenia in older adults can be reversed fully with resistance training alone. Answer: False
Rationale: Resistance training helps but complete reversal depends on multiple factors including
nutrition and underlying disease.
11. Depression in older adults always presents with sadness and obvious emotional symptoms.
Answer: False Rationale: Depression often presents atypically with somatic complaints or
, apathy rather than overt sadness.
12. The risk of falls increases with age due to impaired balance, vision, and medication effects.
Answer: True Rationale: Multiple age-related factors contribute to fall risk.
13. Older adults have a decreased pain threshold compared to younger adults, so they feel pain more
intensely. Answer: False Rationale: Pain perception varies, but response to pain can be blunted,
sometimes leading to underreporting.
Short Answer Questions
14. List three common geriatric syndromes and their potential consequences. Answer:
• Falls → fractures, disability
• Delirium → longer hospital stays, cognitive decline
• Incontinence → skin infections, social isolation
Rationale: Recognizing syndromes helps prevent complications in older adults.
15. Explain why comprehensive geriatric assessment (CGA) is integral to care planning. Answer:
CGA evaluates medical, psychological, functional, and social aspects to create holistic,
individualized care plans.
Rationale: CGA is a multidimensional approach crucial for optimizing outcomes.
16. What is orthostatic hypotension and why is it common in elderly patients? Answer: A drop in
blood pressure upon standing due to impaired autonomic regulation, common due to aging
vascular and neurologic changes.
Rationale: Awareness helps prevent falls and syncope.
17. Provide two key nursing strategies for managing polypharmacy. Answer:
• Regular medication review and reconciliation
• Educating patients on medication purpose and side effects
, Rationale: These reduce adverse drug events.
18. Describe how sarcopenia can impact activities of daily living (ADLs) in elderly individuals.
Answer: Muscle loss leads to weakness, reduced mobility, decreased balance, and difficulty
performing ADLs like bathing or dressing.
Rationale: Understanding impact guides interventions.
Matching Questions
19–25. Match the geriatric syndrome (left) with the appropriate nursing intervention (right).
Geriatric Syndrome Nursing Intervention
1) Orientation and environmental
A) Delirium
modifications
B) Pressure ulcers 2) Pressure redistribution and skin care
C) Urinary
3) Bladder training and scheduled toileting
incontinence
4) Psychosocial support and possible
D) Depression
medication
5) Fall risk assessment and home safety
E) Falls
evaluation
6) Nutritional support and monitoring
F) Malnutrition
weight
G) Polypharmacy 7) Medication review and simplification
Answers: A-1 | B-2 | C-3 | D-4 | E-5 | F-6 | G-7
Rationale: Interventions align with commonly accepted management of geriatric syndromes.
Fill in the Blank
26. The term __________ describes age-related decline in cognitive function that interferes with daily
life. Answer: dementia Rationale: Distinguishes normal aging from pathological cognitive
decline.
