PRN1600 – GERIATRIC NURSING MIDTERM
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2025|2026 Q&A | INSTANT DOWNLOAD PDF
1. Which age-related change most commonly affects drug metabolism in older
adults?
A. Increased renal blood flow
B. Increased hepatic mass
C. B. Decreased hepatic enzyme activity
D. Increased total body water
Rationale: Hepatic enzyme activity (phase I) commonly decreases with age,
reducing metabolism of many drugs and increasing drug half-life.
2. The most appropriate screening tool to assess cognition at the bedside in
older adults is:
A. Katz Index of ADLs
B. Geriatric Depression Scale
C. C. Mini-Mental State Examination (MMSE)
D. Braden Scale
Rationale: The MMSE is a commonly used brief cognitive screening tool;
Katz assesses ADLs, GDS screens for depression, and Braden assesses
pressure ulcer risk.
3. Which sign most strongly suggests delirium rather than dementia?
A. Progressive memory loss over months
B. B. Acute onset with fluctuating attention
C. Slowly worsening language impairment
D. Long-standing personality change
Rationale: Delirium has an acute onset and fluctuating course with
inattention, whereas dementia is chronic and progressive.
,4. A 78-year-old has orthostatic hypotension. The best immediate nursing
action when he feels dizzy upon standing is to:
A. Encourage him to walk slowly
B. Give him a glass of juice
C. C. Assist him to sit or lie down and take vitals
D. Tell him to shimmy his legs
Rationale: Assist to a safe position and assess vitals to prevent falls and
identify hypotension; fluids may help later but immediate safety is priority.
5. Which intervention most effectively reduces risk of pressure ulcers?
A. Using lotion once daily
B. Turning and repositioning every 2 hours
C. Applying dressings prophylactically
D. Using a high-protein supplement only
Rationale: Regular repositioning and pressure relief are primary preventive
measures for pressure ulcers.
Answer: B
Rationale: Repositioning every 2 hours reduces prolonged pressure on bony
prominences, key for prevention.
6. Polypharmacy is best defined as:
A. Taking three or more vitamins
B. B. Use of multiple medications, often unnecessary or risky
C. Prescribing the same drug by two physicians
D. Use of alternative medicine with prescriptions
Rationale: Polypharmacy commonly refers to use of multiple drugs,
increasing risk of interactions and adverse effects.
7. The most common cause of unintentional weight loss in older adults is:
A. Cancer only
B. B. Multifactorial — including medications, depression, dental and social
issues
C. Purely hyperthyroidism
D. Excessive exercise
Rationale: Weight loss often has multiple contributing factors in older
adults rather than a single cause.
, 8. Which vaccine is recommended annually for older adults?
A. Tdap every year
B. B. Influenza vaccine
C. PPSV23 every year
D. Herpes zoster vaccine annually
Rationale: Annual influenza vaccination is recommended due to seasonal
strain changes; other vaccines have different schedules.
9. An older adult with urinary incontinence who has sudden confusion and
fever most likely has:
A. Age-related incontinence only
B. B. Urinary tract infection contributing to delirium
C. Overactive bladder unrelated to cognitive change
D. Early dementia
Rationale: UTIs in older adults commonly precipitate acute
confusion/delirium and should be evaluated promptly.
10.The best measure to prevent falls in hospitalized older adults is:
A. Keep bedrails up at all times
B. B. Fall risk assessment plus individualized interventions (e.g., gait aid,
environment)
C. Limit visitors
D. Use physical restraints when needed
Rationale: Formal risk assessment with targeted interventions reduces falls;
restraints increase harm and are not first-line.
11.Advanced directives are important because they:
A. Automatically prevent hospitalization
B. Replace the need for family discussion
C. C. Communicate the patient’s wishes about future care when they
cannot decide
D. Are legally binding in all settings without nuance
Rationale: Advance directives guide care consistent with patient values
when decision-making capacity is lost.
12.A common sensory change in aging that affects communication is:
A. Increased taste sensitivity
EXAM QUESTIONS AND CORRECT ANSWERS
(VERIFIED ANSWERS) PLUS RATIONALES
2025|2026 Q&A | INSTANT DOWNLOAD PDF
1. Which age-related change most commonly affects drug metabolism in older
adults?
A. Increased renal blood flow
B. Increased hepatic mass
C. B. Decreased hepatic enzyme activity
D. Increased total body water
Rationale: Hepatic enzyme activity (phase I) commonly decreases with age,
reducing metabolism of many drugs and increasing drug half-life.
2. The most appropriate screening tool to assess cognition at the bedside in
older adults is:
A. Katz Index of ADLs
B. Geriatric Depression Scale
C. C. Mini-Mental State Examination (MMSE)
D. Braden Scale
Rationale: The MMSE is a commonly used brief cognitive screening tool;
Katz assesses ADLs, GDS screens for depression, and Braden assesses
pressure ulcer risk.
3. Which sign most strongly suggests delirium rather than dementia?
A. Progressive memory loss over months
B. B. Acute onset with fluctuating attention
C. Slowly worsening language impairment
D. Long-standing personality change
Rationale: Delirium has an acute onset and fluctuating course with
inattention, whereas dementia is chronic and progressive.
,4. A 78-year-old has orthostatic hypotension. The best immediate nursing
action when he feels dizzy upon standing is to:
A. Encourage him to walk slowly
B. Give him a glass of juice
C. C. Assist him to sit or lie down and take vitals
D. Tell him to shimmy his legs
Rationale: Assist to a safe position and assess vitals to prevent falls and
identify hypotension; fluids may help later but immediate safety is priority.
5. Which intervention most effectively reduces risk of pressure ulcers?
A. Using lotion once daily
B. Turning and repositioning every 2 hours
C. Applying dressings prophylactically
D. Using a high-protein supplement only
Rationale: Regular repositioning and pressure relief are primary preventive
measures for pressure ulcers.
Answer: B
Rationale: Repositioning every 2 hours reduces prolonged pressure on bony
prominences, key for prevention.
6. Polypharmacy is best defined as:
A. Taking three or more vitamins
B. B. Use of multiple medications, often unnecessary or risky
C. Prescribing the same drug by two physicians
D. Use of alternative medicine with prescriptions
Rationale: Polypharmacy commonly refers to use of multiple drugs,
increasing risk of interactions and adverse effects.
7. The most common cause of unintentional weight loss in older adults is:
A. Cancer only
B. B. Multifactorial — including medications, depression, dental and social
issues
C. Purely hyperthyroidism
D. Excessive exercise
Rationale: Weight loss often has multiple contributing factors in older
adults rather than a single cause.
, 8. Which vaccine is recommended annually for older adults?
A. Tdap every year
B. B. Influenza vaccine
C. PPSV23 every year
D. Herpes zoster vaccine annually
Rationale: Annual influenza vaccination is recommended due to seasonal
strain changes; other vaccines have different schedules.
9. An older adult with urinary incontinence who has sudden confusion and
fever most likely has:
A. Age-related incontinence only
B. B. Urinary tract infection contributing to delirium
C. Overactive bladder unrelated to cognitive change
D. Early dementia
Rationale: UTIs in older adults commonly precipitate acute
confusion/delirium and should be evaluated promptly.
10.The best measure to prevent falls in hospitalized older adults is:
A. Keep bedrails up at all times
B. B. Fall risk assessment plus individualized interventions (e.g., gait aid,
environment)
C. Limit visitors
D. Use physical restraints when needed
Rationale: Formal risk assessment with targeted interventions reduces falls;
restraints increase harm and are not first-line.
11.Advanced directives are important because they:
A. Automatically prevent hospitalization
B. Replace the need for family discussion
C. C. Communicate the patient’s wishes about future care when they
cannot decide
D. Are legally binding in all settings without nuance
Rationale: Advance directives guide care consistent with patient values
when decision-making capacity is lost.
12.A common sensory change in aging that affects communication is:
A. Increased taste sensitivity
