GERIA

1. An older adult with moderate Alzheimer's disease

becomes agitated and repeats the same question
multiple times. What is the nurse's best response? 6. The nurse employed in a long term care facility is
caring for an older male client. Which nursing action
a. Correct their memory deficit by providing contributes to encouraging autonomy in the client?
detailed explanations
b. Answer the question calmly and simply, then a. Decorating his room
redirect to another topic or activity. b. Scheduling his barber appointment
c. Ignore the question, hoping they will stop c. Planning his meals
repeating it. d. Allowing him to choose social activities
d. Tell the patient, 'You just asked me that,' to
help them remember. 7. The home care nurse is visiting an older female
client whose husband died 6 months ago. Which
behavior by the client indicates ineffective coping?
2. Knowing the difference between normal age
related changes and pathologic findings, which a. Participating in senior citizen’s program
findings should the nurse identify as pathologic in b. Looking at old snapshots of her family
the 74 yrs old client? c. Visiting her husband’s grave once a month.
d. Neglecting her personal grooming

a. Increased in diastolic blood pressure 8. A 74 yrs old women is hospitalized for dehydration.
b. Increase in residual lung volume During the admission interview, she admits to the
c. Decreased response to touch, heat and pain nurse that she is depressed. The nurse would expect
d. Decrease in sphincter control of the bladder this client to exhibit which of the following symptoms?

3. When an older adult repeatedly states, 'My back a. Increased autonomy

hurts,' but rates their pain as 2/10 on a 0-10 scale, b. Increased energy level
what should the nurse consider regarding pain c. Increased socialization
communication? d. Increased anxiety

a. The pain scale is always accurate, so the nurse 9. A 76 yrs old man who is resident in an extended care
should trust the numerical rating. facility is in the late stages of Alzheimer’s disease. He
b. They likely have cognitive impairment and tells his nurse that he has sore back muscles from all
cannot accurately report pain. the construction work he has been doing all day. Which
c. Older adults may underreport pain due to response by the nurse is most appropriate?
cultural beliefs, fear of addiction, or belief that
pain is a normal part of aging. a. “you’re 76 yrs old and you’ve been here all day.
d. Their pain is clearly exaggerated, and the You don’t work in construction anymore.”
nurse should focus on distraction. b. “what type of motion did you do to precipitate
this soreness?”
4. The nurse is providing an educational session to new c. “would you like me to rub your back for you?”
employees, and the topic is abuse of the client. The d. “ you know you don’t work in construction
nurse helps the employee identify that which is most anymore”
typical of a victim of abuse?
10. An older, medically controlled manic – depressive
a. A 90 yrs old woman who was advanced and asthmatic man has been under the care of his
Parkinson’s disease primary phycisian for many years. Recently, a
b. A 75 yrs old man who has moderate cardiologist prescribed cardiac
hypertension medication for CHF. He complains to the home care
c. A 68 yrs old woman who has newly diagnosed nurse that he is nauseated. It would be justifiable for
cataract the nurses to reach which of the following conclusions
d. A 70 yrs old women who has early diagnosed as to the cause of client’s nausea?
Lyme disease
a. The nausea could be psychosomatic and
5. A 74 yrs old, widowed client is hospitalized for related to the client’s depression over having
cataract surgery. During his admission interview, he to take new medications
repeatedly talks about how he wishes he was strong b. The problem of polypharmacy may exist as the
and energetic as he was when he was younger. In client symptomatology may be a result of
planning care for this client, the multiple drug interaction.
nurse should include which of the following? c. The client may be taking too much of his new
medications, which may contribute to his
a. Incorporation of humorous view of the normal symptoms
loss of strength d. The reaction between the new medication
b. Confrontation of the client about being so grim regimen and the food caused the nausea
c. Changing the topic whenever he brings up
d. Use of the intervention reminiscence
11. Which of the following is a common non-verbal hearing loss. The nurse tells the assistant that clients
indicator of pain in a non-communicative patient at the with hearing loss:
end of life?
a. Are you often distracted
a. A calm and relaxed state b. Develop moist cerumen production
b. Regular, even breathing c. Have middle ear changes
c. Facial grimacing and restlessness d. Respond to low pitched tones

d. Low blood pressure

12. Which of the following physical signs most 18. Which assessment findings in the elderly is caused
strongly indicates that a patient is very near death by decreased vessel elasticity and increased peripheral
(within hours or days)? resistance?

a. Increased periods of sleep a. An increase in blood pressure

b. Decreased appetite b. Wide QRS complexes on the ECG
c. Mottling of the skin on the extremities c. Confusion and disorientation
d. Social withdrawal d. An irregular peripheral pulse rate

13. When providing end-of-life care, a nurse 19. What is a common and effective pharmacological
demonstrates cultural competence by: intervention for managing the sensation of dyspnea
(shortness of breath) in a terminally ill patient?
a. Following the hospital's standard end of-life
protocol without deviation. a. Anxiolytics, such as lorazepam
b. Assuming that all patients from a certain b. High-flow oxygen via a non High-flow oxygen
culture want the same rituals. via a non rebreather mask
c. Asking the patient and family about their c. Diuretics, such as furosemide
specific cultural or religious rituals and d. Low-dose opioids, such as morphine
preferences.
d. Contacting a spiritual advisor without first 20. Which of the following measure is necessary to
consulting the patient or family. incorporate into plan of care for a client who is
diagnosed with senile dementia?
14. When discussing a new diagnosis with an older
adult patient and their family, which approach is best a. Communicate in simple words, short sentence
for ensuring understanding and shared decision and calm tone of voice
making? b. Environmental stimuli need to be eliminated
c. Schedule more demanding activities later in
a. Use complex medical jargon to demonstrate the day
professional expertise. d. Because these clients are easily bored, they
b. Present information clearly and concisely, need to be challenged bored, they need to be
check for understanding frequently, and allow challenged with new activities
ample time for questions.
c. Give all information directly to the family, 21. An 86 yrs old male with senile dementia has been
assuming they will explain it to the patient. physically abused and neglected for the past two
d. Rush through the explanation to avoid years by his live- in caregiver. He has since moved and
overwhelming the patient. is living with his son and
daughter -in-law. Which response by the clients son
15. What is a common environmental barrier to would cause the nurse great concern?
effective communication in a long-term care facility?
a. "I plan to ask my sister and brother to help my
a. Low lighting in patient rooms. wife and me with Dad on the weekends"
b. Individualized care plans for each resident. b. “how can we obtain reliable help to assist us in
c. Ample seating for family visits taking care of dad?We cant do it alone.”
d. High noise levels from televisions, call bells, c. "Dad used to beat us kids all the time. I wonder
and staff conversations. if he remembered that when it happened to
him?"
16. An 87 year old woman has come to the medical d. "I;m not sure how to deal with Dad's constant
clinic for her annual physical examination. The nurses repetition words "
assessing her knows that pulmonary functions in
elderly clients often shows 22. An older adult with advanced dementia
continuously searches for their deceased spouse. What
a. A decrease in residual volume acidosis is the most appropriate nursing communication
b. Blood gasses that reflect mild approach?
c. An increase in functional alveoli
d. Reduction in vital capacity a. Ignore their statements about their spouse.
b. Repeatedly correct them by stating their
17. The nurse is providing instructions to a nursing spouse is dead.
assistant regarding care of an older client with c. Join in their delusion and pretend the spouse is
present.
 d. Acknowledge their feelings of loss and redirect d. Interview the son-in- law to gain his
to a comforting topic or activity. perspective of the situation

23. Honor the patient's wishes as stated in the living 28. Which non-verbal cue from an older adult patient
will. might indicate they are experiencing pain or
discomfort, even if they deny it verbally?
a. Cheyne-Stokes respirations
b. Biot's respirations a. Maintaining steady eye contact and a calm
c. Kussmaul respirations demeanor.
d. Agonal breathing b. Guarding a body part, grimacing, or increased
restlessness
c. Requesting more visitors and social interaction.
d. Speaking in a loud, clear voice with animated
24. A sexually active 63 yrs old client complains of gestures.
painful intercourse secondary to vaginal dryness.
Which information is most important for the nurse to
include in a teaching plan for this client?
29. Which notation on the nursing care plan reflects
a. Prepare the client for a vascular work up since inappropriate care of the older client with hearing
the dryness is often related to vascular problem?
deficiencies.
b. Instruct the client to use an artificial water a. hearing aide daily
based lubricant in the vagina to decrease the b. Speak loudly when talking to the client
discomfort of intercourse c. Face the client, speaking slowly and clearly
c. Teach the client alternative methods of d. Examine ears for cerumen accumulation
intimacy in the form of touch e. Assess the proper function of hearing aide daily
d. Ask the client for the list of all medication
including OTC drugs ,that she has taken in the 30. A nurse facilitates a group discussion where older
past month in order to determine a possible adults share memories from their youth. This
etiology for the dryness. therapeutic communication technique is known as:

25. An older adult patient states, 'I feel like a burden to a. Reminiscence therapy
my family.' Which therapeutic communication b. Reality orientation
technique is the nurse using by responding, 'It sounds c. Validation therapy
like you're feeling guilty about something? d. Cognitive behavioral therapy

a. Advising 31. An older female client reports that she has been
b. Probing using more salt in her foods than she used to. The
c. Giving false reassurance nurse understands that this is most likely because she
d. Reflecting
a. Need more sodium to ensure renal function
26. A patient has a living will that states they do not
want mechanical ventilation. The patient's family b. Is attempting to compensate for loss of fluids
insists that 'everything be done.' What is the nurse's c. Has a decreased number of taste buds
primary ethical and legal obligation? d. Is confused because of advanced age

a. Ask the physician to make the final decision.

b. Follow the family's wishes, as they are the next 32. A normal sign of aging in the renal system
of kin.
c. Honor the patient's wishes as stated in the a. A decreased glomerular filtration
living will. b. Microscopic hematuria
d. Call an ethics committee meeting before taking c. Concentrated urine rate
any action. d. Intermittent incontinence

27. An alert and oriented 84 yrs old client is receiving 33. The nurse is providing medication instruction to an
home care services following a CVA that has a left her older client who is taking digoxin daily. The nurse notes
with right sided hemiparesis. She lives with her middle- that which age related body changes could place the
aged daughter and son -in-law. The nurse suspects she client at risk for digoxin toxicity?
is being physically abused by her daughter. To elicit
information effectively, the nurse should do which of a. Decreased cough efficiency and decreased vital
the following? capacity.
b. Decreased salivation and decreased
a. Confront the daughter with suspicious Gastrointestinal motility.
b. Wait until enough trust has been developed to c. Decreased lean body mass and decreased
enable the client to approach the nurse first glomerular filtration rate.
c. Directly ask the client if she has been d. Decreased muscle strength and loss of bone
physically struck or hurt by anyone density
34. A nurse administers a high dose of morphine to a b. .Speak to them as if they are a child, using
terminally ill patient to manage severe pain, knowing a 'baby talk.'
potential side effect is respiratory depression which c. assume they don't understand you and only
could hasten death. This action is ethically justifiable communicate with their family.
under which principle? d. Complete their sentences for them to speed up
conversation.
a. The principle of beneficence
b. The principle of double effect 40. An older client has several
c. The principle of autonomy medications ordered and has
d. The principle of non-maleficence difficulty swallowing them. What
strategy should the nurse use to
35. When communicating with an older adult who has administer these medications?
presbycusis (age-related hearing loss), which nursing
action is most effective? a. Dissolve medication in liquid
b. Crush the medication and mix with soft foods
a. Shout loudly to ensure they hear you. c. Hide the medication by placing them in meat
b. Communicate only through written notes to d. Substitute injectable medications
avoid misinterpretation.
c. Speak rapidly to get all information across
quickly.
d. Speak slowly and clearly in a lower pitched
voice, facing the patient.

36. What is the primary distinction between palliative

care and hospice care?

a. Palliative care can be initiated at any stage of a

serious illness, while hospice care is for
patients with a life expectancy of six months or
less.
b. Hospice care focuses on curative treatments,
while palliative care does not.
c. Only patients who have a Do Not Resuscitate
(DNR) order can receive palliative care.
d. Palliative care is only provided in a hospital
setting.

37. What is a key nursing responsibility during

postmortem care?

a. Immediately notifying the organ donation

team.
b. Preparing the body with dignity and respect for
family viewing.
c. Determining the official time of death
d. Removing all tubes and lines before the family
arrives.

38. A nurse's role in supporting a grieving family

includes which of the following actions?

a. Encouraging the family to make decisions

about funeral arrangements immediately.
b. Providing a quiet, private space for the family
and offering to contact bereavement support
services.
c. Sharing personal stories of loss to show
empathy.
d. Telling the family 'They are in a better place
now.'

39. An older adult patient who had a stroke now has

expressive aphasia. Which strategy would best
facilitate communication?

a. Use simple, short sentences and allow ample

time for the patient to respond.
 of Daily Living (ADLs) and Instrumental Activities of
Daily Living (IADLs).

 True

10.This is the first stage of grief, characterized by

feelings of shock and disbelief that the death or loss
has occurred.
 Denial

11.Scenario: Mrs. Elena, a 92-year-old widow, has been

admitted to the long-term care facility. She has a
history of mild dementia and is mostly non-verbal. The
nurse observes that Mrs. Elena is frail and unsteady on
her feet, and she often seems agitated during meal
times. Her family has expressed concerns about her
risk for falls and her recent weight loss. The care team
wants to develop a person-centered care plan that
addresses her needs while promoting her dignity and
comfort.
Question: Based on the scenario, which of the following
GERIA RLE nursing interventions would be most appropriate for
Mrs. Elena's care plan? (Select all that apply)
1. The "double effect" principle in end-of-life care
allows for an intervention, such as pain medication,
even if it has an unintended negative side effect, as
long as the primary intent is to relieve suffering.  Assist ambulation with gait belt = safety.
 Assist with meals, soft/pureed foods = prevents
The "double effect" principle in end-of-life care… → weight loss.
True  e) Use calm non-verbal cues = effective
(It permits giving medication like opioids to relieve communication for dementia.
suffering, even if it may unintentionally shorten life,  f) Encourage independence in care = dignity.
provided the intent is comfort, not hastening death.)
12.A key component of the functional assessment of an
older adult is to evaluate their ability to perform:
2.This is a type of communication that focuses on
active listening and validating a person's feelings and
experiences a. Daily exercise routines.
b. Instrumental Activities of Daily Living
This is a type of communication that focuses on active (IADLs), such as shopping and managing
listening and validating a person's feelings and finances.
experiences → ✅ Therapeutic communication c. Complex problem-solving tasks.
d. Advanced computer skills.

4. This term refers to a patient's difficulty swallowing, 13.When assisting a patient with feeding, the nurse
which puts them at a high risk for aspiration. should create a pleasant and calm environment by:
 Dysphagia
a. Leaving the television on to provide distraction.
5. This is a legal document that allows a person to b. Rushing the patient to finish the meal quickly.
state their wishes for medical treatment in advance, in c. Sitting at eye level with the patient and
case they become unable to make their own decisions. engaging in conversation.
 Advance Directive d. Telling the patient they must eat everything on
the plate.
6. A patient in end-of-life care is experiencing
shortness of breath. The nurse should prioritize which 14.Scenario: Mr. Sanchez, a 75-year-old patient with a
intervention? recent stroke, has right-sided weakness and a history
 Elevating the head of the bed of heart disease. He is preparing for discharge to his
home, where he lives alone. The nurse is developing a
7. When feeding a patient with dysphagia, it is best to discharge plan and providing education to Mr. Sanchez
place them in a supine (flat) position to prevent to ensure a safe transition.
aspiration. Question: Which of the following topics are most critical
 False for the nurse to review with Mr. Sanchez and his family
to prevent a fall at home? (Select all that apply)
(Patients with dysphagia should be upright, usually in a
high Fowler’s position, to reduce aspiration risk.) a. The importance of taking a daily
multivitamin.
9. A key part of a geriatric nursing assessment is to b. Using a walker or cane for ambulation.
evaluate the patient's ability to perform both Activities
 c. The need for a home health physical therapist 21.The primary goal of end-of-life care is to cure the
to assess his ome environment. patient's disease.
d. The proper technique for performing a bed  False
bath.
e. The signs and symptoms of another 22.A patient is actively dying and the family is
stroke. concerned about their lack of appetite. The nurse
should explain that:
15.A nurse is providing morning care for an 85-year-old
patient with arthritis. The nurse should implement a. This is a normal part of the dying process.
which of the following interventions to promote comfort b. They need to force the patient to eat.
and independence? (Select all that apply) c. They should try to give the patient a large
meal.
a. Encourage the patient to dress d. The patient will get stronger if they eat.
themselves with minimal assistance.
b. Use warm water and gentle movements 23.Which of the following is a key sign that a patient
during bathing. with dementia may be finished eating?
c. Tell the patient to get ready quickly to avoid
being late for breakfast. a. The patient is eating slowly and deliberately.
d. Provide a non-slip mat in the shower or b. The patient is pushing the food away or
tub area. turning their head.
e. Use a long-handled brush to help the c. The patient is asking for a second serving.
patient wash their back. d. The patient is making direct eye contact with
the caregiver.
a) Encourage self-care = independence.
b) Warm water & gentle movement = comfort. 24.Therapeutic activities for older adults should be
d) Non-slip mat = safety. challenging and require the learning of completely new
e) Long-handled brush = independence. skills to keep their minds sharp.
(c is wrong — rushing decreases comfort and dignity.)  False

25.A 78-year-old patient with limited mobility needs

assistance with morning care. What should the nurse
16. The nurse is discussing an advance directive with prioritize?
an older adult. The most important thing to clarify is:
a. Providing a complete bed bath to ensure
a. The type of burial the patient wants. thorough cleaning.
b. The patient's wishes regarding medical
treatments. b. Encouraging the patient to participate in as
c. Who will inherit the patient's possessions. many tasks as possible.
d. The patient's favorite foods. c. Leaving the room after providing the
basin and soap to give the patient
17.When a patient with a hearing impairment does not privacy.
understand what you're saying, you should speak d. Washing the patient's hair first to refresh them.
louder and in a higher pitch.
 False (Instead, speak clearly, slowly, and in a (Promotes independence and dignity)
lower pitch if needed.)
26.Which of the following is a comfort measure that the
18.Which of the following is a normal part of the nurse can provide for a patient at the end of life with
grieving process for family members of a dying dry mouth?
patient?
a. Offering a large glass of water.
a. Immediate acceptance of the situation. b. Providing small sips of water or ice chips.
b. Anger directed at the healthcare staff. c. Brushing their teeth vigorously.
c. Complete emotional detachment from the d. Applying a petroleum jelly-based lip balm.
patient.
d. No tears or outward signs of sadness.
28.Scenario: Mrs. Lee, an 88-year-old patient, has been
(Anger is a common grief response.) declining rapidly and is now receiving hospice care.
She is semi-comatose and her breathing has become
19.In end-of-life care, a patient's lack of appetite is a shallow and irregular. Her family is at the bedside and
normal and expected part of the dying process. is visibly distressed by her changing condition.
 True Question: What are the most appropriate nursing
interventions for Mrs. Lee and her family at this time?
20.This is the stage of grief where a person may direct (Select all that apply)
feelings of frustration and anger toward the healthcare (3 Points)
team.
 Anger
a. Vigorously shake Mrs. Lee to see if she is still
responsive.
 b. Provide oral care with a moist sponge to keep  False (That indicates pathology, e.g.,
her mouth from becoming dry. dementia.)
c. Reassure the family that her irregular breathing
is a normal part of the dying process. 36.The nurse is conducting a comprehensive
d. Tell the family that they must leave the room assessment of an older adult. Which of the following is
so the nurse can work. considered a normal age-related change?
e. Offer to contact the hospice chaplain or a grief
counselor for the family. a. Sudden and severe memory loss.
b. Incontinence that has no identifiable cause.
29.True or False :A gait belt should be used on all c. Decreased hearing, especially of high-
patients to prevent falls, regardless of their mobility frequency sounds.
level. d. The inability to learn new information.
 False (Used only if needed — not all patients
require it.) 37.When assisting a patient who is unsteady on their
feet to ambulate, the nurse should stand:
30.When providing therapeutic communication and
care to a patient at the end of life, which of the a. In front of the patient, pulling them forward.
following are appropriate nursing actions? (Select all b. Behind the patient, pushing them from the
that apply) back.
c. To the side and slightly behind the
a. Reassure the patient by saying, "Everything will patient, with one hand on the gait belt.
be okay." d. Far away from the patient to give them space.
b. Use active listening and provide a calm,
reassuring presence. 38.A gait belt is used during ambulation to:
c. Provide clear, honest information about
their condition and prognosis. a. Keep the patient's clothes from getting
d. Encourage the patient to verbalize their wrinkled.
fears and feelings. b. Provide a secure hold for the nurse to
e. Offer to contact spiritual or religious assist and support the patient.
support as per the patient's wishes. c. Prevent the patient from bending their knees
while walking.
31.Which of the following are appropriate nursing d. Measure the distance the patient walks.
interventions when assisting a patient with dysphagia
(difficulty swallowing)? (Select all that apply) 39.When providing a bed bath to an elderly patient,
should the nurse prioritize which of the following safety
a. Place the patient in a high-Fowler's measures?
position during meals.
b. Encourage the patient to take large gulps of a. Using extremely hot water to ensure
liquid to help food go down. sterilization.
c. Provide thickened liquids as prescribed. b. Leaving the side rails down to make it easier
d. Ensure the patient swallows each bite for the patient to get out of bed.
before offering the next. c. Covering the patient with a blanket to
e. Encourage conversation and laughter while maintain privacy and warmth.
the patient is eating. d. Massaging the patient's legs vigorously to
improve circulation.
32.True or False: When assisting with morning care for
an older adult, the primary goal is to complete all tasks
as quickly as possible. 40.The family of a dying patient is struggling with the
emotional process. The nurse's most appropriate action
 False (Goal = comfort, dignity, is to:
independence — not rushing.)
a. Tell them to be strong for the patient.
33. This is the term for a common age-related hearing b. Provide them with information about
loss, particularly for high-frequency sounds. spiritual counseling and social services.
c. Minimize their feelings by saying, "He's in a
 Presbycusis better place."
d. Ask them to leave the room to give the patient
34.The most important role of the nurse in end-of-life privacy.
care is to be an advocate for the patient's:
41.When assessing an older adult for pain, the nurse
a. Medical history. should understand that older adults may:
b. Wishes and comfort.
c. Financial situation. a. Always report pain verbally and clearly.
d. Previous work experience. b. Have a higher pain tolerance and report pain
less frequently.
35.It is normal for an older adult to experience sudden, c. Express pain through non-verbal cues like
severe memory loss as they age. grimacing or guarding.
d. Not feel pain at all due to nerve degeneration.
The nurse is conducting a functional assessment on an
older adult. The nurse should ask about the patient's
ability to perform which of the following? (Select all
that apply)

a. Reading and writing complex documents.

b. Bathing and dressing independently.
c. Driving a car or using public transportation.
d. Managing their own medications.
e. Preparing their own meals.

For a functional assessment in an older adult, the nurse

focuses on ADLs (activities of daily living) and IADLs
(instrumental activities of daily living).

➡️Correct answers: b), c), d), e)

b) Bathing and dressing independently = ADL.

c) Driving a car or using public transportation = IADL.

d) Managing their own medications = IADL.

e) Preparing their own meals = IADL.

(a is not part of functional assessment — it’s more
cognitive/educational.)