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Gerontological Nursing Certification (GERO-BC) practice questions

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Question 1Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

In gerontological literature, the term "young-old" generally refers to which age range?

  1. 75 to 84 years
  2. 65 to 74 years Correct answer.
  3. 95 years and older
  4. 85 to 94 years

Explanation

Gerontology commonly divides the older population into young-old (65–74), middle-old (75–84), and oldest-old (85 and older). These cohorts differ substantially in health status, functional ability, and social roles, which is why the distinction matters for planning care.

Question 2Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which theory of aging proposes that successful aging involves mutual withdrawal between the individual and society?

  1. Activity theory
  2. Continuity theory
  3. Disengagement theory Correct answer.
  4. Life course perspective

Explanation

Disengagement theory, developed by Cumming and Henry, holds that aging involves a mutually satisfying withdrawal between the older person and society. Activity and continuity theories instead emphasize maintaining engagement and a stable sense of self.

Question 3Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A cognitively intact 82-year-old declines a recommended dialysis treatment after a full discussion of the risks. Which ethical principle most directly supports honoring this refusal?

  1. Veracity
  2. Beneficence
  3. Autonomy Correct answer.
  4. Nonmaleficence

Explanation

Autonomy is the right of a person with decisional capacity to determine what happens to his or her own body, even when the choice seems unwise to clinicians. The clinician's duty to recommend beneficial treatment does not override a capable patient's informed refusal.

Question 4Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which document allows a person to name someone who will make health care decisions if that person later loses decisional capacity?

  1. A POLST form
  2. A health care proxy form Correct answer.
  3. A living will
  4. A do-not-resuscitate order

Explanation

A durable power of attorney for health care, also called a health care proxy, names a surrogate decision maker and becomes active when the patient loses capacity. A living will records treatment preferences but does not appoint anyone to speak for the patient.

Question 5Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

The federal Nursing Home Reform Act (OBRA 1987) is best known for establishing which requirement for Medicaid-certified nursing homes?

  1. Mandatory private rooms for every resident
  2. A residents' bill of rights and individualized care planning Correct answer.
  3. A minimum ratio of one registered nurse per resident on every shift
  4. Free physical therapy for all residents regardless of need

Explanation

OBRA 1987 set federal standards for Medicare- and Medicaid-certified nursing homes, including a residents' bill of rights, comprehensive assessment with the Minimum Data Set, and individualized care planning. It shifted regulation toward resident-centered quality of care and reduction of unnecessary restraints.

Question 6Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which theory of aging attributes cellular aging to cumulative damage from reactive oxygen species?

  1. Neuroendocrine theory
  2. Programmed cell death theory
  3. Wear-and-tear theory
  4. Free radical theory Correct answer.

Explanation

The free radical theory holds that reactive oxygen species damage DNA, proteins, and lipids over time, and that declining antioxidant defenses contribute to age-related decline. It is one of the stochastic, damage-based explanations of aging.

Question 7Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Providing prompt analgesia to a dying patient who reports pain best illustrates which ethical principle?

  1. Autonomy
  2. Fidelity
  3. Beneficence Correct answer.
  4. Justice

Explanation

Beneficence is the obligation to act in ways that promote the patient's good, such as relieving suffering and restoring comfort. It is the principle underlying most active clinical interventions.

Question 8Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which segment of the U.S. population is growing most rapidly?

  1. Adults 25 to 44 years
  2. Adults 65 to 74 years
  3. Children younger than 5 years
  4. Adults 85 and older Correct answer.

Explanation

Adults aged 85 and older are the fastest-growing age segment in the United States as life expectancy at older ages rises. This group carries the highest rates of frailty, disability, and long-term care use, which drives demand for gerontological services.

Question 9Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A 78-year-old who has always been socially active continues volunteering and attending church after retirement. Which theory best explains this pattern?

  1. Subculture theory
  2. Disengagement theory
  3. Socioemotional selectivity theory
  4. Continuity theory Correct answer.

Explanation

Continuity theory proposes that older adults maintain the personality, values, and activity patterns established earlier in life. The patient's lifelong engagement simply continues into later life, which is the pattern the theory predicts.

Question 10Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which element is essential for a patient's informed consent to be ethically valid?

  1. A consent form is signed by the patient's adult child
  2. Two registered nurses witness the patient's signature
  3. The patient understands the information and chooses voluntarily Correct answer.
  4. The ethics committee formally reviews and approves the planned intervention

Explanation

Valid informed consent requires decisional capacity, adequate disclosure, comprehension of the information, and voluntariness. A signature is only documentation; the ethical substance is the patient's understanding and free choice.

Question 11Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A home health nurse notices unexplained bruising on an older adult and suspects caregiver abuse. What is the most appropriate initial action?

  1. Confront the caregiver and ask for an explanation
  2. Wait until the patient confirms the abuse before taking action
  3. Report the suspicion to adult protective services Correct answer.
  4. Document the finding and continue to monitor the bruising at each subsequent visit

Explanation

Nurses are mandated reporters in nearly every state, and reasonable suspicion, not proof, triggers the duty to report to adult protective services. Investigation and confirmation are the agency's responsibility, and confrontation may place the patient at greater risk.

Question 12Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

The Patient Self-Determination Act (1990) requires hospitals and nursing homes participating in Medicare and Medicaid to take which action?

  1. Provide free legal advice to patients about estate planning
  2. Restrict visitors during end-of-life care to reduce stimulation
  3. Honor family requests for treatment even without documentation
  4. Inform patients of their right to complete advance directives Correct answer.

Explanation

The law requires participating facilities to inform patients of their rights to accept or refuse treatment and to complete advance directives, and to document this in the medical record. It does not require the facility to provide legal services or to honor undocumented family requests.

Question 13Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Under traditional Medicare Part A, coverage of skilled nursing facility care generally requires which preceding circumstance?

  1. A prior nursing home admission within the preceding 12 months
  2. A hospital stay of at least 3 consecutive inpatient days Correct answer.
  3. Certification by a home health agency
  4. An emergency department visit within 30 days

Explanation

Medicare Part A covers post-acute skilled nursing facility care after a qualifying hospital stay of at least 3 consecutive inpatient days, with a physician order and a documented need for skilled services. The benefit is limited to up to 100 days per benefit period and requires ongoing skilled need.

Question 14Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A public health plan allocates a limited supply of influenza vaccine first to residents of long-term care facilities. Which ethical principle best justifies this allocation?

  1. Justice Correct answer.
  2. Veracity
  3. Autonomy
  4. Paternalism

Explanation

Distributive justice concerns the fair allocation of scarce resources and supports prioritizing groups at highest risk of severe outcomes. The justification rests on need and expected benefit across the population, not on the clinician's authority.

Question 15Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which age-related immune change contributes to increased infection risk in older adults?

  1. Expanded bone marrow reserve with faster neutrophil production and increased vaccine response
  2. Enhanced mucosal antibody responses
  3. Impaired cell-mediated immunity with declining T-cell function Correct answer.
  4. Increased thymic production of naive T cells

Explanation

Immunosenescence includes thymic involution, reduced production of naive T cells, and impaired cell-mediated immunity. These changes raise susceptibility to infection, blunt vaccine responses, and can mask classic signs of infection such as fever.

Question 16Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which situation is best classified as self-neglect rather than caregiver abuse?

  1. An older adult living alone cannot maintain hygiene or nutrition Correct answer.
  2. A nurse aide rough-handles a resident during transfers
  3. A son diverts his mother's pension funds for his own personal expenses
  4. A daughter repeatedly yells at her father and threatens him

Explanation

Self-neglect is the inability or failure of an older adult to meet basic needs such as hygiene, nutrition, and safety, in the absence of a caregiver causing the harm. The other scenarios involve a caregiver's financial exploitation, physical abuse, or emotional abuse.

Question 17Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which statement about the older adult population in the United States is accurate?

  1. Older women are more likely than older men to be widowed Correct answer.
  2. The majority of adults over 65 reside in long-term care facilities
  3. Men older than 65 outnumber women of the same age
  4. Most adults over 65 live below the federal poverty line

Explanation

Because women have longer life expectancy and typically marry men somewhat older, older women are far more likely to be widowed and to live alone. The large majority of older adults live in the community rather than in institutions, and most are above the poverty line.

Question 18Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which federal law prohibits employment discrimination against workers aged 40 and older?

  1. Family and Medical Leave Act
  2. Title VII of the Civil Rights Act of 1964
  3. Age Discrimination in Employment Act Correct answer.
  4. Fair Labor Standards Act

Explanation

The Age Discrimination in Employment Act protects workers 40 and older from discrimination in hiring, promotion, pay, and termination. Title VII addresses race, color, religion, sex, and national origin rather than age.

Question 19Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which concept describes the cumulative physiologic wear resulting from repeated adaptation to stress across the lifespan?

  1. Allostatic load Correct answer.
  2. Compression of morbidity
  3. Homeostenosis
  4. Frailty phenotype

Explanation

Allostatic load is the cumulative burden of chronic activation of stress-response systems, reflected in neuroendocrine, immune, and metabolic measures. High allostatic load is associated with frailty, cognitive decline, and increased mortality.

Question 20Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A nurse tells an older adult that a procedure "will not hurt at all" when discomfort is likely. Which ethical principle is being violated?

  1. Beneficence
  2. Autonomy
  3. Veracity Correct answer.
  4. Justice

Explanation

Veracity is the duty to be truthful with patients. Understating a predictable sensation misleads the patient and undermines the trust required for informed participation in care.

Question 21Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

The hypothesis of compression of morbidity proposes which idea?

  1. Morbidity is largely unrelated to individual health behaviors
  2. Average life expectancy cannot exceed 85 years under any circumstances
  3. Chronic illness inevitably expands to fill any gains in life expectancy
  4. Late-life disability can be compressed by delaying disease onset Correct answer.

Explanation

Compression of morbidity, proposed by Fries, holds that if the onset of chronic disease is postponed more than life expectancy is extended, the period of disability before death shrinks. Prevention and healthy behaviors are central to the hypothesis.

Question 22Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

An older adult has never had decisional capacity and left no advance directive. Which standard should guide the surrogate's decisions?

  1. Substituted judgment standard
  2. Best interests standard Correct answer.
  3. Reasonable person standard
  4. Therapeutic privilege

Explanation

Substituted judgment requires evidence of what the patient would have wanted, so it cannot be applied when the patient never had capacity. In that situation, the best interests standard weighs the benefits and burdens of options for this particular patient.

Question 23Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which category of aging theory treats aging as the result of random, cumulative molecular damage rather than a genetically timed program?

  1. Stochastic theory Correct answer.
  2. Programmed longevity theory
  3. Neuroendocrine theory
  4. Immunologic theory

Explanation

Stochastic theories describe aging as arising from random damage such as somatic mutations, free radical injury, cross-linking, and error catastrophe. Programmed theories instead view aging as genetically regulated and timed.

Question 24Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

An older adult with advanced dementia has no advance directive and no willing family members. Which arrangement best authorizes decisions about both health care and finances?

  1. A living will completed at the time of admission
  2. Court-appointed guardianship Correct answer.
  3. A POLST form signed by the physician
  4. A durable power of attorney executed now by the patient

Explanation

When a patient lacks capacity and has no advance directive or available surrogate, a court appoints a guardian whose authority is defined by the court and may include health care and financial decisions. Executing a power of attorney requires capacity the patient no longer has.

Question 25Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

To qualify for the Medicare hospice benefit, a patient must meet which requirement?

  1. A failed trial of curative treatment lasting at least 6 months
  2. A prognosis of 6 months or less if the disease follows its usual course Correct answer.
  3. A prognosis of 12 months or less documented by a nurse practitioner
  4. A signed living will and a do-not-resuscitate order

Explanation

The Medicare hospice benefit requires physician certification that the terminal illness carries a prognosis of 6 months or less if it runs its usual course. The benefit is palliative in focus, and patients may revoke it or recertify if eligibility criteria continue to be met.

Question 26Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which theory of aging proposes that older adults and society gradually withdraw from one another as a natural and mutually satisfying process?

  1. Exchange
  2. Activity
  3. Disengagement Correct answer.
  4. Continuity

Explanation

Disengagement theory, developed by Cumming and Henry, views aging as a mutual withdrawal between the older adult and society that is normal and satisfying for both. Activity theory instead emphasizes continued engagement, continuity theory emphasizes maintained roles and identity, and exchange theory focuses on social exchange of resources.

Question 27Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which demographic measure compares the number of adults aged 65 and older with the number of working-age adults?

  1. Median age
  2. Life expectancy at birth in years
  3. Sex ratio
  4. Old-age dependency ratio Correct answer.

Explanation

The old-age dependency ratio compares the population aged 65 and older with the working-age population, usually ages 15 to 64. It is used to estimate the support burden on working-age adults.

Question 28Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A cognitively intact 80-year-old declines a recommended cardiac procedure. Her son insists she proceed, and the nurse arranges the procedure over her objection “for her own good.” Which ethical concept does this best illustrate?

  1. Fidelity
  2. Distributive justice
  3. Veracity
  4. Paternalism Correct answer.

Explanation

Paternalism occurs when a clinician overrides or disregards an informed patient's autonomous choice because the clinician believes it is in the patient's best interest. A cognitively intact adult retains the right to refuse treatment, even when family disagrees.

Question 29Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

Which requirement for Medicare-certified nursing homes was established by the Omnibus Budget Reconciliation Act (OBRA) of 1987?

  1. Hospice enrollment for every resident
  2. Federal licensure of nursing assistants
  3. A fixed national staffing ratio
  4. Resident assessment and care planning Correct answer.

Explanation

OBRA 1987 established nursing home reform standards, including residents' rights, a standardized comprehensive assessment, and individualized care planning. It did not create federal licensure for nursing assistants, national staffing ratios, or automatic hospice enrollment.

Question 30Foundations of Gerontological Nursing Practice (aging theories, demographics, ethics, legal and regulatory issues)

A demographer observes that a country's survival curve has become more rectangular. Which interpretation is most accurate?

  1. Infant mortality rose sharply.
  2. Life expectancy at birth has fallen substantially.
  3. Deaths cluster near the maximum lifespan. Correct answer.
  4. The population has stopped aging.

Explanation

Rectangularization of mortality describes a survival curve that becomes more square: most people survive to older ages and deaths cluster near the maximum lifespan. This reflects reduced premature mortality and compression of deaths into a narrower age range.

Question 31Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which task is classified as an instrumental activity of daily living (IADL)?

  1. Managing finances Correct answer.
  2. Bathing independently
  3. Transferring from bed to chair
  4. Toileting without help

Explanation

IADLs are higher-order tasks that require cognitive and social competence, such as money management, shopping, cooking, telephone use, and transportation. Basic ADLs are the self-care tasks of bathing, dressing, toileting, transferring, continence, and feeding.

Question 32Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The Mini-Cog consists of which two components?

  1. A 30-point cognitive scale plus a caregiver questionnaire
  2. Recall of three words plus a clock-drawing test Correct answer.
  3. Two separate administrations of the full MMSE
  4. Verbal fluency testing combined with trail-making part B

Explanation

The Mini-Cog pairs a three-item word recall with a clock-drawing task and takes about three minutes to administer. It is used as a brief dementia screen and performs reasonably well across educational levels.

Question 33Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The Confusion Assessment Method (CAM) is designed to:

  1. Identify delirium using four core features Correct answer.
  2. Stage the severity of Alzheimer disease
  3. Quantify caregiver distress over time
  4. Screen specifically for late-life depression

Explanation

The CAM identifies delirium through acute onset with fluctuating course, inattention, disorganized thinking, and altered level of consciousness. It is a detection tool rather than a dementia staging or mood instrument.

Question 34Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which Geriatric Depression Scale–15 result is typically treated as suggestive of depression?

  1. A score of 1 or higher indicates mild depression
  2. A score of 5 or higher suggests depression Correct answer.
  3. The GDS-15 measures cognition rather than mood
  4. Only scores above 13 are considered abnormal

Explanation

On the 15-item GDS, scores of 5 or more generally warrant further evaluation for depression, with higher cutoffs sometimes used in research settings. The instrument is a mood screen and does not assess cognition.

Question 35Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The Katz Index is used to assess which domain?

  1. Instrumental tasks such as shopping and cooking
  2. Cognitive status and short-term memory
  3. Basic self-care such as bathing and dressing Correct answer.
  4. Home safety hazards and fall risks

Explanation

The Katz Index of Independence in Activities of Daily Living rates six basic self-care functions: bathing, dressing, toileting, transferring, continence, and feeding. Instrumental tasks are covered by scales such as the Lawton IADL.

Question 36Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

A nurse performs the Timed Up and Go test on an older adult. Which statement about this test is accurate?

  1. It is scored on a 0-to-30-point ordinal scale
  2. It requires the patient to walk a distance of fifty feet
  3. It measures only lower-extremity muscle strength
  4. Twelve seconds or longer suggests increased fall risk Correct answer.

Explanation

The Timed Up and Go records the time to rise from a chair, walk 3 meters, turn, and return to sitting. A time of about 12 seconds or more is commonly used to flag increased fall risk.

Question 37Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The Beers criteria are used for which purpose?

  1. Setting maximum daily opioid doses for chronic pain
  2. Flagging potentially inappropriate medications in older adults Correct answer.
  3. Ranking medications by their relative cost for older adults
  4. Listing drugs that require renal dose adjustment before use

Explanation

The Beers criteria, maintained by the American Geriatrics Society, identify medications that are potentially inappropriate for older adults because of risks such as falls, confusion, and anticholinergic burden. They support medication review rather than setting dosing limits or costs.

Question 38Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which statement about temperature in older adults is accurate when assessing for infection?

  1. Aging raises the pain threshold but does not affect fever
  2. Older adults usually mount a higher fever than younger adults do
  3. Oral temperature is the most reliable fever indicator in old age
  4. Baseline temperature is often lower, so fever may be blunted Correct answer.

Explanation

Baseline body temperature tends to decline with age, and the febrile response is often attenuated, so serious infection may present without a classic high fever. Change from baseline and other signs such as confusion or functional decline are important clues.

Question 39Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The clock-drawing test is used primarily to assess which function?

  1. Verbal memory encoding and delayed recall
  2. Hearing acuity for conversational speech
  3. Fine motor speed of the dominant hand alone
  4. Executive function and visuospatial ability Correct answer.

Explanation

Clock drawing draws on planning, sequencing, abstraction, and visuospatial skills, making it a sensitive marker of executive dysfunction. It is not a memory or hearing test.

Question 40Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

How is the Lawton Instrumental Activities of Daily Living scale scored?

  1. A lower score indicates greater independence
  2. A higher score indicates greater independence Correct answer.
  3. Only the total number of deficits is reported
  4. Scores are expressed as a percentage of age norms

Explanation

Each Lawton item is scored so that the highest value reflects the most independent level of function, and the items are summed. A higher total therefore indicates greater independence in instrumental tasks.

Question 41Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

A 78-year-old with four years of formal schooling scores 22 on the MMSE. What is the best interpretation?

  1. The score confirms a diagnosis of Alzheimer disease
  2. The score is normal for any older adult
  3. The result should be discarded because the MMSE is invalid in old age
  4. The score may overstate impairment because of limited education Correct answer.

Explanation

MMSE performance is influenced by education, language, and culture, and a cutoff of 24 can misclassify people with limited schooling as impaired. Cognitive screening results require interpretation alongside educational and cultural background.

Question 42Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

A highly educated 74-year-old reports worsening memory but scores normally on the MMSE. Which tool is most appropriate for detecting mild cognitive impairment?

  1. MoCA Correct answer.
  2. GDS-15
  3. CAM
  4. Mini-Cog

Explanation

The Montreal Cognitive Assessment places greater demands on executive function and attention and is more sensitive than the MMSE to mild cognitive impairment, especially in highly educated adults. The MMSE may show a ceiling effect in this group.

Question 43Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which characteristic of the Geriatric Depression Scale makes it well suited to older adults?

  1. It omits somatic symptoms that may reflect medical illness Correct answer.
  2. It must be administered by a trained clinician
  3. It scores five somatic items heavily
  4. It measures cognition alongside mood

Explanation

The GDS uses a yes/no format and deliberately avoids somatic and neurovegetative items that could be caused by physical illness or medications. This reduces false positives in medically complex older adults.

Question 44Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

A hospitalized older adult receives a Braden Scale score of 12. What does this score indicate?

  1. Low risk, so routine skin care is sufficient
  2. High risk for pressure injury requiring preventive measures Correct answer.
  3. A normal nutritional status
  4. High risk for falls requiring bed alarms

Explanation

The Braden Scale sums six subscales covering sensory perception, moisture, activity, mobility, nutrition, and friction/shear; lower totals indicate higher risk. A score of 12 falls in the high-risk range, prompting repositioning, support surfaces, and skin inspection.

Question 45Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which questions reflect the CDC STEADI fall-risk screen for community-dwelling older adults?

  1. Falls in the past year, weight loss, and episodes of dizziness
  2. Fear of falling, incontinence, and uncorrected vision loss
  3. Number of falls, medication count, and measured gait speed
  4. Falls in the past year, unsteadiness, and worry about falling Correct answer.

Explanation

The STEADI three key questions ask about falls in the past year, feeling unsteady when standing or walking, and worrying about falling. A positive response triggers gait, strength, and balance testing.

Question 46Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The PAINAD scale is appropriate for which situation?

  1. Distinguishing nociceptive from neuropathic pain
  2. Measuring caregiver anxiety about a patient's pain
  3. Observational pain assessment in advanced dementia Correct answer.
  4. A patient who reliably self-reports pain intensity

Explanation

The PAINAD relies on observed behaviors such as breathing, negative vocalization, facial expression, body language, and consolability. It is intended for people with advanced dementia who cannot reliably report pain.

Question 47Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Comprehensive geriatric assessment (CGA) is best described as:

  1. A single cognitive screening test given at hospital admission
  2. A multidimensional, interdisciplinary evaluation leading to a care plan Correct answer.
  3. A standardized calculator that estimates fall risk
  4. A pharmacy review focused only on drug interactions

Explanation

CGA evaluates medical, functional, cognitive, psychological, social, and environmental domains and produces an integrated, team-based management plan. Evidence supports CGA in improving outcomes for frail older adults.

Question 48Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The SARC-F questionnaire is a screening tool for which condition?

  1. Sarcopenia Correct answer.
  2. Delirium
  3. Urinary incontinence
  4. Malnutrition

Explanation

SARC-F asks about strength, assistance with walking, rising from a chair, climbing stairs, and falls, and is used to screen for sarcopenia. Positive screens are followed by measures such as grip strength or muscle mass.

Question 49Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

Which home modification most directly reduces fall risk during bathing for an older adult with balance impairment?

  1. Placing a loose bath mat beside the tub
  2. Raising the water heater temperature setting
  3. Using a night-light only in the hallway
  4. Installing grab bars and a shower chair Correct answer.

Explanation

Grab bars and a shower chair address the slippery surface and the need to stand or transfer in the tub, which are the main hazards of bathing. Effective home safety recommendations target the specific task and deficit identified.

Question 50Gerontological Assessment (physical, functional, cognitive, psychosocial, and environmental assessment of the older adult)

The Zarit Burden Interview is used to measure which construct?

  1. The strain experienced by a family caregiver Correct answer.
  2. The older adult's functional independence
  3. The safety of the home environment
  4. The dementia stage of the care recipient

Explanation

The Zarit Burden Interview quantifies the perceived physical, emotional, and financial strain of caregiving. High burden scores signal the need for respite, support services, and care planning.