An 84-year-old woman with type 2 diabetes comes to the clinic reporting two hours of sudden fatigue, nausea, and shortness of breath. She denies chest pain. Vital signs are stable. What should the nurse do FIRST?

Obtain a 12-lead electrocardiogram

Give an antiemetic and reassess in one hour

Collect a urine specimen to rule out infection

Complete a full functional status assessment

A 77-year-old man recalls two of three words on the Mini-Cog. His clock drawing has all numbers present, but the hands point to the wrong time. How should the nurse interpret the result?

A score of 2, a positive screen needing further evaluation

A score of 4, a negative screen

A score of 2, a negative screen because recall was 2 or more

A score of 3, a borderline result to repeat next year

A patient with stage 4 chronic kidney disease has a serum potassium of 6.6 mEq/L and peaked T waves on the cardiac monitor. Which prescribed treatment should the nurse give FIRST?

Regular insulin IV with dextrose

Sodium zirconium cyclosilicate orally

An 81-year-old is admitted for elective colon surgery and has several risk factors for delirium. Which intervention is MOST effective for preventing delirium?

Use glasses and hearing aids and mobilize early

Give low-dose haloperidol at bedtime as prophylaxis

Keep the room lights on at night for safety checks

Limit family visits so the patient can rest

An 83-year-old with Original Medicare had a 5-day inpatient stay for a hip fracture and is being discharged to a skilled nursing facility for rehabilitation. Her daughter asks how long Medicare will pay for the stay. Which explanation by the case manager is accurate?

Days 1 to 20 are fully covered, and later days carry daily coinsurance

Medicare pays the full cost for up to 100 days with no coinsurance

Medicare pays for as long as she needs help with bathing and dressing

Medicare Part B pays for the stay once her Part A hospital days end

A 79-year-old woman reports a 12-lb weight loss over four months, low mood, and loss of interest in activities. An ECG done today shows new atrial fibrillation. She denies heat intolerance or tremor. Which laboratory test is MOST important to evaluate her presentation?

Serum vitamin B12 and folate levels

Which tool is MOST appropriate for assessing pain in a nursing home resident with advanced dementia who cannot verbally report pain?

Pain Assessment in Advanced Dementia (PAINAD)

Wong-Baker FACES Pain Rating Scale

A 78-year-old on hemodialysis has an arteriovenous fistula in the left forearm. Which finding requires the nurse to notify the provider immediately?

No palpable thrill or audible bruit over the fistula

A palpable thrill along the fistula

A continuous bruit over the anastomosis

Mild bruising and tenderness at the last cannulation site

A resident with moderate dementia hits staff during the scheduled morning shower. Which intervention is MOST appropriate?

Offer a towel bath at her preferred time and explain each step

Have two staff members complete the shower more quickly

Give as-needed lorazepam 30 minutes before each shower

Skip bathing until she agrees to a shower verbally

A 79-year-old with capacity insists on going home alone after a hospitalization for a fall. The team is concerned about her safety. Which action by the case manager BEST balances autonomy and safety?

Plan home services with her and document her informed choice

Arrange a nursing home transfer for her own protection

Delay discharge until she agrees to have a relative stay with her

Ask her son to make the discharge decision for her

Gerontological Nursing Certification Exam (GERO-BC)

Free Gerontological Nursing Practice Questions

10 sample questions for the Gerontological Nursing Certification Exam (GERO-BC), with the correct answer and an explanation for each. No account needed. Try each one before you open the answer.

Sections covered on the exam: Assessment and Diagnosis, Planning, Implementation, and Evaluation, Professional Foundation.

Question 1 · Assessment and Diagnosis
An 84-year-old woman with type 2 diabetes comes to the clinic reporting two hours of sudden fatigue, nausea, and shortness of breath. She denies chest pain. Vital signs are stable. What should the nurse do FIRST?
- A.Give an antiemetic and reassess in one hour
- B.Collect a urine specimen to rule out infection
- C.Complete a full functional status assessment
- D.Obtain a 12-lead electrocardiogram
Show answer and explanation
Answer: D. Obtain a 12-lead electrocardiogram
Older adults, especially those with diabetic autonomic neuropathy, often have myocardial infarction without chest pain; dyspnea, fatigue, and nausea are common anginal equivalents. Treating the nausea or looking for infection first could delay recognition of an acute coronary syndrome.
Question 2 · Assessment and Diagnosis
A 77-year-old man recalls two of three words on the Mini-Cog. His clock drawing has all numbers present, but the hands point to the wrong time. How should the nurse interpret the result?
- A.A score of 4, a negative screen
- B.A score of 2, a positive screen needing further evaluation
- C.A score of 2, a negative screen because recall was 2 or more
- D.A score of 3, a borderline result to repeat next year
Show answer and explanation
Answer: B. A score of 2, a positive screen needing further evaluation
Each recalled word earns 1 point (0 to 3), and the clock earns 2 points only if it is entirely correct, including the hands. His total is 2 of 5; a total below 3 is a positive screen that warrants further cognitive evaluation.
Question 3 · Planning, Implementation, and Evaluation
A patient with stage 4 chronic kidney disease has a serum potassium of 6.6 mEq/L and peaked T waves on the cardiac monitor. Which prescribed treatment should the nurse give FIRST?
- A.Furosemide IV
- B.Calcium gluconate IV
- C.Regular insulin IV with dextrose
- D.Sodium zirconium cyclosilicate orally
Show answer and explanation
Answer: B. Calcium gluconate IV
When hyperkalemia causes ECG changes, IV calcium is given first because it stabilizes the cardiac membrane within minutes. Insulin with dextrose shifts potassium into cells and binders or diuretics remove it, but none of these protects the heart as quickly.
Question 4 · Planning, Implementation, and Evaluation
An 81-year-old is admitted for elective colon surgery and has several risk factors for delirium. Which intervention is MOST effective for preventing delirium?
- A.Give low-dose haloperidol at bedtime as prophylaxis
- B.Keep the room lights on at night for safety checks
- C.Limit family visits so the patient can rest
- D.Use glasses and hearing aids and mobilize early
Show answer and explanation
Answer: D. Use glasses and hearing aids and mobilize early
Multicomponent nondrug bundles that include sensory aids, early mobility, orientation, hydration, and sleep promotion reduce delirium incidence. Antipsychotic prophylaxis is not recommended, and bright nighttime lighting or isolating the patient from family disrupts orientation and sleep.
Question 5 · Professional Foundation
An 83-year-old with Original Medicare had a 5-day inpatient stay for a hip fracture and is being discharged to a skilled nursing facility for rehabilitation. Her daughter asks how long Medicare will pay for the stay. Which explanation by the case manager is accurate?
- A.Medicare pays the full cost for up to 100 days with no coinsurance
- B.Medicare pays for as long as she needs help with bathing and dressing
- C.Days 1 to 20 are fully covered, and later days carry daily coinsurance
- D.Medicare Part B pays for the stay once her Part A hospital days end
Show answer and explanation
Answer: C. Days 1 to 20 are fully covered, and later days carry daily coinsurance
Part A covers up to 100 days of skilled nursing facility care per benefit period while the resident needs daily skilled care; the first 20 days have no coinsurance, and days 21 through 100 carry a daily coinsurance. Coverage ends when skilled needs end, because custodial help with bathing and dressing alone is not covered, and Part B does not pay for the facility stay.
Question 6 · Assessment and Diagnosis
A 79-year-old woman reports a 12-lb weight loss over four months, low mood, and loss of interest in activities. An ECG done today shows new atrial fibrillation. She denies heat intolerance or tremor. Which laboratory test is MOST important to evaluate her presentation?
- A.Hemoglobin A1c
- B.Thyroid-stimulating hormone
- C.Serum vitamin B12 and folate levels
- D.B-type natriuretic peptide
Show answer and explanation
Answer: B. Thyroid-stimulating hormone
Apathetic hyperthyroidism in older adults often presents with weight loss, depression, and atrial fibrillation rather than the classic hypermetabolic symptoms, so TSH is the key test. The other tests do not explain this combination of findings.
Question 7 · Assessment and Diagnosis
Which tool is MOST appropriate for assessing pain in a nursing home resident with advanced dementia who cannot verbally report pain?
- A.Pain Assessment in Advanced Dementia (PAINAD)
- B.Numeric Rating Scale (0 to 10)
- C.Wong-Baker FACES Pain Rating Scale
- D.Brief Pain Inventory
Show answer and explanation
Answer: A. Pain Assessment in Advanced Dementia (PAINAD)
PAINAD is an observational tool that scores breathing, negative vocalization, facial expression, body language, and consolability for people who cannot self-report. The numeric scale, FACES scale, and Brief Pain Inventory all require the person to rate their own pain.
Question 8 · Planning, Implementation, and Evaluation
A 78-year-old on hemodialysis has an arteriovenous fistula in the left forearm. Which finding requires the nurse to notify the provider immediately?
- A.No palpable thrill or audible bruit over the fistula
- B.A palpable thrill along the fistula
- C.A continuous bruit over the anastomosis
- D.Mild bruising and tenderness at the last cannulation site
Show answer and explanation
Answer: A. No palpable thrill or audible bruit over the fistula
A thrill and bruit confirm flow; their absence suggests thrombosis, which needs prompt intervention to save the access. Mild bruising after cannulation is expected.
Question 9 · Planning, Implementation, and Evaluation
A resident with moderate dementia hits staff during the scheduled morning shower. Which intervention is MOST appropriate?
- A.Have two staff members complete the shower more quickly
- B.Offer a towel bath at her preferred time and explain each step
- C.Give as-needed lorazepam 30 minutes before each shower
- D.Skip bathing until she agrees to a shower verbally
Show answer and explanation
Answer: B. Offer a towel bath at her preferred time and explain each step
Bathing-related aggression usually reflects fear, cold, or pain; a person-centered approach such as a towel bath at a preferred time reduces distress and aggression. Sedation and forcing the shower increase harm, and indefinite delay neglects hygiene.
Question 10 · Professional Foundation
A 79-year-old with capacity insists on going home alone after a hospitalization for a fall. The team is concerned about her safety. Which action by the case manager BEST balances autonomy and safety?
- A.Arrange a nursing home transfer for her own protection
- B.Plan home services with her and document her informed choice
- C.Delay discharge until she agrees to have a relative stay with her
- D.Ask her son to make the discharge decision for her
Show answer and explanation
Answer: B. Plan home services with her and document her informed choice
A person with capacity may choose a living situation that involves some risk; the case manager negotiates a plan that reduces risk, such as home health, a medical alert device, and meal delivery, and documents the discussion. Overriding her choice or deferring to her son violates her autonomy.

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