Gerontological Nursing for the NCLEX-RN Exam

Common failure modes

These are the patterns that cause most candidates to lose marks on this topic. Recognising them in advance is half the work.

• !Missing acute delirium (rapid onset, fluctuating course, attention deficit) and labeling it as worsening dementia
• !Administering Beers-Criteria meds (diphenhydramine, lorazepam, NSAIDs) to elderly patients without alternative consideration
• !Underestimating fall risk — Morse Fall Scale or Hendrich II should be reassessed every shift in inpatient settings
• !Not engaging family or surrogate in advance-care-planning discussions early in admission

Study tips

• 1Memorize the 3 D's of mental status: Delirium (acute, fluctuating, reversible), Dementia (chronic, progressive, irreversible), Depression (often co-existent, treatable).
• 2Know the most-tested Beers Criteria items: diphenhydramine (Benadryl), benzodiazepines, NSAIDs, anticholinergics, sliding-scale insulin without long-acting basal.
• 3Drill the fall-prevention bundle: bed in low position, call light in reach, non-skid socks, frequent rounding, toileting schedule, gait belt.
• 4Hospice vs. palliative: palliative care is appropriate at any disease stage; hospice requires prognosis of ≤6 months and the patient must agree to forgo curative treatment.

Sample NCLEX-RN Gerontological Nursing questions

These sample items mirror the format and difficulty of real NCLEX-RN questions. Practice with thousands more on the free Koydo question bank.

1. 1

   An 82-year-old client is admitted with pneumonia and develops new confusion, attention difficulty, and visual hallucinations 2 days later. The nurse recognizes this as:

   • AWorsening dementia
   • BAcute deliriumCorrect
   • CMajor depressive disorder
   • DNormal aging
   Why this answer?

   Acute onset of confusion, attention deficit, and hallucinations in an elderly hospitalized patient is delirium until proven otherwise. Common reversible causes include infection (often UTI or pneumonia), medication side effects, dehydration, and electrolyte imbalance. Treat the underlying cause.