Free ANCC Gerontological Nursing board certification examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the ANCC Gerontological Nursing board certification examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1An older inpatient has a new pressure injury risk assessment using the Norton Scale. Which domain should the nurse score as part of that scale?

   1. A. Sensory perception
   2. B. Mental condition
   3. C. Friction and shear
   4. D. Nutritional intake

   Answer: B

   Explanation: The AHRQ description states, "The Norton Scale is made up of five subscales (physical condition, mental condition, activity, mobility, incontinence)". Mental condition is therefore a Norton domain; the other choices are Braden domains.

   Reference: 3. What are the best practices in pressure ulcer prevention that we want to use? — Section 3.3.4, Norton and Braden scales

2. 2A gerontological nurse reviews medicines prescribed in several care settings. In which care context does AGS expressly say its Beers Criteria do not apply?

   1. A. Hospice care
   2. B. Primary care
   3. C. Acute hospital care
   4. D. Long-term care

   Answer: A

   Explanation: AGS states, "The AGS Beers Criteria® don’t apply if an older adult is getting palliative care (pain and symptom relief) or hospice care (end-of-life)." Hospice is the excluded context among these care settings.

   Reference: Medications that Older Adults Should Avoid or use with Caution — How Health Professionals Are to Use this List

3. 3An older adult who has never received a pneumococcal conjugate vaccine receives PCV15 today. When the usual follow-up vaccine is available, which vaccine does CDC recommend next in the series?

   1. A. PCV13
   2. B. PCV20
   3. C. PCV21
   4. D. PPSV23

   Answer: D

   Explanation: CDC states, "If PCV15 is used, CDC recommends following it with a dose of PPSV23." The patient has just received PCV15, so PPSV23 is the usual next vaccine in the series.

   Reference: Recommended Vaccines for Adults — Adults who never received a PCV

4. 4Four older inpatients have Braden Scale scores of 7, 11, 16, and 22. Which patient has the greatest indicated pressure injury risk?

   1. A. The patient with a score of 16
   2. B. The patient with a score of 22
   3. C. The patient with a score of 7
   4. D. The patient with a score of 11

   Answer: C

   Explanation: AHRQ states, "A lower Braden Scale score indicates higher levels of risk for pressure ulcer development." Seven is the lowest of the four scores and therefore indicates the greatest risk.

   Reference: 3. What are the best practices in pressure ulcer prevention that we want to use? — Section 3.3.4, Braden Scale interpretation

5. 5An older adult has reduced kidney function, and the nurse uses the 2023 AGS Beers Criteria during medication review. Which category of recommendations directly addresses this situation?

   1. A. Medicines to avoid or dose-adjust in poor kidney function
   2. B. Medicine combinations with harmful drug-drug interactions
   3. C. Medicines to use cautiously across all older adults
   4. D. Medicines inappropriate with specific health conditions

   Answer: A

   Explanation: The AGS summary explicitly includes "Medications that should be avoided or have their dose changed in people with poor kidney function." The other choices describe different Beers categories.

   Reference: Medications that Older Adults Should Avoid or use with Caution — What the 2023 Updated AGS Beers Criteria Include

6. 6On a nursing home's QAPI team, a gerontological nurse tests a redesigned fall-risk handoff, measures results, and adjusts the process to prevent recurring omissions. Which QAPI function does this work exemplify?

   1. A. Quality assurance review
   2. B. Performance improvement work
   3. C. Governance and leadership work
   4. D. Feedback and monitoring work

   Answer: B

   Explanation: CMS defines PI as "the continuous study and improvement of processes" and specifies "testing new approaches to fix underlying causes of persistent/systemic problems or barriers to improvement." Testing and revising the handoff is PI.

   Reference: QAPI Description and Background — QAPI Description, PI paragraph

7. 7A nurse assesses pressure injury risk in an older patient with sepsis and poor peripheral perfusion. Which mechanism directly increases skin vulnerability in this condition?

   1. A. Reduced oxygen delivery caused by cigarette smoke
   2. B. Limited blood supply caused by peripheral vascular disease
   3. C. Inadequate skin perfusion caused by systemic hypoperfusion
   4. D. Prolonged pressure caused by restricted mobility

   Answer: C

   Explanation: AHRQ explains, "Patients who are not perfusing vital organs as a result of conditions such as sepsis, dehydration, or heart failure are also not adequately perfusing the skin." The patient's sepsis makes inadequate skin perfusion the pertinent mechanism.

   Reference: 3. What are the best practices in pressure ulcer prevention that we want to use? — Section 3.3.3, hypoperfusion states

8. 8An older adult is being considered for a short course of nitrofurantoin, and the gerontological nurse checks creatinine clearance. According to the 2023 AGS Beers Criteria, below what CrCl value should this medicine be avoided?

   1. A. 15 mL/min
   2. B. 30 mL/min
   3. C. 50 mL/min
   4. D. 60 mL/min

   Answer: B

   Explanation: The AGS Beers Criteria state, "Avoid in individuals with CrCl <30 mL/ min or for long-term suppression." Because this is a short course, the relevant renal boundary is a CrCl below 30 mL/min. The question asks for the cutoff, so a higher or lower number does not identify the Beers threshold.

   Reference: American Geriatrics Society 2023 Updated AGS Beers Criteria for Potentially Inappropriate Medication Use in Older Adults — Table 2, Anti-infective, Nitrofurantoin

9. 9An 80-year-old patient received one RSV vaccine dose last year and asks whether another dose is due before the coming RSV season. Which response follows current CDC guidance?

   1. A. Another RSV dose is due this season
   2. B. Another RSV dose is due after two seasons
   3. C. Another RSV dose is due after five seasons
   4. D. No additional RSV dose is currently recommended

   Answer: D

   Explanation: CDC states, "People who have already received one dose have completed their vaccination and should not receive another dose at this time." The patient's prior dose completes the current RSV recommendation.

   Reference: RSV Vaccine Guidance for Adults — What to know, dose schedule

10. 10An older patient has a healed stage III pressure injury. Which finding explains why the healed site remains vulnerable to new breakdown?

    1. A. Scar tissue lacks the former tensile strength of skin
    2. B. Peripheral arteries limit blood supply to the legs
    3. C. Sedation causes a rapid decline in patient mobility
    4. D. Smoking interferes with oxygen delivery to tissue

    Answer: A

    Explanation: AHRQ states, "When Stage III or IV ulcers close through a process of scar tissue formation and eventual epithelialization, the resulting skin is not normal as it lacks its former tensile strength and is very prone to break down again." This directly explains the healed site's vulnerability.

    Reference: 3. What are the best practices in pressure ulcer prevention that we want to use? — Section 3.3.3, prior Stage III or IV pressure ulcers