33+ PNLE Geriatric Nursing Nursing Questions Study Guide and Review Materials
Introduction
Let's face it, *Geriatrics* is where things get intricate. Seniors have unique care needs, and the PNLE tests your ability to navigate those nuanced scenarios. You can't just rely on rote memorization here. Geriatric questions often demand application, especially around medication safety, geriatric syndromes, and chronic disease management.
The geriatric section will challenge your ability to integrate your knowledge of pharmacology, pain management, and patient safety in a way that's clinically sound. It often trips people up because you're dealing with complex cases where everything is interconnected. Students sometimes overlook this because they think it's just about understanding the basics of aging.
Trust me, spending time here pays off in understanding how all nursing topics play nice together—or don’t.
Key concepts
What to expect on the PNLE
Expect around 2-4 questions on geriatrics. Most will be medium difficulty, testing your application of concepts rather than simple recall.
- Application questions that dive into scenarios involving fall prevention, med management, and chronic illness.
- Pain and mental status assessments in elderly patients keep popping up.
- A killer question? Prioritize a set of interventions for a patient with multiple geriatric syndromes. The trick is often in choosing the first action you would take rather than the complete care plan.
- Trap answers mix up ‘frequent’ interventions with ‘priority’ ones. Remember, what's often done isn’t always what’s best to do first in emergencies.
Study tips
- Draw the Syndromes: Sketch out key geriatric syndromes and their symptoms. Seeing it on paper helps map it in your mind for quick recall.
- Watch Real Demos: Find videos showing a functional assessment or mental status exam in elderly patients. Visual cues stick, especially for exam-style scenario questions.
- Bullet Point Med List: Make a list that matches common meds with side effects, especially those heightened in geriatrics. It's particularly useful for questions on med safety.
- Pain Mnemonics: Use mnemonic devices like OLD CARTS (Onset, Location, Duration, Characteristics, Aggravating factors, Relieving factors, Treatment, Severity). They simplify complex assessments.
- Go Interactive: Discuss geriatric case studies with a peer or explain them to someone not in the field. Teaching forces clarity in understanding.
Common mistakes to avoid
- Ignoring Subtle Symptoms: "You have an elderly patient complaining of abdominal discomfort and mild confusion. You go with constipation because it seems obvious, but it’s actually the early signs of diverticulitis worsening. The PNLE wants you to dig deeper."
- Overprescribing Meds: "You see a question about managing hypertension in an elderly patient. You think ‘add more medication’ is the key, but where possible, non-pharmacologic interventions should be prioritized first. This catches many off guard."
- Miss Acute Changes: "An elderly patient is suddenly restless and agitated. You think it's dementia acting up again, but it's acute delirium. The PNLE checks if you caught the sudden onset."
- Assuming Normal Aging: "You read that an elderly patient is experiencing joint swelling. You decide it’s normal aging when, in fact, it’s osteoarthritis needing management. Normality and pathology blur in questions like this."
Try a question
A real Geriatric Nursing question from our bank. Give it a shot.
What is the definitive cure for cataract-related blindness?
Cataract-related blindness is caused by opacity of the eye’s natural crystalline lens, which blocks and scatters light before it reaches the retina. Because the problem is a structural change of the lens, the only definitive cure is to remove the cloudy lens and replace it with an intraocular lens, which is done through cataract extraction surgery (commonly phacoemulsification with IOL implantation). This restores the optical pathway and is the standard of care for visually significant cataracts.
In community health nursing, this is high yield because cataract is a major, treatable cause of visual impairment, especially among older adults. Nurses support prevention of complications and disability by screening for functional vision decline, facilitating referral for ophthalmologic evaluation, and teaching preoperative and postoperative care. A practical pearl is that cataracts cause painless, progressive blurred vision, glare, and reduced night vision. Any sudden painful red eye is not typical of cataract and warrants urgent evaluation for other causes.
| Option | Why it is correct or incorrect |
|---|---|
| A. Antibiotic eye therapy | Incorrect. Antibiotics treat bacterial infections such as conjunctivitis or keratitis. Cataract is not infectious, so antibiotics do not remove lens opacity or restore vision. Antibiotics may be used perioperatively in some protocols to reduce infection risk, but they are not curative for cataract blindness. |
| B. Topical anti-inflammatory eye drops | Incorrect. Anti-inflammatory drops reduce inflammation (for example, uveitis) and are commonly prescribed after cataract surgery to control postoperative inflammation. They cannot reverse lens protein denaturation and clouding, so they do not cure cataract-related blindness. |
| C. Lens extraction cataract surgery | Correct. Surgery directly addresses the pathophysiology by removing the opaque lens and typically implanting an intraocular lens, which restores focusing ability and visual acuity for most patients. Indications are based on functional impairment (difficulty reading, driving, ADLs), not just the presence of a cataract. |
| D. Corrective eyeglasses | Incorrect. Glasses may temporarily improve early refractive changes (frequent prescription changes) but cannot overcome significant lens opacity. Once the lens becomes sufficiently cloudy, no external lens can transmit clear images to the retina, so glasses are not definitive treatment. |
Nursing concepts and clinical reasoning
- Pathophysiology link: cataract equals lens opacity, so definitive treatment must be anatomic correction, not medication.
- Community health focus: promote early consult, reduce fall risk from low vision, and address barriers (cost, transport, fear of surgery).
- Postoperative teaching essentials: avoid increased intraocular pressure (no heavy lifting, bending at waist, straining), protect eye shield as ordered, report red flags such as severe pain, sudden vision loss, increasing redness, or flashes/floaters.
Skill tested: recognizing the definitive intervention by matching the treatment to the underlying cause and distinguishing supportive or adjunct therapies from curative management.
Cataract in the Adult Eye Preferred Practice Pattern®. American Academy of Ophthalmology Preferred Practice Pattern Cataract/Anterior Segment Panel (Miller KM, Oetting TA, Tweeten JP, et al.). 2022. Ophthalmology.
World report on vision. World Health Organization (WHO). 2019. WHO.
Eye care, vision impairment and blindness (WHO programme/technical information page; notes unoperated cataract as a main cause of vision impairment and highlights cataract surgery as a highly cost-effective intervention). World Health Organization (WHO). 2021 (updated). WHO.
Golozar A, Chen Y, Lindsley K, et al. Identification and Description of Reliable Evidence for 2016 American Academy of Ophthalmology Preferred Practice Pattern Guidelines for Cataract in the Adult Eye. 2018. JAMA Ophthalmology.
Interventions to improve access to cataract surgical services and their impact on equity in low- and middle-income countries. (Cochrane Eyes and Vision / systematic review; notes surgical removal of the opaque lens as the only treatment option and usual implantation of an intraocular lens). 2019. Cochrane Database of Systematic Reviews.
PhilHealth Circular 2025-0001 (Enhanced Benefits for Extracapsular Cataract Extraction with Insertion of Intraocular Lens [IOL]). Philippine Health Insurance Corporation (PhilHealth). 2025.
More Geriatric Nursing questions
65+ questions available. Sign up to practice all of them.
Which condition is the leading cause of bilateral blindness in the Philippines according to national surveys?
A nurse is caring for a 68-year-old patient with a 45-pack-year smoking history who reports chronic cough and exertional dyspnea. After receiving a short-acting bronchodilator, the patient’s spirometry improves slightly but the FEV1/FVC ratio remains below normal. Which statement best explains the airflow limitation the nurse should anticipate with COPD when planning ongoing care?
A nurse in a primary care clinic assesses a 78-year-old client whose blood pressure has gradually increased over the past year. Today the client’s BP is 168/72 mm Hg. The client denies pain and has no new medications. Which age-related physiological change is the most likely contributor to this pattern of elevated systolic blood pressure with a relatively normal diastolic pressure?
Practice questions
Q: An elderly patient is admitted with confusion and hallucinations after a medication change. What should be the nurse’s first step in managing this situation?
Answer: D. Immediate safety and environmental control are priorities before addressing medications. B is tempting but not immediate. View more questions
Q: A nurse is planning discharge for a geriatric patient with chronic osteoarthritis. Which of the following should be included in the care plan?
Answer: B. Regular activity supports function and decreases stiffness. A seems obvious but risks addiction. View more questions
Q: During rounds, you find an elderly patient with a sudden change in mental status. What is the best initial assessment?
Answer: B. Recent medication changes often precipitate confusion. A or C delves too deep initially. View more questions
Q: A senior patient complains of frequent urinary incontinence. What is the most appropriate intervention?
Answer: B. Scheduled voiding prevents accidents. A seems easier but isn’t proactive care. View more questions
Q: Your patient has had multiple falls this month. What should be your first step to prevent further falls?
Answer: B. A thorough assessment identifies specific risks. D addresses only a part of potential hazards. View more questions
References and further reading
- Geriatric Nursing Journal journal
A peer-reviewed journal providing comprehensive clinical information and management advice for the care of older adults, covering topics like acute and chronic disorder management, drug issues, and caregiver education. - Journal of Gerontological Nursing journal
A monthly, peer-reviewed journal publishing interdisciplinary and clinically relevant research and review articles on gerontological and age-friendly care, including sections on geropharmacology and public policy. - International Journal of Older People Nursing journal
A quarterly peer-reviewed journal focusing on advances in knowledge and practice in gerontological nursing, aiming to inform debates about health and social care for older people worldwide. - Research in Gerontological Nursing journal
A bimonthly peer-reviewed journal covering gerontological nursing, providing research articles that inform clinical practice and policy in the care of older adults. - Geriatric Nursing - MeSH - NCBI government
A Medical Subject Headings (MeSH) entry providing a definition and classification of geriatric nursing, useful for understanding the scope and standards of the field. - Long-Term Care Models in Geriatric Nursing: A Comparative Analysis and Recommendations for Optimal Care journal
A peer-reviewed article analyzing various long-term care models in geriatric nursing, offering recommendations for optimal care practices. - Geriatric Nursing - Academic Journal | Mosby journal
An academic journal published by Mosby, focusing on general science and providing access to peer-reviewed research articles and scholarly publications in geriatric nursing.