100+ Free GERO-BC Practice Questions

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An 84-year-old woman in a nursing home has not bathed in several days and refuses when staff approaches. She has dementia and becomes agitated during bathing. Which approach reflects person-centered dementia care?

Document the refusal and forego bathing indefinitely

Obtain a physician's order to physically assist the patient with bathing over her objections

Use flexible scheduling, preferred water temperature, and a consistent calm caregiver; offer alternative bathing methods such as towel baths or bed baths

Increase her antipsychotic medication dose before bathing to reduce resistance

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2026 Statistics

Key Facts: GERO-BC Exam

150

Total Questions

125 scored

3.5 hrs

Exam Time

ANCC

~70%

Pass Rate

ANCC 2024

40%

Planning & Implementation

Largest domain

$295-$395

Exam Fee

ANCC 2026

5 years

Certification Valid

Recertification cycle

The GERO-BC exam has 150 questions (125 scored) over 3.5 hours with a scaled passing score of 350 out of 500. The three content domains are Planning/Implementation/Evaluation (40%), Professional Foundation (32%), and Assessment/Diagnosis (28%). Pass rate is approximately 70%. Eligibility requires active RN license, 2 years full-time practice, 2,000 hours in gerontological nursing in the last 3 years, and 30 CE hours in geriatric nursing.

Sample GERO-BC Practice Questions

Try these sample questions to test your GERO-BC exam readiness. Each question includes a detailed explanation. Start the interactive quiz above for the full 100+ question experience with AI tutoring.

1A nurse is assessing an 82-year-old patient who developed sudden confusion, disorientation, and inattention over the past 6 hours. The patient's mental status fluctuates throughout the day. Which assessment tool is MOST appropriate to confirm delirium?

A.Geriatric Depression Scale (GDS)

B.Confusion Assessment Method (CAM)

C.Mini-Cog

D.Montreal Cognitive Assessment (MoCA)

Explanation: The Confusion Assessment Method (CAM) is the gold-standard tool for diagnosing delirium. It requires the presence of acute onset with fluctuating course AND inattention, PLUS either disorganized thinking or altered level of consciousness. The GDS screens for depression, while Mini-Cog and MoCA assess for dementia rather than acute delirium.

2An 88-year-old woman with Alzheimer's disease is admitted to a long-term care facility. Her daughter reports that the patient has been refusing to eat and has lost 10 pounds in 2 months. Which intervention is the HIGHEST priority?

A.Insert a nasogastric tube immediately for nutritional support

B.Order a high-protein oral supplement with each meal

C.Assess for reversible causes of weight loss including depression, pain, and dysphagia

D.Initiate total parenteral nutrition to restore nutritional status

Explanation: Before initiating any intervention for weight loss in a patient with dementia, the nurse must assess for reversible causes including depression (treatable), dental problems, dysphagia, medication side effects, pain, and constipation. Evidence shows that tube feeding does not improve outcomes in advanced dementia and may increase suffering. Assessment is always the first step.

3A gerontological nurse is reviewing medications for a 79-year-old man with chronic insomnia, hypertension, and osteoarthritis. Which medication listed on his current regimen should be flagged according to the Beers Criteria?

A.Lisinopril 10 mg daily

B.Diphenhydramine 50 mg at bedtime

C.Amlodipine 5 mg daily

D.Acetaminophen 500 mg every 6 hours as needed

Explanation: Diphenhydramine is an anticholinergic antihistamine listed on the Beers Criteria as potentially inappropriate for older adults. Anticholinergic effects in the elderly include confusion, dry mouth, urinary retention, constipation, blurred vision, and increased fall risk. Safer alternatives for insomnia include melatonin or low-dose doxepin. Lisinopril, amlodipine, and acetaminophen are generally acceptable in older adults.

4A 76-year-old patient scores 2 on the Braden Scale in the 'Moisture' category and 2 in the 'Activity' category. What is the clinical significance of these scores?

A.The patient is at low risk for pressure injury development

B.The patient has very moist skin and is chairfast, indicating high pressure injury risk

C.The patient requires repositioning every 4 hours

D.The scores indicate Stage 2 pressure injury is already present

Explanation: On the Braden Scale, lower scores indicate higher risk. A score of 2 in Moisture means skin is 'very moist' (dampened nearly constantly), and a score of 2 in Activity means the patient is 'chairfast' (walks very little or cannot bear weight, confined mainly to chair or bed). These scores contribute to a high overall pressure injury risk. Total Braden scores of 12 or below indicate high risk.

5A 72-year-old patient with moderate dementia is being evaluated for fall risk. His Morse Fall Scale score is 65. Which intervention is MOST appropriate at this score?

A.No additional fall precautions needed since this is below the high-risk threshold

B.Implement standard fall precautions including call light within reach

C.Implement high-risk fall precautions including bed alarm, non-slip footwear, frequent surveillance, and fall risk signage

D.Apply physical restraints to prevent ambulation without assistance

Explanation: A Morse Fall Scale score of 45 or above indicates high risk for falls. At a score of 65, this patient requires high-risk fall prevention interventions: bed alarm, non-slip footwear, fall risk identification bracelet or door sign, hourly rounding, bed in lowest position, and environment free of clutter. The nurse should also involve physical therapy for gait and strength evaluation.

6An older adult patient scores 18 on the Mini-Mental State Examination (MMSE). How should this score be interpreted?

A.Normal cognition — no further assessment needed

B.Mild cognitive impairment — education and monitoring recommended

C.Moderate cognitive impairment — requires assistance with complex daily activities

D.Severe cognitive impairment — patient likely cannot perform basic self-care

Explanation: MMSE scores range from 0 to 30. Scores of 24-30 are generally normal; 18-23 indicate mild cognitive impairment or early dementia; 10-17 indicate moderate dementia; and below 10 indicate severe dementia. A score of 18 falls at the boundary of mild-to-moderate impairment, suggesting the patient likely needs assistance with complex activities (IADLs) and some basic ADLs, and warrants further evaluation.

7The nurse is performing a Mini-Cog assessment on a 78-year-old patient. The patient recalls 1 out of 3 words and draws a normal clock. How should the nurse interpret this result?

A.Positive screen for cognitive impairment — further evaluation is warranted

B.Negative screen — no signs of cognitive impairment

C.Indeterminate — the Mini-Cog cannot be interpreted without MMSE results

D.Normal result — the clock drawing is the most important component

Explanation: Mini-Cog scoring: recall 0 words = positive (cognitive impairment); recall 1-2 words with abnormal clock = positive; recall 1-2 words with normal clock = positive; recall 3 words = negative regardless of clock. A patient recalling only 1 word scores positive even with a normal clock drawing, indicating a positive screen for possible dementia requiring further evaluation.

8A 75-year-old patient with chronic obstructive pulmonary disease (COPD) and type 2 diabetes is prescribed metformin. Which age-related pharmacokinetic change MOST increases this patient's risk for drug accumulation?

A.Decreased gastric acid production reducing drug absorption

B.Increased plasma albumin levels affecting protein binding

C.Decreased glomerular filtration rate reducing renal drug clearance

D.Increased hepatic blood flow enhancing first-pass metabolism

Explanation: Metformin is renally cleared. Age-related decline in glomerular filtration rate (GFR) — approximately 1 mL/min/year after age 40 — reduces renal clearance of metformin, risking accumulation and lactic acidosis. Metformin is contraindicated or dose-reduced when eGFR falls below 30-45 mL/min/1.73m². This is the most clinically significant pharmacokinetic change for renally cleared drugs in older adults.

9A nurse identifies a Stage 3 pressure injury on a 84-year-old patient's sacrum. Which finding is consistent with a Stage 3 classification according to NPIAP?

A.Non-blanchable erythema of intact skin

B.Partial-thickness skin loss with exposed dermis

C.Full-thickness skin loss with visible subcutaneous fat but no exposed fascia, tendon, or bone

D.Full-thickness skin and tissue loss with exposed bone, tendon, or muscle

Explanation: NPIAP Stage 3 pressure injuries involve full-thickness skin loss through the dermis into subcutaneous tissue. Subcutaneous fat may be visible, but fascia, tendon, ligament, cartilage, or bone is NOT exposed. Undermining and tunneling may occur. Stage 1 = non-blanchable erythema; Stage 2 = partial-thickness with exposed dermis; Stage 4 = exposed bone/tendon/muscle.

10A nurse suspects elder financial abuse in an 80-year-old patient living with her adult son. Which finding is MOST indicative of financial exploitation?

A.Patient reports feeling sad and isolated since her husband died

B.Patient cannot recall her own bank account number

C.Patient's son accompanies her to all appointments and answers questions on her behalf

D.Patient has unpaid utility bills despite having adequate retirement income and a caregiver who manages her finances

Explanation: Unpaid bills or financial obligations despite adequate income — especially when a caregiver controls finances — is a classic sign of financial exploitation. Other red flags include sudden changes in financial documents, unexplained withdrawals, caregiver refusing to allow the patient financial control, and the patient appearing fearful about money. The nurse has a mandatory reporting obligation.

About the GERO-BC Exam

The GERO-BC certification validates registered nurses' entry-level clinical knowledge and skills in gerontological nursing. The exam contains 150 questions (125 scored, 25 unscored pretest) over 3.5 hours. Content spans three domains: Planning, Implementation, and Evaluation (40%), Professional Foundation (32%), and Assessment and Diagnosis (28%). Key clinical areas include polypharmacy and Beers Criteria, delirium vs. dementia screening (CAM, Mini-Cog), falls prevention, pressure injury management, elder abuse recognition, and advance care planning.

Questions

150 scored questions

Time Limit

3.5 hours

Passing Score

Scaled 350/500

Exam Fee

$295-$395 (American Nurses Credentialing Center (ANCC) / Prometric)

GERO-BC Exam Content Outline

28%

Assessment and Diagnosis

Comprehensive geriatric assessment using validated tools (CAM, Mini-Cog, MMSE, MoCA, GDS, Katz ADL, Lawton IADL, Braden Scale, Morse Fall Scale, Hendrich II), differential diagnosis of age-related conditions, system-specific assessment, and recognition of atypical presentations in older adults

40%

Planning, Implementation, and Evaluation

Care planning for complex older adults, polypharmacy management (Beers Criteria, START/STOPP), fall prevention programs (STEADI), pressure injury prevention and staging (NPIAP), pain management, chronic disease management, nutrition and hydration, delirium prevention and management, dementia care, mobility, continence, and outcome evaluation

32%

Professional Foundation

Ethical and legal principles in gerontological care, elder abuse and neglect identification and reporting, advance care planning and advance directives, end-of-life and palliative care, care coordination across settings, patient/family education, evidence-based practice, professional standards, HIPAA, advocacy, and quality improvement

How to Pass the GERO-BC Exam

What You Need to Know

Passing score: Scaled 350/500
Exam length: 150 questions
Time limit: 3.5 hours
Exam fee: $295-$395

Keys to Passing

Complete 500+ practice questions
Score 80%+ consistently before scheduling
Focus on highest-weighted sections
Use our AI tutor for tough concepts

GERO-BC Study Tips from Top Performers

1Memorize the Confusion Assessment Method (CAM) four diagnostic features for delirium

2Know the Beers Criteria drug categories — anticholinergics, benzodiazepines, NSAIDs, and sleep aids in older adults

3Distinguish delirium, dementia, and depression using clinical features and assessment tools

4Learn NPIAP pressure injury stages 1-4 plus unstageable and deep tissue pressure injury

5Study STEADI fall prevention components: screen, assess, intervene

6Know Katz ADL (6 basic activities) vs. Lawton IADL (8 instrumental activities) and their clinical applications

7Review Geriatric Depression Scale (GDS) 15-item and 30-item versions and scoring

8Understand START/STOPP criteria as evidence-based alternatives to Beers for medication review

9Study advance directives: living wills, healthcare proxies, POLST/MOLST forms

10Know elder abuse types (physical, emotional, financial, sexual, neglect, abandonment) and mandatory reporting requirements

Frequently Asked Questions

What is the GERO-BC exam?

The GERO-BC (Gerontological Nurse – Board Certified) is a specialty certification offered by the American Nurses Credentialing Center (ANCC). It validates entry-level clinical knowledge and skills of registered nurses in gerontological specialty practice, covering assessment, care planning, and professional foundations for caring for older adults.

What are the GERO-BC eligibility requirements?

To sit for the GERO-BC exam you must have: (1) current active RN license, (2) minimum 2 years of full-time equivalent RN practice, (3) at least 2,000 hours of clinical practice in gerontological nursing within the last 3 years, and (4) 30 contact hours of continuing education in gerontological nursing within the last 3 years.

How many questions are on the GERO-BC exam?

The GERO-BC exam contains 150 total questions: 125 are scored and 25 are unscored pretest items. You have 3.5 hours to complete the exam. The exam is administered at Prometric testing centers.

What is the passing score for the GERO-BC exam?

The GERO-BC uses scaled scoring with a maximum score of 500. The minimum passing score is 350. Approximately 70% of candidates passed in 2024 (458 of 654 examinees), according to ANCC data.

What content domains are on the GERO-BC exam?

The GERO-BC covers three domains: Planning, Implementation, and Evaluation (40% — the largest domain covering care planning, polypharmacy, fall prevention, pressure injuries); Professional Foundation (32% — ethics, elder abuse, advance directives, end-of-life); and Assessment and Diagnosis (28% — geriatric assessment tools, screening, differential diagnosis).

How much does the GERO-BC exam cost?

GERO-BC exam fees are $295 for ANA members, $340 for GAPNA members, and $395 for non-members. All fees include a $140 non-refundable administrative fee. Renewal fees range from $250 to $350 depending on membership.

How long is GERO-BC certification valid?

GERO-BC certification is valid for 5 years. Recertification is achieved through continuing education or by retaking the exam. Renewal applications are accepted up to 1 year before the credential expires.

What are the most important topics to study for the GERO-BC?

Focus on validated geriatric assessment tools (CAM, Mini-Cog, MMSE, GDS, Braden, Morse Fall Scale), polypharmacy and the Beers Criteria, delirium vs. dementia differentiation, falls prevention (STEADI protocol), pressure injury staging (NPIAP), elder abuse recognition and reporting, and advance care planning including advance directives and end-of-life decision-making.

100+ Free GERO-BC Practice Questions

ANCC GERO-BC Gerontological Nursing

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