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In geriatric patients, a decreased cough reflex is a notable change due to the natural aging process, which affects many aspects of respiratory function. As individuals grow older, the strength and efficiency of their respiratory muscles may decline, leading to a weakened cough reflex. This can make it more difficult for older adults to clear secretions from their airways, increasing the risk of respiratory infections and complications.

The other choices do not accurately reflect typical changes observed in geriatric patients. For instance, rather than an increase in blood pressure during shock, older adults may experience a more blunted response to cardiovascular stress. Higher pulse rates are not characteristic of geriatric patients; they often have lower resting heart rates due to physiological changes. Additionally, improved overall health is generally not observed in the geriatric population, as aging often comes with various health challenges and chronic conditions. Therefore, the option reflecting a decreased cough reflex aligns with the physiological changes commonly seen in older adults.