Adult-Gerontology Assessment Practice
Questions
Course Introduction
Adult-Gerontology Assessment focuses on the comprehensive evaluation of health status in adults and older adults, emphasizing the physiological, psychological, and functional changes associated with aging. The course equips students with knowledge and skills in obtaining patient histories, conducting physical examinations, and utilizing diagnostic reasoning tailored to individuals across the adult lifespan. Key topics include age-related assessment techniques, identification of common and atypical presentations of disease in older populations, and integration of evidence-based tools for holistic health care planning. Participants will develop proficiency in differentiating normal aging from pathological conditions, ensuring effective and person-centered care for diverse adult and geriatric populations.
Recommended Textbook
Advanced Assessment Interpreting Findings and Formulating Differential Diagnoses 3rd Edition
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Page 2
Chapter 1: Assessment and Clinical Decision-Making: Overview
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Sample Questions
Q1) Which of the following clinical reasoning tools is defined as evidence-based resource based on mathematical modeling to express the likelihood of a condition in select situations,settings,and/or patients?
A) Clinical practice guideline
B) Clinical decision rule
C) Clinical algorithm
D) Clinical recommendation
Answer: B
Q2) The following can be used to assist in sound clinical decision-making:
A) Algorithm published in a peer-reviewed journal article
B) Clinical practice guidelines
C) Evidence-based research
D) All of the above
Answer: D
Q3) Essential parts of a health history include all of the following except:
A) Chief complaint
B) History of the present illness
C) Current vital signs
D) All of the above are essential history components
Answer: C
Page 3
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Chapter 2: An Overview of Genetic Assessment
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Sample Questions
Q1) When analyzing the pedigree for autosomal dominant disorders,it is common to see:
A) Several generations of affected members
B) Many consanguineous relationships
C) More members of the maternal lineage affected than paternal
D) More members of the paternal lineage affected than maternal
Answer: A
Q2) An affected individual who manifests symptoms of a particular condition through whom a family with a genetic disorder is ascertained is called a(n):
A) Consultand
B) Consulband
C) Index patient
D) Proband Answer: D
Q3) The pedigree of a family with a mitochondrial DNA disorder is unique in that:
A) None of the female offspring will have the disease
B) All offspring from an affected female will have disease
C) None of the offspring of an affected female will have the disease
D) All the offspring from an affected male will have disease
Answer: B
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Page 4
Chapter 3: Skin
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Sample Questions
Q1) A patient suffered a laceration of the shin three days ago,and today presents with a painful,warm,red swollen region around the area.The laceration has a purulent exudate.The clinician should recognize that the infected region is called:
A) Contact dermatitis
B) Folliculitis
C) Hidradenitis suppurative
D) Cellulitis
Answer: D
Q2) A patient has a tender,firm,nodular cystic lesion on his scalp that produces cheesy discharge with foul odor.This is most likely a:
A) Bacterial folliculitis
B) Basal cell carcinoma
C) Bullous impetigo
D) Epidermoid cyst
Answer: D
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Chapter 4: Head,face,and Neck
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Sample Questions
Q1) On physical examination,your 55-year-old female patient has an enlarged thyroid gland.She complains of feeling hot all the time,nervousness,palpitations,tremor,and recent weight loss of 10 pounds over the past 3 weeks.These signs and symptoms are commonly due to:
A) Hypothyroidism
B) Hyperthyroidism
C) Thyroid cancer
D) All of the above
Q2) Your patient presents to the ER due to a bee sting on the cheek.As you are examining the patient,you note increasing facial swelling and redness as well as swelling of the lips and eyes.This condition is due to:
A) Angioedema
B) Parotitis
C) Sinusitis
D) Sialoadenitis
Q3) Inflammation of the parotid gland can cause which of the following conditions?
A) Trigeminal neuralgia
B) Bruxism
C) Mumps
D) Temporomandibular joint syndrome
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Chapter 5: The Eye
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Sample Questions
Q1) The fundoscopic examination allows the clinician to directly observe:
A) Cranial nerve I
B) Cranial nerve II
C) Cranial nerve III
D) Cranial nerve IV
Q2) The most common type of eye disorder is:
A) Refractive errors
B) Macular conditions
C) Neurological conditions
D) Astigmatisms
Q3) Your patient describes blurry vision as well as halos and glares in response to bright lights or when driving in the dark.There is no pain.These are symptoms of:
A) Glaucoma
B) Macular degeneration
C) Cataracts
D) Diabetic retinopathy
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Chapter 6: Ear, nose, mouth, and Throat
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Sample Questions
Q1) A 6-year-old child presents with complaints of unilateral ear pain,fever,and sore throat.The clinician should recognize that this is most commonly due to:
A) Otitis externa
B) Inner ear infection
C) Sinusitis
D) Otitis media
Q2) Your patient is a 78-year-old female with a smoking history of 120-pack years.She complains of hoarseness that has developed over the last few months.It is important to exclude the possibility of:
A) Thrush
B) Laryngeal cancer
C) Carotidynia
D) Thyroiditis
Q3) Nasal discharge of green-yellow mucus,pharyngitis,and otitis media commonly indicate:
A) Allergic rhinitis
B) Viral infection
C) Bacterial infection
D) Nasal polyps
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Page 8
Chapter 7: Cardiac and Peripheral Vascular Systems
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Sample Questions
Q1) Aortic regurgitation occurs after S<sub>2</sub> during because there is turbulent flow that refluxes into the left ventricle after the aortic valve closes.
A) Early diastole
B) Late diastole
C) Early systole
D) Mid-systole
Q2) Upon examination of a child,an innocent systolic murmur is heard at the second intercostal space left sternal border.This is usually due to:
A) Atrial septal defect
B) Patent foramen ovale
C) Low flow velocity
D) High flow turbulence
Q3) When an examiner presses on the liver and elicits hepato-jugular reflux,which of the following conditions is likely?
A) Left ventricular failure
B) Right ventricular failure
C) Hepatomegaly
D) Pulmonary edema
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Chapter 8: Respiratory System
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Sample Questions
Q1) While assessing auscultated spoken sounds,the ausculated sound is heard as "a-a-a" when he is asked to repeat "e-e-e." This is indicative of:
A) Asthma
B) Tumor
C) Pneumonia
D) Pleural effusion
Q2) A 24-year-old patient presents to the emergency department after sustaining multiple traumatic injuries after a motorcycle accident.Upon examination,you note tachypnea,use of intercostal muscles to breathe,asymmetric chest expansion,and no breath sounds over the left lower lobe.It is most important to suspect:
A) Pulmonary embolism
B) Pleural effusion
C) Pneumothorax
D) Fracture of ribs
Q3) Alpha-1 antitrypsin deficiency should be considered in patients diagnosed with:
A) Exercise-induced cough
B) Bronciectasis
C) COPD
D) Pericarditis
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Page 10
Chapter 9: Breasts
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Sample Questions
Q1) Your patient has a rubbery,firm,mobile breast mass.In order to completely exclude the possibility of cancer,the triple test is necessary,which includes:
A) CT scan
B) MRI
C) Biopsy
D) All of the above
Q2) Bloody breast discharge is associated with which of the following?
A) Bleeding disorder such as von Willebrand disease
B) Malignancy
C) Excessive non-steroidal anti-inflammatories
D) A and C
Q3) Your patient is a 46-year-old woman suffering from psychosis complains of milky discharge from both her breasts.Upon examination,there are no significant findings and the patient is not pregnant,breastfeeding,or in the postpartum period.You should:
A) Order CT scan of head to rule out pituitary tumor
B) Obtain a complete list of the patient's medications
C) Have the patient keep a menstrual cycle diary
D) Refer the patient for mammogram
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11
Chapter 10: Abdomen
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Sample Questions
Q1) A 76-year-old patient presents to the emergency department with severe left lower quadrant abdominal pain,diarrhea,and fever.On physical examination,you note the patient has a positive heel strike,and left lower abdominal rebound tenderness.These are typical signs and symptoms of which of the following conditions?
A) Diverticulitis
B) Salpingitis
C) Inflammatory bowel disease
D) Irritable bowel syndrome
Q2) Your patient is lying supine and you ask him to raise his leg while you place resistance against the thigh.The examiner is testing the patient for:
A) Psoas sign
B) Obturator sign
C) Rovsing's sign
D) Murphys' sign
Q3) In abdominal assessment,a digital rectal examination is performed to assess for:
A) Hemorrhoids
B) Prostate size
C) Blood in stool
D) Ureteral stenosis
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Page 12
Chapter 11: Genitourinary System
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Sample Questions
Q1) On DRE,you note that a 45-year-old patient has a firm,smooth,non-tender but asymmetrically shaped prostate.The patient has no symptoms and has a normal urinalysis.The patient's PSA is within normal limits for the patient's age.The clinician should:
A) Refer the patient for transrectal ultrasound guided prostate biopsy
B) Obtain an abdominal x-ray of kidneys,ureter,and bladder
C) Recognize this as a normal finding that requires periodic follow-up
D) Obtain urine culture and sensitivity for prostatitis
Q2) Your 66-year-old patient complains of frequency of urination and hesitancy of the urine stream.On DRE,there is a hard,nodular,enlarged,non-tender prostate.The clinician should recognize these as symptoms of:
A) Prostatitis
B) Prostate cancer
C) Urethritis
D) Benign prostatic hyperplasia
Q3) An intravenous pyelogram should not be performed if serum creatinine is:
A) Less than 1.5
B) Greater than 1.0
C) Greater than 1.6
D) Less than 1.0
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Chapter 12: Male Reproductive System
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Sample Questions
Q1) Which of the following is a risk factor for testicular cancer?
A) Fournier's disease
B) Testicular torsion
C) Varicocele of the testes
D) Cryptorchidism
Q2) Your male patient is 456 pounds and complains of erectile dysfunction.On physical examination,you note gynecomastia,decreased pubic,facial,and axillary hair,as well as atrophic testes.This is due to:
A) Vascular disease that affects the testes
B) Conversion of testosterone in fatty tissue to estradiol
C) Androgen resistance of fatty tissue
D) All of the above
Q3) In order for the clinician to diagnose a varicocele,the patient needs to:
A) Lie in the left lateral recumbent position
B) Stand and bear down
C) Lean over for digital rectal exam
D) Lie in the supine position
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Chapter 13: Female Reproductive System
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Sample Questions
Q1) Your 16-year-old patient reports that she gets her period sometimes every month and sometimes she skips a month.If menstrual periods are irregular,the term for this condition is:
A) Menorrhagia
B) Metrorrhagia
C) Dysmenorrhea
D) Amenorrhea
Q2) Your patient that has a uterine fibroid complains of bleeding through up to 10 tampons per day.Excessive bleeding at the time of the menstrual cycle is termed:
A) Menorrhagia
B) Metrorrhagia
C) Dysmenorrhea
D) Premenstrual syndrome
Q3) Which of the following infections can cause an eye infection in the newborn during vaginal delivery?
A) Candida vaginitis
B) Chlamydia trachomatis
C) Trichomonas vaginalis
D) Gardnerella vaginalis
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Page 15
Chapter 14: Musculoskeletal System
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Sample Questions
Q1) Your patient is a 55-year-old male who presents with sudden,severely tender,swollen,erythematous elbow.The patient reports that he experienced similar symptoms in the past.You note the right elbow has a swollen,tender,soft 3 cm round nodule.The clinician should recognize these are signs and symptoms of:
A) Gouty arthritis
B) Rheumatoid arthritis
C) Epicondylitis
D) Reiter's syndrome
Q2) A 56-year-old male presents with complaints of right-sided neck pain with radiation down the right arm into the right index finger and thumb.He reports a recent fall from a scaffold while painting on the job.On physical examination,you note a 0/4 biceps reflex on the right compared to 2/4 on the left and 1/5 grip strength of the right hand compared to 5/5 of the left hand.Which of the following is a test that can be performed to assist in the diagnosis of cervical disk herniation?
A) Spurling's sign
B) Apley's sign
C) Lhermitte's sign
D) A and C
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Chapter 15: Neurological System
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Sample Questions
Q1) An 81-year-old patient with heart failure comes into the emergency room accompanied by his daughter.The daughter reports that her father "banged his head" as he was getting out of the car 4 days ago.He did not complain of headache pain,so she did not obtain medical advice.She reports that she noticed a mild facial droop,slurring of speech,and gait disturbance in her father today.She reports that her father takes Coumadin,digoxin,and an ACE inhibitor.On physical examination,there is decreased right hand grip 2/5 strength and decreased right quadriceps strength 2/ 5 compared to the left side 5/5.CT scan shows an intracranial bleed.Which of the following is the most probable diagnosis?
A) Subarachnoid hemorrhage
B) Epidural hematoma
C) Subdural hematoma
D) Intracerebral hemorrhage
Q2) In order to test abstract thought on the mental status exam,the clinician can ask:
A) Count by serial 7's backward
B) Spell the word "world" backward
C) Draw a clock that shows 2:30
D) How is your brother-in-law related to you?
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Page 17
Chapter 16: Nonspecific Complaints
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Sample Questions
Q1) A 22-year-old female patient complains of excessive thirst,feeling "shaky when she misses meals" and increased frequency of urination.Family history is positive for cardiovascular disease,cerebrovascular disease,and diabetes.The patient denies use of tobacco,alcohol,or other drugs.She takes no medication.Daily diet is fast food,and the patient does not exercise regularly.On physical examination,there are no significant findings except obesity,demonstrated by a BMI of 35 and blood pressure of 145/ 90.The signs and symptoms are characteristic of:
A) Type 2 diabetes mellitus
B) Chronic fatigue syndrome
C) Cushing's disease
D) Clinical depression
Q2) Which of the following is/are diagnostic criteria for primary insomnia?
A) The sleep disturbance is defined as difficulty initiating or maintaining sleep,or non-restorative sleep,for at least 1 month
B) The disturbance does not occur during the course of another mental disorder
C) The sleep disturbance or associated daytime fatigue causes clinically significant distress or impairment in social,occupational,or other important areas of functioning
D) All of the above
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Chapter 17: Psychiatric Mental Health
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Sample Questions
Q1) It is widely recognized that bereavement-associated depression can last for up to:
A) 6 months
B) 1 year
C) 2 years
D) 5 years
Q2) Which of the following is a feature of physical dependence in substance abusers?
A) Tolerance
B) Compulsive behavior
C) Withdrawal
D) A and C
Q3) Eating disorders are driven by:
A) Perfectionism
B) Feelings of inadequacy
C) Obsessive-compulsive disorder
D) A and B
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Chapter 18: Pediatric Patients
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Sample Questions
Q1) Which of the following stances is normal in a toddler?
A) Genu varum
B) Genu valgum
C) Lordosis
D) A and C
Q2) Which of the following statements is true regarding the average child's growth and development?
A) A child's weight typically triples at a year
B) A child's weight typically quadruples by age 2
C) During the puberty growth spurt,females gain approximately 38 pounds
D) All of the above
Q3) Which of the following is false regarding newborn reflexes?
A) When startled,a newborn should exhibit the Moro reflex
B) Stroking the cheek of a newborn should elicit a rooting reflex
C) A newborn's dominant hand palmer grasp is stronger than the nondominant hand grasp
D) A newborn should have a strong suck reflex at birth
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Chapter 19: Pregnant Patients
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Sample Questions
Q1) As you assess a pregnant patient,you suspect false small-for-dates presentation.You should recognize that a possible cause for this is:
A) Error in date of LMP
B) Fetus in tranverse lie
C) Error in calculation of fundal height
D) All of the above
Q2) The clinician should be aware of the Wells' Criteria when evaluating a patient for deep vein thrombosis (DVT).Wells' Criteria are risk factors that are assigned points toward the likelihood of DVT.Wells' Criteria include:
A) Active cancer
B) Recent bedridden condition
C) Pitting edema
D) All of the above
Q3) In a pregnant woman,a glucose screening test should be done at:
A) 24 weeks
B) 20 weeks
C) 16 weeks
D) 10 weeks
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Chapter 20: Older Patients
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Sample Questions
Q1) One of the most common causes for cognitive impairment in older patients suffering from infection is:
A) Delirium
B) Depression
C) Dementia
D) Pseudodementia
Q2) Obesity defined as a BMI greater than is an independent risk factor for functional decline in the elderly patient.
A) 20
B) 24
C) 30
D) 35
Q3) What are some tests of mobility to include in a physical examination of older adults?
A) Get up and go
B) Tinetti Evaluation
C) Fall toolkit
D) All of the above
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Page 22