Adult-Gerontology Nurse Practitioner
Chapter Exam Questions
Course Introduction
The Adult-Gerontology Nurse Practitioner course equips nursing students with the advanced knowledge and clinical skills required to provide comprehensive, patient-centered care to adults and elderly populations. Emphasizing health promotion, disease prevention, and management of acute and chronic health conditions, the course covers topics such as advanced assessment, diagnostic reasoning, pharmacology, and evidence-based interventions. Students engage in both classroom learning and supervised clinical experiences that foster expertise in caring for diverse adult populations across the healthcare continuum, preparing graduates to function as primary care providers in a variety of settings.
Recommended Textbook
Advanced Practice Nursing in the Care of Older Adults 1st Edition by Laurie Kennedy Malone
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19 Chapters
312 Verified Questions
312 Flashcards
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2
Chapter 1: Changes With Aging
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Sample Questions
Q1) The cytochrome p system involves enzymes that are generally:
A) Inhibited by drugs
B) Induced by drugs
C) Inhibited or induced by drugs
D) Associated with decreased liver perfusion
Answer: C
Q2) Atypical presentation of disease in the elderly is reflected by all the following except:
A) Infection without fever
B) Depression without dysphoric mood
C) Myocardial infarction with chest pain and diaphoresis
D) Cardiac manifestations of thyroid disease
Answer: C
Q3) Pharmacokinetic changes with aging is reflective of:
A) What the drug does to the body
B) What the body does to the drug
C) The effect at the site of action and the time and intensity of the drug
D) The side effects commonly associated with the drug
Answer: B
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3
Chapter 2: Health Promotion
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Sample Questions
Q1) What insect precautions are not necessary to prevent insect-borne diseases in the tropics?
A) Using 100% DEET on skin to prevent bites
B) Treating clothes with permetherin
C) Covering up exposed skin to lessen biting surface
D) Taking malaria pills as directed for areas at risk for malaria
Answer: A
Q2) The leading cause of death in elderly travelers worldwide is:
A) Cardiovascular disease
B) Infections
C) Accidents
D) Malaria
Answer: C
Q3) An example of secondary prevention you could recommend/order for older adults would be to:
A) Check for fecal occult blood
B) Wear seat belts in the car
C) Provide foot care for a diabetic patient
D) Administer a tetanus shot
Answer: A
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Chapter 3: Exercise in Older Adults
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Sample Questions
Q1) Exercise recommended for older adults should include activities that:
A) Conserve energy
B) Restrict flexibility
C) Strengthen muscles
D) Are anaerobic in nature
Answer: C
Q2) When the nurse practitioner recommends exercise for a sedentary older adult,which of the following pieces of advice should be considered for all types of exercise?
A) Only use equipment recommended by physical trainers
B) Start low and go slow
C) Only group exercise is beneficial to someone who has not been active in a long time
D) Focus only on one type of exercise for the first few months
Answer: B
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Chapter 4: Comprehensive Geriatric Assessment
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Sample Questions
Q1) What is reflective of functional decline in older adults?
A) Functional decline is synonymous with advanced age.
B) Some individuals die of "old age" but have maintained an active and healthy lifestyle.
C) Instrumental activities of daily living are preserved longer than activities of daily living.
D) It is always possible to prevent functional deterioration.
Q2) A validated tool for assessing cognitive function specific to dementia is:
A) Mini-cog
B) Confusion assessment method
C) Yesavage GDS scale
D) NuDesc
Q3) The evidence reflects that comprehensive geriatric assessment should be conducted:
A) On all individuals 65 and older
B) On all individuals 75 and older
C) By an inter-disciplinary team of professionals
D) Targeting the vulnerable and frail elderly
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Chapter 5: Symptoms and Syndromes
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Sample Questions
Q1) Risk factors associated with the finding of a malignancy in a patient with hemoptysis include all of the following except:
A) Male sex
B) Smoking history
C) Over age 40
D) Childhood asthma
Q2) All of the following statements about tremor are true except:
A) The most common tremor is the Parkinson tremor
B) Most individuals with tremor do not seek medical attention
C) Psychogenic tremor is uncommon
D) Tremor is more prevalent in whites than blacks
Q3) Chronic fatigue syndrome is best described as:
A) Fatigue that is constant,lasting more than three months
B) Fatigue lasting longer than six months and not relieved by rest
C) Fatigue that waxes and wanes over a period of three months
D) Total exhaustion with inability to get out of bed
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Chapter 6: Skin and Lymphatic Disorders
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Sample Questions
Q1) Cellulitis is a deep skin infection involving the dermis and subcutaneous tissues.The nurse practitioner suspects cellulitis in a 70-year-old Asian diabetic male presenting with reddened edematous skin around his nares.Which statement below will the nurse practitioner use in her decision-making process for the differential diagnosis pertaining to reddened edematous skin?
A) Cellulitis is two times more common in women
B) Facial cellulitis is more common in people >55
C) There is low incidence of cellulitis in patients with diabetes
D) Cellulitis is only a disease of the lower extremities of patients with known arterial insufficiency
Q2) Which of the following descriptions accurately documents cellulitis?
A) Cool,erythematous,shiny hairless extremity with decreased pulse
B) Scattered,erythematous ring-like lesions with clear centers
C) Clearly demarcated,raised erythematous area of face
D) Diffusely inflamed skin that is warm and tender to palpation
Q3) A wound with drainage and foul odor should be cleansed with:
A) Normal saline
B) Hydrogen peroxide
C) 20% acetic acid
D) Betadine
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Chapter 7: Head, neck, and Face Disorders
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Sample Questions
Q1) You have a patient complaining of vertigo and want to know what could be the cause.Knowing there are many causes for vertigo,you question the length of time the sensation lasts.She tells you several hours to days and is accompanied by tinnitus and hearing loss.You suspect which of the following conditions?
A) Ménière's disease
B) Benign paroxysmal positional vertigo
C) TIA
D) Migraine
Q2) Sensory impairment (vision and hearing)in the elderly is associated with:
A) Impaired quality of life
B) Decreased function
C) Increased mortality
D) All of the above
Q3) A gross screening for hearing is the whisper tests.Which cranial nerve is being tested when the nurse practitioner conducts this test?
A) Cranial nerve V
B) Cranial nerve VII
C) Cranial nerve VIII
D) Cranial nerve IV
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Chapter 8: Chest Disorders
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Sample Questions
Q1) A 55-year-old post-menopausal woman with a history of hypertension complains of jaw pain on heavy exertion.There were no complaints of chest pain.Her ECG indicates normal sinus rhythm without ST segment abnormalities.Your plan may include:
A) Echocardiogram
B) Exercise stress test
C) Cardiac catheterization
D) Myocardial perfusion imaging
Q2) Which of the following statements is true concerning anti-arrhythmic drugs?
A) Amiodarone is the only one not associated with increased mortality and it has a very favorable side effect profile.
B) Both long-acting and short-acting calcium channel blockers are associated with an increased risk of cardiovascular morbidity and mortality.
C) Most anti-arrhythmics have a low toxic/therapeutic ratio and some are exceedingly toxic.
D) Anti-arrhythmic therapy should be initiated in the hospital for all patients.
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Chapter 9: Peripheral Vascular Disorders
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Sample Questions
Q1) The imaging gold standard for lymphedema is:
A) Lymphosonogram
B) Lymphoscintigraphy
C) Lymphoangiogram
D) CT scan
Q2) The initial treatment for symptomatic abdominal aortic aneurysm involves:
A) Emergency surgery
B) Aggressive blood pressure control
C) Watch-and-wait approach
D) Cardiology consult
Q3) A thorough vascular exam includes all of the following except:
A) Cardiac exam
B) Reproductive organ exam
C) Peripheral vascular exam
D) Cranial nerve exam
Q4) All of the following are classic signs of venous insufficiency except:
A) Pain
B) Dependent edema
C) Hemosiderosis
D) Dermatitis
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Chapter 10: Abdominal Disorders
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Sample Questions
Q1) Your 70-year-old patient has gastroesophageal reflux disease (GERD).After a trial of lifestyle modifications and antacids,the patient continues to have occasional mild heartburn after occasional meals and at night.The most appropriate next action is:
A) Prokinetic agents
B) H<sub>2</sub> antagonists
C) Proton pump inhibitors
D) Surcralfate
Q2) The nurse practitioner is discussing lifestyle changes with a patient diagnosed with gastroesophageal reflux.What are the nonpharmacological management interventions that should be included?
A) Weight reduction and rest 30 minutes after each meal in the supine position
B) Elevation of head of the bed 4-6 inches on blocks and weight reduction
C) Encouraged to wear restrictive clothing to add support for diaphragmatic breathing
D) Using oral mints to relieve gastric distress
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Chapter 11: Urological and Gynecological Disorders
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Sample Questions
Q1) A pelvic mass in a postmenopausal woman:
A) is most commonly due to uterine fibroids.
B) is always symptomatic.
C) is highly suspicious for ovarian cancer.
D) should be monitored over a period of time.
Q2) All of the following antimicrobials may be indicated in chronic bacterial prostatitis except:
A) Ciprofloxacin
B) Levofloxacin
C) Trimethoprim
D) Azithromycin
Q3) Age-related changes in the bladder,urethra,and ureters include all of the following in older women except:
A) Increased estrogen production's influence on the bladder and ureter
B) Decline in bladder outlet function
C) Decline in ureteral resistance pressure
D) Laxity of the pelvic muscle
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13
Chapter 12: Musculoskeletal Disorders
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Sample Questions
Q1) You suspect that your patient has polymyalgia rheumatica and now are concerned that the patient may also have Giant Cell Arteritis (GCA).Which of the following two symptoms are most indicative of GCA and PMR?
A) Jaw pain and heart murmur
B) Joint swelling and sudden loss of central vision bilaterally
C) Hoarseness and the total inability to grasp small objects
D) Scalp tenderness and aching in shoulder and pelvic girdle
Q2) When examining the spine of an older adult you notice a curvature with a sharp angle.This is referred to as a:
A) Gibbus
B) Scoliosis
C) Kyphosis
D) Lordosis
Q3) Patients with osteoarthritis of the hip and knee often have a distinguishable gait described as:
A) Ataxic
B) Festinating
C) Antalgic
D) Steppage
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Page 14
Chapter 13: Central and Peripheral Nervous System Disorders
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Sample Questions
Q1) An elderly nursing home resident is maintained on phenytoin therapy for a history of a seizure disorder.In addition to periodic serum drug concentrations,which of the following are needed for annual evaluation?
A) Complete blood count,liver function tests,and renal function tests
B) Complete blood count,liver function tests,and platelet count
C) Renal function and calculated creatinine clearance
D) Serum albumin,liver function tests,and renal function tests
Q2) You are evaluating an elderly patient's complaint of a new onset of "hand shaking" when he drinks from a cup.The patient is euthyroid and does not drink alcohol.Which of the following signs indicate that this tremor is most likely an essential tremor rather than a Parkinson's tremor?
A) It is characteristic of "pill rolling" and occurs at rest
B) It is a moderate amplitude tremor that occurs only with movement/activity
C) The tremor is also associated with slowed movements
D) The tremor is accompanied by dyskinesia
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Chapter 14: Endocrine, metabolic, and Nutritional Disorders
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Sample Questions
Q1) A 62-year-old female complains of fatigue and lack of energy.Constipation has increased and the patient has gained ten pounds in the past 3 months.Depression is denied although the patient reports a lack of interest in usual hobbies.Vital signs are within normal limits and the patient's skin is dry and cool.Which of the following must be included in the differential?
A) Hyperthyroidism
B) Hypothyroidism
C) Hyperparathyroidism
D) Grave's disease
Q2) The primary reason levothyroxine sodium is initiated at a low dose in an elderly patient with hypothyroidism is to prevent which of the following untoward effects?
A) Angina and arrhythmia
B) Nausea and diarrhea
C) Confusion and delirium
D) Osteoporosis and muscle weakness
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16
Chapter 15: Hematological and Immune System Disorders
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Sample Questions
Q1) In addition to the CBC with differential,which of the following laboratory tests is considered to be most useful in diagnosing ACD and IDA?
A) Serum iron
B) Total iron binding capacity
C) Transferrin saturation
D) Serum ferritin
Q2) The main focus of treatment of patients with ACD is:
A) Replenishing iron stores
B) Providing for adequate nutrition high in iron
C) Management of the underlying disorder
D) Administration of monthly vitamin B<sub>12</sub> injections
Q3) Education of patient and family regarding ACD includes discussion of all of the following except:
A) Early prevention of chronic conditions through healthy lifestyle measures
B) Importance of adherence to the treatment plan for management of chronic conditions
C) Explaining the ACD is mainly attributed to the aging process
D) Importance of regular follow-up to monitor responses to treatments
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Chapter 16: Psychological Disorders
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Sample Questions
Q1) When treating depression associated with dementia,which of the following would be a poor choice and should not be prescribed?
A) Fluoxetine
B) Desipramine
C) Amitriptyline
D) Mirtazapine
Q2) Of the following,which one is the most useful clinical evaluation tool to assist in the diagnosis of dementia?
A) Folstein's Mini-Mental Status Exam (MMSE)
B) St.Louis University Mental Status Exam (SLUMS)
C) Montreal Cognitive Assessment (MoCA)
D) Geriatric Depression Scale (GDS)
Q3) Which of the following is the most appropriate screening tool for delirium?
A) Lawton Scale of Instrumental Activities of Daily Living
B) Confusion Assessment Method
C) Folstein's Mini-Mental Status Examination
D) Montreal Cognitive Assessment
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18
Chapter 17: Nutritional Support in the Older Adult
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Sample Questions
Q1) A key issue that needs to be addressed to families and patients with Alzheimer's disease about the use of feeding tubes is that a feeding tube:
A) Decreases the risk of aspirational pneumonia
B) Does not improve nutritional status or quality of life
C) Is a simple bedside procedure to place the tube and has minimal complications
D) Is an irreversible process once the patient is started on feedings
Q2) What is the name of the federal program that allots a month supply of food stamps to eligible participants?
A) Meals on Wheels
B) Food Assistance
C) Second Harvest
D) Supplemental Nutrition Assistance Program (SNAP)
Q3) Which of the following is a major indicator of protein-energy malnutrition?
A) Total cholesterol less than 200 mg/dl with LDL <100
B) Intentional weight loss of 25 pounds in 2 years
C) Mid-arm circumference less than 16 inches
D) Unintentional low body weight less than 10% of average for height and age
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Chapter 18: Chronic Illness and the Advanced Practice
Registered Nurse Aprn
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Sample Questions
Q1) The highest number of people with multiple chronic conditions are those that are:
A) Over age 85
B) Diagnosed with type 2 diabetes
C) African American women over age 65
D) Diagnosed with COPD
Q2) All of the following are health consequences of obesity except:
A) Mortality of aging
B) Hypertension
C) Coronary artery disease
D) Sleep apnea
Q3) All of the following statements about the Chronic Care Model are true except:
A) It was developed with Robert Wood Johnson Foundation funding
B) It focuses exclusively on a self-management model
C) It is an evidence-based policy response designed to meet the needs of the chronically ill
D) It directs quality improvement and system change for patients with chronic disease
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Chapter 19: Palliative Care and End-Of-Life Care
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Sample Questions
Q1) The highest level of evidence with the use of adjuvant analgesics is with:
A) Tricyclic antidepressants avoided due to high adverse events
B) Therapeutic trials before discontinuing drugs
C) Patient with fibromyalgia are candidates for adjuvant analgesics
D) Neuropathic pain patients are candidates for adjuvant analgesia
Q2) The strongest level of evidence reflects the absolute contraindication for NSAID use exists with:
A) Chronic kidney disease
B) Peptic ulcer disease
C) Heart disease
D) Liver disease
Q3) The drug specific for severe opioid-induced constipation is:
A) Lactulose
B) Ducolax
C) Mineral oil
D) Methylnaltrexone
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