Advanced Clinical Practice in Gerontology
Exam Questions
Course Introduction
This course delves into the advanced clinical assessment, management, and evidence-based interventions essential for providing comprehensive care to older adults. Emphasizing an interdisciplinary approach, students will explore topics such as complex chronic disease management, functional assessment, cognitive health, pharmacologic considerations, cultural competence, and ethical decision-making in geriatric populations. Through case studies and clinical simulations, learners will refine their skills in formulating care plans that address the physical, psychological, and social needs of elderly patients, preparing them for leadership roles in gerontological advanced practice 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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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) All of the following statements are true about drug distribution in the elderly except:
A) Drugs distributed in water have lower concentration
B) Drugs distributed in fat have less intense,more prolonged effect
C) Drugs highly protein bound have greater potential to cause an adverse drug reaction
D) The fastest way to deliver a drug to the action site is by inhalation
Answer: A
Q2) The strongest evidence regarding normal physiological aging is available through:
A) Randomized controlled clinical trials
B) Cross-sectional studies
C) Longitudinal studies
D) Case control studies
Answer: C
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3
Chapter 2: Health Promotion
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The nurse practitioner demonstrates an understanding of primary prevention of falling among the elderly through which management plan?
A) Evaluate a need for assistive devices for ambulation after the client has been injured from a fall.
B) Provide resources to correct hazards contributing to falls in the home environment.
C) Reinforce the need to use prescribed eyeglasses to prevent further injury from falls.
D) Provide information about medications,side effects,and interactions.
Answer: D
Q2) 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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4
Chapter 3: Exercise in Older Adults
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) Which of the following medical conditions is not considered restrictive for engaging in physical activity?
A) Unstable angina
B) Dehydration
C) Depression
D) Uncontrolled tachycardia
Answer: C
Q2) 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
Q3) The best recommendation for a patient who states they have no equipment to exercise would be:
A) Sign a contract for a year's membership to a local gym
B) Borrow free weights from grandchildren
C) Have a personal trainer come to the home three times a week
D) Improvise with recommended objects at home that can be used
Answer: D
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Chapter 4: Comprehensive Geriatric Assessment
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13 Verified Questions
13 Flashcards
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Sample Questions
Q1) Evidence-based geriatric assessment instruments available to the clinician:
A) Are largely screening instruments to detect a condition
B) Largely do not exist and if they do they have limited clinical utility
C) Include screening,evaluation,and measurement instruments in multiple domains
D) Have applicability in the outpatient but not the inpatient setting
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) When interviewing the older adult with a suspected dementia,it is most important that:
A) Mental status be evaluated first in order to determine if the patient is a reliable historian
B) The examiner use short simple questions and recognize non-verbal signs of discomfort
C) Postpone the mental status evaluation for the following visit and establish a rapport first
D) The clinician get in contact with a family member to obtain the history
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Page 6
Chapter 5: Symptoms and Syndromes
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) Lipedema is best described as:
A) Bilateral accumulation of interstitial fluid
B) Bilateral distribution of fat in the lower extremities
C) Fluid retention caused by a compromised lymphatic system
D) Lipid molecules that break down and cause fluid retention
Q2) The most cost-effective interventions used to prevent falls are:
A) Use of sitters
B) Use of alarms (bed,chair,monitors)
C) Tai Chi exercises
D) Home modifications and vitamin D supplements
Q3) The anal wink reflex is used to test:
A) Rectal prolapse
B) Sensation and pudental nerve function
C) Baseline and squeeze sphincter tone
D) Fissures and fistulas
Q4) Overflow incontinence is usually associated with:
A) Loss of urine that occurs with urgency
B) Cognitive impairment
C) Weak pelvic floor muscles
D) Bladder outlet obstruction
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Chapter 6: Skin and Lymphatic Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) A nursing home resident with a Stage 4 pressure ulcer that extends to the muscle layer and has significant undermining with heavy exudate should be treated with:
A) Dry gauze dressings
B) Duoderm
C) Chemical debridement
D) Calcium alginate dressings
Q2) Identify the type of malignant melanoma that is associated with the Hutchinson's sign of the cuticle of the finger.
A) Lentigo maligna
B) Acral lentiginous
C) Nodular
D) Superficial spreading malignant melanoma
Q3) Which of the following descriptions best illustrates assessment findings consistent with tinea capitis?
A) Circular erythematous patches with papular,scaly annular borders and clear centers
B) Inflamed scaly dry patches with broken hairs
C) Web lesions with erythema and scaling borders
D) Scaly pruritic erythematous lesions on inguinal creases
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Chapter 7: Head, neck, and Face Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Causes of sensorineural hearing loss include:
A) Ototoxicity
B) Ménière's disease
C) Otosclerosis
D) Inner ear fistula
Q2) A nonmodifiable risk factor for the development of cataracts is:
A) Long-term exposure to ultraviolet B radiation
B) High alcohol intake
C) Strong family history
D) Diabetes mellitus
Q3) The nurse practitioner knows that antihistamines work primarily through which of the following mechanisms?
A) Vasodilatation
B) Blocking leukotriene effects
C) Inhibiting histamine receptor sites
D) Vasoconstriction
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Chapter 8: Chest Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) Which test is the clinical standard for the assessment of aortic stenosis?
A) Cardiac catheterization
B) Stress test
C) Chest x-ray
D) Echocardiography
Q2) Susan P. ,a 60-year-old woman with a 30 pack year history,presents to your primary care practice for evaluation of a persistent,daily cough with increased sputum production,worse in the morning,occurring over the past three months.She tells you,"I have the same thing,year after year." Which of the following choices would you consider strongly in your critical thinking process?
A) Seasonal allergies
B) Acute bronchitis
C) Bronchial asthma
D) Chronic bronchitis
Q3) The best way to diagnose structural heart disease/dysfunction non-invasively is:
A) Chest x-ray
B) EKG
C) Echocardiogram
D) Heart catheterization
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Page 10
Chapter 9: Peripheral Vascular Disorders
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) Known risk factors for lymphedema include all of the following except:
A) Osteoarthritis
B) Rheumatoid arthritis
C) Obesity
D) Venous ulcer disease
Q2) The best initial screening test for abdominal aortic aneurysm is:
A) Angiography
B) CT scan with IV contrast
C) Abdominal ultrasound
D) MRI
Q3) The imaging gold standard for lymphedema is:
A) Lymphosonogram
B) Lymphoscintigraphy
C) Lymphoangiogram
D) CT scan
Q4) The most common cause of secondary lymphedema is:
A) Surgery
B) Cancer treatment
C) Infection
D) Trauma
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Chapter 10: Abdominal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) 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
Q2) When teaching a group of older adults regarding prevention of gastroesophageal reflux disease symptoms,the nurse practitioner will include which of the following instructions?
A) Raise the head of the bed with pillows at night and chew peppermints when symptoms of heartburn begins
B) Raise the head of the bed on blocks and take the proton pump inhibitor medication at bedtime
C) Sit up for an hour after taking any medication and restrict fluid intake
D) Avoid food intolerances,raise head of bed on blocks,and take a proton pump inhibitor before a meal
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Page 12
Chapter 11: Urological and Gynecological Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) All of the following may be reasons associated with an elevated PSA besides prostate cancer except:
A) Prostatitis
B) Urinary tract infection
C) Perineal trauma
D) Digital rectal exam
Q2) Which ethnic group has the highest incidence of prostate cancer?
A) Asians
B) Hispanics
C) African Americans
D) American Indians
Q3) All of the following antimicrobials may be indicated in chronic bacterial prostatitis except:
A) Ciprofloxacin
B) Levofloxacin
C) Trimethoprim
D) Azithromycin
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Chapter 12: Musculoskeletal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which of the following best describes the pain associated with osteoarthritis?
A) Constant,burning,and throbbing with an acute onset?
B) Dull and primarily affected by exposure to cold and barometric pressure
C) Begins upon arising and after prolonged weight bearing and/or use of the joint
D) Begins in the morning but decreases with activity
Q2) Osteoarthritis of the cervical and lumbar spine causes pain that is related to all of the following except:
A) Bone spur formation
B) Pressure of the ligaments
C) Reactive muscle spasm
D) Crystal deposition
Q3) In differentiating osteoarthritis from chronic gout,pseudogout,or septic arthritis,the most valuable diagnostic study would be:
A) Erythrocyte sedimentation rate (ESR)
B) Synovial fluid analysis
C) C-reactive protein analysis
D) Complete blood cell count
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Chapter 13: Central and Peripheral Nervous System Disorders
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) An older adult female patient had a stroke.What symptoms are not usually expressed by patients who have had a vertebrobasilar stroke?
A) Vertigo
B) Ataxia
C) Dysarthria
D) Monocular blindness
Q2) Which of the following assessment findings is commonly noted in a client with advanced Parkinson's disease?
A) Macrographia
B) Micrographia
C) Ataxic gait
D) Increased arm swing
Q3) Which of the following assessments are commonly noted in a client with Parkinson's disease?
A) Macrographia and bradycardia
B) Micrographia and bradykinesia
C) Exaggeration of rapid successive movements
D) Increased arm swing
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Chapter 14: Endocrine, metabolic, and Nutritional Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which patient is most likely to have osteoporosis?
A) An 80-year-old underweight male who smokes and has been on steroids for psoriasis
B) A 90-year-old female with no family history of osteoporosis who is on hormone replacement therapy
C) A 68-year-old overweight female who drinks 1-2 drinks alcohol/day
D) An 82-year-old female with a normal BMI takes calcium and performs weight-bearing exercise daily
Q2) A patient has been prescribed metformin (Glucophage).One week later he returns with lowered blood sugars but complains of some loose stools during the week.How should the nurse practitioner respond?
A) Discontinue the medication immediately
B) Reassure the patient that this is an anticipated side effect
C) Double the dosage of medication and have patient return in 1 week
D) Order a chem.7 to check for lactic acidosis
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16
Chapter 15: Hematological and Immune System Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Immune system changes that render older adults more susceptible to contracting HIV include all of the following except:
A) Hyper-responsive T cells
B) Age-related thymic involution
C) Depletion of naïve CD4 cells
D) Decline in B cell function
Q2) Initial therapy for patients with IDA is:
A) Blood transfusion
B) Increasing dietary intake of green leafy vegetables
C) Ferrous sulfate 325 mg orally bid-tid
D) Parenteral administration of Venofer
Q3) Mrs.G,a 70-year-old patient,presents to you with a hemoglobin of 9.4 and a decreased MCV/MCV.You diagnose her with IDA and start her on ferrous sulfate 325 mg PO tid.The next step in your work-up would be:
A) Send Mrs.G for a GI consult
B) Obtain hemoglobin one week after oral therapy
C) Schedule Mrs.G for an upper GI series
D) Obtain stool for occult blood
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17
Chapter 16: Psychological Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) In late stages of dementia,a phenomenon called "sun downing" occurs,in which cognitive disturbances tend to:
A) Improve as the day goes on
B) Become worse toward the evening
C) Fluctuate during the course of the day
D) Peak mid-day
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) The elderly are at high risk for delirium because of:
A) Multisensory declines
B) Polypharmacy
C) Multiple medical problems
D) All of the above
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Chapter 17: Nutritional Support in the Older Adult
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10 Verified Questions
10 Flashcards
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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) The use of feeding gastrostomy tubes at the end of life in Alzheimer's disease patients has been associated with:
A) Prolongation of life
B) Aspirational pneumonia
C) Increase in decubitus ulcer rate
D) Reversal of any clinical signs of failure to thrive
Q3) 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)
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Chapter 18: Chronic Illness and the Advanced Practice
Registered Nurse Aprn
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14 Verified Questions
14 Flashcards
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Sample Questions
Q1) Evidence-based clinical practice guidelines may have limited applicability in the older population because:
A) They often are disease specific
B) They often have complex comorbid conditions
C) Both A and B
D) None of the above evidence-based clinical practice guidelines are always the standard
Q2) 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
Q3) Long durations of a chronic illness that are most commonly associated in both women and men are:
A) Heart disease and obesity
B) Diabetes and COPD
C) Arthritis and dementia
D) Dyslipidemia and eye disease
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Chapter
16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The first step in treating delirium is to:
A) Give low-dose Haldol if the patient has psychosis
B) Identify the cause
C) Provide reality orientation
D) Use side rails and/or wrist restraints to keep the patient safe
Q2) Delirium is typically characterized by all of the following except:
A) Inattention
B) Hyperactive level of psychomotor activity
C) Disorganized thinking
D) Altered level of consciousness
Q3) The highest level of evidence to support interventions at the end of life is with:
A) Opioids for pain control
B) Hyocsyamine for respiratory secretions
C) Stimulant laxatives for treating constipation
D) Opioids for dyspnea
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