Advanced Geriatric Nursing Exam
Solutions
Course Introduction
Advanced Geriatric Nursing focuses on the comprehensive care of older adults, emphasizing the complexities of aging and the management of chronic health conditions common in this population. The course delves into advanced assessment techniques, evidence-based interventions, pharmacologic considerations, and multidisciplinary approaches to promote functional independence and quality of life. Students will explore ethical and legal issues, palliative and end-of-life care, and the psychosocial aspects influencing geriatric health. Through case studies and clinical experiences, learners develop critical thinking and leadership skills necessary for delivering safe, culturally competent, and patient-centered care to elderly individuals in diverse healthcare settings.
Recommended Textbook
Advanced Practice Nursing in the Care of Older Adults 1st Edition by Laurie
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19 Chapters
312 Verified Questions
312 Flashcards
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Page 2
Kennedy Malone
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) Men have faster and more efficient biotransformation of drugs and this is thought to be due to:
A) Less obesity rates than women
B) Prostate enlargement
C) Testosterone
D) Less estrogen than women
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) A local chapter of a nurse practitioner organization has begun planning a community-based screening for hypertension at a local congregate living facility.This population was selected on the basis of:
A) A predicted decreased incidence of high blood pressure in this population
B) A recognized element of high risk within this group
C) Readily available treatment measures
D) Achieving an administrative goal for the congregate living facility
Answer: B
Q2) Which of the following should be avoided in countries where food and water precautions are to be observed?
A) Hot coffee
B) Bottled water
C) Salad buffet
D) Unpeeled bananas
Answer: C
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Chapter 3: Exercise in Older Adults
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5 Verified Questions
5 Flashcards
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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) 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
Q3) 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
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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) 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
Q2) Timing of the get-and-go test enhances its sensitivity.The process should take less than:
A) Thirty seconds
B) Sixteen seconds
C) Sixty seconds
D) Ten seconds
Q3) Which is not considered a dimension of symptomatology?
A) Onset
B) Physical signs
C) Location
D) Absence of associated symptoms
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6
Chapter 5: Symptoms and Syndromes
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) The routine testing of tuberculosis should occur in all of the following vulnerable populations except:
A) Nursing home residents
B) Prison inmates
C) Hospitalized elderly
D) Immune-compromised patients
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) Thoracic aortic dissection presents typically as:
A) Sharp stabbing pain in the mid thorax
B) Pleuretic chest pain and dyspnea
C) Severe retrosternal chest pain that radiates to the back and both arms
D) Unilateral pleuretic chest pain and dyspnea
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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) 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
Q2) A hyperkeratatotic nodule formed as the result of exposure of the foot to moisture from perspiration is called:
A) Hard corn
B) Tinea pedis
C) Soft corn
D) Plantar warts (verrucae)
Q3) A full thickness pressure ulcer is partially covered with eschar and the surrounding tissue is reddened.Which of the following is the most appropriate treatment for this condition?
A) Apply an occlusive dressing
B) Debride mechanically or chemically
C) Saline moistened gauze dressings
D) Vacuum-assisted wound closure
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Page 8
Chapter 7: Head, neck, and Face Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) Cromolyn sodium may also be used in the treatment of allergic rhinitis.What is the mechanism of action of this medication?
A) Mast cell stabilization
B) Blocking the effects of IgE
C) Leukotriene inhibition
D) Histamine blockade
Q2) Patients that have atopic disorders are mediated by the production of IGE will have histamine stimulated as an immediate phase response.This release of histamine results in which of the following?
A) Sinus pain,increased vascular permeability,and bronchodilation
B) Bronchospasm,vascular permeability,and vasodilatation
C) Contraction of smooth muscle,decreased vascular permeability,and vasoconstriction
D) Vasodilatation,bronchodilation,and increased vascular permeability
Q3) Causes of sensorineural hearing loss include:
A) Ototoxicity
B) Ménière's disease
C) Otosclerosis
D) Inner ear fistula
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9
Chapter 8: Chest Disorders
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21 Verified Questions
21 Flashcards
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Sample Questions
Q1) In mitral stenosis,p waves may suggest:
A) Left atrial enlargement
B) Right atrial enlargement
C) Left ventricle enlargement
D) Right ventricle enlargement
Q2) What is the most common valvular heart disease in the older adult?
A) Aortic regurgitation
B) Aortic stenosis
C) Mitral regurgitation
D) Mitral stenosis
Q3) The best way to diagnose structural heart disease/dysfunction non-invasively is:
A) Chest x-ray
B) EKG
C) Echocardiogram
D) Heart catheterization
Q4) On examination,what type of murmur can be auscultated with aortic regurgitation?
A) Austin flint
B) Systolic ejection
C) Soft S1 and a Loud S2
D) Loud S1
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Chapter 9: Peripheral Vascular Disorders
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18 Verified Questions
18 Flashcards
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Sample Questions
Q1) All of the following are classic signs of venous insufficiency except:
A) Pain
B) Dependent edema
C) Hemosiderosis
D) Dermatitis
Q2) Home exercise programs for peripheral arterial disease focus on:
A) Walk until pain develops then stop
B) Walk through the pain then stop
C) Begin at a slow speed with 10 minutes a day and build up to 30 minutes
D) Walk through the pain,rest until it goes away,then resume walking
Q3) The major cause of death after an abdominal aortic aneurysm repair is:
A) AAA rupture
B) Hemorrhage
C) Renal failure
D) Myocardial infarction
Q4) 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
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Chapter 10: Abdominal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Asymptomatic 1+ bacteruria is found in a nursing home resident with an indwelling catheter.The nurse practitioner's initial intervention includes:
A) Assessing resident's cognitive status and last change of the catheter/bag
B) Prescribing prophylactic Bactrim 1 tablet at bedtime
C) Ordering a urine culture and sensitivity and prescribing empiric treatment until results obtained
D) Ordering an x-ray of the kidney,urine,and bladder
Q2) The nurse practitioner is examining a 62-year-old female who has been complaining of lower abdominal pain.Upon auscultation,bowel sounds are high pitched and tinkling.Which of the following terms describes this finding?
A) Succession splash
B) Borborygmi
C) Tenesmus
D) Puddle sign
Q3) A clinical clue for suspected renal artery stenosis would be:
A) Decreased urine output
B) Development of resistant hypertension in a previously well-controlled patient
C) Retroperitoneal pain on the affected side
D) Rising BUN level with normal creatinine level
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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) In the diagnosis of acute bacterial prostatitis,a midstream urine culture is of benefit.To be diagnostic,the specimen should reveal how many white blood cells per high-power field?
A) Five
B) Ten
C) Fifteen
D) Twenty
Q2) 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
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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Page 13
Chapter 12: Musculoskeletal Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) In providing health teaching related to dietary restrictions,the nurse practitioner should advise a patient with gout to avoid which of the following dietary items:
A) Green leafy vegetables
B) Beer,sausage,fried seafood
C) Sugar
D) Gluten and bread items
Q2) Which of the following differential diagnosis for patients presenting with polymyalgia rheumatica (PMR)can be ruled out with a muscle biopsy?
A) Parkinson's disease
B) Polymyositis
C) Late onset rheumatoid arthritis
D) Giant Cell Arteritis
Q3) The best method of verifying a diagnosis of gout in a joint is which of the following:
A) Radiographic examination of the joint with two views
B) Ultrasound
C) Palpation
D) Joint aspiration and polarized-light microscopy
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14
Chapter 13: Central and Peripheral Nervous System Disorders
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19 Verified Questions
19 Flashcards
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Sample Questions
Q1) In review of a nursing home patient's chart,the nurse practitioner discovers that the neurology consult identified that the client has a homonymous hemianopsia.Which of the following statements accurately describes these findings?
A) Partial loss of visual acuity in the ipsilateral peripheral fields
B) Diplopia in the eye contralateral to the cerebral lesion
C) Loss of vision in either the right or left halves of the visual fields
D) Nystagmus in both eyes with asymmetrical movement
Q2) A 78-year-old man with Parkinson's disease is being cared for in a nursing home.The nurses observe that he coughs at mealtime;he has the ability to still feed himself with adaptive equipment.He has had no aspirations.Oral exam is normal,except during his swallowing assessment you note there is slight delayed elicitation.You assess that he has only mild dysphagia.You recommend which of the following as the next step in his care?
A) Consult gastroenterologist for g-tube decision
B) Consult speech pathologist for video fluoroscopy
C) Provide a trial of foods of differing consistency
D) Require that he is fed all his meals
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Page 15
Chapter 14: Endocrine, metabolic, and Nutritional Disorders
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20 Verified Questions
20 Flashcards
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Sample Questions
Q1) Which of the following signs of hyperthyroidism commonly manifest in younger populations,but is notably lacking in the elderly?
A) Weight gain
B) Constipation
C) Bradycardia
D) Exophthalmos
Q2) 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
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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) Symptoms in the initial HIV infection include all of the following except:
A) Sore throat
B) Fever
C) Weight loss
D) Headache
Q2) Iron Deficiency Anemia (IDA)is classified as a microcytic,hypochromic anemia.This classification refers to which of the following laboratory data?
A) Hemoglobin and hematocrit
B) Mean Corpuscular Volume (MCV)and Mean Corpuscular Hemoglobin (MCH)
C) Serum ferritin and serum iron
D) Total iron binding capacity and transferrin saturation
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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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) The justification for ordering a CBC,TSH,and serum B12 for a patient you suspect may have clinical depression is:
A) To determine the cause of sadness
B) Because of overlapping symptoms with anemia,thyroid dysfunction,and nutritional deficiencies
C) To differentiate between depression and metabolic disorders
D) To rule out vascular disease
Q2) The elderly are at high risk for delirium because of:
A) Multisensory declines
B) Polypharmacy
C) Multiple medical problems
D) All of the above
Q3) 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
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18
Chapter 17: Nutritional Support in the Older Adult
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10 Verified Questions
10 Flashcards
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Sample Questions
Q1) Which lab test is most indicative that a patient has refeeding syndrome?
A) A serum albumin level of 3.0 g/dL
B) Hemoglobin of 10.0 g/dL
C) Prealbumin level of 17 mg/dL
D) Serum phosphate level of less than 0.6 mmol/L
Q2) Which of the following is not considered a benefit of high protein supplements added to diets of hospitalized older adults?
A) Improved grip strength
B) Increased weight
C) Overall increased intake of food
D) Reduced readmissions to the hospital
Q3) Patients at risk of Refeeding Syndrome include those with:
A) No food intake for more than 10 days
B) Chronic malnutrition
C) Dysphagia
D) All of the above
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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) All of the following criteria define frailty except:
A) Unintentional weight loss >10 pounds in the past year
B) Slow walking speed
C) Stooped posture
D) Self-reported exhaustion
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) Reported outcome measures for the Patient Centered Medical Home include all of the following except:
A) Emergency room use
B) Hospitalizations
C) Patient/family satisfaction
D) Number of primary care visits
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Chapter 19: Palliative Care and End-Of-Life Care
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16 Verified Questions
16 Flashcards
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Sample Questions
Q1) The most prevalent symptom in end-of-life care includes all of the following except:
A) Lower extremity weakness
B) Pain
C) Dyspnea
D) Delirium
Q2) The drug specific for severe opioid-induced constipation is:
A) Lactulose
B) Ducolax
C) Mineral oil
D) Methylnaltrexone
Q3) A drug that can be used to treat two very common symptoms in a dying patient (pain and dyspnea)is:
A) Morphine
B) Methadone
C) Gabapentin
D) Lorazepam
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