Advanced Practice Nursing: Geriatrics
Textbook Exam Questions
Course Introduction
This course delves into advanced nursing practices focused on the care of geriatric populations. Students will explore complex physiological, psychological, and social changes associated with aging, and learn to assess, diagnose, and manage acute and chronic conditions prevalent among older adults. The curriculum emphasizes evidence-based interventions, medication management, and interdisciplinary collaboration, while addressing ethical, legal, and cultural issues in geriatric care. Through case studies and clinical simulations, students will develop skills to promote health, independence, and quality of life for elderly patients in diverse healthcare 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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Chapter 1: Changes With Aging
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13 Flashcards
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Sample Questions
Q1) Biochemical individuality is best described as:
A) Each individual's variation is often much greater than that of a larger group
B) The unique biochemical profile of a selected population
C) The truly "normal" individual-falling within average range
D) Each individual's variation is often much smaller than that of a larger group
Answer: D
Q2) Polypharmacy is best described as taking:
A) More than nine medications per day
B) More than five medications per day
C) Even a single medication if there is not a clear indication for its use
D) When a drug is given to treat the side effect of another drug
Answer: C
Q3) 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
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Chapter 2: Health Promotion
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16 Flashcards
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Sample Questions
Q1) Ivan W.is a 65-year-old man who is new to your practice.He has a history of COPD,CAD,hypertension,and type 2 diabetes mellitus.He has had no immunizations since his discharge from the military at age 25.Childhood diseases included chickenpox,measles,mumps,and "German measles." He presents for a disease management visit.Which of the following immunizations would you recommend for Ivan?
A) MMR,influenza,pneumococcal,Zostavax
B) Influenza,pneumococcal,PPD,Hepatitis B
C) Tdap,pneumococcal,influenza,Zostavax
D) Hepatitis B,influenza,pneumococcal,Hepatitis A
Answer: C
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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Page 4
Chapter 3: Exercise in Older Adults
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5 Verified Questions
5 Flashcards
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Sample Questions
Q1) 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
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
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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) What statement is true about nutrition intake in the elderly?
A) Deficiencies in protein intake are common with aging.
B) Malnutrition is the most common nutritional disorder among the elderly living in the community.
C) Increased caloric consumption is needed as one ages.
D) The serum albumin is a good reflection of protein stores.
Q2) 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
Q3) The leading cause of traumatic death in the elderly is due to:
A) Motor vehicle accidents
B) Pedestrian injuries
C) Falls
D) Burns
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Chapter 5: Symptoms and Syndromes
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27 Verified Questions
27 Flashcards
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Sample Questions
Q1) Recent weight loss is defined as:
A) loss of >10 pounds over the past 3-6 months
B) loss of >2 pounds a week
C) 5% weight loss in three months
D) 10% weight loss in one year
Q2) 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
Q3) The term "geriatric syndrome" is best described as:
A) A condition that has multiple underlying factors and involves multiple systems
B) A condition that has a discreet etiology that is difficult to pinpoint
C) Significant progress has been made in understanding geriatric syndromes,especially falls and delirium
D) Therapeutic management of a geriatric syndrome can be accomplished once a specific diagnosis is made
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Chapter 6: Skin and Lymphatic Disorders
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20 Flashcards
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Sample Questions
Q1) Which of the following dermatological conditions results from reactivation of the dormant varicella virus?
A) Tinea versicolor
B) Seborrheic keratosis
C) Verruca
D) Herpes zoster
Q2) An 82-year-old female has a "pimple" on his nose that occasionally bleeds and may have increased in size in the past year.The lesion is a 0.7-cm,dome-shaped,umbilicated papule with pearly translucence.There is also a hemorrhagic crust covering the central portion.Which of the following is the most likely diagnosis?
A) Squamous cell carcinoma
B) Basal cell carcinoma
C) Keratocanthoma
D) Sebaceous hyperplasia
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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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) 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
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 Flashcards
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Sample Questions
Q1) 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.
Q2) A key symptom of ischemic heart disease is chest pain.However,angina equivalents may include exertional dyspnea.Angina equivalents are important because:
A) Women with ischemic heart disease many times do not present with chest pain
B) Some patients may have no symptoms or atypical symptoms.Diagnosis may only be made at the time of an actual myocardial infarction
C) Elderly patients have the most severe symptoms
D) A & B only
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Chapter 9: Peripheral Vascular Disorders
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18 Flashcards
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Sample Questions
Q1) Inspection of the distal nails and nail beds should be evaluated for signs of decreased perfusion.Signs include:
A) Clubbing
B) Cyanosis
C) Petechiae
D) All of the above
Q2) The hallmark of venous stasis ulcers include all of the following except:
A) Lower extremity edema
B) Hyperpigmentation of the lower extremities
C) Ulcers on the medial or lateral malleolus
D) Copious draining ulcers
Q3) The imaging gold standard for lymphedema is:
A) Lymphosonogram
B) Lymphoscintigraphy
C) Lymphoangiogram
D) CT scan
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Chapter 10: Abdominal Disorders
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Sample Questions
Q1) A 62-year-old woman presents with a recurrent urinary tract infection.She now has a fever of 104°F and severe costovertebral tenderness with pyuria.What is the appropriate diagnosis and intervention for this patient?
A) Septic arthritis and oral prednisolone is indicated
B) Pyelonephritis and hospitalization is required
C) Recurrent cystitis and 10 days of antibiotics are needed
D) Pelvic inflammatory disease and 7 days of antibiotics are indicated
Q2) Which of the following findings would indicate a need for another endoscopy in clients with peptic ulcer disease?
A) Cases of dyspepsia with constipation
B) Symptoms persisting after 6-8 weeks of therapy
C) All clients with dyspepsia who smoke and drink alcohol
D) When a therapeutic response to empiric treatment is obtained
Q3) Which of the following is not a contributing factor to the development of esophagitis in older adults?
A) Increased gastric emptying time
B) Regular ingestion of NSAIDs
C) Decreased salivation
D) Fungal infections such as Candida
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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) 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
Q2) Men with an initial PSA level below 2.5 ng/ml can reduce their screening frequency to what intervals?
A) Every 6 months
B) Yearly
C) Every 2 years
D) Every 2 to 4 years
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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Sample Questions
Q1) You have ordered a CBC for your patient you suspect has polymyalgia rheumatica (PMR).Which two clinical findings are common in patients with PMR?
A) Neutropenia and hypochromic,normocytic anemia
B) Normochromic,normocytic anemia and thrombocytosis
C) Microcytic,hypochromic anemia and reticulocytopenia
D) Macrocytic,hyperchromic anemia and leukocytopenia
Q2) Which of the following statements about osteoarthritis is true?
A) It affects primarily weight-bearing joints
B) It is a systemic inflammatory illness
C) The metacarpal phalangeal joints are commonly involved
D) Prolonged morning stiffness is common
Q3) The nurse practitioner is examining the hands of a 55-year-old woman with rheumatoid arthritis and notes bilateral spindle shaped deformities on the middle interphalangeal joints.These are known as:
A) Haygarth's nodes
B) Heberden's nodes
C) Bouchard's nodes
D) Benediction hands
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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) 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
Q2) An older male patient is experiencing acute onset of right-sided weakness,slurred speech,and confusion.What should the nurse practitioner do promptly?
A) Administer an aspirin by mouth
B) Evaluate for stroke and arrange transport to the hospital right away
C) Do a thorough medication review and stat blood sugar
D) Order an EKG and administer O<sub>2</sub> by cannula immediately
Q3) The most common neurological cause of seizures in an older adult is:
A) Alzheimer's disease
B) Multiple sclerosis
C) Stroke
D) Peripheral neuropathy
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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) During a routine physical examination of a 62-year-old female patient,the nurse practitioner identifies xanthelasma around both his eyes.What is the significance of this finding?
A) High potential for future blindness and requires immediate referral
B) None,normal variant of aging process
C) Abnormal lipid metabolism requiring medical management
D) Hereditary variant that is of no consequence but requires watchful waiting
Q2) Which is a "cardinal feature" of failure to thrive?
A) Decline in toileting ability
B) Gait disturbance
C) Poor nutritional status
D) Spiritual distress
Q3) A 60-year-old obese male client has type 2 diabetes mellitus and a lipid panel of TC = 250,HDL = 32,LDL = 165.The nurse practitioner teaches the patient about his modifiable cardiac risk factors,which include:
A) Advancing age,diabetes,hyperlipidemia,and male gender
B) Diabetes,obesity,and hyperlipidemia
C) Hyperlipidemia,smoking,and family history of heart disease
D) Male with age > 45,diabetes mellitus,and hyperlipidemia
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Page 16
Chapter 15: Hematological and Immune System Disorders
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15 Verified Questions
15 Flashcards
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Sample Questions
Q1) In the older adult,which group comprises the highest rate of HIV/AIDS?
A) African American women
B) African American men
C) Hispanic women
D) Hispanic men
Q2) Contributing factors in HIV development in the older adult include all of the following except:
A) Older adults are less likely to be tested
B) Healthcare providers do not routinely ask older adults about HIV risks
C) Older adults are less likely to use condoms
D) Older adults are at low risk to contract HIV
Q3) 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
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Chapter 16: Psychological Disorders
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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) Older adults with dementia sometimes suffer from agnosia,which is defined as the inability to:
A) Use language
B) Understand language
C) Recognize objects
D) Remember events and places
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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18
Chapter 17: Nutritional Support in the Older Adult
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Sample Questions
Q1) 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
Q2) 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
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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19
Chapter 18: Chronic Illness and the Advanced Practice
Registered Nurse Aprn
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Sample Questions
Q1) 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
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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Page 20
Chapter 19: Palliative Care and End-Of-Life Care
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Sample Questions
Q1) 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
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 most prevalent symptom in end-of-life care includes all of the following except:
A) Lower extremity weakness
B) Pain
C) Dyspnea
D) Delirium
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