NURS5461: Adult Gerontology Management Quiz 2026 – UTA
1. A 65-year-old male patient presents with a persistent cough and shortness of
breath. His FEV1/FVC ratio is 0.65. According to the GOLD criteria, what is the
diagnosis?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Restrictive lung disease
C. Acute Bronchitis
D. Congestive Heart Failure
Answer: A
Rationale: An FEV1/FVC ratio of less than 0.70 is the diagnostic threshold for COPD
according to GOLD guidelines.
2. Which of the following is considered a first-line treatment for an elderly
patient diagnosed with Major Depressive Disorder, considering the side effect
profile?
A. Amitriptyline
B. Phenelzine
C. Diazepam
D. Sertraline
Answer: D
Rationale: SSRIs like sertraline are preferred in the elderly due to a more favorable side
effect profile compared to TCAs like amitriptyline, which have high anticholinergic effects.
,3. A 72-year-old patient with Type 2 Diabetes has a serum creatinine of 1.8 and
a GFR of 28 mL/min. Which medication is contraindicated?
A. Glipizide
B. Metformin
C. Insulin Glargine
D. Pioglitazone
Answer: B
Rationale: Metformin is contraindicated in patients with a GFR less than 30 mL/min due to
the increased risk of lactic acidosis.
4. Which Medicare part covers outpatient services, including provider visits and
laboratory tests?
A. Medicare Part A
B. Medicare Part D
C. Medicare Part C
D. Medicare Part B
Answer: D
Rationale: Medicare Part B covers medical insurance, including outpatient care, doctor
services, and durable medical equipment.
5. According to the Beers Criteria, which of the following medications should be
avoided in older adults due to the risk of falls?
A. Lisinopril
B. Zolpidem
C. Metformin
D. Atorvastatin
Answer: B
Rationale: Zolpidem (and other sedative-hypnotics) increases the risk of delirium, falls,
and fractures in older adults.
, 6. A patient presents with ‘the worst headache of my life.’ Which condition
should the nurse practitioner suspect first?
A. Migraine
B. Tension-type headache
C. Subarachnoid hemorrhage
D. Cluster headache
Answer: C
Rationale: The classic description of a ‘thunderclap’ or ‘worst headache of life’ is indicative
of a subarachnoid hemorrhage, a medical emergency.
7. Which physical exam finding is most indicative of Osteoarthritis rather than
Rheumatoid Arthritis?
A. Heberden’s nodes
B. Ulnar deviation
C. Symmetrical joint swelling
D. Boutonniere deformity
Answer: A
Rationale: Heberden’s nodes (DIP joints) and Bouchard’s nodes (PIP joints) are classic
signs of Osteoarthritis.
8. What is the gold standard for diagnosing sleep apnea in the elderly?
A. Pulse oximetry
B. Patient self-report
C. Chest X-ray
D. Polysomnography
Answer: D
Rationale: An overnight sleep study, or polysomnography, is the gold standard for
diagnosing obstructive sleep apnea.
1. A 65-year-old male patient presents with a persistent cough and shortness of
breath. His FEV1/FVC ratio is 0.65. According to the GOLD criteria, what is the
diagnosis?
A. Chronic Obstructive Pulmonary Disease (COPD)
B. Restrictive lung disease
C. Acute Bronchitis
D. Congestive Heart Failure
Answer: A
Rationale: An FEV1/FVC ratio of less than 0.70 is the diagnostic threshold for COPD
according to GOLD guidelines.
2. Which of the following is considered a first-line treatment for an elderly
patient diagnosed with Major Depressive Disorder, considering the side effect
profile?
A. Amitriptyline
B. Phenelzine
C. Diazepam
D. Sertraline
Answer: D
Rationale: SSRIs like sertraline are preferred in the elderly due to a more favorable side
effect profile compared to TCAs like amitriptyline, which have high anticholinergic effects.
,3. A 72-year-old patient with Type 2 Diabetes has a serum creatinine of 1.8 and
a GFR of 28 mL/min. Which medication is contraindicated?
A. Glipizide
B. Metformin
C. Insulin Glargine
D. Pioglitazone
Answer: B
Rationale: Metformin is contraindicated in patients with a GFR less than 30 mL/min due to
the increased risk of lactic acidosis.
4. Which Medicare part covers outpatient services, including provider visits and
laboratory tests?
A. Medicare Part A
B. Medicare Part D
C. Medicare Part C
D. Medicare Part B
Answer: D
Rationale: Medicare Part B covers medical insurance, including outpatient care, doctor
services, and durable medical equipment.
5. According to the Beers Criteria, which of the following medications should be
avoided in older adults due to the risk of falls?
A. Lisinopril
B. Zolpidem
C. Metformin
D. Atorvastatin
Answer: B
Rationale: Zolpidem (and other sedative-hypnotics) increases the risk of delirium, falls,
and fractures in older adults.
, 6. A patient presents with ‘the worst headache of my life.’ Which condition
should the nurse practitioner suspect first?
A. Migraine
B. Tension-type headache
C. Subarachnoid hemorrhage
D. Cluster headache
Answer: C
Rationale: The classic description of a ‘thunderclap’ or ‘worst headache of life’ is indicative
of a subarachnoid hemorrhage, a medical emergency.
7. Which physical exam finding is most indicative of Osteoarthritis rather than
Rheumatoid Arthritis?
A. Heberden’s nodes
B. Ulnar deviation
C. Symmetrical joint swelling
D. Boutonniere deformity
Answer: A
Rationale: Heberden’s nodes (DIP joints) and Bouchard’s nodes (PIP joints) are classic
signs of Osteoarthritis.
8. What is the gold standard for diagnosing sleep apnea in the elderly?
A. Pulse oximetry
B. Patient self-report
C. Chest X-ray
D. Polysomnography
Answer: D
Rationale: An overnight sleep study, or polysomnography, is the gold standard for
diagnosing obstructive sleep apnea.
