NURS 5461 Adult Gerontology Management
Across the Continuum of Care – Final
Assessment Review Graded A+
Q1. Which intervention is most appropriate for an older adult with mild cognitive
impairment who lives alone?
A. Initiate cholinesterase inhibitors
B. Recommend structured routines and memory aids
B. Refer for immediate nursing home placement
C. Begin antipsychotic therapy
Rationale: Non-pharmacologic strategies such as routines and memory aids are first-
line for mild cognitive impairment. Medications are reserved for diagnosed dementia.
Q2. In managing heart failure with preserved ejection fraction (HFpEF) in older adults,
the primary treatment goal is:
A. Increase contractility with digoxin
B. Control blood pressure and volume status
B. Use high-dose beta agonists
C. Aggressively lower heart rate below 50 bpm
Rationale: HFpEF management focuses on controlling hypertension, fluid overload, and
comorbidities rather than contractility.
Q3. Which screening tool is most appropriate for detecting depression in geriatric
patients?
A. Mini-Mental State Exam (MMSE)
B. Geriatric Depression Scale (GDS)
B. Montreal Cognitive Assessment (MoCA)
C. PHQ-9 only
Rationale: The GDS is validated for older adults and minimizes somatic symptom bias
common in depression screening.
Q4. An 82-year-old with diabetes presents with polypharmacy. Which principle guides
deprescribing?
A. Stop all non-essential medications immediately
B. Evaluate risk-benefit ratio and prioritize symptom control
B. Reduce medications only if cost is high
C. Continue all medications to avoid withdrawal
Rationale: Deprescribing requires careful evaluation of risks, benefits, and patient-
centered goals, not abrupt discontinuation.
Q5. Which vaccine is recommended for all adults ≥65 years regardless of prior
immunization history?
A. Live attenuated influenza vaccine
,B. Pneumococcal conjugate vaccine (PCV20 or sequential PCV15 + PPSV23)
B. Varicella vaccine
C. HPV vaccine
Rationale: Pneumococcal vaccination is essential in older adults to reduce morbidity
and mortality from pneumonia.
Q6. The most effective non-pharmacologic intervention for fall prevention in older adults
is:
A. Bed rest
B. Strength and balance training (e.g., Tai Chi)
B. Vitamin D supplementation alone
C. Restricting mobility
Rationale: Exercise programs targeting strength and balance significantly reduce fall
risk.
Q7. Which finding indicates frailty syndrome in geriatric patients?
A. BMI >30
B. Unintentional weight loss, weakness, and slow walking speed
B. Hypertension and hyperlipidemia
C. Mild memory impairment
Rationale: Frailty is defined by ≥3 of the following: weight loss, exhaustion, weakness,
slow walking speed, and low physical activity.
Q8. For an older adult with advanced COPD, the most appropriate palliative care focus
is:
A. Aggressive bronchodilator therapy
B. Symptom relief (dyspnea management, oxygen, psychosocial support)
B. Surgical intervention
C. Long-term mechanical ventilation
Rationale: Palliative care emphasizes symptom control and quality of life rather than
curative measures in advanced disease.
Q9. Which lab value is most reliable for assessing renal function in older adults?
A. Serum creatinine alone
B. Estimated glomerular filtration rate (eGFR)
B. BUN only
C. Urine specific gravity
Rationale: eGFR accounts for age-related changes in muscle mass, making it more
accurate than serum creatinine alone.
Q10. In managing delirium in hospitalized older adults, the first-line intervention is:
A. Antipsychotic medication
B. Identify and treat underlying causes (infection, electrolyte imbalance, medications)
B. Physical restraints
C. Sedative-hypnotics
Rationale: Delirium management begins with correcting reversible causes; medications
, are reserved for severe agitation threatening safety.
Q11. Which intervention best reduces hospital readmissions in older adults with CHF?
A. Increase diuretic dose only
B. Comprehensive discharge planning with follow-up calls
B. Restrict fluids completely
C. Avoid all physical activity
Rationale: Transitional care programs with structured discharge planning and follow-up
reduce readmissions.
Q12. The most appropriate pain management strategy for an older adult with
osteoarthritis is:
A. Long-term opioids
B. Acetaminophen and non-pharmacologic measures first
B. Corticosteroids daily
C. Muscle relaxants
Rationale: First-line therapy includes acetaminophen, exercise, and weight
management; opioids are last resort.
Q13. Which finding suggests elder abuse?
A. Multiple bruises in various healing stages
B. Inconsistent explanations for injuries
B. Delay in seeking care
C. All of the above
Rationale: Elder abuse often presents with multiple suspicious signs; all listed are red
flags.
Q14. For an older adult with atrial fibrillation, anticoagulation decisions should be guided
by:
A. Age alone
B. CHA₂DS₂-VASc score
B. Presence of hypertension only
C. Patient preference only
Rationale: Stroke risk stratification using CHA₂DS₂-VASc guides anticoagulation
therapy.
Q15. Which intervention is most effective for urinary incontinence in older women?
A. Indwelling catheter
B. Pelvic floor muscle training (Kegels)
B. Daily diuretics
C. Fluid restriction
Rationale: Pelvic floor strengthening is first-line for stress incontinence.
Q16. The best indicator of malnutrition in older adults is:
A. BMI alone
B. Unintentional weight loss >10% in 6 months
Across the Continuum of Care – Final
Assessment Review Graded A+
Q1. Which intervention is most appropriate for an older adult with mild cognitive
impairment who lives alone?
A. Initiate cholinesterase inhibitors
B. Recommend structured routines and memory aids
B. Refer for immediate nursing home placement
C. Begin antipsychotic therapy
Rationale: Non-pharmacologic strategies such as routines and memory aids are first-
line for mild cognitive impairment. Medications are reserved for diagnosed dementia.
Q2. In managing heart failure with preserved ejection fraction (HFpEF) in older adults,
the primary treatment goal is:
A. Increase contractility with digoxin
B. Control blood pressure and volume status
B. Use high-dose beta agonists
C. Aggressively lower heart rate below 50 bpm
Rationale: HFpEF management focuses on controlling hypertension, fluid overload, and
comorbidities rather than contractility.
Q3. Which screening tool is most appropriate for detecting depression in geriatric
patients?
A. Mini-Mental State Exam (MMSE)
B. Geriatric Depression Scale (GDS)
B. Montreal Cognitive Assessment (MoCA)
C. PHQ-9 only
Rationale: The GDS is validated for older adults and minimizes somatic symptom bias
common in depression screening.
Q4. An 82-year-old with diabetes presents with polypharmacy. Which principle guides
deprescribing?
A. Stop all non-essential medications immediately
B. Evaluate risk-benefit ratio and prioritize symptom control
B. Reduce medications only if cost is high
C. Continue all medications to avoid withdrawal
Rationale: Deprescribing requires careful evaluation of risks, benefits, and patient-
centered goals, not abrupt discontinuation.
Q5. Which vaccine is recommended for all adults ≥65 years regardless of prior
immunization history?
A. Live attenuated influenza vaccine
,B. Pneumococcal conjugate vaccine (PCV20 or sequential PCV15 + PPSV23)
B. Varicella vaccine
C. HPV vaccine
Rationale: Pneumococcal vaccination is essential in older adults to reduce morbidity
and mortality from pneumonia.
Q6. The most effective non-pharmacologic intervention for fall prevention in older adults
is:
A. Bed rest
B. Strength and balance training (e.g., Tai Chi)
B. Vitamin D supplementation alone
C. Restricting mobility
Rationale: Exercise programs targeting strength and balance significantly reduce fall
risk.
Q7. Which finding indicates frailty syndrome in geriatric patients?
A. BMI >30
B. Unintentional weight loss, weakness, and slow walking speed
B. Hypertension and hyperlipidemia
C. Mild memory impairment
Rationale: Frailty is defined by ≥3 of the following: weight loss, exhaustion, weakness,
slow walking speed, and low physical activity.
Q8. For an older adult with advanced COPD, the most appropriate palliative care focus
is:
A. Aggressive bronchodilator therapy
B. Symptom relief (dyspnea management, oxygen, psychosocial support)
B. Surgical intervention
C. Long-term mechanical ventilation
Rationale: Palliative care emphasizes symptom control and quality of life rather than
curative measures in advanced disease.
Q9. Which lab value is most reliable for assessing renal function in older adults?
A. Serum creatinine alone
B. Estimated glomerular filtration rate (eGFR)
B. BUN only
C. Urine specific gravity
Rationale: eGFR accounts for age-related changes in muscle mass, making it more
accurate than serum creatinine alone.
Q10. In managing delirium in hospitalized older adults, the first-line intervention is:
A. Antipsychotic medication
B. Identify and treat underlying causes (infection, electrolyte imbalance, medications)
B. Physical restraints
C. Sedative-hypnotics
Rationale: Delirium management begins with correcting reversible causes; medications
, are reserved for severe agitation threatening safety.
Q11. Which intervention best reduces hospital readmissions in older adults with CHF?
A. Increase diuretic dose only
B. Comprehensive discharge planning with follow-up calls
B. Restrict fluids completely
C. Avoid all physical activity
Rationale: Transitional care programs with structured discharge planning and follow-up
reduce readmissions.
Q12. The most appropriate pain management strategy for an older adult with
osteoarthritis is:
A. Long-term opioids
B. Acetaminophen and non-pharmacologic measures first
B. Corticosteroids daily
C. Muscle relaxants
Rationale: First-line therapy includes acetaminophen, exercise, and weight
management; opioids are last resort.
Q13. Which finding suggests elder abuse?
A. Multiple bruises in various healing stages
B. Inconsistent explanations for injuries
B. Delay in seeking care
C. All of the above
Rationale: Elder abuse often presents with multiple suspicious signs; all listed are red
flags.
Q14. For an older adult with atrial fibrillation, anticoagulation decisions should be guided
by:
A. Age alone
B. CHA₂DS₂-VASc score
B. Presence of hypertension only
C. Patient preference only
Rationale: Stroke risk stratification using CHA₂DS₂-VASc guides anticoagulation
therapy.
Q15. Which intervention is most effective for urinary incontinence in older women?
A. Indwelling catheter
B. Pelvic floor muscle training (Kegels)
B. Daily diuretics
C. Fluid restriction
Rationale: Pelvic floor strengthening is first-line for stress incontinence.
Q16. The best indicator of malnutrition in older adults is:
A. BMI alone
B. Unintentional weight loss >10% in 6 months
