ADULT-GERONTOLOGY PRACTICE EXAM
2026 FULL QUESTIONS AND DETAILED
SOLUTIONS
●● Rovsing's Sign. Answer: Palpation in LLQ ilicits pain in RLQ
indicates appendicitis
●● NYHA classes of Heart Failure. Answer: I No limitation of physical
activity. Ordinary physical activity does not cause undue fatigue,
palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary
physical activity results in fatigue, palpitation, dyspnea (shortness of
breath).
III Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort.
Symptoms of heart failure at rest. If any physical activity is undertaken,
discomfort increases.
●● Step-wise Approach to Asthma Diagnosis & Treatment. Answer:
Step 1- Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2
days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms
> 2 days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt
cromolyn, montelukast, nedocromil, theophylline.
,Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily
Symptoms. SABA plus low dose ICS or med dose ICS or low dose with
leukotriene inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted.
Symptoms most of day. High dose ICS plus long acting B2 agonist plus
oral steroid daily (prednisone).
●● Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone:. Answer: PEF based on Height Age Gender.
Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or
Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
●● PPD. Answer: Neg- No firm bump forms at the test site, or a bump
forms that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in
people who are in a high-risk group. HIV, immunocompromise, exposed.
, A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in
people who are in a moderate-risk group. healthcare workers,
immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in
people who are in a low-risk group no risk for tb.
●● Digoxin (Cardiac Glycosides). Answer: Therapuetic 0.5-2.0
Overdose toxcitity GI upset, arrhythmias, confusion visual changes
(yellow/green tinge vision- scotomas). Tx with digibind. order dig level,
electrolytes, creatinine ekg.
●● Thiazide Diuretics. Answer: Pt with both htn and osteoporosis have
an extra benefit from thiazides. thiazide diuretics decrease calcium
excretion by the kidneys and stimulate osteoclasts formation. Patients
with serious sulfa allergies should avoid thiazide diuretics. Potassium
sparing diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide),
indapamide (lozol), metolazone (zaroxolyn); indicated for decreased
fluid volume, inexpensive, effective, useful in severe hypertension,
effective orally, enhances other antihypertensives; adverse reactions:
hypokalemia symptoms, hyperuricemia, glucose tolerance,
hypercholesterolemia, sexual dysfunction; observe for postural
hypotension, caution with renal failure gout and client taking lithium;
2026 FULL QUESTIONS AND DETAILED
SOLUTIONS
●● Rovsing's Sign. Answer: Palpation in LLQ ilicits pain in RLQ
indicates appendicitis
●● NYHA classes of Heart Failure. Answer: I No limitation of physical
activity. Ordinary physical activity does not cause undue fatigue,
palpitation, dyspnea (shortness of breath).
II Slight limitation of physical activity. Comfortable at rest. Ordinary
physical activity results in fatigue, palpitation, dyspnea (shortness of
breath).
III Marked limitation of physical activity. Comfortable at rest. Less than
ordinary activity causes fatigue, palpitation, or dyspnea.
IV Unable to carry on any physical activity without discomfort.
Symptoms of heart failure at rest. If any physical activity is undertaken,
discomfort increases.
●● Step-wise Approach to Asthma Diagnosis & Treatment. Answer:
Step 1- Mild Intermitten FEV1/PEF > 80% predicted. Symptoms <2
days/week. Albuterol as needed.
Step 2- Mild presistent Asthma (FEV1/PEF > 80% predicted. Symptoms
> 2 days/week. Albuterol as needed. Low dose ICS ex Flovent. Alt
cromolyn, montelukast, nedocromil, theophylline.
,Step 3- Mod presistent (FEV1 or PEF 60-80% predicted. Daily
Symptoms. SABA plus low dose ICS or med dose ICS or low dose with
leukotriene inhibitor (singulair, theophylline, zileuton).
Step 4- Severe presistent asthma (FEV1/PEF <60% predicted.
Symptoms most of day. High dose ICS plus long acting B2 agonist plus
oral steroid daily (prednisone).
●● Peak Expiratory Flow Rate (HAG):
Green Yellow Red Zone:. Answer: PEF based on Height Age Gender.
Blow hard using spirometer highest value recorded.
80-100% expected volume Green Zone maintain or reduce meds
50-80% expected volume Yellow Zone increase maintenance therapy. Or
Having exacerbation.
Below 50% expected volume Red Zone call 911 give epinephrine inj.
●● PPD. Answer: Neg- No firm bump forms at the test site, or a bump
forms that is smaller than 5 mm (0.2 in.).
A firm bump that is 5 mm (0.2 in.) in size suggests a TB infection in
people who are in a high-risk group. HIV, immunocompromise, exposed.
, A firm bump that is 10 mm (0.4 in.) in size suggests a TB infection in
people who are in a moderate-risk group. healthcare workers,
immigrants, homeless.
A firm bump that is 15 mm (0.6 in.) in size suggests a TB infection in
people who are in a low-risk group no risk for tb.
●● Digoxin (Cardiac Glycosides). Answer: Therapuetic 0.5-2.0
Overdose toxcitity GI upset, arrhythmias, confusion visual changes
(yellow/green tinge vision- scotomas). Tx with digibind. order dig level,
electrolytes, creatinine ekg.
●● Thiazide Diuretics. Answer: Pt with both htn and osteoporosis have
an extra benefit from thiazides. thiazide diuretics decrease calcium
excretion by the kidneys and stimulate osteoclasts formation. Patients
with serious sulfa allergies should avoid thiazide diuretics. Potassium
sparing diuretics can be used as alternative.
Chlorthalidone (hygroton), hydrochlororthiazide (esidrix, microzide),
indapamide (lozol), metolazone (zaroxolyn); indicated for decreased
fluid volume, inexpensive, effective, useful in severe hypertension,
effective orally, enhances other antihypertensives; adverse reactions:
hypokalemia symptoms, hyperuricemia, glucose tolerance,
hypercholesterolemia, sexual dysfunction; observe for postural
hypotension, caution with renal failure gout and client taking lithium;
