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UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL ACTUAL
EXAM QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE — UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL PAPER
The NURS 5462 Final Paper focuses on the comprehensive management of a complex older
adult patient in the primary care setting. Key content areas include:
Comprehensive Geriatric Assessment — Functional assessment (ADLs, IADLs), cognitive
screening (MoCA, Mini-Cog, SLUMS), fall risk assessment (Timed Up and Go, Get Up and Go),
medication review (Beers Criteria, STOPP/START, polypharmacy), nutritional screening (MNA,
unintentional weight loss), social assessment (support system, elder abuse risk, driving safety),
advanced care planning (advance directives, POLST, healthcare proxy) .
Common Geriatric Syndromes — Falls, frailty, delirium (hyperactive, hypoactive, mixed),
dementia (Alzheimer’s, vascular, Lewy body, frontotemporal, Parkinson’s disease dementia),
urinary incontinence (stress, urge, overflow, functional, mixed), pressure ulcers, sleep disorders,
sarcopenia, dizziness, hearing/vision impairment .
Chronic Disease Management in Older Adults — Hypertension (targets, fall risk with
overtreatment), diabetes (A1C goals relaxed 7.5-8.5% in frail elderly, hypoglycemia risk), heart
failure (HFpEF vs HFrEF, diuretics, monitoring), COPD, osteoarthritis, osteoporosis, chronic
kidney disease (stage-based management, medication adjustments), depression (PHQ-9, GDS,
SSRIs with caution, START criteria), anxiety, Parkinson’s disease .
Pharmacology in Aging — Pharmacokinetic changes (reduced renal clearance, decreased
hepatic metabolism, increased volume of distribution for lipophilic drugs), pharmacodynamic
changes (increased sensitivity to CNS depressants, anticoagulants), high-risk medications (Beers
List: benzodiazepines, anticholinergics, NSAIDs, muscle relaxants, sulfonylureas, sliding scale
insulin, meperidine, tricyclic antidepressants, antipsychotics for dementia-related behaviors) .
Ethical and Legal Issues — Capacity vs competency, surrogate decision-making, guardianship,
elder abuse reporting (mandatory in Texas), driving cessation, end-of-life care (palliative vs
hospice, goals of care conversations) .
Health Promotion and Prevention in Older Adults — Vaccines (influenza, pneumococcal,
shingles, Tdap, COVID-19, RSV), cancer screening (mammogram, colonoscopy, PSA – shared
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decision-making, stopping ages), falls prevention (home safety, vitamin D, balance exercises),
bone density screening, advance care planning discussions .
UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL PAPER — 200 RANDOMIZED SCENARIO-
BASED MCQS
1. An 82-year-old male with hypertension and diabetes presents for annual exam. He reports no
new concerns. Which screening test is no longer routinely recommended by USPSTF for this
patient?
A) Colorectal cancer screening
B) Blood pressure measurement
C) Diabetes screening
D) Hearing screening
Answer: A
*RATIONALE: USPSTF recommends stopping colorectal cancer screening after age 75 in average-
risk patients, though individual factors may be considered up to age 85 .*
2. A 78-year-old female with stage 3 CKD (eGFR 35) and type 2 diabetes has an A1C of 7.2%. She
is on metformin and glipizide. Which medication change is most appropriate to reduce
hypoglycemia risk?
A) Increase metformin
B) Add insulin glargine
C) Discontinue glipizide
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D) Add SGLT2 inhibitor
Answer: C
*RATIONALE: Sulfonylureas (glipizide) increase hypoglycemia risk in older adults with CKD; de-
prescribing is recommended per Beers Criteria, especially when A1C is controlled .*
3. A 74-year-old male with hypertension on lisinopril and HCTZ reports dizziness when standing.
BP seated is 130/80, standing 100/60. What is the most appropriate next step?
A) Add midodrine
B) Discontinue lisinopril
C) Decrease HCTZ dose
D) Increase fluid intake only
Answer: B
RATIONALE: Orthostatic hypotension from ACE inhibitor; discontinue the most likely culprit
(lisinopril) first, monitor BP, then adjust diuretic if needed .
4. An 80-year-old female with Alzheimer's dementia is started on donepezil. Her daughter
reports the patient had a bowel movement yesterday after 5 days of nothing. What is the most
likely cause?
A) Donepezil side effect
B) Normal aging change
C) Dehydration
D) Opioid use
Answer: A
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RATIONALE: Cholinesterase inhibitors (donepezil) increase GI motility and can cause diarrhea but
also constipation due to decreased fluid intake; however, increased cholinergic tone can cause
both; here, likely donepezil-related GI effects .
5. A 76-year-old male with heart failure with preserved ejection fraction (HFpEF) presents with
worsening dyspnea and 4-lb weight gain in 3 days. He is on furosemide 40 mg daily. What is the
most appropriate next step?
A) Increase furosemide to 40 mg BID
B) Add metolazone
C) Admit to hospital
D) Double beta-blocker dose
Answer: C
RATIONALE: Rapid weight gain and worsening dyspnea in HF indicate acute decompensation
requiring hospital admission for IV diuretics and monitoring .
6. A 72-year-old male with COPD on tiotropium and albuterol PRN presents with increased
shortness of breath, purulent sputum, and low-grade fever for 3 days. He is afebrile now with
O2 sat 91% on room air. What is the most appropriate next step?
A) Oral prednisone 40 mg daily for 5 days
B) Levofloxacin 750 mg daily for 5 days
C) Azithromycin 500 mg once then 250 mg daily for 5 days
D) Both A and C
Answer: D
UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL ACTUAL
EXAM QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
EXAM COVERAGE — UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL PAPER
The NURS 5462 Final Paper focuses on the comprehensive management of a complex older
adult patient in the primary care setting. Key content areas include:
Comprehensive Geriatric Assessment — Functional assessment (ADLs, IADLs), cognitive
screening (MoCA, Mini-Cog, SLUMS), fall risk assessment (Timed Up and Go, Get Up and Go),
medication review (Beers Criteria, STOPP/START, polypharmacy), nutritional screening (MNA,
unintentional weight loss), social assessment (support system, elder abuse risk, driving safety),
advanced care planning (advance directives, POLST, healthcare proxy) .
Common Geriatric Syndromes — Falls, frailty, delirium (hyperactive, hypoactive, mixed),
dementia (Alzheimer’s, vascular, Lewy body, frontotemporal, Parkinson’s disease dementia),
urinary incontinence (stress, urge, overflow, functional, mixed), pressure ulcers, sleep disorders,
sarcopenia, dizziness, hearing/vision impairment .
Chronic Disease Management in Older Adults — Hypertension (targets, fall risk with
overtreatment), diabetes (A1C goals relaxed 7.5-8.5% in frail elderly, hypoglycemia risk), heart
failure (HFpEF vs HFrEF, diuretics, monitoring), COPD, osteoarthritis, osteoporosis, chronic
kidney disease (stage-based management, medication adjustments), depression (PHQ-9, GDS,
SSRIs with caution, START criteria), anxiety, Parkinson’s disease .
Pharmacology in Aging — Pharmacokinetic changes (reduced renal clearance, decreased
hepatic metabolism, increased volume of distribution for lipophilic drugs), pharmacodynamic
changes (increased sensitivity to CNS depressants, anticoagulants), high-risk medications (Beers
List: benzodiazepines, anticholinergics, NSAIDs, muscle relaxants, sulfonylureas, sliding scale
insulin, meperidine, tricyclic antidepressants, antipsychotics for dementia-related behaviors) .
Ethical and Legal Issues — Capacity vs competency, surrogate decision-making, guardianship,
elder abuse reporting (mandatory in Texas), driving cessation, end-of-life care (palliative vs
hospice, goals of care conversations) .
Health Promotion and Prevention in Older Adults — Vaccines (influenza, pneumococcal,
shingles, Tdap, COVID-19, RSV), cancer screening (mammogram, colonoscopy, PSA – shared
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decision-making, stopping ages), falls prevention (home safety, vitamin D, balance exercises),
bone density screening, advance care planning discussions .
UTA NURS 5462 ADULT-GERO PRIMARY CARE FINAL PAPER — 200 RANDOMIZED SCENARIO-
BASED MCQS
1. An 82-year-old male with hypertension and diabetes presents for annual exam. He reports no
new concerns. Which screening test is no longer routinely recommended by USPSTF for this
patient?
A) Colorectal cancer screening
B) Blood pressure measurement
C) Diabetes screening
D) Hearing screening
Answer: A
*RATIONALE: USPSTF recommends stopping colorectal cancer screening after age 75 in average-
risk patients, though individual factors may be considered up to age 85 .*
2. A 78-year-old female with stage 3 CKD (eGFR 35) and type 2 diabetes has an A1C of 7.2%. She
is on metformin and glipizide. Which medication change is most appropriate to reduce
hypoglycemia risk?
A) Increase metformin
B) Add insulin glargine
C) Discontinue glipizide
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D) Add SGLT2 inhibitor
Answer: C
*RATIONALE: Sulfonylureas (glipizide) increase hypoglycemia risk in older adults with CKD; de-
prescribing is recommended per Beers Criteria, especially when A1C is controlled .*
3. A 74-year-old male with hypertension on lisinopril and HCTZ reports dizziness when standing.
BP seated is 130/80, standing 100/60. What is the most appropriate next step?
A) Add midodrine
B) Discontinue lisinopril
C) Decrease HCTZ dose
D) Increase fluid intake only
Answer: B
RATIONALE: Orthostatic hypotension from ACE inhibitor; discontinue the most likely culprit
(lisinopril) first, monitor BP, then adjust diuretic if needed .
4. An 80-year-old female with Alzheimer's dementia is started on donepezil. Her daughter
reports the patient had a bowel movement yesterday after 5 days of nothing. What is the most
likely cause?
A) Donepezil side effect
B) Normal aging change
C) Dehydration
D) Opioid use
Answer: A
, Page 4 of 92
RATIONALE: Cholinesterase inhibitors (donepezil) increase GI motility and can cause diarrhea but
also constipation due to decreased fluid intake; however, increased cholinergic tone can cause
both; here, likely donepezil-related GI effects .
5. A 76-year-old male with heart failure with preserved ejection fraction (HFpEF) presents with
worsening dyspnea and 4-lb weight gain in 3 days. He is on furosemide 40 mg daily. What is the
most appropriate next step?
A) Increase furosemide to 40 mg BID
B) Add metolazone
C) Admit to hospital
D) Double beta-blocker dose
Answer: C
RATIONALE: Rapid weight gain and worsening dyspnea in HF indicate acute decompensation
requiring hospital admission for IV diuretics and monitoring .
6. A 72-year-old male with COPD on tiotropium and albuterol PRN presents with increased
shortness of breath, purulent sputum, and low-grade fever for 3 days. He is afebrile now with
O2 sat 91% on room air. What is the most appropriate next step?
A) Oral prednisone 40 mg daily for 5 days
B) Levofloxacin 750 mg daily for 5 days
C) Azithromycin 500 mg once then 250 mg daily for 5 days
D) Both A and C
Answer: D
