NURS 6540 Advanced Practice Care of Frail Elders
– Comprehensive Assessment Actual Exam –
Complete Questions and Answers with Detailed
Rationales – Pass Guaranteed – A+ Graded
Foundations: Frailty, Geriatric Syndromes & Comprehensive Assessment
Q1: Which of the following best describes the frailty phenotype as defined by Fried and
colleagues?
A. A cumulative index of diseases, disabilities, and social deficits that accumulate over a
lifetime
B. The presence of unintentional weight loss, exhaustion, weakness, slow walking
speed, and low physical activity
C. A state of severe cognitive decline accompanied by functional dependency and
nutritional deficiency
D. The inability to perform three or more instrumental activities of daily living due to
chronic disease burden
Correct Answer: B
Rationale: The best answer is B, because the Fried frailty phenotype specifically
identifies frailty through five physical criteria: unintentional weight loss, self-reported
exhaustion, weakness (grip strength), slow walking speed, and low physical activity,
which distinguishes it from the broader deficit accumulation model.
Q2: When using the deficit accumulation model to assess frailty, a patient is generally
considered frail if their Frailty Index score reaches what threshold?
A. Greater than 0.10 (10% deficit accumulation)
B. Greater than 0.20 (20% deficit accumulation)
C. Greater than 0.30 (30% deficit accumulation)
D. Greater than 0.50 (50% deficit accumulation)
Correct Answer: C
Rationale: This is correct because the Frailty Index calculates the proportion of potential
health deficits present in a patient, and a score exceeding 0.30, or 30%, is the widely
accepted clinical cutoff for identifying a frail older adult who is at high risk for adverse
health outcomes.
,Q3: A 76-year-old patient is found to have unintentional weight loss, slow gait speed,
and weakness. As the AGPCNP, you know that identifying these frailty criteria is crucial
because frailty is strongly linked to which clinical consequences?
A. Complete reversal of cognitive impairment with physical exercise only
B. Increased risk of falls, hospitalization, institutionalization, and death
C. A guarantee that the patient will develop Alzheimer disease within two years
D. Strictly isolated musculoskeletal decline without systemic effects
Correct Answer: B
Rationale: The best answer is B, because frailty is a state of decreased physiological
reserve and multisystem dysregulation; recognizing it early allows us to intervene and
hopefully prevent the cascade of adverse outcomes like falls, heightened hospitalization
risk, and increased mortality.
Q4: An 84-year-old female is brought to the clinic by her daughter for a "UTI." The
patient has no dysuria or frequency, but she has been increasingly confused and
lethargic for the past two days. What geriatric concept does this presentation best
illustrate?
A. The typical progression of Alzheimer disease to the moderate stage
B. An atypical presentation of illness, where delirium is the sole sign of an underlying
infection
C. Normal age-related cognitive changes that require no medical workup
D. A classic presentation of late-onset major depressive disorder
Correct Answer: B
Rationale: This is correct because older adults often present with atypical symptoms
when they are ill; instead of classic localized symptoms like dysuria, an infection might
manifest solely as an acute change in mental status or delirium, requiring a high index
of suspicion.
Q5: Which of the following groupings correctly represents classic geriatric syndromes?
A. Osteoporosis, rheumatoid arthritis, and osteoarthritis
B. Delirium, falls, urinary incontinence, and pressure injuries
C. Type 2 diabetes, hypertension, and hyperlipidemia
D. Asthma, chronic bronchitis, and emphysema
Correct Answer: B
Rationale: The best answer is B, because geriatric syndromes are multifactorial
conditions that do not fit into discrete disease categories—like delirium, falls,
incontinence, and pressure injuries—and they share common underlying risk factors
such as cognitive impairment and functional decline.
, Q6: During a comprehensive geriatric assessment, you observe that a patient has
significant loss of skeletal muscle mass and strength, which is contributing to their gait
instability. What is the clinical term for this condition?
A. Sarcopenia
B. Cachexia
C. Frailty
D. Failure to thrive
Correct Answer: A
Rationale: This is correct because sarcopenia specifically refers to the age-related,
progressive loss of skeletal muscle mass and function; while it is a key driver of frailty, it
is its own distinct diagnosable condition that directly impacts mobility and fall risk.
Q7: A graduate nursing student asks you to list the core domains included in a
Comprehensive Geriatric Assessment (CGA). Which response is the most accurate?
A. Cardiovascular, pulmonary, gastrointestinal, and neurological systems
B. Physical, functional, psychological, social, environmental, and spiritual
C. Acute, subacute, chronic, and terminal illness phases
D. Surgical, medical, pharmacological, and rehabilitative needs
Correct Answer: B
Rationale: The best answer is B, because a true CGA is a multidimensional,
interdisciplinary diagnostic process designed to determine a frail older person's medical,
psychological, and functional capabilities, specifically spanning those six holistic
domains to guide a care plan.
Q8: A 78-year-old patient lives alone and is still able to bathe, dress, and toilet
independently. However, her daughter notes that the patient's house is very dirty, she
has been burning pots on the stove, and she forgot to pay her electric bill for the third
month in a row. How do you interpret this functional decline?
A. The patient has lost her ability to perform basic Activities of Daily Living (ADLs).
B. The patient is demonstrating declines in Instrumental Activities of Daily Living
(IADLs), which often signal early cognitive or functional decline.
C. The patient is fully independent and these are just isolated, harmless mistakes.
D. The patient requires immediate 24-hour skilled nursing care for basic survival.
Correct Answer: B
Rationale: This is correct because managing finances, cooking, and housekeeping are
IADLs, which are more complex tasks that typically decline earlier in the disease
process; losing the ability to safely perform IADLs is a major red flag for early cognitive
impairment even when basic ADLs remain intact.
– Comprehensive Assessment Actual Exam –
Complete Questions and Answers with Detailed
Rationales – Pass Guaranteed – A+ Graded
Foundations: Frailty, Geriatric Syndromes & Comprehensive Assessment
Q1: Which of the following best describes the frailty phenotype as defined by Fried and
colleagues?
A. A cumulative index of diseases, disabilities, and social deficits that accumulate over a
lifetime
B. The presence of unintentional weight loss, exhaustion, weakness, slow walking
speed, and low physical activity
C. A state of severe cognitive decline accompanied by functional dependency and
nutritional deficiency
D. The inability to perform three or more instrumental activities of daily living due to
chronic disease burden
Correct Answer: B
Rationale: The best answer is B, because the Fried frailty phenotype specifically
identifies frailty through five physical criteria: unintentional weight loss, self-reported
exhaustion, weakness (grip strength), slow walking speed, and low physical activity,
which distinguishes it from the broader deficit accumulation model.
Q2: When using the deficit accumulation model to assess frailty, a patient is generally
considered frail if their Frailty Index score reaches what threshold?
A. Greater than 0.10 (10% deficit accumulation)
B. Greater than 0.20 (20% deficit accumulation)
C. Greater than 0.30 (30% deficit accumulation)
D. Greater than 0.50 (50% deficit accumulation)
Correct Answer: C
Rationale: This is correct because the Frailty Index calculates the proportion of potential
health deficits present in a patient, and a score exceeding 0.30, or 30%, is the widely
accepted clinical cutoff for identifying a frail older adult who is at high risk for adverse
health outcomes.
,Q3: A 76-year-old patient is found to have unintentional weight loss, slow gait speed,
and weakness. As the AGPCNP, you know that identifying these frailty criteria is crucial
because frailty is strongly linked to which clinical consequences?
A. Complete reversal of cognitive impairment with physical exercise only
B. Increased risk of falls, hospitalization, institutionalization, and death
C. A guarantee that the patient will develop Alzheimer disease within two years
D. Strictly isolated musculoskeletal decline without systemic effects
Correct Answer: B
Rationale: The best answer is B, because frailty is a state of decreased physiological
reserve and multisystem dysregulation; recognizing it early allows us to intervene and
hopefully prevent the cascade of adverse outcomes like falls, heightened hospitalization
risk, and increased mortality.
Q4: An 84-year-old female is brought to the clinic by her daughter for a "UTI." The
patient has no dysuria or frequency, but she has been increasingly confused and
lethargic for the past two days. What geriatric concept does this presentation best
illustrate?
A. The typical progression of Alzheimer disease to the moderate stage
B. An atypical presentation of illness, where delirium is the sole sign of an underlying
infection
C. Normal age-related cognitive changes that require no medical workup
D. A classic presentation of late-onset major depressive disorder
Correct Answer: B
Rationale: This is correct because older adults often present with atypical symptoms
when they are ill; instead of classic localized symptoms like dysuria, an infection might
manifest solely as an acute change in mental status or delirium, requiring a high index
of suspicion.
Q5: Which of the following groupings correctly represents classic geriatric syndromes?
A. Osteoporosis, rheumatoid arthritis, and osteoarthritis
B. Delirium, falls, urinary incontinence, and pressure injuries
C. Type 2 diabetes, hypertension, and hyperlipidemia
D. Asthma, chronic bronchitis, and emphysema
Correct Answer: B
Rationale: The best answer is B, because geriatric syndromes are multifactorial
conditions that do not fit into discrete disease categories—like delirium, falls,
incontinence, and pressure injuries—and they share common underlying risk factors
such as cognitive impairment and functional decline.
, Q6: During a comprehensive geriatric assessment, you observe that a patient has
significant loss of skeletal muscle mass and strength, which is contributing to their gait
instability. What is the clinical term for this condition?
A. Sarcopenia
B. Cachexia
C. Frailty
D. Failure to thrive
Correct Answer: A
Rationale: This is correct because sarcopenia specifically refers to the age-related,
progressive loss of skeletal muscle mass and function; while it is a key driver of frailty, it
is its own distinct diagnosable condition that directly impacts mobility and fall risk.
Q7: A graduate nursing student asks you to list the core domains included in a
Comprehensive Geriatric Assessment (CGA). Which response is the most accurate?
A. Cardiovascular, pulmonary, gastrointestinal, and neurological systems
B. Physical, functional, psychological, social, environmental, and spiritual
C. Acute, subacute, chronic, and terminal illness phases
D. Surgical, medical, pharmacological, and rehabilitative needs
Correct Answer: B
Rationale: The best answer is B, because a true CGA is a multidimensional,
interdisciplinary diagnostic process designed to determine a frail older person's medical,
psychological, and functional capabilities, specifically spanning those six holistic
domains to guide a care plan.
Q8: A 78-year-old patient lives alone and is still able to bathe, dress, and toilet
independently. However, her daughter notes that the patient's house is very dirty, she
has been burning pots on the stove, and she forgot to pay her electric bill for the third
month in a row. How do you interpret this functional decline?
A. The patient has lost her ability to perform basic Activities of Daily Living (ADLs).
B. The patient is demonstrating declines in Instrumental Activities of Daily Living
(IADLs), which often signal early cognitive or functional decline.
C. The patient is fully independent and these are just isolated, harmless mistakes.
D. The patient requires immediate 24-hour skilled nursing care for basic survival.
Correct Answer: B
Rationale: This is correct because managing finances, cooking, and housekeeping are
IADLs, which are more complex tasks that typically decline earlier in the disease
process; losing the ability to safely perform IADLs is a major red flag for early cognitive
impairment even when basic ADLs remain intact.
