Informatics Nursing Certification
Comprehensive Final Test (Qns & Ans)
2025
1. Scenario: An 87‑year‑old woman with a history of
osteoporosis, mild cognitive impairment, and previous falls
presents for a routine visit. During her assessment, you observe
decreased lower extremity strength and poor balance. Which
intervention is most appropriate to reduce her fall risk?
A) Recommend complete bed rest to eliminate fall risk.
B) Initiate a supervised physical therapy program focused on
strength and balance training.
C) Advise her to use a walker exclusively without further
intervention.
D) Increase her calcium supplement dosage.
©2025
, ANS: B) Initiate a supervised physical therapy program
focused on strength and balance training.
Rationale: Supervised exercise programs have been shown to
improve balance, muscle strength, and functional mobility in
older adults, thereby reducing fall risk. Complete immobilization
(A) can lead to deconditioning, while immediately prescribing a
walker (C) without additional therapy may not address underlying
deficits. Increasing supplements (D) is not directly linked to
reducing fall risk.
2. Scenario: During a comprehensive assessment, a 78‑year‑old
man with chronic kidney disease and heart failure exhibits signs
of polypharmacy. He complains of dizziness and confusion.
Which approach should the nurse prioritize?
A) Advise the patient to continue his medications without
change.
B) Conduct a medication reconciliation in collaboration with
a pharmacist and the care team.
C) Immediately discontinue all nonessential medications.
D) Refer the patient for cognitive behavioral therapy.
ANS: B) Conduct a medication reconciliation in
collaboration with a pharmacist and the care team.
Rationale: Polypharmacy is common in geriatric patients and
increases the risk of adverse drug interactions. A formal
medication reconciliation allows the care team to ensure that each
medication is necessary, appropriately dosed, and to identify
©2025
,potential interactions that may be contributing to the patient’s
symptoms.
3. Scenario: A 90‑year‑old patient with known mild cognitive
impairment and limited vision has difficulty managing his self-
care. Which assessment tool is most appropriate to evaluate his
functional status in this context?
A) Mini-Mental State Examination (MMSE)
B) Katz Index of Independence in Activities of Daily Living
C) Braden Scale
D) Confusion Assessment Method (CAM)
ANS: B) Katz Index of Independence in Activities of Daily
Living
Rationale: The Katz Index measures independence in basic
activities of daily living (ADLs) and is particularly useful in
evaluating the functional status of older adults, which is crucial
for developing appropriate care plans in the geriatric population.
4. Scenario: A family nurse practitioner (FNP) is managing an
82‑year‑old patient recently admitted for acute decompensated
heart failure. Which clinical finding would most strongly suggest
that the patient requires a revision of his outpatient management
plan?
A) A slight weight gain of 1 kg over a week.
©2025
, B) An increase in B-type natriuretic peptide (BNP) levels and
pulmonary crackles on auscultation.
C) A heart rate of 88 beats per minute at rest.
D) Mild ankle edema with a history of CHF.
ANS: B) An increase in B‑type natriuretic peptide (BNP)
levels and pulmonary crackles on auscultation.
Rationale: Elevated BNP and pulmonary crackles indicate
increased cardiac stress and pulmonary congestion, which are
strong markers of acute heart failure decompensation in older
adults. Minor changes (A, C, D) may be less specific.
5. Scenario: A 76‑year‑old patient with a history of diabetes
and hypertension presents with a new onset of intermittent
claudication. Which non-pharmacologic strategy is most
beneficial in managing this condition?
A) Initiate a supervised exercise program focusing on
walking therapy.
B) Recommend complete avoidance of physical activity.
C) Schedule immediate vascular surgery consultation.
D) Advise the patient to increase dietary iron.
ANS: A) Initiate a supervised exercise program focusing on
walking therapy.
©2025
Comprehensive Final Test (Qns & Ans)
2025
1. Scenario: An 87‑year‑old woman with a history of
osteoporosis, mild cognitive impairment, and previous falls
presents for a routine visit. During her assessment, you observe
decreased lower extremity strength and poor balance. Which
intervention is most appropriate to reduce her fall risk?
A) Recommend complete bed rest to eliminate fall risk.
B) Initiate a supervised physical therapy program focused on
strength and balance training.
C) Advise her to use a walker exclusively without further
intervention.
D) Increase her calcium supplement dosage.
©2025
, ANS: B) Initiate a supervised physical therapy program
focused on strength and balance training.
Rationale: Supervised exercise programs have been shown to
improve balance, muscle strength, and functional mobility in
older adults, thereby reducing fall risk. Complete immobilization
(A) can lead to deconditioning, while immediately prescribing a
walker (C) without additional therapy may not address underlying
deficits. Increasing supplements (D) is not directly linked to
reducing fall risk.
2. Scenario: During a comprehensive assessment, a 78‑year‑old
man with chronic kidney disease and heart failure exhibits signs
of polypharmacy. He complains of dizziness and confusion.
Which approach should the nurse prioritize?
A) Advise the patient to continue his medications without
change.
B) Conduct a medication reconciliation in collaboration with
a pharmacist and the care team.
C) Immediately discontinue all nonessential medications.
D) Refer the patient for cognitive behavioral therapy.
ANS: B) Conduct a medication reconciliation in
collaboration with a pharmacist and the care team.
Rationale: Polypharmacy is common in geriatric patients and
increases the risk of adverse drug interactions. A formal
medication reconciliation allows the care team to ensure that each
medication is necessary, appropriately dosed, and to identify
©2025
,potential interactions that may be contributing to the patient’s
symptoms.
3. Scenario: A 90‑year‑old patient with known mild cognitive
impairment and limited vision has difficulty managing his self-
care. Which assessment tool is most appropriate to evaluate his
functional status in this context?
A) Mini-Mental State Examination (MMSE)
B) Katz Index of Independence in Activities of Daily Living
C) Braden Scale
D) Confusion Assessment Method (CAM)
ANS: B) Katz Index of Independence in Activities of Daily
Living
Rationale: The Katz Index measures independence in basic
activities of daily living (ADLs) and is particularly useful in
evaluating the functional status of older adults, which is crucial
for developing appropriate care plans in the geriatric population.
4. Scenario: A family nurse practitioner (FNP) is managing an
82‑year‑old patient recently admitted for acute decompensated
heart failure. Which clinical finding would most strongly suggest
that the patient requires a revision of his outpatient management
plan?
A) A slight weight gain of 1 kg over a week.
©2025
, B) An increase in B-type natriuretic peptide (BNP) levels and
pulmonary crackles on auscultation.
C) A heart rate of 88 beats per minute at rest.
D) Mild ankle edema with a history of CHF.
ANS: B) An increase in B‑type natriuretic peptide (BNP)
levels and pulmonary crackles on auscultation.
Rationale: Elevated BNP and pulmonary crackles indicate
increased cardiac stress and pulmonary congestion, which are
strong markers of acute heart failure decompensation in older
adults. Minor changes (A, C, D) may be less specific.
5. Scenario: A 76‑year‑old patient with a history of diabetes
and hypertension presents with a new onset of intermittent
claudication. Which non-pharmacologic strategy is most
beneficial in managing this condition?
A) Initiate a supervised exercise program focusing on
walking therapy.
B) Recommend complete avoidance of physical activity.
C) Schedule immediate vascular surgery consultation.
D) Advise the patient to increase dietary iron.
ANS: A) Initiate a supervised exercise program focusing on
walking therapy.
©2025
