Quiz 2: NURS 5461 Adult Gerontology Management Across the Continuum
of Care Actual Exam 2026/2027 Complete Questions and Answers
Detailed Rationales - Pass Guaranteed - A+ Graded
Transitional Care & Discharge Planning
Q1: You are rounding on a 78-year-old patient ready for discharge after hospitalization
for heart failure exacerbation. The patient lives alone and has a history of medication
non-adherence. Which transitional care intervention is most strongly associated with
reducing 30-day readmission rates for this patient?
A. Providing the patient with a standard packet of printed discharge instructions
B. Scheduling a primary care follow-up appointment within 7 to 14 days post-discharge
C. A single pharmacist-led medication reconciliation prior to leaving the hospital
D. Referring the patient to the Emergency Department for any recurring symptoms
Correct Answer: B
Rationale: While medication reconciliation is important, early follow-up with a primary
care provider is consistently linked to lower readmission rates because it ensures the
patient is stabilized and the plan is working in the community setting.
Q2: An 82-year-old patient is being discharged from the hospital to a Skilled Nursing
Facility (SNF) for rehabilitation after a hip fracture. The family asks why the patient
wasn't sent to an Inpatient Rehabilitation Facility (IRF) instead. Which criteria
determines if a patient qualifies for IRF-level care?
A. The patient must require 24-hour skilled nursing care
B. The patient must be able to tolerate and benefit from at least 3 hours of intensive
therapy per day
C. The patient must have a life expectancy of less than 6 months
D. The patient must require assistance with at least two activities of daily living (ADLs)
Correct Answer: B
Rationale: The "3-hour rule" is the key distinction for IRF admission; patients must be
able to tolerate and participate in at least 3 hours of therapy daily, whereas SNFs
provide a lower intensity of rehabilitation.
Q3: During a discharge teach-back session, you instruct a patient with newly diagnosed
COPD on how to use their inhalers. The patient nods and repeats the instructions back
to you verbatim but seems unsure when asked to demonstrate the technique. What is
your next best action?
A. Document that the patient verbalized understanding and proceed with discharge
, B. Provide written handouts and assume the patient will learn at home
C. Ask the family member to administer the medications for the patient
D. Re-teach the technique using a different method and ask the patient to demonstrate
it again
Correct Answer: D
Rationale: Teach-back isn't just about repeating words; it's about showing
understanding. If the patient can't demonstrate the skill, you need to re-teach using a
different approach before they can safely go home.
Q4: The LACE index is a commonly used tool to estimate the risk of readmission. Which
of the following factors is NOT a component of the LACE index score?
A. Length of stay
B. Acuity of admission
C. Comorbidities (measured by Charlson Index)
D. Economic status of the patient
Correct Answer: D
Rationale: LACE stands for Length of stay, Acuity, Comorbidities, and Emergency
department visits; it does not directly factor in economic status, though social
determinants are important to consider separately.
Q5: A 70-year-old patient is being discharged home after a stroke. You note that the
patient has difficulty swallowing thin liquids (dysphagia). To ensure safety across the
continuum of care, which order is the priority to communicate to the home health nurse?
A. Initiation of a pureed diet
B. Thickening of all liquids to honey consistency
C. Consultation with a speech-language pathologist (SLP) for safe swallowing strategy
D. Insertion of a percutaneous endoscopic gastrostomy (PEG) tube
Correct Answer: C
Rationale: While diet modifications are often needed, the priority is a formal SLP
evaluation to determine the exact severity and safest diet texture, as "honey thick" or
pureed diets may not be necessary for everyone.
Q6: [Medication List Snippet] A patient is being discharged. Their home list includes:
Metformin 1000mg BID, Lisinopril 20mg daily. Their hospital list adds: Amlodipine 5mg
daily, HCTZ 25mg daily, and Furosemide 20mg daily. Which action is essential to
prevent harm at discharge?
A. Discontinue all antihypertensives to prevent hypotension
B. Keep all three diuretics (HCTZ, Furosemide, Amlodipine) and double the Metformin
of Care Actual Exam 2026/2027 Complete Questions and Answers
Detailed Rationales - Pass Guaranteed - A+ Graded
Transitional Care & Discharge Planning
Q1: You are rounding on a 78-year-old patient ready for discharge after hospitalization
for heart failure exacerbation. The patient lives alone and has a history of medication
non-adherence. Which transitional care intervention is most strongly associated with
reducing 30-day readmission rates for this patient?
A. Providing the patient with a standard packet of printed discharge instructions
B. Scheduling a primary care follow-up appointment within 7 to 14 days post-discharge
C. A single pharmacist-led medication reconciliation prior to leaving the hospital
D. Referring the patient to the Emergency Department for any recurring symptoms
Correct Answer: B
Rationale: While medication reconciliation is important, early follow-up with a primary
care provider is consistently linked to lower readmission rates because it ensures the
patient is stabilized and the plan is working in the community setting.
Q2: An 82-year-old patient is being discharged from the hospital to a Skilled Nursing
Facility (SNF) for rehabilitation after a hip fracture. The family asks why the patient
wasn't sent to an Inpatient Rehabilitation Facility (IRF) instead. Which criteria
determines if a patient qualifies for IRF-level care?
A. The patient must require 24-hour skilled nursing care
B. The patient must be able to tolerate and benefit from at least 3 hours of intensive
therapy per day
C. The patient must have a life expectancy of less than 6 months
D. The patient must require assistance with at least two activities of daily living (ADLs)
Correct Answer: B
Rationale: The "3-hour rule" is the key distinction for IRF admission; patients must be
able to tolerate and participate in at least 3 hours of therapy daily, whereas SNFs
provide a lower intensity of rehabilitation.
Q3: During a discharge teach-back session, you instruct a patient with newly diagnosed
COPD on how to use their inhalers. The patient nods and repeats the instructions back
to you verbatim but seems unsure when asked to demonstrate the technique. What is
your next best action?
A. Document that the patient verbalized understanding and proceed with discharge
, B. Provide written handouts and assume the patient will learn at home
C. Ask the family member to administer the medications for the patient
D. Re-teach the technique using a different method and ask the patient to demonstrate
it again
Correct Answer: D
Rationale: Teach-back isn't just about repeating words; it's about showing
understanding. If the patient can't demonstrate the skill, you need to re-teach using a
different approach before they can safely go home.
Q4: The LACE index is a commonly used tool to estimate the risk of readmission. Which
of the following factors is NOT a component of the LACE index score?
A. Length of stay
B. Acuity of admission
C. Comorbidities (measured by Charlson Index)
D. Economic status of the patient
Correct Answer: D
Rationale: LACE stands for Length of stay, Acuity, Comorbidities, and Emergency
department visits; it does not directly factor in economic status, though social
determinants are important to consider separately.
Q5: A 70-year-old patient is being discharged home after a stroke. You note that the
patient has difficulty swallowing thin liquids (dysphagia). To ensure safety across the
continuum of care, which order is the priority to communicate to the home health nurse?
A. Initiation of a pureed diet
B. Thickening of all liquids to honey consistency
C. Consultation with a speech-language pathologist (SLP) for safe swallowing strategy
D. Insertion of a percutaneous endoscopic gastrostomy (PEG) tube
Correct Answer: C
Rationale: While diet modifications are often needed, the priority is a formal SLP
evaluation to determine the exact severity and safest diet texture, as "honey thick" or
pureed diets may not be necessary for everyone.
Q6: [Medication List Snippet] A patient is being discharged. Their home list includes:
Metformin 1000mg BID, Lisinopril 20mg daily. Their hospital list adds: Amlodipine 5mg
daily, HCTZ 25mg daily, and Furosemide 20mg daily. Which action is essential to
prevent harm at discharge?
A. Discontinue all antihypertensives to prevent hypotension
B. Keep all three diuretics (HCTZ, Furosemide, Amlodipine) and double the Metformin
