Latest Edition
Verified Questions and Answers
Total Questions Format Sections
100 Multiple Choice (A-D) 11 Sections
Chamberlain University
College of Nursing
Advanced Practice Nursing Program
Aligned with AGNP/FNP Certification Competencies
,Section 1: Geriatric Assessment, Prevention, and Health Maintenance
Q1: A 72-year-old female presents for her annual wellness visit. She lives alone, reports no falls, and denies
visual or hearing difficulties. According to the USPSTF guidelines for comprehensive geriatric assessment
(CGA), which component is MOST important to routinely evaluate in this patient even when she appears to be
functioning well independently?
A. Bone mineral density testing
B. Cognitive screening with a validated instrument **[CORRECT]**
C. Complete audiometric evaluation
D. Cardiac stress testing
Correct Answer: B
Rationale: Cognitive screening with a validated instrument such as the Mini-Cog or MMSE is a core component of the
Comprehensive Geriatric Assessment (CGA) and should be performed routinely in all older adults, even those who appear to
function independently. Cognitive impairment is often underdetected in primary care, and early identification allows for timely
intervention and planning. Bone mineral density testing is important but is indicated specifically for osteoporosis screening per age
and risk factors. Audiometric evaluation and cardiac stress testing are not routine components of CGA and are ordered based on
specific clinical indications rather than universally.
Q2: A 68-year-old male with a 40-pack-year smoking history asks about the single most beneficial preventive
intervention he can undertake at his age. Which of the following responses by the nurse practitioner is MOST
accurate based on current evidence?
A. Initiating a statin medication for primary prevention of cardiovascular disease
B. Smoking cessation, which provides the greatest single mortality and morbidity benefit for older adults
**[CORRECT]**
C. Annual pneumococcal vaccination to prevent respiratory infections
D. Enrolling in a supervised cardiac rehabilitation exercise program
Correct Answer: B
Rationale: Smoking cessation provides the greatest single mortality and morbidity benefit for older adults. Even in later life,
quitting smoking reduces cardiovascular and cancer risk within months to years. While statin therapy, pneumococcal vaccination,
and exercise programs are all valuable preventive measures, the evidence consistently demonstrates that smoking cessation yields
the most significant overall health benefit for older adults who smoke. The nurse practitioner should strongly counsel this patient
on tobacco cessation and offer pharmacotherapy and behavioral support.
Q3: A 74-year-old woman asks about colorectal cancer screening. She has no personal or family history of
colorectal cancer or adenomatous polyps, and her last colonoscopy at age 65 was normal. According to current
USPSTF guidelines, what is the MOST appropriate recommendation?
A. No further screening is recommended after age 70
B. Continue screening with colonoscopy every 10 years until age 85
C. Individualized decision-making for screening; consider stopping based on life expectancy and health status
**[CORRECT]**
D. Switch to annual fecal occult blood testing instead of colonoscopy
Correct Answer: C
Rationale: Current USPSTF guidelines recommend colorectal cancer screening for adults aged 45 to 75 years. For adults aged 76
to 85 years, the decision to screen should be individualized, taking into account the patient's overall health, prior screening history,
,life expectancy, and personal preferences. This patient had a normal colonoscopy at age 65, and at age 74 she falls within the
individualized decision-making window. The nurse practitioner should discuss the potential benefits and harms of continued
screening with the patient, noting that the benefits diminish and risks increase with advancing age.
Q4: A 67-year-old female with no risk factors for osteoporosis presents for a well-woman examination.
According to current screening recommendations, when should she receive her first DEXA scan?
A. At age 60 for all postmenopausal women
B. At age 65 for women without risk factors **[CORRECT]**
C. At age 70 for women without risk factors
D. DEXA scanning is not recommended for women without risk factors
Correct Answer: B
Rationale: DEXA (dual-energy X-ray absorptiometry) screening for osteoporosis is recommended for all women at age 65,
regardless of risk factors. For women with risk factors such as low body weight, prior fracture, or family history of hip fracture,
screening should begin earlier. For men, screening is recommended beginning at age 70. This patient has no risk factors, so her
first DEXA scan should be at age 65, which she has already passed. She should receive DEXA screening now.
Q5: A 78-year-old patient with well-controlled type 2 diabetes mellitus asks about recommended screening for
diabetic retinopathy. What is the MOST appropriate recommendation?
A. Annual dilated eye examination by an ophthalmologist or optometrist **[CORRECT]**
B. Dilated eye examination every 2 years since diabetes is well-controlled
C. Referral for retinal photography only if visual symptoms develop
D. Dilated eye examination every 6 months due to the patient's age
Correct Answer: A
Rationale: Annual dilated eye examination is recommended for all patients with diabetes mellitus to screen for diabetic
retinopathy. This recommendation applies regardless of how well the diabetes is controlled, because retinopathy can develop even
with good glycemic control. For non-diabetic older adults, eye exams are recommended every 1 to 2 years. The patient's age of 78
does not change the annual recommendation for diabetic patients. Early detection and treatment of diabetic retinopathy can
prevent significant vision loss.
Q6: A 70-year-old male who has never received the herpes zoster vaccine presents to the clinic. Which of the
following is the MOST appropriate recommendation regarding zoster vaccination?
A. Administer Zostavax (live attenuated vaccine) since he has no contraindications
B. Administer Shingrix (recombinant zoster vaccine) as the preferred vaccine for adults 50 and older
**[CORRECT]**
C. No vaccination is needed at this age because his risk of herpes zoster is low
D. Administer Shingrix only if he has a history of herpes zoster infection
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine, RZV) is the preferred herpes zoster vaccine for all adults aged 50 years and
older, regardless of prior zoster history or zoster vaccine receipt. Shingrix is recommended over Zostavax (live attenuated zoster
vaccine, ZVL) due to its superior efficacy and longer duration of protection. The CDC recommends two doses of Shingrix
separated by 2 to 6 months. Zostavax is no longer available in the United States as of November 2020.
Q7: A 66-year-old sedentary female with osteoarthritis wants to start an exercise program. What is the MOST
appropriate exercise prescription for this patient based on geriatric physical activity guidelines?
A. Begin with 150 minutes of moderate-intensity aerobic activity per week immediately
B. Start low and go slow, gradually building toward 150 minutes of moderate-intensity aerobic activity per
week **[CORRECT]**
, C. Restrict activity to low-impact stretching only due to her osteoarthritis
D. Recommend high-intensity interval training to maximize cardiovascular benefit
Correct Answer: B
Rationale: The recommended approach for initiating physical activity in sedentary older adults is 'start low and go slow.' The
target goal is 150 minutes per week of moderate-intensity aerobic activity, but this should be achieved gradually. This patient has
osteoarthritis, which makes a gradual approach even more important to avoid exacerbating joint pain. High-intensity interval
training is not appropriate for a sedentary older adult with osteoarthritis as a starting point. Restricting activity to stretching only
would be overly limiting and would not provide the cardiovascular, musculoskeletal, and metabolic benefits of aerobic exercise.
Q8: A 75-year-old woman is found to have a T-score of -2.7 on DEXA scan of the hip. The nurse practitioner
identifies additional risk factors including low body weight, current smoking, and a maternal history of hip
fracture. What is the MOST appropriate initial pharmacologic treatment for this patient?
A. Calcium and Vitamin D supplementation alone
B. Bisphosphonate therapy (e.g., alendronate) in addition to calcium and Vitamin D **[CORRECT]**
C. Hormone replacement therapy as first-line treatment
D. Calcitonin nasal spray as initial therapy
Correct Answer: B
Rationale: This patient has osteoporosis (T-score of -2.7, which is below -2.5) with multiple risk factors including low body
weight, smoking, and family history of hip fracture. First-line pharmacologic treatment includes a bisphosphonate such as
alendronate, in addition to calcium and Vitamin D supplementation. While calcium and Vitamin D are important adjuncts, they
are not sufficient alone for treating established osteoporosis in a high-risk patient. Hormone replacement therapy is not first-line
for osteoporosis treatment due to associated risks. Calcitonin is no longer recommended as first-line therapy due to limited
efficacy compared to bisphosphonates.
Q9: An 80-year-old male presents with unintentional weight loss of 15 pounds over the past 6 months,
decreased appetite, and generalized weakness. His BMI is 19.5. Which of the following is the MOST accurate
statement regarding malnutrition in this patient?
A. Malnutrition is rare in community-dwelling older adults and is primarily a concern in long-term care facilities
B. Malnutrition in older adults is often overlooked and contributes to functional decline **[CORRECT]**
C. A BMI of 19.5 is within the normal range for an 80-year-old and does not indicate malnutrition
D. Nutritional screening is only necessary when the patient reports inadequate dietary intake
Correct Answer: B
Rationale: Malnutrition in older adults is often overlooked and contributes to functional decline, impaired immunity, delayed
wound healing, and increased morbidity and mortality. This patient has significant risk factors: unintentional weight loss of 15
pounds in 6 months, decreased appetite, generalized weakness, and a BMI of 19.5 (underweight for older adults). Nutritional
screening should be a routine component of the comprehensive geriatric assessment for all older adults, not only those who report
inadequate intake. Malnutrition is prevalent in both community-dwelling and institutionalized older adults.
Q10: A 71-year-old female asks about mammography screening. She has no family history of breast cancer,
and her last mammogram at age 69 was normal. What is the MOST appropriate recommendation based on
current guidelines?
A. Discontinue mammography screening since she is over 70
B. Continue biennial mammography screening and engage in shared decision-making about continuing
beyond age 75 **[CORRECT]**
C. Switch to annual breast MRI instead of mammography
D. Continue annual mammography until age 85 regardless of health status
Correct Answer: B
Verified Questions and Answers
Total Questions Format Sections
100 Multiple Choice (A-D) 11 Sections
Chamberlain University
College of Nursing
Advanced Practice Nursing Program
Aligned with AGNP/FNP Certification Competencies
,Section 1: Geriatric Assessment, Prevention, and Health Maintenance
Q1: A 72-year-old female presents for her annual wellness visit. She lives alone, reports no falls, and denies
visual or hearing difficulties. According to the USPSTF guidelines for comprehensive geriatric assessment
(CGA), which component is MOST important to routinely evaluate in this patient even when she appears to be
functioning well independently?
A. Bone mineral density testing
B. Cognitive screening with a validated instrument **[CORRECT]**
C. Complete audiometric evaluation
D. Cardiac stress testing
Correct Answer: B
Rationale: Cognitive screening with a validated instrument such as the Mini-Cog or MMSE is a core component of the
Comprehensive Geriatric Assessment (CGA) and should be performed routinely in all older adults, even those who appear to
function independently. Cognitive impairment is often underdetected in primary care, and early identification allows for timely
intervention and planning. Bone mineral density testing is important but is indicated specifically for osteoporosis screening per age
and risk factors. Audiometric evaluation and cardiac stress testing are not routine components of CGA and are ordered based on
specific clinical indications rather than universally.
Q2: A 68-year-old male with a 40-pack-year smoking history asks about the single most beneficial preventive
intervention he can undertake at his age. Which of the following responses by the nurse practitioner is MOST
accurate based on current evidence?
A. Initiating a statin medication for primary prevention of cardiovascular disease
B. Smoking cessation, which provides the greatest single mortality and morbidity benefit for older adults
**[CORRECT]**
C. Annual pneumococcal vaccination to prevent respiratory infections
D. Enrolling in a supervised cardiac rehabilitation exercise program
Correct Answer: B
Rationale: Smoking cessation provides the greatest single mortality and morbidity benefit for older adults. Even in later life,
quitting smoking reduces cardiovascular and cancer risk within months to years. While statin therapy, pneumococcal vaccination,
and exercise programs are all valuable preventive measures, the evidence consistently demonstrates that smoking cessation yields
the most significant overall health benefit for older adults who smoke. The nurse practitioner should strongly counsel this patient
on tobacco cessation and offer pharmacotherapy and behavioral support.
Q3: A 74-year-old woman asks about colorectal cancer screening. She has no personal or family history of
colorectal cancer or adenomatous polyps, and her last colonoscopy at age 65 was normal. According to current
USPSTF guidelines, what is the MOST appropriate recommendation?
A. No further screening is recommended after age 70
B. Continue screening with colonoscopy every 10 years until age 85
C. Individualized decision-making for screening; consider stopping based on life expectancy and health status
**[CORRECT]**
D. Switch to annual fecal occult blood testing instead of colonoscopy
Correct Answer: C
Rationale: Current USPSTF guidelines recommend colorectal cancer screening for adults aged 45 to 75 years. For adults aged 76
to 85 years, the decision to screen should be individualized, taking into account the patient's overall health, prior screening history,
,life expectancy, and personal preferences. This patient had a normal colonoscopy at age 65, and at age 74 she falls within the
individualized decision-making window. The nurse practitioner should discuss the potential benefits and harms of continued
screening with the patient, noting that the benefits diminish and risks increase with advancing age.
Q4: A 67-year-old female with no risk factors for osteoporosis presents for a well-woman examination.
According to current screening recommendations, when should she receive her first DEXA scan?
A. At age 60 for all postmenopausal women
B. At age 65 for women without risk factors **[CORRECT]**
C. At age 70 for women without risk factors
D. DEXA scanning is not recommended for women without risk factors
Correct Answer: B
Rationale: DEXA (dual-energy X-ray absorptiometry) screening for osteoporosis is recommended for all women at age 65,
regardless of risk factors. For women with risk factors such as low body weight, prior fracture, or family history of hip fracture,
screening should begin earlier. For men, screening is recommended beginning at age 70. This patient has no risk factors, so her
first DEXA scan should be at age 65, which she has already passed. She should receive DEXA screening now.
Q5: A 78-year-old patient with well-controlled type 2 diabetes mellitus asks about recommended screening for
diabetic retinopathy. What is the MOST appropriate recommendation?
A. Annual dilated eye examination by an ophthalmologist or optometrist **[CORRECT]**
B. Dilated eye examination every 2 years since diabetes is well-controlled
C. Referral for retinal photography only if visual symptoms develop
D. Dilated eye examination every 6 months due to the patient's age
Correct Answer: A
Rationale: Annual dilated eye examination is recommended for all patients with diabetes mellitus to screen for diabetic
retinopathy. This recommendation applies regardless of how well the diabetes is controlled, because retinopathy can develop even
with good glycemic control. For non-diabetic older adults, eye exams are recommended every 1 to 2 years. The patient's age of 78
does not change the annual recommendation for diabetic patients. Early detection and treatment of diabetic retinopathy can
prevent significant vision loss.
Q6: A 70-year-old male who has never received the herpes zoster vaccine presents to the clinic. Which of the
following is the MOST appropriate recommendation regarding zoster vaccination?
A. Administer Zostavax (live attenuated vaccine) since he has no contraindications
B. Administer Shingrix (recombinant zoster vaccine) as the preferred vaccine for adults 50 and older
**[CORRECT]**
C. No vaccination is needed at this age because his risk of herpes zoster is low
D. Administer Shingrix only if he has a history of herpes zoster infection
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine, RZV) is the preferred herpes zoster vaccine for all adults aged 50 years and
older, regardless of prior zoster history or zoster vaccine receipt. Shingrix is recommended over Zostavax (live attenuated zoster
vaccine, ZVL) due to its superior efficacy and longer duration of protection. The CDC recommends two doses of Shingrix
separated by 2 to 6 months. Zostavax is no longer available in the United States as of November 2020.
Q7: A 66-year-old sedentary female with osteoarthritis wants to start an exercise program. What is the MOST
appropriate exercise prescription for this patient based on geriatric physical activity guidelines?
A. Begin with 150 minutes of moderate-intensity aerobic activity per week immediately
B. Start low and go slow, gradually building toward 150 minutes of moderate-intensity aerobic activity per
week **[CORRECT]**
, C. Restrict activity to low-impact stretching only due to her osteoarthritis
D. Recommend high-intensity interval training to maximize cardiovascular benefit
Correct Answer: B
Rationale: The recommended approach for initiating physical activity in sedentary older adults is 'start low and go slow.' The
target goal is 150 minutes per week of moderate-intensity aerobic activity, but this should be achieved gradually. This patient has
osteoarthritis, which makes a gradual approach even more important to avoid exacerbating joint pain. High-intensity interval
training is not appropriate for a sedentary older adult with osteoarthritis as a starting point. Restricting activity to stretching only
would be overly limiting and would not provide the cardiovascular, musculoskeletal, and metabolic benefits of aerobic exercise.
Q8: A 75-year-old woman is found to have a T-score of -2.7 on DEXA scan of the hip. The nurse practitioner
identifies additional risk factors including low body weight, current smoking, and a maternal history of hip
fracture. What is the MOST appropriate initial pharmacologic treatment for this patient?
A. Calcium and Vitamin D supplementation alone
B. Bisphosphonate therapy (e.g., alendronate) in addition to calcium and Vitamin D **[CORRECT]**
C. Hormone replacement therapy as first-line treatment
D. Calcitonin nasal spray as initial therapy
Correct Answer: B
Rationale: This patient has osteoporosis (T-score of -2.7, which is below -2.5) with multiple risk factors including low body
weight, smoking, and family history of hip fracture. First-line pharmacologic treatment includes a bisphosphonate such as
alendronate, in addition to calcium and Vitamin D supplementation. While calcium and Vitamin D are important adjuncts, they
are not sufficient alone for treating established osteoporosis in a high-risk patient. Hormone replacement therapy is not first-line
for osteoporosis treatment due to associated risks. Calcitonin is no longer recommended as first-line therapy due to limited
efficacy compared to bisphosphonates.
Q9: An 80-year-old male presents with unintentional weight loss of 15 pounds over the past 6 months,
decreased appetite, and generalized weakness. His BMI is 19.5. Which of the following is the MOST accurate
statement regarding malnutrition in this patient?
A. Malnutrition is rare in community-dwelling older adults and is primarily a concern in long-term care facilities
B. Malnutrition in older adults is often overlooked and contributes to functional decline **[CORRECT]**
C. A BMI of 19.5 is within the normal range for an 80-year-old and does not indicate malnutrition
D. Nutritional screening is only necessary when the patient reports inadequate dietary intake
Correct Answer: B
Rationale: Malnutrition in older adults is often overlooked and contributes to functional decline, impaired immunity, delayed
wound healing, and increased morbidity and mortality. This patient has significant risk factors: unintentional weight loss of 15
pounds in 6 months, decreased appetite, generalized weakness, and a BMI of 19.5 (underweight for older adults). Nutritional
screening should be a routine component of the comprehensive geriatric assessment for all older adults, not only those who report
inadequate intake. Malnutrition is prevalent in both community-dwelling and institutionalized older adults.
Q10: A 71-year-old female asks about mammography screening. She has no family history of breast cancer,
and her last mammogram at age 69 was normal. What is the MOST appropriate recommendation based on
current guidelines?
A. Discontinue mammography screening since she is over 70
B. Continue biennial mammography screening and engage in shared decision-making about continuing
beyond age 75 **[CORRECT]**
C. Switch to annual breast MRI instead of mammography
D. Continue annual mammography until age 85 regardless of health status
Correct Answer: B
