NURS 5461 Final Exam – Adult Gerontology Management
Across the Continuum of Care | Questions and Answers with
Rationale | Latest Update 2026-2027
1. Which of the following best describes the primary purpose of a prevention
diagnosis in adult-gerontology primary care?
A) To identify acute illness management strategies for hospitalized older adults
B) To assess the patient's risk profile and prevention needs with deficits to guide
an individualized prevention plan
C) To determine the appropriate surgical intervention for a complex chronic
condition
D) To reconcile medications and document adverse drug reactions
Correct Answer: To assess the patient's risk profile and prevention needs with
deficits to guide an individualized prevention plan
Rationale: A prevention diagnosis includes the patient risk profile as well as
prevention needs and deficits. This guides the nurse practitioner in developing an
individualized prevention plan, which is distinct from an acute care diagnosis. It is
not focused solely on acute illness management, surgical planning, or medication
reconciliation, although these may be components of comprehensive care.
2. What is the primary function of the patient risk profile in preventive care?
A) To document only the patient's current medication list
B) To include age, gender, racial and ethnic risks, as well as personal and family
risks
C) To determine the patient's insurance coverage for preventive services
D) To evaluate the patient's response to acute illness treatment
Correct Answer: To include age, gender, racial and ethnic risks, as well as personal
and family risks
,Rationale: A patient risk profile includes age, gender, racial and ethnic risks, as
well as personal and family risks. This comprehensive assessment helps identify
appropriate screening and prevention strategies. It is not limited to medication
lists, insurance coverage, or treatment response.
3. According to the exam blueprint, what is the initial goal for weight loss in a
patient with obesity?
A) Reduce body weight by 5 percent from baseline in 3 months
B) Reduce body weight by 10 percent from baseline in 6 months
C) Reduce body weight by 20 percent from baseline in 1 year
D) Reduce body weight by 15 percent from baseline in 9 months
Correct Answer: Reduce body weight by 10 percent from baseline in 6 months
Rationale: The initial goal for weight loss is to reduce body weight by 10 percent
from baseline in 6 months. This degree of weight loss has been shown to
significantly improve cardiovascular risk factors and metabolic parameters. More
aggressive or slower goals are not supported by current evidence.
4. Which finding is most consistent with the recommended daily caloric intake
for females?
A) Greater than 1000 calories
B) Greater than 1200 calories
C) Greater than 1500 calories
D) Greater than 1800 calories
Correct Answer: Greater than 1200 calories
Rationale: The general recommended daily caloric intake for females is greater
than 1200 calories. Diets below this level may not provide adequate nutrition and
are not sustainable. This is a key counseling point for weight management in
adult-gerontology primary care.
5. What is the general recommended daily caloric intake for males?
A) Greater than 1200 calories
B) Greater than 1500 calories
,C) Greater than 1800 calories
D) Greater than 2500 calories
Correct Answer: Greater than 1800 calories
Rationale: The general recommended daily caloric intake for males is greater than
1800 calories. This ensures adequate nutrition while promoting weight loss when
combined with physical activity. This is a fundamental guideline for nutrition
counseling in primary care.
6. How many ounces of water should an individual drink daily based on body
weight?
A) One-fourth body weight in ounces
B) One-half body weight in ounces
C) Equal to body weight in ounces
D) Twice body weight in ounces
Correct Answer: One-half body weight in ounces
Rationale: The recommended water intake is one-half of body weight in ounces.
For example, a 200-pound person should drink approximately 100 ounces of water
daily. This is a practical guideline for hydration counseling in adult-gerontology
care.
7. Approximately how many steps are equal to one mile?
A) 1000 steps
B) 1500 steps
C) 2000 steps
D) 3000 steps
Correct Answer: 2000 steps
Rationale: Approximately 2000 steps equal one mile. This is useful for counseling
patients on physical activity goals, with 10,000 steps per day being a common
target. This knowledge supports the nurse practitioner's role in promoting physical
activity.
8. What percentage of the majority of our diet should consist of
carbohydrates?
, A) 20 to 30 percent
B) 30 to 40 percent
C) 50 to 55 percent
D) 60 to 70 percent
Correct Answer: 50 to 55 percent
Rationale: The majority of our diet should consist of 50 to 55 percent
carbohydrates. This is consistent with dietary guidelines that emphasize
carbohydrates as the primary energy source. This is a key component of
nutritional counseling in primary care.
9. Which finding is most consistent with the hallmark clinical sign of delirium
in an older adult patient?
A) Insidious onset with progressive memory loss
B) Acute onset with fluctuating level of consciousness and inattention
C) Stable, non-fluctuating cognitive deficits
D) Gradual decline in executive function over several years
Correct Answer: Acute onset with fluctuating level of consciousness and
inattention
Rationale: Delirium is characterized by an acute onset with a fluctuating level of
consciousness and inattention. This is a hallmark clinical sign. Insidious onset and
progressive memory loss are more consistent with dementia. Stable, non-
fluctuating deficits are not characteristic of delirium.
10.According to the Beers Criteria, which class of medications should be
avoided in older adults with a history of falls or fractures?
A) Benzodiazepines
B) Beta-blockers
C) Proton pump inhibitors
D) Statins
Correct Answer: Benzodiazepines
Rationale: The Beers Criteria identify benzodiazepines as potentially inappropriate
medications in older adults with a history of falls or fractures because they
Across the Continuum of Care | Questions and Answers with
Rationale | Latest Update 2026-2027
1. Which of the following best describes the primary purpose of a prevention
diagnosis in adult-gerontology primary care?
A) To identify acute illness management strategies for hospitalized older adults
B) To assess the patient's risk profile and prevention needs with deficits to guide
an individualized prevention plan
C) To determine the appropriate surgical intervention for a complex chronic
condition
D) To reconcile medications and document adverse drug reactions
Correct Answer: To assess the patient's risk profile and prevention needs with
deficits to guide an individualized prevention plan
Rationale: A prevention diagnosis includes the patient risk profile as well as
prevention needs and deficits. This guides the nurse practitioner in developing an
individualized prevention plan, which is distinct from an acute care diagnosis. It is
not focused solely on acute illness management, surgical planning, or medication
reconciliation, although these may be components of comprehensive care.
2. What is the primary function of the patient risk profile in preventive care?
A) To document only the patient's current medication list
B) To include age, gender, racial and ethnic risks, as well as personal and family
risks
C) To determine the patient's insurance coverage for preventive services
D) To evaluate the patient's response to acute illness treatment
Correct Answer: To include age, gender, racial and ethnic risks, as well as personal
and family risks
,Rationale: A patient risk profile includes age, gender, racial and ethnic risks, as
well as personal and family risks. This comprehensive assessment helps identify
appropriate screening and prevention strategies. It is not limited to medication
lists, insurance coverage, or treatment response.
3. According to the exam blueprint, what is the initial goal for weight loss in a
patient with obesity?
A) Reduce body weight by 5 percent from baseline in 3 months
B) Reduce body weight by 10 percent from baseline in 6 months
C) Reduce body weight by 20 percent from baseline in 1 year
D) Reduce body weight by 15 percent from baseline in 9 months
Correct Answer: Reduce body weight by 10 percent from baseline in 6 months
Rationale: The initial goal for weight loss is to reduce body weight by 10 percent
from baseline in 6 months. This degree of weight loss has been shown to
significantly improve cardiovascular risk factors and metabolic parameters. More
aggressive or slower goals are not supported by current evidence.
4. Which finding is most consistent with the recommended daily caloric intake
for females?
A) Greater than 1000 calories
B) Greater than 1200 calories
C) Greater than 1500 calories
D) Greater than 1800 calories
Correct Answer: Greater than 1200 calories
Rationale: The general recommended daily caloric intake for females is greater
than 1200 calories. Diets below this level may not provide adequate nutrition and
are not sustainable. This is a key counseling point for weight management in
adult-gerontology primary care.
5. What is the general recommended daily caloric intake for males?
A) Greater than 1200 calories
B) Greater than 1500 calories
,C) Greater than 1800 calories
D) Greater than 2500 calories
Correct Answer: Greater than 1800 calories
Rationale: The general recommended daily caloric intake for males is greater than
1800 calories. This ensures adequate nutrition while promoting weight loss when
combined with physical activity. This is a fundamental guideline for nutrition
counseling in primary care.
6. How many ounces of water should an individual drink daily based on body
weight?
A) One-fourth body weight in ounces
B) One-half body weight in ounces
C) Equal to body weight in ounces
D) Twice body weight in ounces
Correct Answer: One-half body weight in ounces
Rationale: The recommended water intake is one-half of body weight in ounces.
For example, a 200-pound person should drink approximately 100 ounces of water
daily. This is a practical guideline for hydration counseling in adult-gerontology
care.
7. Approximately how many steps are equal to one mile?
A) 1000 steps
B) 1500 steps
C) 2000 steps
D) 3000 steps
Correct Answer: 2000 steps
Rationale: Approximately 2000 steps equal one mile. This is useful for counseling
patients on physical activity goals, with 10,000 steps per day being a common
target. This knowledge supports the nurse practitioner's role in promoting physical
activity.
8. What percentage of the majority of our diet should consist of
carbohydrates?
, A) 20 to 30 percent
B) 30 to 40 percent
C) 50 to 55 percent
D) 60 to 70 percent
Correct Answer: 50 to 55 percent
Rationale: The majority of our diet should consist of 50 to 55 percent
carbohydrates. This is consistent with dietary guidelines that emphasize
carbohydrates as the primary energy source. This is a key component of
nutritional counseling in primary care.
9. Which finding is most consistent with the hallmark clinical sign of delirium
in an older adult patient?
A) Insidious onset with progressive memory loss
B) Acute onset with fluctuating level of consciousness and inattention
C) Stable, non-fluctuating cognitive deficits
D) Gradual decline in executive function over several years
Correct Answer: Acute onset with fluctuating level of consciousness and
inattention
Rationale: Delirium is characterized by an acute onset with a fluctuating level of
consciousness and inattention. This is a hallmark clinical sign. Insidious onset and
progressive memory loss are more consistent with dementia. Stable, non-
fluctuating deficits are not characteristic of delirium.
10.According to the Beers Criteria, which class of medications should be
avoided in older adults with a history of falls or fractures?
A) Benzodiazepines
B) Beta-blockers
C) Proton pump inhibitors
D) Statins
Correct Answer: Benzodiazepines
Rationale: The Beers Criteria identify benzodiazepines as potentially inappropriate
medications in older adults with a history of falls or fractures because they
