NR580 Exam 4 Actual Exam Style V2 | NR
580 Adult-Gerontology Primary Care
Capstone and Intensive | Chamberlain
1. A 72-year-old male presents for a follow-up of hypertension. He reports feeling ‘unsteady’
lately. Which screening tool is most appropriate to assess his risk for falls?
A. The PHQ-9 scale
B. The Timed Up and Go (TUG) test
C. The Mini-Mental State Exam
D. The Epworth Sleepiness Scale
Answer: B
Rationale: The Timed Up and Go (TUG) test is a validated tool for assessing mobility and
fall risk in the geriatric population. It measures the time taken for a patient to rise from a
chair, walk three meters, turn, and sit back down. A result of 12 seconds or more generally
indicates a high risk for falling.
2. When managing a patient with multiple chronic conditions, the Nurse Practitioner (NP)
utilizes the Beers Criteria. What is the primary purpose of this tool?
A. To determine the level of nursing care required in long-term facilities
B. To calculate the appropriate dosage of renal-cleared drugs
C. To identify medications that are potentially inappropriate for older adults
,D. To diagnose various stages of dementia and cognitive decline
Answer: C
Rationale: The Beers Criteria is a list of medications that should generally be avoided or
used with caution in patients over 65. It helps clinicians reduce polypharmacy and prevent
adverse drug reactions in the elderly. Regularly reviewing this list during medication
reconciliation is considered a standard of geriatric care.
3. An NP is billing for an office visit where more than 50 percent of the time was spent on
counseling and coordination of care. Which factor determines the level of the visit in this
scenario?
A. The total time spent with the patient
B. The complexity of the physical exam
C. The number of review of systems (ROS) documented
D. The number of chronic conditions addressed
Answer: A
Rationale: Current coding guidelines allow providers to bill based on time if more than
50% of the encounter is spent on counseling or coordination of care. This must be clearly
documented in the chart with the total time and the content of the discussion. This
approach acknowledges the high cognitive load and effort involved in primary care
education.
, 4. A 80-year-old female with advanced heart failure expresses interest in palliative care. What
is a key difference between palliative care and hospice care?
A. Palliative care is only available in the last 6 months of life
B. Hospice care allows for continued curative treatments
C. Hospice care is only provided in a hospital setting
D. Palliative care can be provided alongside curative treatments
Answer: D
Rationale: Palliative care focuses on symptom management and quality of life at any stage
of a serious illness, even during curative treatment. In contrast, hospice care requires the
patient to forgo curative treatment for their terminal diagnosis. Both services utilize
interdisciplinary teams to support the patient and their family.
5. Which of the following is a symptom of ‘Frailty Syndrome’ in the geriatric population?
A. Unintentional weight loss and slow walking speed
B. Increased appetite and weight gain
C. Heightened mental alertness and cognitive function
D. Improved muscle strength and grip
Answer: A
Rationale: Frailty syndrome is characterized by a decrease in physiologic reserve and
increased vulnerability to stressors. Indicators include unintended weight loss, exhaustion,
580 Adult-Gerontology Primary Care
Capstone and Intensive | Chamberlain
1. A 72-year-old male presents for a follow-up of hypertension. He reports feeling ‘unsteady’
lately. Which screening tool is most appropriate to assess his risk for falls?
A. The PHQ-9 scale
B. The Timed Up and Go (TUG) test
C. The Mini-Mental State Exam
D. The Epworth Sleepiness Scale
Answer: B
Rationale: The Timed Up and Go (TUG) test is a validated tool for assessing mobility and
fall risk in the geriatric population. It measures the time taken for a patient to rise from a
chair, walk three meters, turn, and sit back down. A result of 12 seconds or more generally
indicates a high risk for falling.
2. When managing a patient with multiple chronic conditions, the Nurse Practitioner (NP)
utilizes the Beers Criteria. What is the primary purpose of this tool?
A. To determine the level of nursing care required in long-term facilities
B. To calculate the appropriate dosage of renal-cleared drugs
C. To identify medications that are potentially inappropriate for older adults
,D. To diagnose various stages of dementia and cognitive decline
Answer: C
Rationale: The Beers Criteria is a list of medications that should generally be avoided or
used with caution in patients over 65. It helps clinicians reduce polypharmacy and prevent
adverse drug reactions in the elderly. Regularly reviewing this list during medication
reconciliation is considered a standard of geriatric care.
3. An NP is billing for an office visit where more than 50 percent of the time was spent on
counseling and coordination of care. Which factor determines the level of the visit in this
scenario?
A. The total time spent with the patient
B. The complexity of the physical exam
C. The number of review of systems (ROS) documented
D. The number of chronic conditions addressed
Answer: A
Rationale: Current coding guidelines allow providers to bill based on time if more than
50% of the encounter is spent on counseling or coordination of care. This must be clearly
documented in the chart with the total time and the content of the discussion. This
approach acknowledges the high cognitive load and effort involved in primary care
education.
, 4. A 80-year-old female with advanced heart failure expresses interest in palliative care. What
is a key difference between palliative care and hospice care?
A. Palliative care is only available in the last 6 months of life
B. Hospice care allows for continued curative treatments
C. Hospice care is only provided in a hospital setting
D. Palliative care can be provided alongside curative treatments
Answer: D
Rationale: Palliative care focuses on symptom management and quality of life at any stage
of a serious illness, even during curative treatment. In contrast, hospice care requires the
patient to forgo curative treatment for their terminal diagnosis. Both services utilize
interdisciplinary teams to support the patient and their family.
5. Which of the following is a symptom of ‘Frailty Syndrome’ in the geriatric population?
A. Unintentional weight loss and slow walking speed
B. Increased appetite and weight gain
C. Heightened mental alertness and cognitive function
D. Improved muscle strength and grip
Answer: A
Rationale: Frailty syndrome is characterized by a decrease in physiologic reserve and
increased vulnerability to stressors. Indicators include unintended weight loss, exhaustion,
