NURS 5432 GERIATRIC & GI DISORDERS 2026/2027 | Primary
Care Complete Solutions | UTA | Pass Guaranteed - A+
Graded
SECTION 1: Geriatric Patient Assessment & Comprehensive Care (Q1-Q15)
Q1: A 78-year-old male presents to the primary care clinic for an annual wellness visit.
His daughter reports he has had two falls in the past 6 months and appears more
forgetful. Which component of the Comprehensive Geriatric Assessment (CGA) should
be prioritized first to guide subsequent evaluation?
A. Nutritional assessment using the Mini-Nutritional Assessment (MNA)
B. Cognitive screening with the Mini-Mental State Examination (MMSE) or Montreal
Cognitive Assessment (MoCA)
C. Social support and financial resource evaluation
D. Comprehensive metabolic panel and vitamin B12 level
Correct Answer: B
Rationale: Cognitive impairment directly impacts medication adherence, safety, and the
reliability of the patient's history; screening with a validated tool like MoCA is essential
early in the CGA to frame all subsequent assessments. While nutrition (A) and social
support (C) are important CGA components, and labs (D) may be indicated, cognitive
status must be established first to ensure accurate data collection and patient safety.
Q2: An 82-year-old female is accompanied by her son who reports she has difficulty
managing her medications, preparing meals, and paying bills since her husband died 3
months ago. Which assessment tool best evaluates her functional status in the primary
care setting?
A. Katz Index of Activities of Daily Living (ADLs)
B. Lawton-Brody Instrumental Activities of Daily Living (IADLs) Scale
C. Fried Frailty Phenotype
D. Geriatric Depression Scale (GDS-15)
Correct Answer: B
,Rationale: The Lawton-Brody IADL scale specifically assesses complex tasks including
medication management, meal preparation, and financial management, making it the
most appropriate tool for this patient's reported deficits. The Katz ADL scale (A)
focuses on basic self-care tasks (bathing, dressing, toileting), the Fried Frailty
Phenotype (C) measures physical frailty, and the GDS-15 (D) screens for depression.
Q3: A 76-year-old male with hypertension, type 2 diabetes, and osteoarthritis is taking
14 medications prescribed by three different providers. During medication
reconciliation, the FNP identifies duplicate therapy and two potentially inappropriate
medications. Which intervention aligns with best practice for this geriatric patient?
A. Continue all medications and schedule monthly follow-up visits
B. Discontinue all non-essential medications immediately without patient input
C. Conduct a structured medication review using the Beers Criteria and engage in
shared decision-making for deprescribing
D. Refer the patient to a cardiologist for all medication management decisions
Correct Answer: C
Rationale: The Beers Criteria identify potentially inappropriate medications in older
adults, and deprescribing should be a collaborative, gradual process involving shared
decision-making to avoid adverse withdrawal events. Continuing all medications (A)
perpetuates polypharmacy risks, abrupt discontinuation (B) can cause rebound effects,
and referral (D) does not address the primary care role in medication reconciliation.
Q4: During a comprehensive geriatric assessment, an 84-year-old female scores 6 out of
12 on the Simplified Nutritional Appetite Questionnaire (SNAQ), indicating poor appetite.
She lives alone and has lost 8 pounds in 3 months. What is the most appropriate next
step in primary care management?
A. Initiate megestrol acetate for appetite stimulation
B. Order a comprehensive nutritional assessment, evaluate for depression and social
isolation, and consider oral nutritional supplements
C. Recommend admission to a skilled nursing facility for nutritional rehabilitation
D. Prescribe high-dose vitamin D and calcium supplements only
Correct Answer: B
Rationale: Unintentional weight loss and poor appetite in older adults require a
multifactorial evaluation including psychosocial factors (depression, isolation), medical
,causes, and nutritional intervention; megestrol (A) has limited benefit and increases
thrombotic risk in the elderly. SNF admission (C) is premature without
community-based interventions, and vitamin D/calcium (D) does not address the
underlying etiology.
Q5: A 79-year-old male with advanced COPD and congestive heart failure is
accompanied by his wife to discuss his code status and future care preferences. He
currently has no advance directives documented. What is the FNP's most appropriate
initial action?
A. Assume he wants full resuscitation given his chronic conditions
B. Initiate a goals-of-care conversation using a structured approach and offer to
complete advance directive documents
C. Defer the discussion until the patient is hospitalized with acute decompensation
D. Recommend immediate hospice enrollment regardless of current functional status
Correct Answer: B
Rationale: Primary care providers should proactively engage patients in goals-of-care
discussions using structured communication frameworks; completing advance
directives while the patient has decisional capacity respects autonomy and reduces
future decisional conflict. Assuming full resuscitation (A) violates autonomy, deferring
(C) misses the opportunity for advance care planning, and immediate hospice (D) is
inappropriate without meeting eligibility criteria.
Q6: A geriatric patient presents for a routine visit. The FNP performs the Timed Up and
Go (TUG) test, and the patient takes 18 seconds to complete the task. Based on this
finding, what is the most appropriate clinical interpretation and intervention?
A. The patient has normal mobility; no intervention is needed
B. The patient is at increased fall risk; a multifactorial fall risk assessment and
intervention program should be implemented
C. The patient requires immediate physical therapy referral for gait training only
D. The TUG test is not validated for community-dwelling older adults
Correct Answer: B
Rationale: A TUG time greater than 12-15 seconds indicates increased fall risk in older
adults, warranting a comprehensive fall risk assessment including medication review,
vision check, home safety evaluation, and strength/balance interventions. A TUG of 18
, seconds is abnormal (A), physical therapy alone (C) is insufficient without addressing
multifactorial risks, and the TUG is well-validated for community-dwelling elders (D).
Q7: An 81-year-old female with a history of urinary incontinence, osteoporosis, and
depression is found to have orthostatic hypotension (drop of 28 mmHg systolic upon
standing) during her annual examination. She takes furosemide, alendronate, sertraline,
and oxybutynin. Which medication is most likely contributing to her orthostatic
hypotension and should be critically reviewed?
A. Alendronate
B. Sertraline
C. Oxybutynin
D. Furosemide
Correct Answer: D
Rationale: Furosemide, a loop diuretic, causes volume depletion and orthostatic
hypotension, which is particularly dangerous in older adults due to increased fall risk;
per the Beers Criteria, diuretics should be used with caution and at the lowest effective
dose. Alendronate (A) does not cause hypotension, sertraline (B) may cause mild
orthostasis but less directly than diuretics, and oxybutynin (C) is anticholinergic and
primarily causes confusion, constipation, and urinary retention.
Q8: A 77-year-old male with mild cognitive impairment presents with his daughter. The
FNP is conducting a comprehensive geriatric assessment and needs to evaluate his
social support system. Which question best assesses the adequacy of his social
support?
A. "Do you have any living relatives?"
B. "Who would help you if you became sick or needed assistance with daily tasks, and
how often do you see them?"
C. "Do you prefer to live alone or with others?"
D. "Have you ever attended a senior center activity?"
Correct Answer: B
Rationale: Assessing the availability, reliability, and proximity of caregivers provides
actionable information about the patient's support network and potential need for
community resources. Simply having relatives (A) does not indicate willingness or
Care Complete Solutions | UTA | Pass Guaranteed - A+
Graded
SECTION 1: Geriatric Patient Assessment & Comprehensive Care (Q1-Q15)
Q1: A 78-year-old male presents to the primary care clinic for an annual wellness visit.
His daughter reports he has had two falls in the past 6 months and appears more
forgetful. Which component of the Comprehensive Geriatric Assessment (CGA) should
be prioritized first to guide subsequent evaluation?
A. Nutritional assessment using the Mini-Nutritional Assessment (MNA)
B. Cognitive screening with the Mini-Mental State Examination (MMSE) or Montreal
Cognitive Assessment (MoCA)
C. Social support and financial resource evaluation
D. Comprehensive metabolic panel and vitamin B12 level
Correct Answer: B
Rationale: Cognitive impairment directly impacts medication adherence, safety, and the
reliability of the patient's history; screening with a validated tool like MoCA is essential
early in the CGA to frame all subsequent assessments. While nutrition (A) and social
support (C) are important CGA components, and labs (D) may be indicated, cognitive
status must be established first to ensure accurate data collection and patient safety.
Q2: An 82-year-old female is accompanied by her son who reports she has difficulty
managing her medications, preparing meals, and paying bills since her husband died 3
months ago. Which assessment tool best evaluates her functional status in the primary
care setting?
A. Katz Index of Activities of Daily Living (ADLs)
B. Lawton-Brody Instrumental Activities of Daily Living (IADLs) Scale
C. Fried Frailty Phenotype
D. Geriatric Depression Scale (GDS-15)
Correct Answer: B
,Rationale: The Lawton-Brody IADL scale specifically assesses complex tasks including
medication management, meal preparation, and financial management, making it the
most appropriate tool for this patient's reported deficits. The Katz ADL scale (A)
focuses on basic self-care tasks (bathing, dressing, toileting), the Fried Frailty
Phenotype (C) measures physical frailty, and the GDS-15 (D) screens for depression.
Q3: A 76-year-old male with hypertension, type 2 diabetes, and osteoarthritis is taking
14 medications prescribed by three different providers. During medication
reconciliation, the FNP identifies duplicate therapy and two potentially inappropriate
medications. Which intervention aligns with best practice for this geriatric patient?
A. Continue all medications and schedule monthly follow-up visits
B. Discontinue all non-essential medications immediately without patient input
C. Conduct a structured medication review using the Beers Criteria and engage in
shared decision-making for deprescribing
D. Refer the patient to a cardiologist for all medication management decisions
Correct Answer: C
Rationale: The Beers Criteria identify potentially inappropriate medications in older
adults, and deprescribing should be a collaborative, gradual process involving shared
decision-making to avoid adverse withdrawal events. Continuing all medications (A)
perpetuates polypharmacy risks, abrupt discontinuation (B) can cause rebound effects,
and referral (D) does not address the primary care role in medication reconciliation.
Q4: During a comprehensive geriatric assessment, an 84-year-old female scores 6 out of
12 on the Simplified Nutritional Appetite Questionnaire (SNAQ), indicating poor appetite.
She lives alone and has lost 8 pounds in 3 months. What is the most appropriate next
step in primary care management?
A. Initiate megestrol acetate for appetite stimulation
B. Order a comprehensive nutritional assessment, evaluate for depression and social
isolation, and consider oral nutritional supplements
C. Recommend admission to a skilled nursing facility for nutritional rehabilitation
D. Prescribe high-dose vitamin D and calcium supplements only
Correct Answer: B
Rationale: Unintentional weight loss and poor appetite in older adults require a
multifactorial evaluation including psychosocial factors (depression, isolation), medical
,causes, and nutritional intervention; megestrol (A) has limited benefit and increases
thrombotic risk in the elderly. SNF admission (C) is premature without
community-based interventions, and vitamin D/calcium (D) does not address the
underlying etiology.
Q5: A 79-year-old male with advanced COPD and congestive heart failure is
accompanied by his wife to discuss his code status and future care preferences. He
currently has no advance directives documented. What is the FNP's most appropriate
initial action?
A. Assume he wants full resuscitation given his chronic conditions
B. Initiate a goals-of-care conversation using a structured approach and offer to
complete advance directive documents
C. Defer the discussion until the patient is hospitalized with acute decompensation
D. Recommend immediate hospice enrollment regardless of current functional status
Correct Answer: B
Rationale: Primary care providers should proactively engage patients in goals-of-care
discussions using structured communication frameworks; completing advance
directives while the patient has decisional capacity respects autonomy and reduces
future decisional conflict. Assuming full resuscitation (A) violates autonomy, deferring
(C) misses the opportunity for advance care planning, and immediate hospice (D) is
inappropriate without meeting eligibility criteria.
Q6: A geriatric patient presents for a routine visit. The FNP performs the Timed Up and
Go (TUG) test, and the patient takes 18 seconds to complete the task. Based on this
finding, what is the most appropriate clinical interpretation and intervention?
A. The patient has normal mobility; no intervention is needed
B. The patient is at increased fall risk; a multifactorial fall risk assessment and
intervention program should be implemented
C. The patient requires immediate physical therapy referral for gait training only
D. The TUG test is not validated for community-dwelling older adults
Correct Answer: B
Rationale: A TUG time greater than 12-15 seconds indicates increased fall risk in older
adults, warranting a comprehensive fall risk assessment including medication review,
vision check, home safety evaluation, and strength/balance interventions. A TUG of 18
, seconds is abnormal (A), physical therapy alone (C) is insufficient without addressing
multifactorial risks, and the TUG is well-validated for community-dwelling elders (D).
Q7: An 81-year-old female with a history of urinary incontinence, osteoporosis, and
depression is found to have orthostatic hypotension (drop of 28 mmHg systolic upon
standing) during her annual examination. She takes furosemide, alendronate, sertraline,
and oxybutynin. Which medication is most likely contributing to her orthostatic
hypotension and should be critically reviewed?
A. Alendronate
B. Sertraline
C. Oxybutynin
D. Furosemide
Correct Answer: D
Rationale: Furosemide, a loop diuretic, causes volume depletion and orthostatic
hypotension, which is particularly dangerous in older adults due to increased fall risk;
per the Beers Criteria, diuretics should be used with caution and at the lowest effective
dose. Alendronate (A) does not cause hypotension, sertraline (B) may cause mild
orthostasis but less directly than diuretics, and oxybutynin (C) is anticholinergic and
primarily causes confusion, constipation, and urinary retention.
Q8: A 77-year-old male with mild cognitive impairment presents with his daughter. The
FNP is conducting a comprehensive geriatric assessment and needs to evaluate his
social support system. Which question best assesses the adequacy of his social
support?
A. "Do you have any living relatives?"
B. "Who would help you if you became sick or needed assistance with daily tasks, and
how often do you see them?"
C. "Do you prefer to live alone or with others?"
D. "Have you ever attended a senior center activity?"
Correct Answer: B
Rationale: Assessing the availability, reliability, and proximity of caregivers provides
actionable information about the patient's support network and potential need for
community resources. Simply having relatives (A) does not indicate willingness or
