NURS 5461 / NUR 5461 Final Exam
2026/2027 | Complete Q&A Bank with
Verified Answers & Rationales | Adult
Gerontology Management | UTA &
WPU | Grade A+
Section 1: Geriatric Assessment & Continuum of Care (Questions 1-30)
1. A 72-year-old patient presents with fatigue, weight loss, and confusion. Which
principle of diagnostic reasoning should the AGNP prioritize FIRST?
A) Order comprehensive laboratory panels to rule out all possibilities
B) Consider atypical presentations of common conditions in older adults
C) Apply the "rule of thirds" for geriatric presentations
D) Refer immediately to geriatric psychiatry
Correct Answer: B
Rationale: Older adults frequently present with atypical or nonspecific symptoms (e.g.,
confusion instead of chest pain in MI). The AGNP must prioritize considering how common
conditions manifest differently in geriatric populations before pursuing extensive testing .
, 2. An 80-year-old patient is discharged from the hospital after a hip replacement and
is admitted to a Skilled Nursing Facility (SNF) to receive daily physical therapy.
Which Medicare coverage specifically pays for this post-acute care stay?
A) Medicare Part B
B) Medicare Part D
C) Medicare Part A
D) Medicare Advantage (Part C) supplemental benefit
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, care in a Skilled Nursing Facility
following a qualifying hospital stay, hospice care, and some home health care .
3. A 76-year-old patient requires a walker, outpatient occupational therapy, and a new
prescription for a blood pressure medication upon discharge home. Which
combination of Medicare parts will cover these specific transitional needs?
A) Part A for the walker, Part B for the therapy, Part D for the medication
B) Part B for the walker, Part A for the therapy, Part D for the medication
C) Part D for the walker, Part B for the therapy, Part A for the medication
D) Part B for the walker, therapy, and medication
Correct Answer: A
, Rationale: Medicare Part B covers durable medical equipment (walkers) and outpatient
occupational therapy, while Part D covers prescription medications dispensed at a retail
pharmacy .
4. Which of the following best defines the "Continuum of Care" in adult gerontology
management?
A) A rigid, step-down model where patients move strictly from hospital to home
B) An integrated, patient-centered system of care that spans from health promotion to end-
of-life, adjusting based on patient needs
C) A financial model used by Medicare to cap payments across all settings
D) A siloed approach where each provider manages only their specific acute episode
Correct Answer: B
Rationale: The continuum of care is an integrated system of care that guides and tracks
patients over time through a comprehensive array of health services spanning all levels of
intensity of care .
5. An 82-year-old female presents with insomnia. Her provider is considering a low-
dose hypnotic. Which age-related physiological change most significantly increases
her risk for prolonged sedation?
A) Decreased gastric motility
B) Increased total body water
, C) Increased body fat composition
D) Decreased hepatic blood flow
Correct Answer: C
Rationale: Aging increases body fat and decreases lean mass. Lipophilic drugs (like many
hypnotics and benzodiazepines) have a larger volume of distribution, leading to a longer
half-life and prolonged duration of action .
6. An 82-year-old patient reports feeling dizzy when standing up quickly. Which age-
related physiological change is the most likely cause?
A) Decreased baroreceptor sensitivity
B) Increased cardiac output
C) Thickening of the heart valves
D) Increased blood volume
Correct Answer: A
Rationale: Baroreceptor sensitivity decreases with age, leading to orthostatic hypotension
and dizziness .
7. A 72-year-old male patient asks about the recommended frequency for the
shingles (herpes zoster) vaccine. He received the live zoster vaccine (Zostavax) five
years ago. What is the most appropriate response?
2026/2027 | Complete Q&A Bank with
Verified Answers & Rationales | Adult
Gerontology Management | UTA &
WPU | Grade A+
Section 1: Geriatric Assessment & Continuum of Care (Questions 1-30)
1. A 72-year-old patient presents with fatigue, weight loss, and confusion. Which
principle of diagnostic reasoning should the AGNP prioritize FIRST?
A) Order comprehensive laboratory panels to rule out all possibilities
B) Consider atypical presentations of common conditions in older adults
C) Apply the "rule of thirds" for geriatric presentations
D) Refer immediately to geriatric psychiatry
Correct Answer: B
Rationale: Older adults frequently present with atypical or nonspecific symptoms (e.g.,
confusion instead of chest pain in MI). The AGNP must prioritize considering how common
conditions manifest differently in geriatric populations before pursuing extensive testing .
, 2. An 80-year-old patient is discharged from the hospital after a hip replacement and
is admitted to a Skilled Nursing Facility (SNF) to receive daily physical therapy.
Which Medicare coverage specifically pays for this post-acute care stay?
A) Medicare Part B
B) Medicare Part D
C) Medicare Part A
D) Medicare Advantage (Part C) supplemental benefit
Correct Answer: C
Rationale: Medicare Part A covers inpatient hospital stays, care in a Skilled Nursing Facility
following a qualifying hospital stay, hospice care, and some home health care .
3. A 76-year-old patient requires a walker, outpatient occupational therapy, and a new
prescription for a blood pressure medication upon discharge home. Which
combination of Medicare parts will cover these specific transitional needs?
A) Part A for the walker, Part B for the therapy, Part D for the medication
B) Part B for the walker, Part A for the therapy, Part D for the medication
C) Part D for the walker, Part B for the therapy, Part A for the medication
D) Part B for the walker, therapy, and medication
Correct Answer: A
, Rationale: Medicare Part B covers durable medical equipment (walkers) and outpatient
occupational therapy, while Part D covers prescription medications dispensed at a retail
pharmacy .
4. Which of the following best defines the "Continuum of Care" in adult gerontology
management?
A) A rigid, step-down model where patients move strictly from hospital to home
B) An integrated, patient-centered system of care that spans from health promotion to end-
of-life, adjusting based on patient needs
C) A financial model used by Medicare to cap payments across all settings
D) A siloed approach where each provider manages only their specific acute episode
Correct Answer: B
Rationale: The continuum of care is an integrated system of care that guides and tracks
patients over time through a comprehensive array of health services spanning all levels of
intensity of care .
5. An 82-year-old female presents with insomnia. Her provider is considering a low-
dose hypnotic. Which age-related physiological change most significantly increases
her risk for prolonged sedation?
A) Decreased gastric motility
B) Increased total body water
, C) Increased body fat composition
D) Decreased hepatic blood flow
Correct Answer: C
Rationale: Aging increases body fat and decreases lean mass. Lipophilic drugs (like many
hypnotics and benzodiazepines) have a larger volume of distribution, leading to a longer
half-life and prolonged duration of action .
6. An 82-year-old patient reports feeling dizzy when standing up quickly. Which age-
related physiological change is the most likely cause?
A) Decreased baroreceptor sensitivity
B) Increased cardiac output
C) Thickening of the heart valves
D) Increased blood volume
Correct Answer: A
Rationale: Baroreceptor sensitivity decreases with age, leading to orthostatic hypotension
and dizziness .
7. A 72-year-old male patient asks about the recommended frequency for the
shingles (herpes zoster) vaccine. He received the live zoster vaccine (Zostavax) five
years ago. What is the most appropriate response?
