Advanced Nursing Practice
Adult Gerontology Acute Care
University of Texas at Arlington (UTA)
100-Question Original Practice Examination
2026/2027 Edition
1. An older adult with heart failure is discharged after a 4-day admission. Which action most reduces early
readmission risk?
A) Provide only a printed diagnosis list
B) Delay follow-up until symptoms recur
C) Arrange early follow-up, reconcile medications, and confirm understanding of warning signs
D) Stop chronic medications until the next clinic visit
Correct Answer: Arrange early follow-up, reconcile medications, and confirm understanding of warning signs
Rationale: High-risk transitions require clear medication reconciliation, patient education, timely follow-up, and
communication between settings. Heart-failure readmissions often relate to medication discrepancies, fluid-status
changes, or delayed recognition of deterioration. A diagnosis sheet alone is insufficient, and withholding indicated
chronic therapy may worsen instability.
2. A patient needs intensive inpatient rehabilitation after a stroke. Which functional expectation is
commonly associated with inpatient rehabilitation eligibility?
A) Need for custodial care only
B) No ability to participate in therapy
C) Ability to participate in a substantial daily therapy program
D) Requirement for hospice enrollment
Correct Answer: Ability to participate in a substantial daily therapy program
Rationale: Inpatient rehabilitation is intended for patients who can benefit from coordinated, intensive therapy and
ongoing medical oversight. The exact schedule depends on program and payer rules, but meaningful participation
is central. Custodial needs alone are better matched to other settings, and hospice has a different goal of care.
3. Which patient is the best candidate for skilled nursing facility care after hospitalization?
A) A completely independent patient requesting housing
B) A patient requiring only restaurant delivery
C) A patient needing ongoing skilled nursing and rehabilitation that is less intensive than inpatient rehab
D) A patient needing no skilled services
Correct Answer: A patient needing ongoing skilled nursing and rehabilitation that is less intensive than inpatient
rehab
Rationale: Skilled nursing facilities provide nursing and rehabilitation for patients who still need skilled services but
do not require acute hospitalization or intensive inpatient rehabilitation. Placement should reflect medical needs,
function, goals, and coverage criteria rather than convenience alone.
4. Which finding most strongly supports home-health eligibility after discharge?
A) The patient can freely leave home and needs no skilled care
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, B) The patient requests housekeeping only
C) The patient wants transportation to social events
D) The patient is homebound and requires intermittent skilled nursing or therapy
Correct Answer: The patient is homebound and requires intermittent skilled nursing or therapy
Rationale: Home-health benefits generally require a clinical need for intermittent skilled services and substantial
difficulty leaving home. The program is not intended simply for errands, transportation, or nonmedical
housekeeping. Proper documentation should connect the patient's limitations to the skilled plan of care.
5. A hospitalized patient is expected to need medically necessary hospital care beyond a short observation
period. What is the most important action?
A) Document the clinical rationale for inpatient-level care and expected duration
B) Change status without documentation
C) Discharge immediately despite instability
D) Avoid communicating with utilization review
Correct Answer: Document the clinical rationale for inpatient-level care and expected duration
Rationale: Admission status should match medical necessity and anticipated care needs. Clear documentation
supports continuity, payer review, and appropriate resource use. Status decisions should be clinically justified
rather than based on administrative convenience, and unstable patients should not be discharged simply to avoid a
classification issue.
6. Which communication practice best promotes a culture of safety?
A) Discouraging reporting unless harm occurred
B) Limiting safety discussions to managers
C) Penalizing staff for every reported error
D) Encouraging staff to report concerns and near misses without fear of retaliation
Correct Answer: Encouraging staff to report concerns and near misses without fear of retaliation
Rationale: A strong safety culture supports speaking up, reporting near misses, learning from adverse events, and
improving systems. Punitive environments drive problems underground. Psychological safety is especially
important in high-acuity care, where early communication can prevent progression from a near miss to patient
harm.
7. After a serious medication event, which system response is most appropriate?
A) Hide the event if no lawsuit occurs
B) Respond to the patient, report the event, investigate causes, communicate findings, and implement
improvement
C) Discipline one person without reviewing system factors
D) Wait for another event before changing practice
Correct Answer: Respond to the patient, report the event, investigate causes, communicate findings, and
implement improvement
Rationale: Effective safety programs combine immediate patient care with transparent reporting, structured
analysis, communication, corrective action, and follow-up. Focusing only on individual blame misses latent system
hazards such as workflow, labeling, staffing, or communication problems that can recur with other clinicians.
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