,Maryville NURS 620 Exam 1 | Adult-Gerontology
Health Care I (2026) Q&A
1. Which of the following best describes the primary pathophysiologic mechanism
of heart failure with reduced ejection fraction (HFrEF)?
A) Impaired diastolic relaxation of the left ventricle
B) Reduced left ventricular contractility leading to decreased stroke volume
C) Increased systemic vascular resistance causing pressure overload
D) Pericardial constriction restricting ventricular filling
Correct Answer: Reduced left ventricular contractility leading to decreased
stroke volume
Rationale: HFrEF occurs when the left ventricle loses its ability to contract
effectively, reducing stroke volume and cardiac output. Diastolic dysfunction
(impaired relaxation) characterizes HFpEF. Increased systemic vascular resistance
contributes to pressure overload but is not the primary mechanism of HFrEF.
Pericardial constriction is a separate entity.
2. What is the most common cause of bacterial meningitis in adults?
A) Neisseria meningitidis
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Listeria monocytogenes
Correct Answer: Streptococcus pneumoniae
,Rationale: Streptococcus pneumoniae is the leading cause of bacterial
meningitis in adults. Neisseria meningitidis is more common in adolescents and
young adults. Haemophilus influenzae has become rare due to vaccination. Listeria
is more common in neonates, older adults, and immunocompromised patients.
3. Which finding is most characteristic of hyperthyroidism during a head, face,
and neck examination?
A) Exophthalmos
B) Myxedema
C) Bradycardia
D) Cold intolerance
Correct Answer: Exophthalmos
Rationale: Exophthalmos (bulging eyes) is a classic sign of Graves' disease, a
form of hyperthyroidism. Myxedema is nonpitting edema seen in hypothyroidism.
Bradycardia and cold intolerance are also features of hypothyroidism, not
hyperthyroidism.
4. Which screening tool is specifically designed to assess functional status in older
adults with cognitive impairment?
A) FAQ (Functional Activities Questionnaire)
B) PHQ-9
C) CAGE
D) MMSE
Correct Answer: FAQ (Functional Activities Questionnaire)
, Rationale: The FAQ evaluates performance on 10 complex, higher-order
activities of daily living and is designed for initial assessment of Alzheimer's
disease and related dementias. The PHQ-9 screens for depression. The CAGE
screens for alcohol use disorder. The MMSE assesses cognitive function but not
functional status.
5. A 68-year-old male presents with progressive shortness of breath, orthopnea,
and paroxysmal nocturnal dyspnea. An S3 gallop is heard at the apex. Which of the
following is the most likely diagnosis?
A) Aortic stenosis
B) Heart failure with reduced ejection fraction
C) Pericarditis
D) Mitral valve prolapse
Correct Answer: Heart failure with reduced ejection fraction
Rationale: An S3 gallop is a classic finding in HFrEF, indicating decreased left
ventricular compliance and increased filling pressures. Orthopnea and PND
further support left-sided heart failure. Aortic stenosis presents with a systolic
ejection murmur. Pericarditis presents with a friction rub. Mitral valve prolapse
may present with a mid-systolic click.
6. Which medication class is considered first-line therapy for chronic stable angina
in older adults?
A) Beta-blockers
B) Calcium channel blockers
C) Angiotensin-converting enzyme inhibitors
D) Diuretics
Health Care I (2026) Q&A
1. Which of the following best describes the primary pathophysiologic mechanism
of heart failure with reduced ejection fraction (HFrEF)?
A) Impaired diastolic relaxation of the left ventricle
B) Reduced left ventricular contractility leading to decreased stroke volume
C) Increased systemic vascular resistance causing pressure overload
D) Pericardial constriction restricting ventricular filling
Correct Answer: Reduced left ventricular contractility leading to decreased
stroke volume
Rationale: HFrEF occurs when the left ventricle loses its ability to contract
effectively, reducing stroke volume and cardiac output. Diastolic dysfunction
(impaired relaxation) characterizes HFpEF. Increased systemic vascular resistance
contributes to pressure overload but is not the primary mechanism of HFrEF.
Pericardial constriction is a separate entity.
2. What is the most common cause of bacterial meningitis in adults?
A) Neisseria meningitidis
B) Streptococcus pneumoniae
C) Haemophilus influenzae
D) Listeria monocytogenes
Correct Answer: Streptococcus pneumoniae
,Rationale: Streptococcus pneumoniae is the leading cause of bacterial
meningitis in adults. Neisseria meningitidis is more common in adolescents and
young adults. Haemophilus influenzae has become rare due to vaccination. Listeria
is more common in neonates, older adults, and immunocompromised patients.
3. Which finding is most characteristic of hyperthyroidism during a head, face,
and neck examination?
A) Exophthalmos
B) Myxedema
C) Bradycardia
D) Cold intolerance
Correct Answer: Exophthalmos
Rationale: Exophthalmos (bulging eyes) is a classic sign of Graves' disease, a
form of hyperthyroidism. Myxedema is nonpitting edema seen in hypothyroidism.
Bradycardia and cold intolerance are also features of hypothyroidism, not
hyperthyroidism.
4. Which screening tool is specifically designed to assess functional status in older
adults with cognitive impairment?
A) FAQ (Functional Activities Questionnaire)
B) PHQ-9
C) CAGE
D) MMSE
Correct Answer: FAQ (Functional Activities Questionnaire)
, Rationale: The FAQ evaluates performance on 10 complex, higher-order
activities of daily living and is designed for initial assessment of Alzheimer's
disease and related dementias. The PHQ-9 screens for depression. The CAGE
screens for alcohol use disorder. The MMSE assesses cognitive function but not
functional status.
5. A 68-year-old male presents with progressive shortness of breath, orthopnea,
and paroxysmal nocturnal dyspnea. An S3 gallop is heard at the apex. Which of the
following is the most likely diagnosis?
A) Aortic stenosis
B) Heart failure with reduced ejection fraction
C) Pericarditis
D) Mitral valve prolapse
Correct Answer: Heart failure with reduced ejection fraction
Rationale: An S3 gallop is a classic finding in HFrEF, indicating decreased left
ventricular compliance and increased filling pressures. Orthopnea and PND
further support left-sided heart failure. Aortic stenosis presents with a systolic
ejection murmur. Pericarditis presents with a friction rub. Mitral valve prolapse
may present with a mid-systolic click.
6. Which medication class is considered first-line therapy for chronic stable angina
in older adults?
A) Beta-blockers
B) Calcium channel blockers
C) Angiotensin-converting enzyme inhibitors
D) Diuretics
