Page 1 of 73
NURS 5461: ADULT GERONTOLOGY MANAGEMENT ACROSS THE
CONTINUUM OF CARE HIGH-YIELD EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
NURS 5461: ADULT GERONTOLOGY MANAGEMENT ACROSS THE
CONTINUUM OF CARE
Questions with Answers & Detailed Rationales
Course: NURS 5461 – Adult Gerontology Management Across the Continuum of Care
Institution: The University of Texas at Arlington (UTA), College of Nursing and Health
Innovation
Credit Hours: 4 Hours
Course Focus: Foundations of advanced knowledge of common acute and chronic health
problems in adolescents, adults, and elders across health care settings
Question 1: A 35-year-old woman presents with cervical lymphadenopathy and symptoms of
fever, night sweats, and weight loss. An excisional biopsy of a supraclavicular lymph node
reveals nodular sclerosing Hodgkin's Lymphoma. Staging PET-CT shows bulky mediastinal
lymphadenopathy and she has a baseline ESR of 50 mm/hr. What favorable prognostic
feature does this patient have for early-stage Hodgkin's Lymphoma?
• A) Age less than 50 years
• B) ESR less than 50 mm/hr
• C) Nodular sclerosing subtype
• D) Female gender
Correct Answer: A
Rationale: In early-stage Hodgkin's Lymphoma, favorable prognostic features include age
<50 years, ESR <50 mm/hr (or <30 with B symptoms), and absence of bulky mediastinal
disease. This patient has age <50 as a favorable factor, but bulky mediastinal disease and
ESR of 50 are unfavorable factors. The nodular sclerosing subtype is the most common but
not a prognostic factor.
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Question 2: The most commonly identified benign breast disease is:
• A) Fibroadenomas
• B) Fibrocystic changes
• C) Ductal ectasia
• D) Sclerosing adenosis
Correct Answer: B
Rationale: Fibrocystic changes are the most common benign breast condition, affecting up to
50% of women. They typically present as breast pain, lumpiness, and cysts. The condition is
hormonally mediated and most common in women aged 20–50.
Question 3: Which treatment for nonmelanoma skin cancers preserves the greatest amount of
healthy tissue?
• A) Mohs micrographic surgery
• B) Standard surgical excision
• C) Cryosurgery
• D) Radiation therapy
Correct Answer: A
Rationale: Mohs micrographic surgery is the treatment of choice for nonmelanoma skin
cancers when tissue preservation is critical. It involves removing the tumor layer by layer and
examining each layer microscopically until no cancer cells remain. This maximizes cure rates
while preserving the greatest amount of healthy tissue.
Question 4: A 65-year-old female presents with a breast lump. Fine needle aspiration reveals
malignant cells. The patient is estrogen receptor positive, HER2 negative. What is the first-
line treatment for this patient?
• A) Lumpectomy followed by radiation
• B) Tamoxifen
• C) Aromatase inhibitor
• D) Mastectomy
Correct Answer: A
Rationale: For early-stage breast cancer, breast-conserving surgery (lumpectomy) followed
by radiation is the standard of care, offering equivalent survival to mastectomy. Hormonal
therapy (tamoxifen or aromatase inhibitor) is an adjuvant treatment, not first-line.
, Page 3 of 73
Question 5: A 60-year-old male presents with asymptomatic anemia found on routine labs.
He has a history of chronic kidney disease. The most likely cause of his anemia is:
• A) Iron deficiency
• B) Vitamin B12 deficiency
• C) Erythropoietin deficiency
• D) Gastrointestinal bleeding
Correct Answer: C
Rationale: Anemia of chronic kidney disease is primarily due to decreased production of
erythropoietin by the kidneys. This is a normocytic, normochromic anemia. Treatment
includes erythropoiesis-stimulating agents and iron supplementation.
Question 6: A patient with multiple myeloma presents with bone pain, hypercalcemia, and
renal failure. Which laboratory finding is most characteristic of this condition?
• A) Elevated serum protein electrophoresis with M-spike
• B) Elevated lactate dehydrogenase
• C) Elevated alkaline phosphatase
• D) Elevated uric acid
Correct Answer: A
Rationale: Multiple myeloma is characterized by monoclonal proliferation of plasma cells
producing an M-protein (monoclonal immunoglobulin). Serum protein electrophoresis shows
an M-spike. Other findings include lytic bone lesions, hypercalcemia, anemia, and renal
failure.
Question 7: A patient receiving chemotherapy for breast cancer develops a fever of 38.5°C
and a neutrophil count of 400 cells/mm³. The AGNP should:
• A) Reassure the patient that this is expected
• B) Administer acetaminophen and reassess in 24 hours
• C) Refer the patient to the emergency department for immediate evaluation
• D) Prescribe an oral antibiotic and follow up in 48 hours
Correct Answer: C
Rationale: Febrile neutropenia (fever with absolute neutrophil count <500 cells/mm³) is a
life-threatening oncologic emergency requiring immediate evaluation and broad-spectrum
intravenous antibiotics. This patient requires urgent hospital evaluation.
, Page 4 of 73
Question 8: Which of the following is a risk factor for the development of cervical cancer?
• A) HPV infection
• B) Smoking
• C) Immunosuppression
• D) All of the above
Correct Answer: D
Rationale: Risk factors for cervical cancer include persistent infection with high-risk HPV
types, smoking, immunosuppression (including HIV), early sexual activity, multiple sexual
partners, and lack of regular Pap screening.
Question 9: A 55-year-old male presents with painless hematuria. The AGNP should
suspect:
• A) Urinary tract infection
• B) Bladder cancer
• C) Kidney stones
• D) Prostatitis
Correct Answer: B
Rationale: Painless gross hematuria in an adult over age 50 is a classic presentation of
bladder cancer until proven otherwise. This warrants urgent urologic evaluation with
cystoscopy and imaging.
Question 10: A patient with prostate cancer has a PSA of 12 ng/mL and a Gleason score of
7. The AGNP should explain that:
• A) This indicates low-risk disease
• B) This indicates intermediate-risk disease
• C) This indicates high-risk disease
• D) PSA is not useful for risk stratification
Correct Answer: B
Rationale: A PSA between 10–20 ng/mL and a Gleason score of 7 indicate intermediate-risk
prostate cancer. Low-risk disease typically has PSA <10, Gleason ≤6; high-risk has PSA >20
or Gleason 8–10.
NURS 5461: ADULT GERONTOLOGY MANAGEMENT ACROSS THE
CONTINUUM OF CARE HIGH-YIELD EXAM LATEST VERSION
QUESTIONS AND ANSWERS 2026 EDITION
NURS 5461: ADULT GERONTOLOGY MANAGEMENT ACROSS THE
CONTINUUM OF CARE
Questions with Answers & Detailed Rationales
Course: NURS 5461 – Adult Gerontology Management Across the Continuum of Care
Institution: The University of Texas at Arlington (UTA), College of Nursing and Health
Innovation
Credit Hours: 4 Hours
Course Focus: Foundations of advanced knowledge of common acute and chronic health
problems in adolescents, adults, and elders across health care settings
Question 1: A 35-year-old woman presents with cervical lymphadenopathy and symptoms of
fever, night sweats, and weight loss. An excisional biopsy of a supraclavicular lymph node
reveals nodular sclerosing Hodgkin's Lymphoma. Staging PET-CT shows bulky mediastinal
lymphadenopathy and she has a baseline ESR of 50 mm/hr. What favorable prognostic
feature does this patient have for early-stage Hodgkin's Lymphoma?
• A) Age less than 50 years
• B) ESR less than 50 mm/hr
• C) Nodular sclerosing subtype
• D) Female gender
Correct Answer: A
Rationale: In early-stage Hodgkin's Lymphoma, favorable prognostic features include age
<50 years, ESR <50 mm/hr (or <30 with B symptoms), and absence of bulky mediastinal
disease. This patient has age <50 as a favorable factor, but bulky mediastinal disease and
ESR of 50 are unfavorable factors. The nodular sclerosing subtype is the most common but
not a prognostic factor.
, Page 2 of 73
Question 2: The most commonly identified benign breast disease is:
• A) Fibroadenomas
• B) Fibrocystic changes
• C) Ductal ectasia
• D) Sclerosing adenosis
Correct Answer: B
Rationale: Fibrocystic changes are the most common benign breast condition, affecting up to
50% of women. They typically present as breast pain, lumpiness, and cysts. The condition is
hormonally mediated and most common in women aged 20–50.
Question 3: Which treatment for nonmelanoma skin cancers preserves the greatest amount of
healthy tissue?
• A) Mohs micrographic surgery
• B) Standard surgical excision
• C) Cryosurgery
• D) Radiation therapy
Correct Answer: A
Rationale: Mohs micrographic surgery is the treatment of choice for nonmelanoma skin
cancers when tissue preservation is critical. It involves removing the tumor layer by layer and
examining each layer microscopically until no cancer cells remain. This maximizes cure rates
while preserving the greatest amount of healthy tissue.
Question 4: A 65-year-old female presents with a breast lump. Fine needle aspiration reveals
malignant cells. The patient is estrogen receptor positive, HER2 negative. What is the first-
line treatment for this patient?
• A) Lumpectomy followed by radiation
• B) Tamoxifen
• C) Aromatase inhibitor
• D) Mastectomy
Correct Answer: A
Rationale: For early-stage breast cancer, breast-conserving surgery (lumpectomy) followed
by radiation is the standard of care, offering equivalent survival to mastectomy. Hormonal
therapy (tamoxifen or aromatase inhibitor) is an adjuvant treatment, not first-line.
, Page 3 of 73
Question 5: A 60-year-old male presents with asymptomatic anemia found on routine labs.
He has a history of chronic kidney disease. The most likely cause of his anemia is:
• A) Iron deficiency
• B) Vitamin B12 deficiency
• C) Erythropoietin deficiency
• D) Gastrointestinal bleeding
Correct Answer: C
Rationale: Anemia of chronic kidney disease is primarily due to decreased production of
erythropoietin by the kidneys. This is a normocytic, normochromic anemia. Treatment
includes erythropoiesis-stimulating agents and iron supplementation.
Question 6: A patient with multiple myeloma presents with bone pain, hypercalcemia, and
renal failure. Which laboratory finding is most characteristic of this condition?
• A) Elevated serum protein electrophoresis with M-spike
• B) Elevated lactate dehydrogenase
• C) Elevated alkaline phosphatase
• D) Elevated uric acid
Correct Answer: A
Rationale: Multiple myeloma is characterized by monoclonal proliferation of plasma cells
producing an M-protein (monoclonal immunoglobulin). Serum protein electrophoresis shows
an M-spike. Other findings include lytic bone lesions, hypercalcemia, anemia, and renal
failure.
Question 7: A patient receiving chemotherapy for breast cancer develops a fever of 38.5°C
and a neutrophil count of 400 cells/mm³. The AGNP should:
• A) Reassure the patient that this is expected
• B) Administer acetaminophen and reassess in 24 hours
• C) Refer the patient to the emergency department for immediate evaluation
• D) Prescribe an oral antibiotic and follow up in 48 hours
Correct Answer: C
Rationale: Febrile neutropenia (fever with absolute neutrophil count <500 cells/mm³) is a
life-threatening oncologic emergency requiring immediate evaluation and broad-spectrum
intravenous antibiotics. This patient requires urgent hospital evaluation.
, Page 4 of 73
Question 8: Which of the following is a risk factor for the development of cervical cancer?
• A) HPV infection
• B) Smoking
• C) Immunosuppression
• D) All of the above
Correct Answer: D
Rationale: Risk factors for cervical cancer include persistent infection with high-risk HPV
types, smoking, immunosuppression (including HIV), early sexual activity, multiple sexual
partners, and lack of regular Pap screening.
Question 9: A 55-year-old male presents with painless hematuria. The AGNP should
suspect:
• A) Urinary tract infection
• B) Bladder cancer
• C) Kidney stones
• D) Prostatitis
Correct Answer: B
Rationale: Painless gross hematuria in an adult over age 50 is a classic presentation of
bladder cancer until proven otherwise. This warrants urgent urologic evaluation with
cystoscopy and imaging.
Question 10: A patient with prostate cancer has a PSA of 12 ng/mL and a Gleason score of
7. The AGNP should explain that:
• A) This indicates low-risk disease
• B) This indicates intermediate-risk disease
• C) This indicates high-risk disease
• D) PSA is not useful for risk stratification
Correct Answer: B
Rationale: A PSA between 10–20 ng/mL and a Gleason score of 7 indicate intermediate-risk
prostate cancer. Low-risk disease typically has PSA <10, Gleason ≤6; high-risk has PSA >20
or Gleason 8–10.
