Adult-Gerontology CNS Test Advanced Assessment and Diagnosis 2 — Questions and Answers
Question 1: In an older adult with suspected heart failure, which physical assessment finding is most consistent with fluid overload?
- Bradycardia
- Bilateral basilar crackles (Correct answer)
- Hypotension
- Decreased skin turgor
Correct answer: Bilateral basilar crackles
Bilateral basilar crackles indicate pulmonary edema, a hallmark of left-sided heart failure with fluid overload.
Question 2: Which pain assessment tool is most appropriate for an older adult with moderate cognitive impairment who cannot self-report?
- Numeric Rating Scale
- Visual Analog Scale
- PAINAD Scale (Correct answer)
- McGill Pain Questionnaire
Correct answer: PAINAD Scale
The PAINAD (Pain Assessment in Advanced Dementia) scale uses behavioral observations when self-report is not possible.
Question 3: When should blood pressure be measured to diagnose orthostatic hypotension in an older adult?
- Supine only
- Supine and after 1 minute standing
- Supine and after 3 minutes standing (Correct answer)
- Sitting only
Correct answer: Supine and after 3 minutes standing
Orthostatic hypotension is defined as a drop of 20 mmHg systolic or 10 mmHg diastolic after 3 minutes of standing.
Question 4: Which skin finding on assessment of an older adult is most concerning for potential malignancy?
- Seborrheic keratosis
- Actinic keratosis (Correct answer)
- Cherry angioma
- Lentigo simplex
Correct answer: Actinic keratosis
Actinic keratosis is a premalignant lesion caused by UV exposure that can progress to squamous cell carcinoma.
Question 5: A 75-year-old patient has a BMI of 17.5. How should the CNS classify this nutritional status?
- Normal weight
- Overweight
- Underweight (Correct answer)
- Obese
Correct answer: Underweight
A BMI below 18.5 is classified as underweight, indicating potential malnutrition, which is a significant concern in older adults.
Question 6: Which assessment finding best indicates frailty in an older adult using the Fried Frailty Criteria?
- Hypertension
- Unintentional weight loss of 10 lbs over one year (Correct answer)
- Tachycardia
- Hyperglycemia
Correct answer: Unintentional weight loss of 10 lbs over one year
Unintentional weight loss is one of the five Fried Frailty Criteria, along with exhaustion, weakness, slowness, and low activity.
Adult-Gerontology CNS Test Advanced Assessment and Diagnosis 2
In an older adult with suspected heart failure, which physical assessment finding is most consistent with fluid overload?