Adult-Gerontology CNS Test Chronic Disease Management 2 — Questions and Answers
Question 1: Which staging system is used to classify chronic kidney disease by international guidelines?
- TNM staging
- KDIGO CKD staging by GFR (Correct answer)
- Child-Pugh classification
- NYHA functional classification
Correct answer: KDIGO CKD staging by GFR
KDIGO guidelines classify CKD into five stages based on GFR levels, with additional albuminuria categories for comprehensive staging.
Question 2: A patient with COPD uses a short-acting bronchodilator more than twice a week. What does this indicate?
- Well-controlled disease
- Uncontrolled symptoms requiring therapy adjustment (Correct answer)
- Normal rescue medication use
- Need for oral corticosteroids immediately
Correct answer: Uncontrolled symptoms requiring therapy adjustment
Using rescue bronchodilators more than twice weekly signals inadequate COPD symptom control and warrants reassessment of the maintenance regimen.
Question 3: Which complication of diabetes most commonly leads to hospitalization in older adults?
- Diabetic ketoacidosis
- Hypoglycemic episodes (Correct answer)
- Hyperglycemic hyperosmolar state
- Peripheral neuropathy
Correct answer: Hypoglycemic episodes
Hypoglycemia is the most common acute diabetes-related cause of hospitalization in older adults, especially those on insulin or sulfonylureas.
Question 4: Which pneumococcal vaccine schedule does ACIP recommend for adults aged 65 and older?
- Pneumovax 23 only, given once
- PCV20 alone, or PCV15 followed by PPSV23 one year later (Correct answer)
- PCV13 only, given once
- Annual pneumococcal vaccination
Correct answer: PCV20 alone, or PCV15 followed by PPSV23 one year later
Current ACIP guidelines recommend PCV20 alone or PCV15 followed by PPSV23 one year later for pneumococcal protection in adults 65 and older.
Question 5: A CNS caring for a patient with chronic heart failure notes a 3-pound weight gain in 24 hours. What is the priority action?
- Order a stat ECG
- Assess for fluid overload and notify the provider (Correct answer)
- Encourage increased fluid intake
- Schedule a cardiology appointment in 1 week
Correct answer: Assess for fluid overload and notify the provider
Rapid weight gain in heart failure indicates fluid retention; immediate assessment for decompensation and provider notification are required.
Question 6: Which medication reduces the rate of COPD exacerbations when added to a long-acting bronchodilator regimen?
- Short-acting beta agonists
- Inhaled corticosteroids (Correct answer)
- Oral theophylline
- Systemic corticosteroids
Correct answer: Inhaled corticosteroids
Inhaled corticosteroids added to LABA therapy reduce exacerbation frequency in COPD patients with frequent flare-ups.
Adult-Gerontology CNS Test Chronic Disease Management 2
Which staging system is used to classify chronic kidney disease by international guidelines?