Adult-Gerontology CNS Test Clinical Assessment & Diagnosis 2

Question 1

The ankle-brachial index (ABI) value diagnostic of significant peripheral arterial disease is:

Accepted Answer

0.9 or less

Answer

An ABI of 0.9 or less indicates arterial obstruction reducing ankle pressures relative to brachial pressure, confirming hemodynamically significant PAD.

Question 2

The most sensitive early indicator of acute kidney injury is:

Accepted Answer

Rise in serum creatinine by 0.3 mg/dL or more within 48 hours or 1.5× baseline within 7 days

Answer

The KDIGO AKI definition uses creatinine rise thresholds because small absolute increases early in AKI reflect significant GFR decline before BUN or symptoms appear.

Question 3

On auscultation, a harsh systolic ejection murmur radiating to the carotids in an older adult most suggests:

Accepted Answer

Aortic stenosis

Answer

Aortic stenosis produces a harsh crescendo-decrescendo systolic murmur at the right upper sternal border that radiates to the carotid arteries due to high-velocity turbulent flow.

Question 4

Kussmaul breathing, the deep, labored respiratory pattern, is a clinical sign of:

Accepted Answer

Severe metabolic acidosis requiring respiratory compensation

Answer

Kussmaul respirations represent the body's maximal effort to lower PaCO2 through increased minute ventilation to compensate for severe metabolic acidosis (e.g., DKA, uremia).

Question 5

Thyroid-stimulating hormone (TSH) is the most sensitive test for screening thyroid dysfunction because:

Accepted Answer

Pituitary TSH responds exponentially to small changes in free T4 and T3 levels

Answer

The pituitary's log-linear feedback amplifies small changes in circulating thyroid hormones into large TSH changes, making TSH far more sensitive than direct hormone measurement.

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Practice Test

Adult-Gerontology CNS Test Clinical Assessment & Diagnosis 2