Adult-Gerontology CNS Test Clinical Assessment & Diagnosis

Question 1

The Montreal Cognitive Assessment (MoCA) is preferred over the MMSE for detecting mild cognitive impairment because:

Accepted Answer

It has greater sensitivity for MCI due to inclusion of executive function, visuospatial, and memory domains

Answer

It takes longer and is more detailed

Answer

It requires less training to administer correctly

Answer

It is validated only for hospitalized patients

Question 2

In assessing a patient with dyspnea, the finding of orthopnea (2-pillow preference) most suggests:

Accepted Answer

Heart failure with increased pulmonary venous congestion in the supine position

Answer

COPD exacerbation

Answer

Pulmonary embolism

Answer

Pleural effusion from malignancy

Question 3

A positive Romberg test indicates impairment of:

Accepted Answer

Proprioception and posterior column sensory function

Answer

Cerebellar coordination and motor function

Answer

Vestibular end-organ alone

Answer

Corticospinal tract integrity

Question 4

The "Get Up and Go" test primarily assesses:

Accepted Answer

Mobility, balance, and fall risk in older adults

Answer

Cognitive function and memory recall

Answer

Pulmonary function and exercise tolerance

Answer

Peripheral vascular adequacy

Question 5

A new S3 heart sound (ventricular gallop) in an adult most commonly indicates:

Accepted Answer

Ventricular volume overload or decreased compliance as seen in heart failure

Answer

Aortic stenosis

Answer

Mitral valve prolapse

Answer

Pericarditis

Question 6

When assessing pain in a patient with moderate dementia who cannot self-report, the CNS should use:

Accepted Answer

An observational pain assessment tool such as PAINAD or ABBEY pain scale

Answer

Assume pain-free status since verbal reports are absent

Answer

Only the numeric rating scale with loud prompting

Answer

Analgesics empirically without any formal assessment