Adult-Gerontology Primary Care Nurse Practitioner Exam Geriatric Assessment & Comprehensive Care Planning 2 — Questions and Answers
Question 1: Which instrument is the gold standard for assessing instrumental activities of daily living (IADLs) in older adults?
- Barthel Index
- Katz ADL Scale
- Lawton-Brody IADL Scale (Correct answer)
- FIM Instrument
Correct answer: Lawton-Brody IADL Scale
The Lawton-Brody IADL Scale assesses eight complex activities including telephoning, shopping, cooking, housekeeping, laundry, transportation, medication management, and finances.
Question 2: During a geriatric assessment, the AGPCNP screens an 80-year-old for depression. Which is the most appropriate tool?
- PHQ-9
- Beck Depression Inventory
- Geriatric Depression Scale-15 (GDS-15) (Correct answer)
- Hamilton Rating Scale
Correct answer: Geriatric Depression Scale-15 (GDS-15)
The GDS-15 was specifically developed and validated for older adults, avoiding somatic items that can confound depression diagnosis in this population.
Question 3: A 75-year-old patient is prescribed 8 medications. The AGPCNP applies the Beers Criteria to:
- Identify medications requiring dose adjustment for renal function
- Identify potentially inappropriate medications in older adults (Correct answer)
- Calculate total daily drug cost
- Determine drug-drug interactions
Correct answer: Identify potentially inappropriate medications in older adults
The Beers Criteria, published by the American Geriatrics Society, lists potentially inappropriate medications for older adults due to increased risk of adverse effects.
Question 4: In a geriatric assessment, hearing impairment screening can be quickly performed using:
- Pure-tone audiometry
- Weber test alone
- The Whisper Test or the HHIE-S (Correct answer)
- Rinne test alone
Correct answer: The Whisper Test or the HHIE-S
The Whisper Test or the Hearing Handicap Inventory for the Elderly-Screening Version (HHIE-S) are validated, quick tools for hearing screening in primary care.
Question 5: An AGPCNP documents a patient's 'advance directive.' This document primarily addresses:
- Financial power of attorney
- Patient's preferences for future medical care if unable to communicate (Correct answer)
- Medication reconciliation at discharge
- Insurance coverage for long-term care
Correct answer: Patient's preferences for future medical care if unable to communicate
An advance directive is a legal document that specifies a patient's wishes regarding medical treatment and designates a healthcare proxy if the patient loses decision-making capacity.
Question 6: Which assessment component is unique to the Comprehensive Geriatric Assessment compared to a standard history and physical?
- Review of systems
- Social support and environment evaluation (Correct answer)
- Chief complaint documentation
- Vital signs measurement
Correct answer: Social support and environment evaluation
CGA uniquely includes evaluation of social support networks, living environment, caregiver burden, and community resources, which are not typically part of a standard assessment.
Adult-Gerontology Primary Care Nurse Practitioner Exam Geriatric Assessment & Comprehensive Care Planning 2
Which instrument is the gold standard for assessing instrumental activities of daily living (IADLs) in older adults?