Adult-Gerontology Primary Care Nurse Practitioner Exam Risk Assessment & Management 2 — Questions and Answers
Question 1: A 78-year-old man with a history of falls scores 45 on the Morse Fall Scale. Which intervention is the MOST appropriate next step?
- Reassess in 6 months
- Implement a high-risk fall prevention protocol (Correct answer)
- Refer to physical therapy only
- Advise family to supervise all ambulation
Correct answer: Implement a high-risk fall prevention protocol
A Morse Fall Scale score of 45 or above indicates high fall risk, requiring immediate implementation of a high-risk fall prevention protocol.
Question 2: Which tool is BEST validated for assessing suicide risk in older adults in the primary care setting?
- PHQ-9 question 9 alone
- Columbia Suicide Severity Rating Scale (C-SSRS) (Correct answer)
- Beck Anxiety Inventory
- GDS-15
Correct answer: Columbia Suicide Severity Rating Scale (C-SSRS)
The Columbia Suicide Severity Rating Scale (C-SSRS) is a validated, structured tool specifically designed to assess suicide ideation and behavior severity.
Question 3: An 82-year-old woman is brought in by her daughter who reports she seems confused and has multiple unexplained bruises. Which screening tool is MOST appropriate to assess for elder mistreatment?
- Mini-Cog
- Elder Abuse Suspicion Index (EASI) (Correct answer)
- MMSE
- Katz Index
Correct answer: Elder Abuse Suspicion Index (EASI)
The Elder Abuse Suspicion Index (EASI) is a validated 6-question tool designed for primary care providers to screen for elder mistreatment.
Question 4: A 75-year-old patient with a CHA₂DS₂-VASc score of 4 and non-valvular atrial fibrillation is currently not on anticoagulation. What is the recommended management?
- Start aspirin 81 mg daily
- Start anticoagulation therapy (Correct answer)
- Observe and reassess annually
- Refer for cardioversion first
Correct answer: Start anticoagulation therapy
A CHA₂DS₂-VASc score of ≥2 in men or ≥3 in women with non-valvular AFib indicates high stroke risk warranting anticoagulation therapy.
Question 5: Which of the following is a MAJOR risk factor for pressure injury development in an 85-year-old bedridden patient?
- Intact skin turgor
- BMI of 25
- Fecal incontinence (Correct answer)
- Mild cognitive impairment without immobility
Correct answer: Fecal incontinence
Fecal incontinence causes prolonged skin moisture and chemical irritation, which is a major modifiable risk factor for pressure injury.
Question 6: A 70-year-old patient with diabetes and peripheral neuropathy reports no foot pain despite a visible plantar ulcer. What is the PRIMARY risk this finding represents?
- Hypoglycemia risk
- Amputation risk due to undetected wound progression (Correct answer)
- Risk of gout flare
- Osteosarcoma risk
Correct answer: Amputation risk due to undetected wound progression
Peripheral neuropathy masks pain from diabetic foot ulcers, allowing infection and tissue destruction to progress silently, dramatically increasing amputation risk.
Question 7: When performing a cardiovascular risk assessment using the ACC/AHA Pooled Cohort Equations, which patient characteristic is NOT included in the calculation?
- Age
- Total cholesterol
- Family history of premature CAD (Correct answer)
- Systolic blood pressure
Correct answer: Family history of premature CAD
The ACC/AHA Pooled Cohort Equations use age, sex, race, cholesterol levels, blood pressure, diabetes, and smoking status — family history is NOT a variable in the equation.
Adult-Gerontology Primary Care Nurse Practitioner Exam Risk Assessment & Management 2
A 78-year-old man with a history of falls scores 45 on the Morse Fall Scale.
Which intervention is the MOST appropriate next step?