ANCC Gerontological Nursing 1 — Questions and Answers
Question 1: Which tool is widely used to assess delirium in older hospitalized patients?
- Mini-Mental State Examination (MMSE)
- Confusion Assessment Method (CAM) (Correct answer)
- Montreal Cognitive Assessment (MoCA)
- Geriatric Depression Scale (GDS)
Correct answer: Confusion Assessment Method (CAM)
The Confusion Assessment Method (CAM) is the gold standard tool for identifying delirium in clinical settings.
Question 2: An 82-year-old patient is started on a new benzodiazepine. According to the Beers Criteria, this is concerning because:
- Benzodiazepines are ineffective in elderly patients
- They increase the risk of falls, cognitive impairment, and delirium in older adults (Correct answer)
- They interact with all cardiac medications
- They cause hypertension in patients over 80
Correct answer: They increase the risk of falls, cognitive impairment, and delirium in older adults
The AGS Beers Criteria lists benzodiazepines as potentially inappropriate in older adults due to increased fall and delirium risk.
Question 3: Which physiologic change of normal aging most directly affects drug metabolism in older adults?
- Increased renal clearance
- Decreased hepatic blood flow and liver mass (Correct answer)
- Increased gastric acid secretion
- Increased lean body mass
Correct answer: Decreased hepatic blood flow and liver mass
Decreased hepatic blood flow and liver mass reduce first-pass metabolism and hepatic drug clearance in older adults.
Question 4: A nurse is assessing an older adult for functional status. Which assessment tool evaluates basic activities of daily living (ADLs)?
- Lawton IADL Scale
- Katz Index of Independence
- Barthel Index only
- Both B and C (Correct answer)
Correct answer: Both B and C
Both the Katz Index and the Barthel Index measure basic ADLs such as bathing, dressing, and toileting.
Question 5: Which finding best distinguishes dementia from delirium in an older patient?
- Memory impairment
- Acute onset and fluctuating course
- Gradual onset over months to years (Correct answer)
- Impaired executive function
Correct answer: Gradual onset over months to years
Gradual insidious onset over months to years is the hallmark that distinguishes dementia from the acute onset of delirium.
Question 6: What is the most common cause of dementia in the United States?
- Vascular dementia
- Lewy body dementia
- Alzheimer's disease (Correct answer)
- Frontotemporal dementia
Correct answer: Alzheimer's disease
Alzheimer's disease accounts for approximately 60–80% of all dementia cases in the United States.
ANCC Gerontological Nursing 1
Which tool is widely used to assess delirium in older hospitalized patients?