2024 Spring GAPNA Newsletter Volume 43 Number 1

Unlocking the Power of Gerontological Nursing: The Gero Nurse Prep Course

Prepare for the Gerontological Specialists Certification (GS-C) exam with these 5 practice questions. 

Printable Version

Question 1

The APRN is working in the emergency department where a critically ill 86-year-old patient is being seen by a healthcare provider. The provider orders a drug that appears on the Beers List of Potentially Inappropriate Medications. The APRN should understand that the drug

  1. can only be prescribed by a licensed physician.
  2. may be acceptable in a specific situation for a short period of time.
  3. can be used safely only in younger adults.
  4. needs preauthorization by the payer before it can be prescribed.

B

Blueprint Area: III. Prescribes medications, including consideration of risks and benefits of pharmacotherapy for complex older adults.

Rationale: The Beers Criteria have not been validated for use in the emergency department. It is possible that selected medications on the Beers List would be acceptable for short-term use in a specific situation.

Question 2

A 73-year-old female presents with severe right eye pain, nausea, and decreased vision. The APRN recognizes these findings as signs of

  1. acute glaucoma.
  2. giant cell arteritis.
  3. a detached retina.
  4. an acute ischemic stroke.

A

Blueprint Area: I. Performs comprehensive assessment of the complex older adult.

Rationale: Acute angle-closure glaucoma is an ocular emergency that requires immediate attention. Its symptoms include severe eye and face pain, nausea and vomiting, and an abrupt decrease in visual acuity. Measures must be taken promptly to lower the intraocular pressure to avoid damage to the neurons of the retina or optic nerve, which can lead to a rapid and permanent loss of vision.

Question 3

As a primary care provider, the APRN recognizes that Medicare Advantage Plans include

  1. Medicare A, only.
  2. Medicare A and B, only.
  3. Medicare A, B, and sometimes D.
  4. Medicare A, B, sometimes D, and extra benefits (i.e., dental).

D

Blueprint Area: VI. Anticipates and manages transitions of care between sites and providers.

Rationale: Medicare Advantage Plans include the following benefits:

  1. Part A, which is hospital insurance. This pays for hospital care and treatment.
  2. Part B, which is medical insurance. This pays for doctor/APRN visits (in some cases), for outpatient services, and doctor/APRN visit as a hospital inpatient.
  3. Part D helps pay for prescribed medications.
  4. Medicare Advantage and Special Needs plans, which might be available for certain plans. For example, some plans may include dental benefits and payment for fitness program memberships.

 

Question 4

A 78-year-old male with a history of mild cognitive impairment comes to the office accompanied by his wife. She is concerned because he has become more forgetful and recently got lost going to a neighborhood store. To assess the patient’s change in mental status, which of the following would be the preferred assessment tool?

  1. Clock Drawing Assessment (CDA)
  2. Confusion Assessment Method (CAM)
  3. Montreal Cognitive Assessment (MoCA)
  4. Comprehensive Geriatric Assessment (CGA)

C

Blueprint Area: I. Performs comprehensive assessment of the complex older adult.

Rationale: The Montreal Cognitive Assessment is a cognitive screening test designed to assist healthcare professionals in the detection of mild cognitive impairment and Alzheimer’s disease. It is designed to assess attention and concentration, executive functions, memory, language, conceptual thinking, calculations, and orientation. It is available online and is free to use.

 

Question 5

The APRN has been caring for a patient who was admitted to a skilled nursing facility following a hip fracture. The patient is ready for discharge with home health services. In order for Medicare home health services to be ordered, a face-to-face visit must occur no more than

  1. 7 days prior to home health or within 14 days after the start of care.
  2. 30 days prior to home health or within 7 days after the start of care.
  3. 45 days prior to home health or within 7 days after the start of care.
  4. 90 days prior to home health or within 30 days after the start of care.

D

Blueprint Area: VI. Anticipates and manages transitions of care between sites and providers.

Rationale: According to the CMS regulations (available online), in this case and in similar cases, the APRN must see the patient no more than 90 days prior to the home health start-of-care date or within 30 days after the start-of-care date.