Sample Test Questions

Adult-Gerontology Clinical Nurse Specialist Exam Sample Questions

The following sample questions are similar to those on the examination but do not represent the full range of content or levels of difficulty. The answers to the sample questions are provided after the last question. Please note: Taking these or any sample question(s) is not a requirement to sit for an actual certification examination. Completion of these or any other sample question(s) does not imply eligibility for certification or successful performance on any certification examination.

To respond to the sample questions, first enter your first and last names in the boxes below (this information will not be recorded; it is strictly for purposes of identifying your results). Then click the button corresponding to the best answer for each question. When you are finished, click the "Evaluate" button at the bottom of the page. A new browser window will open, displaying your results, which you may print, if you wish.

This practice exam is not timed, and you may take it as many times as you wish. Good luck!

First name: Last name:

1. A 52-year-old patient reports stiffness and painful swelling of the proximal and distal interphalangeal joints. The expected pathologic findings in this patient include:

bacteria in the synovial fluid.
crystals in the synovial fluid.
erosion of the articular cartilage.
fatty degeneration of skeletal muscle tissue.

2. The adult-gerontology clinical nurse specialist screens patients for intimate partner violence when the clinical nurse specialist observes a patient who:

asks appropriate questions during a visit.
exhibits unusual behavior during a visit.
has laboratory values indicating an electrolyte imbalance.
reliably attends planned appointments.

3. Which clinical tool is used to aid in the diagnosis of Guillain-Barré syndrome?

Cerebrospinal fluid analysis.
Computed tomography angiography.
Magnetic resonance angiography.
Magnetic resonance imaging.

4. Several days after gastrointestinal surgery, a patient begins total parenteral nutrition. In addition to the blood glucose, which laboratory values are most important for the adult-gerontology clinical nurse specialist to monitor?

Creatinine clearance and magnesium.
Potassium and hemoglobin.
Serum electrolytes and blood urea nitrogen.
Total protein level and serum calcium.

5. Which diagnostic tool determines whether a patient's pulmonary edema is cardiac or pulmonary in origin?

Arterial blood gas test.
Brain natriuretic peptide test.
Cardiac marker panel.
Electrolyte panel.

6. A 92-year-old patient with advanced dementia has had three episodes of aspiration pneumonia in five months. The patient has no written advance directives. A speech therapist recommends feeding tube placement. One of the patient's adult children would like a feeding tube placed, the other adult child is unsure, and the patient's spouse states that the patient would never want a feeding tube. The adult-gerontology clinical nurse specialist's next action is to:

bring the case to the attention of the ethics committee.
emphasize to the family that a feeding tube will decrease recurrent pneumonia.
obtain a surgical consultation to schedule a feeding tube placement.
organize a family and staff meeting to discuss the risks and benefits and consider the patient's wishes.

7. A staff nurse admits a patient who has overdosed on cocaine to a busy medical unit. A nurse asks the adult-gerontology clinical nurse specialist, "Why are we bothering with this patient? They will only wind up being readmitted." The clinical nurse specialist's response is,:

"As nurses, we are responsible for learning to recognize our own feelings when caring for patients whose diagnoses we may find difficult to accept."
"As nurses, we need to put the patient first. Our feelings are not supposed to be considered when we care for challenging patients."
"I hear what you are saying, but nurses cannot be judgmental of their patients."
"I'm going to refer you to the employee health nurse so you can receive some help for your burnout."

8. The adult-gerontology clinical nurse specialist consults with a local nursing facility to provide nursing staff development. What does the clinical nurse specialist do after meeting with the administrator to identify the nature of the problem necessitating consultation?

Create an interprofessional teaching team.
Develop outcome measures.
Market an educational plan.
Utilize a survey to assess educational needs.

9. The adult-gerontology clinical nurse specialist examines a patient who is on medication for chronic low back pain, hypercholesterolemia, hypertension, and hypothyroidism. Which medication, when used over a long period of time, may contribute to a diagnosis of osteoporosis?

Antihypertensive medication.
Cholesterol-lowering medication.
Nonsteroidal anti-inflammatory medication.
Thyroid replacement medication.

10. The caregiver of a patient with Alzheimer disease expresses feeling fatigued and stressed about continuing to care for the patient at home. The adult-gerontology clinical nurse specialist helps the caregiver to utilize resources that are available to meet their needs by:

consulting hospice for guidance on end-of-life care.
contacting the Alzheimer's Association to locate adult day care services.
providing a list of sitters who care for older adult patients.
recommending a transfer to a long-term care facility for patients with Alzheimer disease.

11. The initial psychosocial assessment of a patient with a terminal illness, refractory to treatment, includes:

a discussion of hospice care.
a review of critical life incidents.
the family's readiness to learn about the dying process.
the patient's preference for quality versus quantity of life.

12. The adult-gerontology clinical nurse specialist plans to ask experienced users of home glucose monitoring to mentor patients new to this procedure. Which theory supports this approach?

Behavioral learning theory.
Planned behavioral change theory.
Psychomotor learning theory.
Social cognitive theory.

13. An 88-year-old patient who is often incontinent is reluctant to use the call light for assistance. The adult-gerontology clinical nurse specialist instructs the staff to praise the patient each time they use the call light. The clinical nurse specialist's suggestion is based on which theory?

Behavioral learning.
Cognitive reorganization.
Person-environment fit.
Social cognitive.

14. A hospital's administration examines the electronic health record (EHR) to improve patient outcomes. The adult-gerontology clinical nurse specialist recommends a design that:

aggregates the fall risk factors into a fall risk score.
creates a report of the patients' vital signs.
embeds each patient's diagnosis in the nurses' notes.
sends nursing notes directly to the interprofessional team members.

15. The adult-gerontology clinical nurse specialist leads an interprofessional group that is developing a special care unit for people who have dementia. During the second meeting, the nurse manager becomes resistant to the idea and negative about its implementation. This is an important project, and the support of the manager will be needed. The clinical nurse specialist's best response to the situation is to:

meet individually with the nurse manager to discuss the perceived resistance.
report the situation to the nursing director and ask for administrative intervention.
revisit the initial goals of the group at the next meeting and ask for comments.
schedule another group meeting since the majority of the group is supportive.

16. The adult-gerontology clinical nurse specialist is asked to provide a consultation on ways to reduce the use of restraints in a skilled nursing facility. In the initial meeting with the skilled nursing facility administration, the clinical nurse specialist's primary goal is to:

complete a written contract for services that covers expected outcomes, time commitments, support systems, and financial arrangements.
conduct a force field analysis of the variables in the skilled nursing facility that includes use of existing data on restraint use and staff strengths and weaknesses.
discuss the need for consultation, the overall goal of the project, and the working relationship with the staff.
plan a review of how the use of restraints has been accomplished elsewhere, and the models used for education and for changing practice.

17. Based on Change Theory, the adult-gerontology clinical nurse specialist, who is starting a new program in the organization, promotes change and acceptance by:

avoiding the periodic, negative events between the driving and restraining forces.
equalizing the driving and restraining forces to stabilize the environment.
influencing the environment so that the driving forces outnumber the restraining forces.
stimulating the disequilibrium of the driving and restraining forces.

18. An older adult patient is living with cancer that has metastasized to the liver and bone. What does the adult-gerontology clinical nurse specialist recommend for pain management?

Carbamazepine (Carbatrol).
Hydromorphone hydrochloride (Dilaudid).
Ketorolac tromethamine (Acular).
Lorazepam (Ativan).

19. A patient who experienced a hemolytic blood transfusion reaction last evening appears in stable condition. The transfusion was discontinued when the reaction was noted, and the patient was treated appropriately. The patient's morning potassium level is 6.9 mEq/L. Which patient treatment does the adult-gerontology clinical nurse specialist initiate?

Administering furosemide (Lasix) intravenously.
Administering regular insulin along with glucose intravenously.
Preparing for hemodialysis.
Restricting the patient's dietary intake of potassium.

20. After presenting a talk on breast health, the adult-gerontology clinical nurse specialist discovers that at least 60% of the women who attend a large urban senior center do not believe in the benefits of mammography, have never had a mammogram, or had a painful experience and refuse to get another one. Which initial approach is most likely to motivate change?

Administering a survey to assess the exact nature of the women's self-care behaviors before planning the next step.
Arranging for reduced-cost mammograms and free transportation to the local hospital.
Planning some small group sessions with the women to allow them to explore their beliefs and feelings.
Presenting another educational session that includes a speech by a physician and then distribute additional literature.

21. According to the Iowa Model of Evidence-Based Practice to Promote Quality Care, organizations will likely prioritize topics that address high-volume, high-cost procedures and also:

align with the strategic plan.
encourage a culture of inquiry.
support clinical practice.
support evidence-based nursing practice.

22. The adult-gerontology clinical nurse specialist presents a research study on the cardiovascular risk factors of patients who are over age 50. It is noted that all study participants are between 50 and 60 years of age. The potential bias in the study is due to the:

attrition.
confounding variables.
contamination.
homogeneous sample.

23. The colleague of a researcher requests the mailing list of subjects who have participated in the researcher's study. The researcher tells the colleague that:

a formal, written request will be needed before any information may be released.
authorization from all study investigators will be needed before sharing the information.
the information may not be shared without Institutional Review Board approval.
the information will be shared, provided the colleague uses it only as approved by the researcher.

24. To support quality improvement initiatives, the adult-gerontology clinical nurse specialist conducts a root cause analysis utilizing a Pareto chart to identify the:

breakdowns and changes of the system over time.
buy-in of stakeholders and the prioritization of improvement strategies.
key resistors to change and an enhanced understanding of the problem.
principal variables affecting process and the opportunities for improvement.

25. While precepting a nursing student, the adult-gerontology clinical nurse specialist teaches blood glucose monitoring to a patient. As a result, the nursing student learns techniques and strategies for patient teaching. This educational technique is referred to as:

coaching.
collaborating.
guiding.
mentoring.

Sample Test Questions

Adult-Gerontology Clinical Nurse Specialist Exam Sample Questions

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