Free Adult-Gerontology Clinical Nurse Specialist Board Certification Examination Practice Questions

Sample Practice Questions

Try these 10 sample questions from the Adult-Gerontology Clinical Nurse Specialist Board Certification Examination practice bank. Each includes the answer and explanation. Continue with the interactive practice above to review the full question set.

1. 1During a geriatric assessment, a nurse explains that a patient's skeletal muscle cells have become smaller with age. Which cellular change describes this finding?

   1. A. Hypertrophy
   2. B. Atrophy
   3. C. Hyperplasia
   4. D. Dysplasia

   Answer: B

   Explanation: MedlinePlus defines atrophy as follows: "Cells shrink. If enough cells decrease in size, the entire organ atrophies." The observed decrease in cell size is atrophy; hypertrophy enlarges cells, hyperplasia increases cell number, and dysplasia alters mature cell structure.

   Reference: Aging changes in organs, tissue and cells — Terms to Describe Types of Cell Changes: Atrophy

2. 2A clinical nurse specialist discusses Medicare hospice eligibility with the family of a patient whose terminal illness is expected to follow its usual course. What is the longest prognosis that meets the physician-certification criterion?

   1. A. Three months or less
   2. B. Six months or less
   3. C. Nine months or less
   4. D. Twelve months or less

   Answer: B

   Explanation: CMS requires physician certification of a patient as terminally ill with "a medical prognosis of 6 months or less to live if the illness runs its normal course." The boundary is six months under the stated condition.

   Reference: Hospice — Hospice Coverage, eligibility criteria

3. 3A hospital reduces average length of stay and wants to detect whether the change creates harm after discharge. Which metric should the clinical nurse specialist track as a balancing measure?

   1. A. The proportion of patients readmitted after discharge
   2. B. The percentage of discharge checklists completed
   3. C. The average number of inpatient days saved
   4. D. The proportion of staff trained in discharge workflow

   Answer: A

   Explanation: IHI asks of balancing measures, "Are changes designed to improve one part of the system causing new problems in other parts of the system?" Its length-of-stay example specifically checks whether readmission rates rise. That metric detects possible downstream harm.

   Reference: IHI Model for Improvement: Establishing Measures — Three Types of Measures, Balancing Measures

4. 4An older patient reports new memory problems. Which finding most strongly separates a possible dementia syndrome from normal age-related memory change?

   1. A. Sometimes misplacing keys and recalling where they were later
   2. B. Occasionally struggling for a word and recalling it later
   3. C. Losing the ability to make routine decisions in daily life
   4. D. Occasionally forgetting an acquaintance's name and recalling it later

   Answer: C

   Explanation: CDC states that "dementia—which blocks a person's ability to remember, think clearly, or make daily decisions—is NOT a normal part of aging." Functional loss in daily decision-making calls for further evaluation, whereas the other options describe occasional lapses listed as normal age-related changes.

   Reference: Signs and Symptoms of Dementia — Dementia vs. normal aging

5. 5A hospice patient has severe symptoms that cannot be managed outside an inpatient facility. Which Medicare hospice level of care matches this need?

   1. A. Routine home care
   2. B. Continuous home care
   3. C. Inpatient respite care
   4. D. General inpatient care

   Answer: D

   Explanation: CMS defines "General inpatient care" as hospice care in an inpatient facility "for pain control or acute or chronic symptom management, which can’t be managed in other settings." Routine home care, continuous home care, and respite care have different conditions.

   Reference: Hospice — Hospice Levels of Care

6. 6A quality committee wants a structural measure of the hospital's capacity to deliver safe care, rather than a patient result or care process. Which measure fits?

   1. A. Availability of a staffed rapid response service
   2. B. Rate of deaths after an inpatient admission
   3. C. Rate of completed sepsis screening assessments
   4. D. Patient rating of discharge communication

   Answer: A

   Explanation: CMS explains, "Structural measures are measure that assesses features of a health care provider or clinician related to its ability to provide good health care." The presence of a staffed service describes capacity, whereas the other options are outcome, process, or experience measures.

   Reference: CMS Inpatient Measures — Types of measures, Structural measures

7. 7During an assessment, an older patient says a caregiver repeatedly fails to provide food and essential medical care. Which category of older-person mistreatment best fits this account?

   1. A. Physical abuse
   2. B. Emotional abuse
   3. C. Financial abuse
   4. D. Neglect

   Answer: D

   Explanation: CDC defines neglect: "Neglect is the failure to meet an older adult's basic needs. These needs include food, water, shelter, clothing, hygiene, and essential medical care." The caregiver's failure to provide food and essential care fits that category.

   Reference: About Abuse of Older Persons — What is older person abuse?

8. 8An adult with opioid use disorder is considering buprenorphine treatment. Which mu-opioid receptor action does SAMHSA assign to buprenorphine?

   1. A. Full agonist
   2. B. Partial agonist
   3. C. Antagonist
   4. D. Inverse agonist

   Answer: B

   Explanation: SAMHSA identifies "the mu-opioid receptor partial agonist buprenorphine" and contrasts it with methadone, a full agonist, and naltrexone, an antagonist. Buprenorphine therefore has the partial-agonist action.

   Reference: TIP 63: Medications for Opioid Use Disorder — Part 3, Chapter 3A, Overview of Medications for Opioid Use Disorder

9. 9A clinical nurse specialist compares hospitals using patients' reports of their recent inpatient experiences. Which standardized measure source does CMS identify for this purpose?

   1. A. HCAHPS hospital patient survey
   2. B. NHSN device utilization surveillance
   3. C. Medicare claims diagnosis grouping
   4. D. Hospital infection laboratory cultures

   Answer: A

   Explanation: CMS states, "Patient experience of care is measures by a national, standardized survey of hospital patients about their experiences during a recent inpatient hospital stay." CMS identifies that survey as HCAHPS.

   Reference: CMS Inpatient Measures — Patient experience of care

10. 10A patient asks which diabetes test estimates average glycemia over the previous two to three months. Which test should the clinical nurse specialist identify?

    1. A. Fasting plasma glucose test
    2. B. Oral glucose tolerance test
    3. C. A1C test
    4. D. Random plasma glucose test

    Answer: C

    Explanation: CDC states, "The A1C test measures your average blood sugar level over the past 2 or 3 months." The other named glucose tests assess glucose at specific testing times rather than that longer average.

    Reference: Diabetes Testing — Types of tests: A1C test