Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

Which of the following conditions could lead to the need for increased monitoring in older patients?

1. Controlled diabetes

2. Hypertension

3. Heart failure

4. None of the above

The correct answer is: Heart failure

The choice of heart failure as the condition that could lead to the need for increased monitoring in older patients is supported by several factors inherent to the condition and the complexities involved in managing it, especially in the geriatric population. Heart failure, particularly in older adults, is often accompanied by numerous comorbidities and can present with fluctuating clinical states. Patients may experience exacerbations that necessitate frequent reassessment of their symptoms, medication adjustments, and monitoring of vital signs such as blood pressure, heart rate, and respiratory status. Because older adults generally have decreased physiological reserve, the impact of heart failure can be more pronounced, leading to increased vulnerability to complications such as fluid overload, electrolyte imbalances, or acute decompensation. Furthermore, heart failure treatment often involves multiple medications, which can require careful monitoring for efficacy and adverse effects, especially since older individuals may have altered pharmacokinetics and pharmacodynamics. This requires vigilant observation for signs of worsening heart failure or potential side effects related to polypharmacy. In contrast, conditions like controlled diabetes and hypertension may not necessitate the same level of close monitoring in stable patients. While these conditions do require oversight and management, they are generally more manageable and, when well controlled, do not typically present