NR601 Midterm Exam Study Guide | Weeks 1–4 Content |
Chamberlain University | Verified Questions and Answers | A+
Graded | 2026/2027 Edition
Chamberlain University | Primary Care of the Maturing and Aged Family |
NR601
Section 1: Primary Care of the Maturing and Aged Family – Weeks 1–4
Comprehensive Review
Week 1: Geriatric Assessment Principles, Aging Physiology, Health Promotion, and
Preventative Care
Q1: A 78-year-old male presents for his annual wellness visit. His daughter reports he
has had increasing difficulty with activities of daily living (ADLs) over the past 6 months.
On examination, you note decreased grip strength, slower gait speed, and unintentional
weight loss of 12 pounds in 4 months. Which comprehensive geriatric assessment tool
would be most appropriate to evaluate his functional status and identify potential
reversible causes of decline?
A. Mini-Mental State Examination (MMSE) only
B. Katz Index of Independence in Activities of Daily Living and Lawton Instrumental
Activities of Daily Living (IADL) Scale
C. Geriatric Depression Scale (GDS-15) exclusively
D. Clock Drawing Test and Trail Making Test only
,Correct Answer: B
Rationale: The Katz ADL Scale assesses basic self-care functions (bathing, dressing,
toileting, transferring, continence, feeding), while the Lawton IADL Scale evaluates more
complex activities (managing finances, medications, transportation, shopping, meal
preparation, telephone use, housekeeping, laundry). Together, they provide a
comprehensive functional assessment essential for identifying the extent of this
patient's decline and targeting interventions. The patient exhibits classic signs of frailty
syndrome (weight loss, weakness, slow gait, low physical activity), making functional
assessment critical. Option A (MMSE) assesses cognition, which while important, does
not directly measure functional status. Option C (GDS-15) screens for depression, which
could be contributory but doesn't assess functional capacity. Option D assesses
executive function and cognitive processing but not functional independence.
According to the American Geriatrics Society (AGS), functional assessment is
foundational to geriatric care and should be performed at every visit when decline is
suspected.
Q2: A 72-year-old female presents with concerns about memory loss. Her daughter
states she occasionally forgets appointments but remembers them later, sometimes
struggles to find words, and maintains all her daily activities independently. She scores
28/30 on the Montreal Cognitive Assessment (MoCA), losing points only on delayed
recall. Which statement best describes the appropriate interpretation of these findings?
A. This represents definitive early-stage Alzheimer's disease requiring immediate
pharmacological intervention
B. These findings are consistent with normal age-related cognitive changes and do not
meet criteria for mild cognitive impairment (MCI) or dementia
,C. This is clearly mild cognitive impairment requiring cholinesterase inhibitor therapy
D. The MoCA score indicates severe cognitive impairment necessitating immediate
nursing home placement
Correct Answer: B
Rationale: Normal age-related cognitive changes include occasional word-finding
difficulties, transient forgetfulness (remembering later), and preserved functional
independence. A MoCA score of 26-30 is considered normal, and this patient's score of
28 with isolated delayed recall issues falls within normal limits for her age. The key
discriminator is preserved functional status—she maintains all IADLs independently.
Option A is incorrect because there is no evidence of progressive functional decline or
significant cognitive impairment warranting diagnosis or treatment. Option C is
incorrect because MCI requires cognitive decline greater than expected for age AND
preserved basic functional abilities with some difficulty in complex tasks, plus objective
cognitive impairment on testing (typically MoCA <26). Option D is completely
inconsistent with the findings. The National Institute on Aging-Alzheimer's Association
(NIA-AA) criteria emphasize that functional independence is the critical distinction
between normal aging and pathological cognitive decline.
Q3: A 75-year-old male with hypertension, type 2 diabetes, and osteoarthritis presents
for a wellness visit. His blood pressure is 138/82 mmHg, HbA1c is 7.2%, and he reports
moderate knee pain. He takes lisinopril, metformin, and occasional ibuprofen. Which
health maintenance screening is most appropriate to prioritize for this patient at today's
visit?
A. Prostate-specific antigen (PSA) testing immediately
, B. Colorectal cancer screening if not up to date, fall risk assessment, and depression
screening
C. Routine chest X-ray and EKG
D. Comprehensive metabolic panel and HbA1c only, as his chronic conditions are
well-controlled
Correct Answer: B
Rationale: The U.S. Preventive Services Task Force (USPSTF) recommends colorectal
cancer screening for adults aged 45-75 (Grade A), with selective screening for ages
76-85 based on overall health and prior screening history. Fall risk assessment is
recommended annually for adults ≥65 years (USPSTF Grade B), particularly important
given his osteoarthritis and potential NSAID use affecting balance. Depression
screening is recommended for all adults, including older adults (USPSTF Grade B).
Option A: PSA screening is controversial (USPSTF Grade C for ages 55-69, recommends
against for ≥70) and should involve shared decision-making, not immediate testing.
Option C: Routine chest X-ray and EKG are not recommended without specific
indications. Option D misses critical preventive care opportunities. This patient
represents the complexity of geriatric health maintenance—balancing chronic disease
management with age-appropriate preventive services.
Q4: An 82-year-old female residing in an assisted living facility is brought to the clinic by
her son. She has hypertension, atrial fibrillation, and osteoporosis. Her medications
include amlodipine, warfarin, and alendronate. Her son reports increased confusion over
the past week, and she appears lethargic. Vital signs: BP 142/88, HR 72, RR 14, Temp
36.8°C (98.2°F), SpO2 94% on room air. Which physiological principle of aging most
likely contributes to her atypical presentation of potential illness?
Chamberlain University | Verified Questions and Answers | A+
Graded | 2026/2027 Edition
Chamberlain University | Primary Care of the Maturing and Aged Family |
NR601
Section 1: Primary Care of the Maturing and Aged Family – Weeks 1–4
Comprehensive Review
Week 1: Geriatric Assessment Principles, Aging Physiology, Health Promotion, and
Preventative Care
Q1: A 78-year-old male presents for his annual wellness visit. His daughter reports he
has had increasing difficulty with activities of daily living (ADLs) over the past 6 months.
On examination, you note decreased grip strength, slower gait speed, and unintentional
weight loss of 12 pounds in 4 months. Which comprehensive geriatric assessment tool
would be most appropriate to evaluate his functional status and identify potential
reversible causes of decline?
A. Mini-Mental State Examination (MMSE) only
B. Katz Index of Independence in Activities of Daily Living and Lawton Instrumental
Activities of Daily Living (IADL) Scale
C. Geriatric Depression Scale (GDS-15) exclusively
D. Clock Drawing Test and Trail Making Test only
,Correct Answer: B
Rationale: The Katz ADL Scale assesses basic self-care functions (bathing, dressing,
toileting, transferring, continence, feeding), while the Lawton IADL Scale evaluates more
complex activities (managing finances, medications, transportation, shopping, meal
preparation, telephone use, housekeeping, laundry). Together, they provide a
comprehensive functional assessment essential for identifying the extent of this
patient's decline and targeting interventions. The patient exhibits classic signs of frailty
syndrome (weight loss, weakness, slow gait, low physical activity), making functional
assessment critical. Option A (MMSE) assesses cognition, which while important, does
not directly measure functional status. Option C (GDS-15) screens for depression, which
could be contributory but doesn't assess functional capacity. Option D assesses
executive function and cognitive processing but not functional independence.
According to the American Geriatrics Society (AGS), functional assessment is
foundational to geriatric care and should be performed at every visit when decline is
suspected.
Q2: A 72-year-old female presents with concerns about memory loss. Her daughter
states she occasionally forgets appointments but remembers them later, sometimes
struggles to find words, and maintains all her daily activities independently. She scores
28/30 on the Montreal Cognitive Assessment (MoCA), losing points only on delayed
recall. Which statement best describes the appropriate interpretation of these findings?
A. This represents definitive early-stage Alzheimer's disease requiring immediate
pharmacological intervention
B. These findings are consistent with normal age-related cognitive changes and do not
meet criteria for mild cognitive impairment (MCI) or dementia
,C. This is clearly mild cognitive impairment requiring cholinesterase inhibitor therapy
D. The MoCA score indicates severe cognitive impairment necessitating immediate
nursing home placement
Correct Answer: B
Rationale: Normal age-related cognitive changes include occasional word-finding
difficulties, transient forgetfulness (remembering later), and preserved functional
independence. A MoCA score of 26-30 is considered normal, and this patient's score of
28 with isolated delayed recall issues falls within normal limits for her age. The key
discriminator is preserved functional status—she maintains all IADLs independently.
Option A is incorrect because there is no evidence of progressive functional decline or
significant cognitive impairment warranting diagnosis or treatment. Option C is
incorrect because MCI requires cognitive decline greater than expected for age AND
preserved basic functional abilities with some difficulty in complex tasks, plus objective
cognitive impairment on testing (typically MoCA <26). Option D is completely
inconsistent with the findings. The National Institute on Aging-Alzheimer's Association
(NIA-AA) criteria emphasize that functional independence is the critical distinction
between normal aging and pathological cognitive decline.
Q3: A 75-year-old male with hypertension, type 2 diabetes, and osteoarthritis presents
for a wellness visit. His blood pressure is 138/82 mmHg, HbA1c is 7.2%, and he reports
moderate knee pain. He takes lisinopril, metformin, and occasional ibuprofen. Which
health maintenance screening is most appropriate to prioritize for this patient at today's
visit?
A. Prostate-specific antigen (PSA) testing immediately
, B. Colorectal cancer screening if not up to date, fall risk assessment, and depression
screening
C. Routine chest X-ray and EKG
D. Comprehensive metabolic panel and HbA1c only, as his chronic conditions are
well-controlled
Correct Answer: B
Rationale: The U.S. Preventive Services Task Force (USPSTF) recommends colorectal
cancer screening for adults aged 45-75 (Grade A), with selective screening for ages
76-85 based on overall health and prior screening history. Fall risk assessment is
recommended annually for adults ≥65 years (USPSTF Grade B), particularly important
given his osteoarthritis and potential NSAID use affecting balance. Depression
screening is recommended for all adults, including older adults (USPSTF Grade B).
Option A: PSA screening is controversial (USPSTF Grade C for ages 55-69, recommends
against for ≥70) and should involve shared decision-making, not immediate testing.
Option C: Routine chest X-ray and EKG are not recommended without specific
indications. Option D misses critical preventive care opportunities. This patient
represents the complexity of geriatric health maintenance—balancing chronic disease
management with age-appropriate preventive services.
Q4: An 82-year-old female residing in an assisted living facility is brought to the clinic by
her son. She has hypertension, atrial fibrillation, and osteoporosis. Her medications
include amlodipine, warfarin, and alendronate. Her son reports increased confusion over
the past week, and she appears lethargic. Vital signs: BP 142/88, HR 72, RR 14, Temp
36.8°C (98.2°F), SpO2 94% on room air. Which physiological principle of aging most
likely contributes to her atypical presentation of potential illness?
