NR601 Exam 2: Primary Care of the Maturing & Aged Family Practicum
Questions and Answers and Explanations | Latest- Chamberlain
1. According to the GOLD criteria, which medication class is the first-line
maintenance therapy for a patient in Group B (symptomatic, low risk of
exacerbations)?
A. SABA as needed
B. Theophylline
C. Inhaled Corticosteroids (ICS)
D. LAMA or LABA
Answer: D
Explanation: For GOLD Group B patients, long-acting bronchodilators (either LAMA or
LABA) are the recommended initial maintenance treatment.
2. When initiating Levothyroxine in a 75-year-old patient with a history of
coronary artery disease, what is the recommended starting dose?
A. 50 to 75 mcg daily
B. 12.5 to 25 mcg daily
C. 100 mcg daily
D. 75 to 100 mcg daily
Answer: B
,Explanation: In older adults, especially those with cardiac disease, the rule is to ‘start low
and go slow’ to avoid precipitating angina or arrhythmias; 12.5 to 25 mcg is the standard
starting range.
3. Which of the following is the most appropriate HbA1c goal for a frail older
adult with multiple chronic illnesses and limited life expectancy?
A. < 8.0-8.5%
B. < 7.0%
C. < 6.5%
D. < 6.0%
Answer: A
Explanation: For patients with advanced complications, frailty, or limited life expectancy, a
less stringent HbA1c goal of 8.0-8.5% is appropriate to minimize the risk of hypoglycemia.
4. A 70-year-old male presents with urinary urgency, frequency, and a weak
stream. His PSA is 2.1 ng/mL and his DRE shows a smooth, enlarged prostate.
What is the first-line pharmacological treatment for his BPH symptoms?
A. Tamsulosin
B. Finasteride
C. Ciprofloxacin
D. Oxybutynin
Answer: A
,Explanation: Alpha-1 blockers like Tamsulosin provide rapid relief of symptoms by
relaxing smooth muscle in the bladder neck and prostate.
5. Which assessment tool is specifically used to evaluate for delirium in the
clinical setting?
A. Confusion Assessment Method (CAM)
B. Geriatric Depression Scale (GDS)
C. Mini-Mental State Exam (MMSE)
D. PHQ-9
Answer: A
Explanation: The CAM is the gold standard for bedside assessment of delirium, focusing on
acute onset, inattention, and disorganized thinking.
6. In the management of Heart Failure with Reduced Ejection Fraction (HFrEF),
which medication class is contraindicated if the patient has a history of
angioedema with ACE inhibitors?
A. ARBs
B. Loop Diuretics
C. Beta-blockers
D. Calcium Channel Blockers
Answer: A
, Explanation: While ARBs are used in HFrEF, they should be used with extreme caution or
avoided if the patient had life-threatening angioedema with an ACE inhibitor.
7. According to the Beers Criteria, which of the following medications should be
avoided in older adults due to the high risk of orthostatic hypotension and CNS
effects?
A. Metformin
B. Lisinopril
C. Amitriptyline
D. Atorvastatin
Answer: C
Explanation: Amitriptyline is a TCA with strong anticholinergic properties and a high risk
of causing sedation and orthostatic hypotension in the elderly.
8. A 68-year-old female with a T-score of -2.6 on DXA scan is diagnosed with
osteoporosis. What is the first-line treatment if she has no contraindications?
A. Alendronate
B. Calcium 500mg daily only
C. Estrogen replacement therapy
D. Teriparatide
Answer: A
Questions and Answers and Explanations | Latest- Chamberlain
1. According to the GOLD criteria, which medication class is the first-line
maintenance therapy for a patient in Group B (symptomatic, low risk of
exacerbations)?
A. SABA as needed
B. Theophylline
C. Inhaled Corticosteroids (ICS)
D. LAMA or LABA
Answer: D
Explanation: For GOLD Group B patients, long-acting bronchodilators (either LAMA or
LABA) are the recommended initial maintenance treatment.
2. When initiating Levothyroxine in a 75-year-old patient with a history of
coronary artery disease, what is the recommended starting dose?
A. 50 to 75 mcg daily
B. 12.5 to 25 mcg daily
C. 100 mcg daily
D. 75 to 100 mcg daily
Answer: B
,Explanation: In older adults, especially those with cardiac disease, the rule is to ‘start low
and go slow’ to avoid precipitating angina or arrhythmias; 12.5 to 25 mcg is the standard
starting range.
3. Which of the following is the most appropriate HbA1c goal for a frail older
adult with multiple chronic illnesses and limited life expectancy?
A. < 8.0-8.5%
B. < 7.0%
C. < 6.5%
D. < 6.0%
Answer: A
Explanation: For patients with advanced complications, frailty, or limited life expectancy, a
less stringent HbA1c goal of 8.0-8.5% is appropriate to minimize the risk of hypoglycemia.
4. A 70-year-old male presents with urinary urgency, frequency, and a weak
stream. His PSA is 2.1 ng/mL and his DRE shows a smooth, enlarged prostate.
What is the first-line pharmacological treatment for his BPH symptoms?
A. Tamsulosin
B. Finasteride
C. Ciprofloxacin
D. Oxybutynin
Answer: A
,Explanation: Alpha-1 blockers like Tamsulosin provide rapid relief of symptoms by
relaxing smooth muscle in the bladder neck and prostate.
5. Which assessment tool is specifically used to evaluate for delirium in the
clinical setting?
A. Confusion Assessment Method (CAM)
B. Geriatric Depression Scale (GDS)
C. Mini-Mental State Exam (MMSE)
D. PHQ-9
Answer: A
Explanation: The CAM is the gold standard for bedside assessment of delirium, focusing on
acute onset, inattention, and disorganized thinking.
6. In the management of Heart Failure with Reduced Ejection Fraction (HFrEF),
which medication class is contraindicated if the patient has a history of
angioedema with ACE inhibitors?
A. ARBs
B. Loop Diuretics
C. Beta-blockers
D. Calcium Channel Blockers
Answer: A
, Explanation: While ARBs are used in HFrEF, they should be used with extreme caution or
avoided if the patient had life-threatening angioedema with an ACE inhibitor.
7. According to the Beers Criteria, which of the following medications should be
avoided in older adults due to the high risk of orthostatic hypotension and CNS
effects?
A. Metformin
B. Lisinopril
C. Amitriptyline
D. Atorvastatin
Answer: C
Explanation: Amitriptyline is a TCA with strong anticholinergic properties and a high risk
of causing sedation and orthostatic hypotension in the elderly.
8. A 68-year-old female with a T-score of -2.6 on DXA scan is diagnosed with
osteoporosis. What is the first-line treatment if she has no contraindications?
A. Alendronate
B. Calcium 500mg daily only
C. Estrogen replacement therapy
D. Teriparatide
Answer: A
