Chamberlain NR 601 Final Exam - Primary Care of the Maturing and
Older Adult 2026 Chamberlain College
1. Which of the following is considered the gold standard for assessing
functional status in an older adult during a Comprehensive Geriatric Assessment
(CGA)?
A. Direct observation of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
B. The patient’s self-report of daily activities
C. A physical exam focusing on muscle strength
D. Laboratory tests for nutritional markers
Answer: A
Rationale: Functional status is best assessed through standardized tools that evaluate
ADLs (basic self-care) and IADLs (complex tasks like managing finances), preferably
through observation or validated scales.
2. According to the Beers Criteria, which medication class should be avoided in
older adults with a history of falls or fractures?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Angiotensin-Converting Enzyme (ACE) Inhibitors
C. Biguanides (Metformin)
D. HMG-CoA reductase inhibitors (Statins)
Answer: A
Rationale: SSRIs, along with TCAs and antipsychotics, are associated with an increased
risk of falls and fractures in the elderly due to potential side effects like syncope or
hyponatremia.
,3. A 75-year-old patient with multiple comorbidities and limited life expectancy
has an A1C of 8.2%. What is the appropriate management according to ADA
geriatric guidelines?
A. Intensify therapy to bring A1C below 7.0%
B. Immediately start insulin therapy
C. Maintain current therapy as the target for frail elderly is often < 8.0-8.5%
D. Switch to a sliding scale insulin regimen
Answer: C
Rationale: For older adults with complex health issues and limited life expectancy, A1C
goals are relaxed to avoid hypoglycemia; a target of < 8.0% or < 8.5% is generally
acceptable.
4. Which of the following is a key characteristic of delirium that distinguishes it
from dementia?
A. Acute onset with fluctuating levels of consciousness
B. Irreversible cognitive decline
C. Gradual onset over several years
D. Intact attention span
Answer: A
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and
disturbances in attention and consciousness, whereas dementia is chronic and progressive.
5. What is the recommended first-line treatment for an older adult diagnosed
with mild to moderate Osteoarthritis of the knee?
A. Topical NSAIDs and physical therapy
B. Systemic Corticosteroids
C. Oral Narcotics
D. Immediate total knee arthroplasty
Answer: A
, Rationale: Topical NSAIDs are preferred in older adults to minimize systemic side effects,
combined with non-pharmacological interventions like exercise or physical therapy.
6. Which screening tool is most appropriate for identifying depression in the
geriatric population?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. CAGE Questionnaire
D. PHQ-2 followed by PHQ-9
Answer: B
Rationale: The Geriatric Depression Scale (GDS) is specifically validated for use in older
adults, focusing on psychological symptoms rather than somatic complaints.
7. An 80-year-old male presents with a T-score of -2.6 on a DXA scan. This result
indicates:
A. Normal bone density
B. Osteopenia
C. Severe Osteoarthritis
D. Osteoporosis
Answer: D
Rationale: A T-score of -2.5 or lower is the diagnostic threshold for osteoporosis according
to the World Health Organization.
8. Which of the following is an example of an Instrumental Activity of Daily
Living (IADL)?
A. Bathing
B. Dressing
C. Toileting
D. Managing medications
Answer: D
Older Adult 2026 Chamberlain College
1. Which of the following is considered the gold standard for assessing
functional status in an older adult during a Comprehensive Geriatric Assessment
(CGA)?
A. Direct observation of Activities of Daily Living (ADLs) and Instrumental Activities of Daily Living (IADLs)
B. The patient’s self-report of daily activities
C. A physical exam focusing on muscle strength
D. Laboratory tests for nutritional markers
Answer: A
Rationale: Functional status is best assessed through standardized tools that evaluate
ADLs (basic self-care) and IADLs (complex tasks like managing finances), preferably
through observation or validated scales.
2. According to the Beers Criteria, which medication class should be avoided in
older adults with a history of falls or fractures?
A. Selective Serotonin Reuptake Inhibitors (SSRIs)
B. Angiotensin-Converting Enzyme (ACE) Inhibitors
C. Biguanides (Metformin)
D. HMG-CoA reductase inhibitors (Statins)
Answer: A
Rationale: SSRIs, along with TCAs and antipsychotics, are associated with an increased
risk of falls and fractures in the elderly due to potential side effects like syncope or
hyponatremia.
,3. A 75-year-old patient with multiple comorbidities and limited life expectancy
has an A1C of 8.2%. What is the appropriate management according to ADA
geriatric guidelines?
A. Intensify therapy to bring A1C below 7.0%
B. Immediately start insulin therapy
C. Maintain current therapy as the target for frail elderly is often < 8.0-8.5%
D. Switch to a sliding scale insulin regimen
Answer: C
Rationale: For older adults with complex health issues and limited life expectancy, A1C
goals are relaxed to avoid hypoglycemia; a target of < 8.0% or < 8.5% is generally
acceptable.
4. Which of the following is a key characteristic of delirium that distinguishes it
from dementia?
A. Acute onset with fluctuating levels of consciousness
B. Irreversible cognitive decline
C. Gradual onset over several years
D. Intact attention span
Answer: A
Rationale: Delirium is characterized by an acute onset, a fluctuating course, and
disturbances in attention and consciousness, whereas dementia is chronic and progressive.
5. What is the recommended first-line treatment for an older adult diagnosed
with mild to moderate Osteoarthritis of the knee?
A. Topical NSAIDs and physical therapy
B. Systemic Corticosteroids
C. Oral Narcotics
D. Immediate total knee arthroplasty
Answer: A
, Rationale: Topical NSAIDs are preferred in older adults to minimize systemic side effects,
combined with non-pharmacological interventions like exercise or physical therapy.
6. Which screening tool is most appropriate for identifying depression in the
geriatric population?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. CAGE Questionnaire
D. PHQ-2 followed by PHQ-9
Answer: B
Rationale: The Geriatric Depression Scale (GDS) is specifically validated for use in older
adults, focusing on psychological symptoms rather than somatic complaints.
7. An 80-year-old male presents with a T-score of -2.6 on a DXA scan. This result
indicates:
A. Normal bone density
B. Osteopenia
C. Severe Osteoarthritis
D. Osteoporosis
Answer: D
Rationale: A T-score of -2.5 or lower is the diagnostic threshold for osteoporosis according
to the World Health Organization.
8. Which of the following is an example of an Instrumental Activity of Daily
Living (IADL)?
A. Bathing
B. Dressing
C. Toileting
D. Managing medications
Answer: D
