Chamberlain NR 601 Primary Care of the Maturing and Older Adult
Final Exam 2026 Chamberlain College
1. According to the JNC 8 guidelines, what is the target blood pressure for
patients aged 60 years or older without chronic kidney disease or diabetes?
A. Less than 120/80 mmHg
B. Less than 130/80 mmHg
C. Less than 140/90 mmHg
D. Less than 150/90 mmHg
Answer: D
Rationale: JNC 8 guidelines recommend a higher threshold of 150/90 mmHg for patients
over 60 years who do not have DM or CKD to prevent over-treatment and orthostatic
hypotension.
2. Which of the following medications is listed on the Beers Criteria as
potentially inappropriate for older adults due to the high risk of orthostatic
hypotension?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Terazosin
Answer: D
Rationale: Alpha-1 blockers like Terazosin are associated with a high risk of orthostatic
hypotension in the elderly and are generally avoided for hypertension treatment in this
population.
,3. A 75-year-old patient presents with a history of heart failure and a new onset
of a dry, hacking cough. Which medication is most likely the cause?
A. Amlodipine
B. Metoprolol
C. Enalapril
D. Furosemide
Answer: C
Rationale: ACE inhibitors like Enalapril are well-known for causing a dry cough due to the
accumulation of bradykinin in the lungs.
4. What is the recommended HbA1c goal for a ‘frail’ older adult with multiple
comorbidities and limited life expectancy?
A. Between 8.0% and 8.5%
B. Less than 7.0%
C. Between 7.5% and 8.0%
D. Less than 6.5%
Answer: A
Rationale: For frail elderly patients, the goal is to prevent hypoglycemia and symptomatic
hyperglycemia; therefore, a more relaxed HbA1c goal of 8.0% to 8.5% is appropriate.
5. An 82-year-old male reports difficulty initiating urination and a weak stream.
What is the first-line pharmacologic treatment for symptomatic Benign Prostatic
Hyperplasia (BPH)?
A. Finasteride
B. Oxybutynin
C. Tamsulosin
D. Ciprofloxacin
Answer: C
, Rationale: Alpha-adrenergic antagonists like Tamsulosin provide rapid relief of BPH
symptoms by relaxing the smooth muscle of the bladder neck and prostate.
6. Which physical assessment finding is most characteristic of Osteoarthritis
(OA) in the hands?
A. Swan neck deformity
B. Ulnar deviation
C. Heberden’s nodes
D. Boutonniere deformity
Answer: C
Rationale: Heberden’s nodes (DIP joint) and Bouchard’s nodes (PIP joint) are classic signs
of OA, whereas ulnar deviation and swan neck deformities are associated with Rheumatoid
Arthritis.
7. What is the gold standard for diagnosing Chronic Obstructive Pulmonary
Disease (COPD)?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Computed Tomography (CT) scan
D. Spirometry
Answer: D
Rationale: Spirometry is required to confirm the diagnosis of COPD; a post-bronchodilator
FEV1/FVC ratio of less than 0.70 confirms persistent airflow limitation.
Final Exam 2026 Chamberlain College
1. According to the JNC 8 guidelines, what is the target blood pressure for
patients aged 60 years or older without chronic kidney disease or diabetes?
A. Less than 120/80 mmHg
B. Less than 130/80 mmHg
C. Less than 140/90 mmHg
D. Less than 150/90 mmHg
Answer: D
Rationale: JNC 8 guidelines recommend a higher threshold of 150/90 mmHg for patients
over 60 years who do not have DM or CKD to prevent over-treatment and orthostatic
hypotension.
2. Which of the following medications is listed on the Beers Criteria as
potentially inappropriate for older adults due to the high risk of orthostatic
hypotension?
A. Lisinopril
B. Atorvastatin
C. Metformin
D. Terazosin
Answer: D
Rationale: Alpha-1 blockers like Terazosin are associated with a high risk of orthostatic
hypotension in the elderly and are generally avoided for hypertension treatment in this
population.
,3. A 75-year-old patient presents with a history of heart failure and a new onset
of a dry, hacking cough. Which medication is most likely the cause?
A. Amlodipine
B. Metoprolol
C. Enalapril
D. Furosemide
Answer: C
Rationale: ACE inhibitors like Enalapril are well-known for causing a dry cough due to the
accumulation of bradykinin in the lungs.
4. What is the recommended HbA1c goal for a ‘frail’ older adult with multiple
comorbidities and limited life expectancy?
A. Between 8.0% and 8.5%
B. Less than 7.0%
C. Between 7.5% and 8.0%
D. Less than 6.5%
Answer: A
Rationale: For frail elderly patients, the goal is to prevent hypoglycemia and symptomatic
hyperglycemia; therefore, a more relaxed HbA1c goal of 8.0% to 8.5% is appropriate.
5. An 82-year-old male reports difficulty initiating urination and a weak stream.
What is the first-line pharmacologic treatment for symptomatic Benign Prostatic
Hyperplasia (BPH)?
A. Finasteride
B. Oxybutynin
C. Tamsulosin
D. Ciprofloxacin
Answer: C
, Rationale: Alpha-adrenergic antagonists like Tamsulosin provide rapid relief of BPH
symptoms by relaxing the smooth muscle of the bladder neck and prostate.
6. Which physical assessment finding is most characteristic of Osteoarthritis
(OA) in the hands?
A. Swan neck deformity
B. Ulnar deviation
C. Heberden’s nodes
D. Boutonniere deformity
Answer: C
Rationale: Heberden’s nodes (DIP joint) and Bouchard’s nodes (PIP joint) are classic signs
of OA, whereas ulnar deviation and swan neck deformities are associated with Rheumatoid
Arthritis.
7. What is the gold standard for diagnosing Chronic Obstructive Pulmonary
Disease (COPD)?
A. Chest X-ray
B. Arterial Blood Gas (ABG)
C. Computed Tomography (CT) scan
D. Spirometry
Answer: D
Rationale: Spirometry is required to confirm the diagnosis of COPD; a post-bronchodilator
FEV1/FVC ratio of less than 0.70 confirms persistent airflow limitation.
