NR 601 Final Exam Practice: Primary Care of the Maturing and Older
Adult 2026 Chamberlain College
1. Which of the following is the most appropriate initial screening tool for
cognitive impairment in a primary care setting for an older adult?
A. PHQ-9
B. Katz Index
C. GDS-15
D. Mini-Cog
Answer: D
Rationale: The Mini-Cog is a quick, 3-minute instrument that can be used to screen for
cognitive impairment in older adults. PHQ-9 is for depression, GDS-15 is for geriatric
depression, and Katz Index measures ADLs.
2. According to the Beers Criteria, which medication class should be avoided in
older adults due to the high risk of orthostatic hypotension and falls?
A. ACE inhibitors
B. Alpha-1 blockers (e.g., doxazosin)
C. Biguanides
D. Beta-blockers
Answer: B
Rationale: Alpha-1 blockers are listed in the Beers Criteria to be avoided for treatment of
hypertension in older adults because they carry a high risk of orthostatic hypotension.
,3. What is the recommended HbA1c goal for a ‘frail’ older adult with multiple
chronic illnesses and limited life expectancy?
A. Less than 6.5%
B. Less than 7.0%
C. Less than 8.0-8.5%
D. Less than 6.0%
Answer: C
Rationale: For older adults with complex medical issues and limited life expectancy, a less
stringent HbA1c goal (8.0-8.5%) is recommended to avoid hypoglycemia.
4. A 75-year-old patient presents with acute onset of confusion, fluctuating
consciousness, and inattention. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Vascular Dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in attention and consciousness, often triggered by an underlying medical
condition.
5. Which of the following describes ‘Activities of Daily Living’ (ADLs)?
A. Managing finances and shopping
B. Using the telephone and doing laundry
C. Preparing meals and driving
D. Bathing, dressing, and toileting
Answer: D
Rationale: ADLs refer to basic self-care tasks such as bathing, dressing, toileting,
transferring, and feeding. The others are Instrumental ADLs (IADLs).
, 6. The ‘Get Up and Go’ test is used to evaluate which of the following?
A. Cognitive function
B. Hearing loss
C. Risk of falls and mobility
D. Visual acuity
Answer: C
Rationale: The Get Up and Go test (or Timed Up and Go) evaluates a patient’s balance, gait
speed, and overall risk for falling.
7. Which symptom is most characteristic of ‘Pseudodementia’ (depression
mimicking dementia)?
A. Patient makes little effort to answer questions
B. Gradual onset over years
C. Patient tries to hide memory deficits
D. Nocturnal worsening of symptoms (sundowning)
Answer: A
Rationale: In pseudodementia related to depression, patients often answer ‘I don’t know’
and make little effort, whereas dementia patients often try to minimize or cover up their
deficits.
8. According to USPSTF, at what age should routine screening for osteoporosis
with DXA begin for women with no additional risk factors?
A. 65 years old
B. 55 years old
C. 60 years old
D. 50 years old
Answer: A
Rationale: The USPSTF recommends screening for osteoporosis with bone measurement
testing to prevent osteoporotic fractures in women aged 65 years and older.
Adult 2026 Chamberlain College
1. Which of the following is the most appropriate initial screening tool for
cognitive impairment in a primary care setting for an older adult?
A. PHQ-9
B. Katz Index
C. GDS-15
D. Mini-Cog
Answer: D
Rationale: The Mini-Cog is a quick, 3-minute instrument that can be used to screen for
cognitive impairment in older adults. PHQ-9 is for depression, GDS-15 is for geriatric
depression, and Katz Index measures ADLs.
2. According to the Beers Criteria, which medication class should be avoided in
older adults due to the high risk of orthostatic hypotension and falls?
A. ACE inhibitors
B. Alpha-1 blockers (e.g., doxazosin)
C. Biguanides
D. Beta-blockers
Answer: B
Rationale: Alpha-1 blockers are listed in the Beers Criteria to be avoided for treatment of
hypertension in older adults because they carry a high risk of orthostatic hypotension.
,3. What is the recommended HbA1c goal for a ‘frail’ older adult with multiple
chronic illnesses and limited life expectancy?
A. Less than 6.5%
B. Less than 7.0%
C. Less than 8.0-8.5%
D. Less than 6.0%
Answer: C
Rationale: For older adults with complex medical issues and limited life expectancy, a less
stringent HbA1c goal (8.0-8.5%) is recommended to avoid hypoglycemia.
4. A 75-year-old patient presents with acute onset of confusion, fluctuating
consciousness, and inattention. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Major Depressive Disorder
C. Vascular Dementia
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in attention and consciousness, often triggered by an underlying medical
condition.
5. Which of the following describes ‘Activities of Daily Living’ (ADLs)?
A. Managing finances and shopping
B. Using the telephone and doing laundry
C. Preparing meals and driving
D. Bathing, dressing, and toileting
Answer: D
Rationale: ADLs refer to basic self-care tasks such as bathing, dressing, toileting,
transferring, and feeding. The others are Instrumental ADLs (IADLs).
, 6. The ‘Get Up and Go’ test is used to evaluate which of the following?
A. Cognitive function
B. Hearing loss
C. Risk of falls and mobility
D. Visual acuity
Answer: C
Rationale: The Get Up and Go test (or Timed Up and Go) evaluates a patient’s balance, gait
speed, and overall risk for falling.
7. Which symptom is most characteristic of ‘Pseudodementia’ (depression
mimicking dementia)?
A. Patient makes little effort to answer questions
B. Gradual onset over years
C. Patient tries to hide memory deficits
D. Nocturnal worsening of symptoms (sundowning)
Answer: A
Rationale: In pseudodementia related to depression, patients often answer ‘I don’t know’
and make little effort, whereas dementia patients often try to minimize or cover up their
deficits.
8. According to USPSTF, at what age should routine screening for osteoporosis
with DXA begin for women with no additional risk factors?
A. 65 years old
B. 55 years old
C. 60 years old
D. 50 years old
Answer: A
Rationale: The USPSTF recommends screening for osteoporosis with bone measurement
testing to prevent osteoporotic fractures in women aged 65 years and older.
