NR 601 Midterm Exam Study Guide – Primary Care of the
Maturing and Aged Adult with Comprehensive Nursing
Review Questions and Clinical Practice Preparation 2026-
2027 latest updated test A+ GRADED
Question 1
Which theory of aging proposes that aging is caused by the accumulation of damage
from reactive oxygen species?
A. Programmed aging theory
B. Free radical theory
C. Immunological theory
D. Neuroendocrine theory
Correct Answer: B
Rationale: The free radical theory (Harman) states that reactive oxygen species cause
cumulative cellular damage. Programmed aging is genetically determined;
immunological involves declining immune function; neuroendocrine involves hormonal
changes.
Question 2
A 78-year-old patient presents with falls, polypharmacy, and confusion. What is the
most appropriate next step?
A. Order a head CT
,B. Comprehensive Geriatric Assessment (CGA)
C. Refer to neurology
D. Increase antihypertensive dose
Correct Answer: B
Rationale: CGA is the gold standard for evaluating multifactorial geriatric syndromes,
including falls, cognitive impairment, and polypharmacy.
Question 3
According to the Beers Criteria, which medication should be avoided in older adults
with a history of falls or fractures?
A. Acetaminophen
B. Aspirin 81 mg
C. Benzodiazepines
D. Metformin
Correct Answer: C
Rationale: Benzodiazepines increase fall risk due to sedation, impaired balance, and
cognitive slowing. They are listed as potentially inappropriate in the Beers Criteria for
older adults with fall history.
Question 4
Which medication is considered potentially inappropriate in older adults regardless of
diagnosis or condition per the Beers Criteria?
A. Levothyroxine
B. Nitrofurantoin
C. Lisinopril
D. Atorvastatin
,Correct Answer: B
*Rationale: Nitrofurantoin is avoided due to risks of pulmonary toxicity, hepatotoxicity,
and peripheral neuropathy, especially with prolonged use or renal impairment (CrCl
<30 mL/min).*
Question 5
A 72-year-old with chronic insomnia requests a sleeping pill. Which is the safest choice
based on the Beers Criteria?
A. Zolpidem
B. Diphenhydramine
C. Trazodone (low dose)
D. Temazepam
Correct Answer: C
*Rationale: Low-dose trazodone (25–50 mg) is preferred over Z-drugs (zolpidem),
benzodiazepines (temazepam), and anticholinergics (diphenhydramine), all of which
are on the Beers list.*
Question 6
What is a key component of the Comprehensive Geriatric Assessment (CGA)?
A. Only medical history
B. Functional, cognitive, social, and medical domains
C. Annual flu shot only
D. Bone density test only
Correct Answer: B
Rationale: CGA is multidimensional, including physical health, functional status,
cognition, mental health, and social supports.
, Question 7
Which functional assessment tool is best for evaluating basic activities of daily living
(ADLs)?
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence
C. Lawton IADL Scale
D. Get Up and Go Test
Correct Answer: B
Rationale: The Katz Index measures basic ADLs (bathing, dressing, toileting,
transferring, continence, feeding). Lawton measures instrumental ADLs (IADLs).
Question 8
Which Beers Criteria medication is associated with an increased risk of delirium in
hospitalized older adults?
A. Metoprolol
B. Diphenhydramine
C. Insulin
D. Warfarin
Correct Answer: B
Rationale: Diphenhydramine is strongly anticholinergic and linked to delirium,
confusion, and cognitive decline in older adults, especially in hospital settings.
Question 9
A 75-year-old with CKD stage 3 (CrCl 35 mL/min) has a UTI. Which antibiotic should be
avoided per Beers Criteria?
A. Cephalexin
Maturing and Aged Adult with Comprehensive Nursing
Review Questions and Clinical Practice Preparation 2026-
2027 latest updated test A+ GRADED
Question 1
Which theory of aging proposes that aging is caused by the accumulation of damage
from reactive oxygen species?
A. Programmed aging theory
B. Free radical theory
C. Immunological theory
D. Neuroendocrine theory
Correct Answer: B
Rationale: The free radical theory (Harman) states that reactive oxygen species cause
cumulative cellular damage. Programmed aging is genetically determined;
immunological involves declining immune function; neuroendocrine involves hormonal
changes.
Question 2
A 78-year-old patient presents with falls, polypharmacy, and confusion. What is the
most appropriate next step?
A. Order a head CT
,B. Comprehensive Geriatric Assessment (CGA)
C. Refer to neurology
D. Increase antihypertensive dose
Correct Answer: B
Rationale: CGA is the gold standard for evaluating multifactorial geriatric syndromes,
including falls, cognitive impairment, and polypharmacy.
Question 3
According to the Beers Criteria, which medication should be avoided in older adults
with a history of falls or fractures?
A. Acetaminophen
B. Aspirin 81 mg
C. Benzodiazepines
D. Metformin
Correct Answer: C
Rationale: Benzodiazepines increase fall risk due to sedation, impaired balance, and
cognitive slowing. They are listed as potentially inappropriate in the Beers Criteria for
older adults with fall history.
Question 4
Which medication is considered potentially inappropriate in older adults regardless of
diagnosis or condition per the Beers Criteria?
A. Levothyroxine
B. Nitrofurantoin
C. Lisinopril
D. Atorvastatin
,Correct Answer: B
*Rationale: Nitrofurantoin is avoided due to risks of pulmonary toxicity, hepatotoxicity,
and peripheral neuropathy, especially with prolonged use or renal impairment (CrCl
<30 mL/min).*
Question 5
A 72-year-old with chronic insomnia requests a sleeping pill. Which is the safest choice
based on the Beers Criteria?
A. Zolpidem
B. Diphenhydramine
C. Trazodone (low dose)
D. Temazepam
Correct Answer: C
*Rationale: Low-dose trazodone (25–50 mg) is preferred over Z-drugs (zolpidem),
benzodiazepines (temazepam), and anticholinergics (diphenhydramine), all of which
are on the Beers list.*
Question 6
What is a key component of the Comprehensive Geriatric Assessment (CGA)?
A. Only medical history
B. Functional, cognitive, social, and medical domains
C. Annual flu shot only
D. Bone density test only
Correct Answer: B
Rationale: CGA is multidimensional, including physical health, functional status,
cognition, mental health, and social supports.
, Question 7
Which functional assessment tool is best for evaluating basic activities of daily living
(ADLs)?
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence
C. Lawton IADL Scale
D. Get Up and Go Test
Correct Answer: B
Rationale: The Katz Index measures basic ADLs (bathing, dressing, toileting,
transferring, continence, feeding). Lawton measures instrumental ADLs (IADLs).
Question 8
Which Beers Criteria medication is associated with an increased risk of delirium in
hospitalized older adults?
A. Metoprolol
B. Diphenhydramine
C. Insulin
D. Warfarin
Correct Answer: B
Rationale: Diphenhydramine is strongly anticholinergic and linked to delirium,
confusion, and cognitive decline in older adults, especially in hospital settings.
Question 9
A 75-year-old with CKD stage 3 (CrCl 35 mL/min) has a UTI. Which antibiotic should be
avoided per Beers Criteria?
A. Cephalexin
