2026/2027
NR 601 Primary Care of the
Maturing and Aged Family Midterm
Examination Success Guide with
Test Bank and Practice Quiz Review
2026/2027
Question 1
An 86-year-old woman wishes to designate her long-term partner as her medical
decision-maker, despite not being legally married. She asks what is required to ensure
her wishes are respected.
A. Power of attorney for finances only
B. Verbal agreement documented in clinic notes
C. Advanced directive documentation
D. Hospital witness statement only
Correct Answer: C. Advanced directive documentation
Rationale: An advance directive legally documents a patient’s healthcare preferences
and designates a surrogate decision-maker. While verbal agreements or informal
documentation may guide care, they are not legally binding. A power of attorney for
finances does not cover medical decisions. A hospital witness statement alone is
insufficient for legal enforceability.
Question 2
An 81-year-old transgender woman who smokes one pack per day presents for routine
care. What is the most appropriate intervention?
A. Start hormone tapering
B. Smoking cessation counseling
C. Immediate chest CT screening
D. Stop estrogen therapy
Correct Answer: B. Smoking cessation counseling
Rationale: Smoking cessation is the most important modifiable risk factor in this
patient and should be prioritized. Estrogen therapy does not need to be stopped solely
due to smoking in routine care, though risks should be discussed. Imaging is not
indicated without symptoms.
,2026/2027
Question 3
An 84-year-old man with multiple sexual partners and inconsistent condom use
requests STI screening. What testing should be performed?
A. Urine testing only
B. Blood testing only
C. Urine, blood, anal, and oropharyngeal swabs
D. No testing needed unless symptomatic
Correct Answer: C. Urine, blood, anal, and oropharyngeal swabs
Rationale: High-risk sexual behavior involving multiple partners and varied sexual
practices requires comprehensive STI screening across all exposure sites. Limiting
testing risks missed infections.
Question 4
Which statement about tolterodine is correct?
A. Once-daily dosing has higher adverse effects
B. Twice-daily formulation has higher adverse effects
C. It has no anticholinergic effects
D. It is safest in severe dementia
Correct Answer: B. Twice-daily formulation has higher adverse effects
Rationale: Twice-daily tolterodine produces higher peak plasma levels, increasing
anticholinergic side effects such as dry mouth and confusion. It is not free of
anticholinergic effects and should be used cautiously in older adults.
Question 5
An 82-year-old man develops worsening nocturia after starting amlodipine. What is
the best next step?
A. Increase amlodipine
B. Stop amlodipine and increase lisinopril
C. Add diuretic
D. Start tamsulosin immediately
Correct Answer: B. Stop amlodipine and increase lisinopril
, 2026/2027
Rationale: Amlodipine can worsen peripheral edema and nocturia. Adjusting
antihypertensive therapy by discontinuing the causative agent and optimizing
alternatives is appropriate.
Question 6
A dementia patient has urinary incontinence only at a day program. What intervention
is required?
A. Urologist referral
B. Bladder catheterization
C. Day program staff intervention
D. Anticholinergic therapy
Correct Answer: C. Day program staff intervention
Rationale: Situational incontinence requires environmental and caregiving
adjustments at the site where symptoms occur. Medication or invasive interventions
are unnecessary.
Question 7
An elderly woman leaks urine while playing golf despite behavioral modifications.
Best management?
A. Surgery
B. Bladder training
C. Immediate medication
D. Indwelling catheter
Correct Answer: B. Bladder training
Rationale: Bladder training is first-line for urge incontinence. Catheters and surgery
are inappropriate initial treatments.
Question 8
Most common cause of erectile dysfunction in older men?
A. Testosterone deficiency
B. Atherosclerosis
C. Psychological trauma
D. Medication allergy
Correct Answer: B. Atherosclerosis
NR 601 Primary Care of the
Maturing and Aged Family Midterm
Examination Success Guide with
Test Bank and Practice Quiz Review
2026/2027
Question 1
An 86-year-old woman wishes to designate her long-term partner as her medical
decision-maker, despite not being legally married. She asks what is required to ensure
her wishes are respected.
A. Power of attorney for finances only
B. Verbal agreement documented in clinic notes
C. Advanced directive documentation
D. Hospital witness statement only
Correct Answer: C. Advanced directive documentation
Rationale: An advance directive legally documents a patient’s healthcare preferences
and designates a surrogate decision-maker. While verbal agreements or informal
documentation may guide care, they are not legally binding. A power of attorney for
finances does not cover medical decisions. A hospital witness statement alone is
insufficient for legal enforceability.
Question 2
An 81-year-old transgender woman who smokes one pack per day presents for routine
care. What is the most appropriate intervention?
A. Start hormone tapering
B. Smoking cessation counseling
C. Immediate chest CT screening
D. Stop estrogen therapy
Correct Answer: B. Smoking cessation counseling
Rationale: Smoking cessation is the most important modifiable risk factor in this
patient and should be prioritized. Estrogen therapy does not need to be stopped solely
due to smoking in routine care, though risks should be discussed. Imaging is not
indicated without symptoms.
,2026/2027
Question 3
An 84-year-old man with multiple sexual partners and inconsistent condom use
requests STI screening. What testing should be performed?
A. Urine testing only
B. Blood testing only
C. Urine, blood, anal, and oropharyngeal swabs
D. No testing needed unless symptomatic
Correct Answer: C. Urine, blood, anal, and oropharyngeal swabs
Rationale: High-risk sexual behavior involving multiple partners and varied sexual
practices requires comprehensive STI screening across all exposure sites. Limiting
testing risks missed infections.
Question 4
Which statement about tolterodine is correct?
A. Once-daily dosing has higher adverse effects
B. Twice-daily formulation has higher adverse effects
C. It has no anticholinergic effects
D. It is safest in severe dementia
Correct Answer: B. Twice-daily formulation has higher adverse effects
Rationale: Twice-daily tolterodine produces higher peak plasma levels, increasing
anticholinergic side effects such as dry mouth and confusion. It is not free of
anticholinergic effects and should be used cautiously in older adults.
Question 5
An 82-year-old man develops worsening nocturia after starting amlodipine. What is
the best next step?
A. Increase amlodipine
B. Stop amlodipine and increase lisinopril
C. Add diuretic
D. Start tamsulosin immediately
Correct Answer: B. Stop amlodipine and increase lisinopril
, 2026/2027
Rationale: Amlodipine can worsen peripheral edema and nocturia. Adjusting
antihypertensive therapy by discontinuing the causative agent and optimizing
alternatives is appropriate.
Question 6
A dementia patient has urinary incontinence only at a day program. What intervention
is required?
A. Urologist referral
B. Bladder catheterization
C. Day program staff intervention
D. Anticholinergic therapy
Correct Answer: C. Day program staff intervention
Rationale: Situational incontinence requires environmental and caregiving
adjustments at the site where symptoms occur. Medication or invasive interventions
are unnecessary.
Question 7
An elderly woman leaks urine while playing golf despite behavioral modifications.
Best management?
A. Surgery
B. Bladder training
C. Immediate medication
D. Indwelling catheter
Correct Answer: B. Bladder training
Rationale: Bladder training is first-line for urge incontinence. Catheters and surgery
are inappropriate initial treatments.
Question 8
Most common cause of erectile dysfunction in older men?
A. Testosterone deficiency
B. Atherosclerosis
C. Psychological trauma
D. Medication allergy
Correct Answer: B. Atherosclerosis
