NR 601 Advanced Practice Nursing – Primary
Care of the Maturing & Aged Family –
Comprehensive Practice Exam
EXAM OVERVIEW
NR 601 focuses on the primary care needs of the maturing and aged family
(adults 65 and older). The course emphasizes a comprehensive,
interdisciplinary approach to caring for older adults, including health
promotion, disease prevention, and management of acute and chronic
conditions. Key concepts include normal aging vs. disease, geriatric
syndromes (falls, delirium, incontinence, frailty), polypharmacy, cognitive
impairment (dementia, delirium, depression), functional assessment,
advance care planning, and end-of-life care. This exam simulates the style
and content of NR 601 midterm and final examinations.
Key Content Areas
• Geriatric Syndromes: Falls, delirium, incontinence, frailty, pressure
ulcers, polypharmacy
• Cognitive Disorders: Delirium, dementia (Alzheimer's, vascular,
Lewy body, frontotemporal), depression
• Cardiovascular & Pulmonary Disorders: HTN, heart failure, CAD,
COPD, PAD
• Endocrine & Metabolic Disorders: Diabetes, thyroid disorders,
osteoporosis, metabolic syndrome
• Neurological Disorders: Stroke, Parkinson's disease, peripheral
neuropathy
• Musculoskeletal Disorders: Osteoarthritis, osteoporosis, fractures
• Sensory & Special Senses: Vision, hearing, age-related changes
, • Advance Care Planning: Goals of care, palliative care, hospice,
advance directives
SECTION 1: Aging & Geriatric Syndromes (Questions 1-15)
Q1. A 75-year-old patient presents with new-onset urinary
incontinence. Which of the following is the MOST appropriate initial
assessment?
• A) Order a CT scan of the abdomen
• B) Perform a focused history, physical exam, and urinalysis
• C) Refer to urology immediately
• D) Prescribe an anticholinergic medication
Answer: B – New-onset urinary incontinence in an older adult requires a
focused evaluation including history (onset, frequency, patterns), physical
exam (including neurological assessment), and urinalysis to rule out
infection. Incontinence is a geriatric syndrome with multiple etiologies that
must be identified before treatment.
Q2. A 72-year-old patient with a history of hypertension is found to have
an elevated blood pressure at a routine visit. Which of the following is
the recommended target blood pressure for adults aged 65 and older?
• A) < 120/80 mmHg
• B) < 130/80 mmHg
• C) < 140/90 mmHg
• D) < 150/90 mmHg
Answer: B – The American College of Cardiology/American Heart
Association (ACC/AHA) guidelines recommend a blood pressure target of <
130/80 mmHg for most adults, including those aged 65 and older.
Individualization is appropriate based on comorbidities and frailty status.
,Q3. A 78-year-old patient is being evaluated for a "mini-stroke" event.
The patient reports episodes where he feels "stiff for a few minutes."
The NP suspects transient ischemic attack (TIA). Which of the following
is the MOST appropriate next step?
• A) Reassure the patient and schedule a follow-up in 6 months
• B) Order a non-contrast head CT, carotid ultrasound, and initiate
antiplatelet therapy
• C) Refer to neurology without further testing
• D) Order an echocardiogram and stress test only
Answer: B – TIA symptoms require urgent evaluation. Non-contrast head
CT rules out hemorrhage or mass; carotid ultrasound assesses for stenosis
(a common cause); antiplatelet therapy (aspirin) reduces risk of
subsequent stroke.
Q4. Which of the following is a hallmark of frailty in older adults?
• A) Increased muscle mass
• B) Unintentional weight loss and decreased physical activity
• C) Increased appetite
• D) Improved mobility
Answer: B – Frailty is characterized by unintentional weight loss (≥10 lbs in
past year), self-reported exhaustion, weakness (decreased grip strength),
slow walking speed, and low physical activity. The presence of three or
more of these indicates frailty.
Q5. A 70-year-old patient with a history of hypertension is noted to have
a heart rate of 110 bpm. An ECG shows atrial fibrillation. Which is the
MOST appropriate initial management?
, • A) Start warfarin without further testing
• B) Assess the patient for symptoms, evaluate for rate control, and
assess stroke risk using CHA₂DS₂-VASc
• C) Start aspirin and digoxin
• D) Perform cardioversion
Answer: B – New-onset atrial fibrillation requires assessment of clinical
stability (rate vs. rhythm control), symptoms (chest pain, SOB, syncope),
and stroke risk (CHA₂DS₂-VASc score). Anticoagulation is indicated for
those with score ≥2.
Q6. A 65-year-old patient presents with acute-onset shortness of
breath, fever, and productive cough. A chest x-ray shows a right lower
lobe infiltrate. Which of the following is the MOST appropriate
antibiotic regimen?
• A) Azithromycin alone
• B) Amoxicillin or doxycycline (if penicillin-allergic)
• C) Levofloxacin alone
• D) Vancomycin
Answer: B – Community-acquired pneumonia (CAP) in a patient without
significant comorbidities is treated with amoxicillin or doxycycline.
Macrolides (azithromycin) are also appropriate. However, the correct
option depends on the specific clinical scenario and guidelines.
Q7. A 78-year-old patient with a history of dementia and heart failure is
brought to the clinic by his daughter. She reports that he has become
increasingly confused over the past 3 days. Which of the following is
the MOST appropriate next step?
• A) Increase the dose of his donepezil
• B) Evaluate for delirium and assess for underlying causes
Care of the Maturing & Aged Family –
Comprehensive Practice Exam
EXAM OVERVIEW
NR 601 focuses on the primary care needs of the maturing and aged family
(adults 65 and older). The course emphasizes a comprehensive,
interdisciplinary approach to caring for older adults, including health
promotion, disease prevention, and management of acute and chronic
conditions. Key concepts include normal aging vs. disease, geriatric
syndromes (falls, delirium, incontinence, frailty), polypharmacy, cognitive
impairment (dementia, delirium, depression), functional assessment,
advance care planning, and end-of-life care. This exam simulates the style
and content of NR 601 midterm and final examinations.
Key Content Areas
• Geriatric Syndromes: Falls, delirium, incontinence, frailty, pressure
ulcers, polypharmacy
• Cognitive Disorders: Delirium, dementia (Alzheimer's, vascular,
Lewy body, frontotemporal), depression
• Cardiovascular & Pulmonary Disorders: HTN, heart failure, CAD,
COPD, PAD
• Endocrine & Metabolic Disorders: Diabetes, thyroid disorders,
osteoporosis, metabolic syndrome
• Neurological Disorders: Stroke, Parkinson's disease, peripheral
neuropathy
• Musculoskeletal Disorders: Osteoarthritis, osteoporosis, fractures
• Sensory & Special Senses: Vision, hearing, age-related changes
, • Advance Care Planning: Goals of care, palliative care, hospice,
advance directives
SECTION 1: Aging & Geriatric Syndromes (Questions 1-15)
Q1. A 75-year-old patient presents with new-onset urinary
incontinence. Which of the following is the MOST appropriate initial
assessment?
• A) Order a CT scan of the abdomen
• B) Perform a focused history, physical exam, and urinalysis
• C) Refer to urology immediately
• D) Prescribe an anticholinergic medication
Answer: B – New-onset urinary incontinence in an older adult requires a
focused evaluation including history (onset, frequency, patterns), physical
exam (including neurological assessment), and urinalysis to rule out
infection. Incontinence is a geriatric syndrome with multiple etiologies that
must be identified before treatment.
Q2. A 72-year-old patient with a history of hypertension is found to have
an elevated blood pressure at a routine visit. Which of the following is
the recommended target blood pressure for adults aged 65 and older?
• A) < 120/80 mmHg
• B) < 130/80 mmHg
• C) < 140/90 mmHg
• D) < 150/90 mmHg
Answer: B – The American College of Cardiology/American Heart
Association (ACC/AHA) guidelines recommend a blood pressure target of <
130/80 mmHg for most adults, including those aged 65 and older.
Individualization is appropriate based on comorbidities and frailty status.
,Q3. A 78-year-old patient is being evaluated for a "mini-stroke" event.
The patient reports episodes where he feels "stiff for a few minutes."
The NP suspects transient ischemic attack (TIA). Which of the following
is the MOST appropriate next step?
• A) Reassure the patient and schedule a follow-up in 6 months
• B) Order a non-contrast head CT, carotid ultrasound, and initiate
antiplatelet therapy
• C) Refer to neurology without further testing
• D) Order an echocardiogram and stress test only
Answer: B – TIA symptoms require urgent evaluation. Non-contrast head
CT rules out hemorrhage or mass; carotid ultrasound assesses for stenosis
(a common cause); antiplatelet therapy (aspirin) reduces risk of
subsequent stroke.
Q4. Which of the following is a hallmark of frailty in older adults?
• A) Increased muscle mass
• B) Unintentional weight loss and decreased physical activity
• C) Increased appetite
• D) Improved mobility
Answer: B – Frailty is characterized by unintentional weight loss (≥10 lbs in
past year), self-reported exhaustion, weakness (decreased grip strength),
slow walking speed, and low physical activity. The presence of three or
more of these indicates frailty.
Q5. A 70-year-old patient with a history of hypertension is noted to have
a heart rate of 110 bpm. An ECG shows atrial fibrillation. Which is the
MOST appropriate initial management?
, • A) Start warfarin without further testing
• B) Assess the patient for symptoms, evaluate for rate control, and
assess stroke risk using CHA₂DS₂-VASc
• C) Start aspirin and digoxin
• D) Perform cardioversion
Answer: B – New-onset atrial fibrillation requires assessment of clinical
stability (rate vs. rhythm control), symptoms (chest pain, SOB, syncope),
and stroke risk (CHA₂DS₂-VASc score). Anticoagulation is indicated for
those with score ≥2.
Q6. A 65-year-old patient presents with acute-onset shortness of
breath, fever, and productive cough. A chest x-ray shows a right lower
lobe infiltrate. Which of the following is the MOST appropriate
antibiotic regimen?
• A) Azithromycin alone
• B) Amoxicillin or doxycycline (if penicillin-allergic)
• C) Levofloxacin alone
• D) Vancomycin
Answer: B – Community-acquired pneumonia (CAP) in a patient without
significant comorbidities is treated with amoxicillin or doxycycline.
Macrolides (azithromycin) are also appropriate. However, the correct
option depends on the specific clinical scenario and guidelines.
Q7. A 78-year-old patient with a history of dementia and heart failure is
brought to the clinic by his daughter. She reports that he has become
increasingly confused over the past 3 days. Which of the following is
the MOST appropriate next step?
• A) Increase the dose of his donepezil
• B) Evaluate for delirium and assess for underlying causes
