NR 601 Midterm Exam Study Guide
Weeks 1-4 content
Section 1: Physiological Changes of Aging
1. Which of the following are the three primary physiological changes of aging?
• A) Decreased muscle mass, increased bone density, improved immune
function
• B) Reduced physiological reserve of most body systems, reduced
homeostatic mechanisms, impaired immunological function
• C) Increased cardiac output, improved renal function, enhanced
thermoregulation
• D) Slower wound healing, increased skin elasticity, improved GI motility
Answer: B
Rationale: The three primary physiological changes of aging are: (1) reduced
physiological reserve of most body systems (especially cardiac, respiratory, and
renal), (2) reduced homeostatic mechanisms that fail to adjust regulatory systems
(temperature control, fluid/electrolyte balance), and (3) impaired immunological
function leading to increased infection risk and autoimmune diseases .
2. The aging process causes which normal physiological changes in the heart?
• A) Increased cardiac output and decreased heart valve thickness
• B) Heart valves thicken and become more rigid
• C) Decreased risk of arrhythmias
• D) Increased baroreceptor sensitivity
,Answer: B
Rationale: Age-related cardiovascular changes include fibrosis and thickening of
heart valves, reduced stroke volume and cardiac output, fibroelastic thickening of
the SA node (slower heart rate), and decreased baroreceptor sensitivity leading to
increased fall risk and orthostatic hypotension .
3. The FEV1/FVC ratio is used to:
• A) Diagnose asthma exclusively
• B) Assess the percentage of forced vital capacity expired in one second,
indicating obstructive vs. restrictive patterns
• C) Measure total lung capacity
• D) Evaluate diffusion capacity
Answer: B
Rationale: The FEV1/FVC ratio is a key spirometry measurement. A ratio <0.70
indicates an obstructive pattern (COPD, asthma). This is the gold standard for
diagnosing COPD and distinguishing it from restrictive lung diseases .
Section 2: The Comprehensive Geriatric Assessment (CGA)
4. The Comprehensive Geriatric Assessment (CGA) encompasses which four
main domains?
• A) Physical, psychological, social, and economic
• B) Physical health, functional health, psychological health, and
socioenvironmental support
• C) Mental, physical, spiritual, and financial
• D) Cognitive, emotional, physical, and environmental
Answer: B
,Rationale: The CGA evaluates four main domains: Physical health (medical history,
PE, diagnostics, nutritional assessment), Functional health (ADLs/IADLs),
Psychological health (cognition and mood), and Socioenvironmental support
(social network, living situation, economic resources) .
5. When should a geriatric assessment be performed?
• A) Only when a patient is hospitalized
• B) When a patient is stable and at the time of the initial visit when
establishing care
• C) Only during acute illness exacerbations
• D) Every 10 years after age 65
Answer: B
Rationale: A geriatric assessment should be performed when the patient is stable
and during the initial visit when establishing care. It is most beneficial for
vulnerable older adults but should be considered for all older adults to identify
preventable conditions and improve outcomes .
Section 3: Polypharmacy & Medication Safety
6. Which of the following is a primary predictor for adverse drug reactions
(ADRs) in older adults?
• A) Age over 75
• B) Polypharmacy (5 or more medications)
• C) Male gender
• D) Low body mass index
Answer: B
, Rationale: Polypharmacy, commonly defined as the use of 5 or more medications,
is a primary predictor for adverse drug reactions in older adults. It accounts for
10% of ER visits and 17% of hospital admissions. Contributing factors include
multiple providers, lack of communication between providers, and prescribing
unnecessary medications .
7. The Beers Criteria is used to:
• A) Diagnose diabetes in older adults
• B) Identify potentially inappropriate medications that should be avoided in
older adults
• C) Calculate GFR in elderly patients
• D) Screen for depression
Answer: B
Rationale: The American Geriatrics Society Beers Criteria is used to improve
medication selection and avoid potentially inappropriate medications in older
adults (65 years and older) in all settings except hospice and palliative care. It
emphasizes the importance of deprescribing to avoid polypharmacy and adverse
drug reactions .
8. The STOPP/START criteria are used for:
• A) Assessing fall risk
• B) Screening for cognitive impairment
• C) Identifying potentially inappropriate prescribing (STOPP) and potential
prescribing omissions (START)
• D) Evaluating nutritional status
Answer: C
Weeks 1-4 content
Section 1: Physiological Changes of Aging
1. Which of the following are the three primary physiological changes of aging?
• A) Decreased muscle mass, increased bone density, improved immune
function
• B) Reduced physiological reserve of most body systems, reduced
homeostatic mechanisms, impaired immunological function
• C) Increased cardiac output, improved renal function, enhanced
thermoregulation
• D) Slower wound healing, increased skin elasticity, improved GI motility
Answer: B
Rationale: The three primary physiological changes of aging are: (1) reduced
physiological reserve of most body systems (especially cardiac, respiratory, and
renal), (2) reduced homeostatic mechanisms that fail to adjust regulatory systems
(temperature control, fluid/electrolyte balance), and (3) impaired immunological
function leading to increased infection risk and autoimmune diseases .
2. The aging process causes which normal physiological changes in the heart?
• A) Increased cardiac output and decreased heart valve thickness
• B) Heart valves thicken and become more rigid
• C) Decreased risk of arrhythmias
• D) Increased baroreceptor sensitivity
,Answer: B
Rationale: Age-related cardiovascular changes include fibrosis and thickening of
heart valves, reduced stroke volume and cardiac output, fibroelastic thickening of
the SA node (slower heart rate), and decreased baroreceptor sensitivity leading to
increased fall risk and orthostatic hypotension .
3. The FEV1/FVC ratio is used to:
• A) Diagnose asthma exclusively
• B) Assess the percentage of forced vital capacity expired in one second,
indicating obstructive vs. restrictive patterns
• C) Measure total lung capacity
• D) Evaluate diffusion capacity
Answer: B
Rationale: The FEV1/FVC ratio is a key spirometry measurement. A ratio <0.70
indicates an obstructive pattern (COPD, asthma). This is the gold standard for
diagnosing COPD and distinguishing it from restrictive lung diseases .
Section 2: The Comprehensive Geriatric Assessment (CGA)
4. The Comprehensive Geriatric Assessment (CGA) encompasses which four
main domains?
• A) Physical, psychological, social, and economic
• B) Physical health, functional health, psychological health, and
socioenvironmental support
• C) Mental, physical, spiritual, and financial
• D) Cognitive, emotional, physical, and environmental
Answer: B
,Rationale: The CGA evaluates four main domains: Physical health (medical history,
PE, diagnostics, nutritional assessment), Functional health (ADLs/IADLs),
Psychological health (cognition and mood), and Socioenvironmental support
(social network, living situation, economic resources) .
5. When should a geriatric assessment be performed?
• A) Only when a patient is hospitalized
• B) When a patient is stable and at the time of the initial visit when
establishing care
• C) Only during acute illness exacerbations
• D) Every 10 years after age 65
Answer: B
Rationale: A geriatric assessment should be performed when the patient is stable
and during the initial visit when establishing care. It is most beneficial for
vulnerable older adults but should be considered for all older adults to identify
preventable conditions and improve outcomes .
Section 3: Polypharmacy & Medication Safety
6. Which of the following is a primary predictor for adverse drug reactions
(ADRs) in older adults?
• A) Age over 75
• B) Polypharmacy (5 or more medications)
• C) Male gender
• D) Low body mass index
Answer: B
, Rationale: Polypharmacy, commonly defined as the use of 5 or more medications,
is a primary predictor for adverse drug reactions in older adults. It accounts for
10% of ER visits and 17% of hospital admissions. Contributing factors include
multiple providers, lack of communication between providers, and prescribing
unnecessary medications .
7. The Beers Criteria is used to:
• A) Diagnose diabetes in older adults
• B) Identify potentially inappropriate medications that should be avoided in
older adults
• C) Calculate GFR in elderly patients
• D) Screen for depression
Answer: B
Rationale: The American Geriatrics Society Beers Criteria is used to improve
medication selection and avoid potentially inappropriate medications in older
adults (65 years and older) in all settings except hospice and palliative care. It
emphasizes the importance of deprescribing to avoid polypharmacy and adverse
drug reactions .
8. The STOPP/START criteria are used for:
• A) Assessing fall risk
• B) Screening for cognitive impairment
• C) Identifying potentially inappropriate prescribing (STOPP) and potential
prescribing omissions (START)
• D) Evaluating nutritional status
Answer: C
