NR 601 PRIMARY CARE OF OLDER ADULTS MIDTERM EXAM | COMPLETE QUESTIONS, ANSWERS & RAT… EXAM
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 601 Primary Care of Older
Adults Midterm Exam | Complete
Questions, Answers & Rationales |
Chamberlain University | 2026/2027
Verified Answers Exam Ready With Rationales
175 QUESTIONS
DOCUMENT OVERVIEW
This resource provides 175 complete questions with verified answers and detailed rationales for NR 601
Primary Care of Older Adults. It covers key concepts in geriatric primary care, offering a comprehensive
study tool for students to review material, solidify understanding, and prepare for certification exams.
CONTENTS
01 Pulmonary and Respiratory Q1–Q8
02 Cardiovascular Assessment and Disease Q9–Q55
03 Musculoskeletal and Rheumatic Conditions Q56–Q81
04 Neurological and Cognitive Health Q82–Q104
05 Pharmacology and Medication Management Q105–Q113
06 Renal and Metabolic Health Q114–Q122
07 Geriatric Syndromes and Functional Status Q123–Q150
08 Preventive Health and Screening Q151–Q168
09 Additional Questions Q169–Q175
Page 1
, E XA M Q U EST I O N S
Q1 QUESTION 1 OF 175
A pulmonology fellow is reviewing spirometry results for a 78-year-old patient presenting with exertional dyspnea. The report shows a
Forced Vital Capacity (FVC) of 3.2 L and a Forced Expiratory Volume in one second (FEV1) of 2.0 L. What percentage of the FVC expired in
one second does this represent?
A) 58%
B) 62.5%
C) 78%
D) 85%
CORRECT ANSWER
B) 62.5%
RATIONALE
5%. This ratio helps distinguish obstructive from restrictive lung disease patterns.
Q2 QUESTION 2 OF 175
A respiratory therapist is assessing an older adult patient with suspected restrictive lung disease. During spirometry, the patient is
instructed to inhale as deeply as possible and then exhale forcefully. The measurement representing the total volume of air exhaled during
this maximal effort is documented. This specific volume is identified as:
A) Forced Expiratory Volume in 1 second (FEV1)
B) Forced Vital Capacity (FVC)
C) Maximum Voluntary Ventilation (MVV)
D) Peak Expiratory Flow Rate (PEFR)
CORRECT ANSWER
B) Forced Vital Capacity (FVC)
RATIONALE
Forced Vital Capacity (FVC) directly measures the total volume of air a patient can exhale forcefully from full inspiration, distinguishing it from FEV1
which measures volume in a set time. This metric is key in diagnosing and monitoring restrictive lung conditions.
Q3 QUESTION 3 OF 175
A pulmonary function test report for a 78-year-old male with a history of COPD shows a measured inspiratory capacity of 4.2 L and a
forced expiratory volume in 1 second (FEV1) of 1.8 L. The technician notes that "maximum lung inflation was not achieved during the test."
What is the most appropriate interpretation of the patient's recorded volume at maximal inflation based on this additional information?
A) The patient's total lung capacity (TLC) is equal to the measured inspiratory capacity of 4.2 L.
B) The measured inspiratory capacity of 4.2 L represents the patient's vital capacity.
Page 2
,C) The patient's total lung capacity (TLC) is greater than the measured inspiratory capacity of 4.2 L.
D) The FEV1 of 1.8 L is the defining value for assessing maximal lung inflation.
CORRECT ANSWER
C) The patient's total lung capacity (TLC) is greater than the measured inspiratory capacity of 4.2 L.
RATIONALE
Total lung capacity (TLC) is the volume of air in the lungs at maximal inflation, which is always greater than or equal to the inspiratory capacity (IC) if
maximal inflation was not achieved. The FEV1 is a measure of airflow, not lung volume at maximal inflation.
Q4 QUESTION 4 OF 175
A pediatric pulmonologist reviews the case of a 7-year-old who has had a persistent, hacking cough for 3 weeks following a mild upper
respiratory infection. The cough is non-productive and has disrupted sleep. Initial antibiotic treatment for presumed bacterial bronchitis
yielded no improvement. The physician suspects Bordetella pertussis given the sub-acute presentation. What clinical finding best
supports this suspicion?
A) Sputum culture positive for Streptococcus pneumoniae
B) Fever exceeding 38.5°C for more than 5 days
C) Paroxysmal coughing fits followed by an inspiratory "whoop"
D) Mild wheezing on bilateral lung auscultation
CORRECT ANSWER
C) Paroxysmal coughing fits followed by an inspiratory "whoop"
RATIONALE
Bordetella pertussis infection is classically characterized by a prolonged, sub-acute cough that often culminates in paroxysmal fits, typically
followed by a high-pitched inspiratory whoop in younger children, distinguishing it from typical bacterial bronchitis. This clinical pattern, rather
than fever or specific bacterial co-infections, is the hallmark presentation.
Q5 QUESTION 5 OF 175
A 78-year-old male patient, diagnosed with moderate chronic obstructive pulmonary disease (COPD) and Stage II heart failure with
preserved ejection fraction (HFpEF), is being evaluated by the geriatric nurse practitioner for a new exercise prescription. The patient's
current medication regimen includes a beta-blocker and an ACE inhibitor. Which of the following diagnoses, if present, would *least*
restrict this patient from participating in a supervised moderate-intensity physical activity program, assuming adequate symptom
management?
A) Uncontrolled atrial fibrillation with a resting heart rate consistently above 100 bpm
B) Severe symptomatic aortic stenosis with a peak systolic gradient of 60 mmHg
C) Major depressive disorder with persistent anhedonia and fatigue
D) Acute decompensated heart failure requiring daily diuretic adjustments
CORRECT ANSWER
C) Major depressive disorder with persistent anhedonia and fatigue
Page 3
, RATIONALE
Major depressive disorder, while impacting motivation and energy, does not inherently pose the same acute cardiovascular or pulmonary risks
during exertion as uncontrolled arrhythmias, severe valvular disease, or active heart failure exacerbations. Effective management of depression can
actually enhance participation.
Q6 QUESTION 6 OF 175
A 78-year-old male patient with a history of COPD is prescribed ipratropium bromide for symptomatic relief of bronchospasm. As the on-
call resident, you review the medication's mechanism of action. To achieve bronchodilation, ipratropium bromide primarily functions by
blocking the effect of what neurotransmitter at which receptor subtype?
A) Norepinephrine at beta-2 adrenergic receptors
B) Acetylcholine at muscarinic type 3 receptors
C) Dopamine at D2 receptors
D) Serotonin at 5-HT1A receptors
CORRECT ANSWER
B) Acetylcholine at muscarinic type 3 receptors
RATIONALE
Ipratropium bromide, an anticholinergic, blocks acetylcholine's action at muscarinic M3 receptors in the airways, leading to smooth muscle
relaxation and bronchodilation. This mechanism is distinct from beta-agonist bronchodilators.
Q7 QUESTION 7 OF 175
The charge nurse notes a patient's peak expiratory flow rate (PEFR) has dropped from 450 L/min to 300 L/min within 12 hours,
accompanied by increased dyspnea and audible wheezing. The patient is currently receiving albuterol via nebulizer every 4 hours as
needed for respiratory distress. What is the MOST appropriate next pharmacological intervention?
A) Administer a short-acting beta agonist (SABA) via metered-dose inhaler every 4 hours.
B) Increase the frequency of the nebulized short-acting beta agonist (SABA) to every 2 hours.
C) Initiate a short course of oral corticosteroids.
D) Add a long-acting muscarinic antagonist (LAMA) to the current treatment regimen.
CORRECT ANSWER
B) Increase the frequency of the nebulized short-acting beta agonist (SABA) to every 2 hours.
RATIONALE
A significant decline in PEFR and worsening respiratory symptoms indicate insufficient bronchodilation, requiring more frequent SABA
administration to stimulate beta-2 adrenergic receptors and relax airway smooth muscle via increased cyclic AMP. Oral corticosteroids are
indicated for inflammation, not immediate bronchospasm.
Q8 QUESTION 8 OF 175
A 72-year-old male presents with a persistent, non-productive cough and a low-grade fever of 3 weeks' duration. Chest X-ray shows
infiltrates in the upper lobes, and sputum smears are positive for acid-fast bacilli. The attending physician notes a report from the CDC
Page 4
P R O F E S S I O N A L P R A C T I C E M AT E R I A L S
NR 601 Primary Care of Older
Adults Midterm Exam | Complete
Questions, Answers & Rationales |
Chamberlain University | 2026/2027
Verified Answers Exam Ready With Rationales
175 QUESTIONS
DOCUMENT OVERVIEW
This resource provides 175 complete questions with verified answers and detailed rationales for NR 601
Primary Care of Older Adults. It covers key concepts in geriatric primary care, offering a comprehensive
study tool for students to review material, solidify understanding, and prepare for certification exams.
CONTENTS
01 Pulmonary and Respiratory Q1–Q8
02 Cardiovascular Assessment and Disease Q9–Q55
03 Musculoskeletal and Rheumatic Conditions Q56–Q81
04 Neurological and Cognitive Health Q82–Q104
05 Pharmacology and Medication Management Q105–Q113
06 Renal and Metabolic Health Q114–Q122
07 Geriatric Syndromes and Functional Status Q123–Q150
08 Preventive Health and Screening Q151–Q168
09 Additional Questions Q169–Q175
Page 1
, E XA M Q U EST I O N S
Q1 QUESTION 1 OF 175
A pulmonology fellow is reviewing spirometry results for a 78-year-old patient presenting with exertional dyspnea. The report shows a
Forced Vital Capacity (FVC) of 3.2 L and a Forced Expiratory Volume in one second (FEV1) of 2.0 L. What percentage of the FVC expired in
one second does this represent?
A) 58%
B) 62.5%
C) 78%
D) 85%
CORRECT ANSWER
B) 62.5%
RATIONALE
5%. This ratio helps distinguish obstructive from restrictive lung disease patterns.
Q2 QUESTION 2 OF 175
A respiratory therapist is assessing an older adult patient with suspected restrictive lung disease. During spirometry, the patient is
instructed to inhale as deeply as possible and then exhale forcefully. The measurement representing the total volume of air exhaled during
this maximal effort is documented. This specific volume is identified as:
A) Forced Expiratory Volume in 1 second (FEV1)
B) Forced Vital Capacity (FVC)
C) Maximum Voluntary Ventilation (MVV)
D) Peak Expiratory Flow Rate (PEFR)
CORRECT ANSWER
B) Forced Vital Capacity (FVC)
RATIONALE
Forced Vital Capacity (FVC) directly measures the total volume of air a patient can exhale forcefully from full inspiration, distinguishing it from FEV1
which measures volume in a set time. This metric is key in diagnosing and monitoring restrictive lung conditions.
Q3 QUESTION 3 OF 175
A pulmonary function test report for a 78-year-old male with a history of COPD shows a measured inspiratory capacity of 4.2 L and a
forced expiratory volume in 1 second (FEV1) of 1.8 L. The technician notes that "maximum lung inflation was not achieved during the test."
What is the most appropriate interpretation of the patient's recorded volume at maximal inflation based on this additional information?
A) The patient's total lung capacity (TLC) is equal to the measured inspiratory capacity of 4.2 L.
B) The measured inspiratory capacity of 4.2 L represents the patient's vital capacity.
Page 2
,C) The patient's total lung capacity (TLC) is greater than the measured inspiratory capacity of 4.2 L.
D) The FEV1 of 1.8 L is the defining value for assessing maximal lung inflation.
CORRECT ANSWER
C) The patient's total lung capacity (TLC) is greater than the measured inspiratory capacity of 4.2 L.
RATIONALE
Total lung capacity (TLC) is the volume of air in the lungs at maximal inflation, which is always greater than or equal to the inspiratory capacity (IC) if
maximal inflation was not achieved. The FEV1 is a measure of airflow, not lung volume at maximal inflation.
Q4 QUESTION 4 OF 175
A pediatric pulmonologist reviews the case of a 7-year-old who has had a persistent, hacking cough for 3 weeks following a mild upper
respiratory infection. The cough is non-productive and has disrupted sleep. Initial antibiotic treatment for presumed bacterial bronchitis
yielded no improvement. The physician suspects Bordetella pertussis given the sub-acute presentation. What clinical finding best
supports this suspicion?
A) Sputum culture positive for Streptococcus pneumoniae
B) Fever exceeding 38.5°C for more than 5 days
C) Paroxysmal coughing fits followed by an inspiratory "whoop"
D) Mild wheezing on bilateral lung auscultation
CORRECT ANSWER
C) Paroxysmal coughing fits followed by an inspiratory "whoop"
RATIONALE
Bordetella pertussis infection is classically characterized by a prolonged, sub-acute cough that often culminates in paroxysmal fits, typically
followed by a high-pitched inspiratory whoop in younger children, distinguishing it from typical bacterial bronchitis. This clinical pattern, rather
than fever or specific bacterial co-infections, is the hallmark presentation.
Q5 QUESTION 5 OF 175
A 78-year-old male patient, diagnosed with moderate chronic obstructive pulmonary disease (COPD) and Stage II heart failure with
preserved ejection fraction (HFpEF), is being evaluated by the geriatric nurse practitioner for a new exercise prescription. The patient's
current medication regimen includes a beta-blocker and an ACE inhibitor. Which of the following diagnoses, if present, would *least*
restrict this patient from participating in a supervised moderate-intensity physical activity program, assuming adequate symptom
management?
A) Uncontrolled atrial fibrillation with a resting heart rate consistently above 100 bpm
B) Severe symptomatic aortic stenosis with a peak systolic gradient of 60 mmHg
C) Major depressive disorder with persistent anhedonia and fatigue
D) Acute decompensated heart failure requiring daily diuretic adjustments
CORRECT ANSWER
C) Major depressive disorder with persistent anhedonia and fatigue
Page 3
, RATIONALE
Major depressive disorder, while impacting motivation and energy, does not inherently pose the same acute cardiovascular or pulmonary risks
during exertion as uncontrolled arrhythmias, severe valvular disease, or active heart failure exacerbations. Effective management of depression can
actually enhance participation.
Q6 QUESTION 6 OF 175
A 78-year-old male patient with a history of COPD is prescribed ipratropium bromide for symptomatic relief of bronchospasm. As the on-
call resident, you review the medication's mechanism of action. To achieve bronchodilation, ipratropium bromide primarily functions by
blocking the effect of what neurotransmitter at which receptor subtype?
A) Norepinephrine at beta-2 adrenergic receptors
B) Acetylcholine at muscarinic type 3 receptors
C) Dopamine at D2 receptors
D) Serotonin at 5-HT1A receptors
CORRECT ANSWER
B) Acetylcholine at muscarinic type 3 receptors
RATIONALE
Ipratropium bromide, an anticholinergic, blocks acetylcholine's action at muscarinic M3 receptors in the airways, leading to smooth muscle
relaxation and bronchodilation. This mechanism is distinct from beta-agonist bronchodilators.
Q7 QUESTION 7 OF 175
The charge nurse notes a patient's peak expiratory flow rate (PEFR) has dropped from 450 L/min to 300 L/min within 12 hours,
accompanied by increased dyspnea and audible wheezing. The patient is currently receiving albuterol via nebulizer every 4 hours as
needed for respiratory distress. What is the MOST appropriate next pharmacological intervention?
A) Administer a short-acting beta agonist (SABA) via metered-dose inhaler every 4 hours.
B) Increase the frequency of the nebulized short-acting beta agonist (SABA) to every 2 hours.
C) Initiate a short course of oral corticosteroids.
D) Add a long-acting muscarinic antagonist (LAMA) to the current treatment regimen.
CORRECT ANSWER
B) Increase the frequency of the nebulized short-acting beta agonist (SABA) to every 2 hours.
RATIONALE
A significant decline in PEFR and worsening respiratory symptoms indicate insufficient bronchodilation, requiring more frequent SABA
administration to stimulate beta-2 adrenergic receptors and relax airway smooth muscle via increased cyclic AMP. Oral corticosteroids are
indicated for inflammation, not immediate bronchospasm.
Q8 QUESTION 8 OF 175
A 72-year-old male presents with a persistent, non-productive cough and a low-grade fever of 3 weeks' duration. Chest X-ray shows
infiltrates in the upper lobes, and sputum smears are positive for acid-fast bacilli. The attending physician notes a report from the CDC
Page 4
