NR 601 FINAL EXAM QUESTIONS & ANSWERS | PRIMARY CARE OF THE MATURING & AGED FAMILY | COMPREHENSIVE C… 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 Final Exam Questions & Answers |
Primary Care of the Maturing & Aged
Family | Comprehensive Case Study
Review | Chamberlain University |
2026/2027
Verified Answers Exam Ready With Rationales
103 QUESTIONS
DOCUMENT OVERVIEW
This document provides 103 comprehensive case study review questions with pre-filled correct answers
and detailed rationales for primary care of the maturing and aged family. It serves as a valuable resource for
students to study and review key concepts, prepare for comprehensive exams, or for certification review in
geriatric primary care.
CONTENTS
01 Neurological Disorders Q1–Q10
02 Endocrine & Metabolic Q11–Q30
03 Respiratory & Sleep Q31–Q37
04 Cardiovascular Health Q38–Q47
05 Genitourinary & Renal Q48–Q63
06 Geriatric Syndromes & Cognitive Q64–Q69
07 Palliative & End-of-Life Care Q70–Q80
08 Musculoskeletal & Pain Q81–Q85
09 Psychosocial & Safety Q86–Q95
10 Additional Questions Q96–Q103
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 103
Page 1
,A 72-year-old male presents to the clinic reporting transient right-sided hemiparesis, dysarthria, and confusion that resolved within 3 hours yesterday. A non-
contrast head CT performed today is unremarkable. The on-call resident is developing the diagnostic and management plan. Which of the following are indicated
next? (Select all that apply.)
A) Administer aspirin 81 mg orally immediately.
B) Discharge home with instructions to return if symptoms recur.
C) Initiate a 24-hour Holter monitor to assess for atrial fibrillation.
D) Order carotid Doppler ultrasound to evaluate for stenosis.
E) Reassure the patient that this event is unlikely to recur given the normal CT.
F) Schedule a fasting lipid profile and HbA1c.
CORRECT ANSWER
C) Initiate a 24-hour Holter monitor to assess for atrial fibrillation.
D) Order carotid Doppler ultrasound to evaluate for stenosis.
F) Schedule a fasting lipid profile and HbA1c.
RATIONALE
Transient ischemic attacks (TIAs) require urgent evaluation to identify underlying causes and reduce future stroke risk, even with a normal CT; therefore, cardiac rhythm
monitoring, vascular imaging, and assessment for diabetes and dyslipidemia are indicated. Reassurance and immediate aspirin without further workup are inappropriate given
the potential for recurrence and stroke.
Q2 QUESTION 2 OF 103
The community health nurse practitioner is assessing a 78-year-old male who presents with a sudden onset of left-sided facial droop, difficulty articulating
words, and confusion that began approximately 1 hour prior to arrival. His last known well time was this morning. Which of the following immediate actions are
most appropriate? (Select all that apply.)
A) Administer 325 mg of aspirin orally to reduce clot formation.
B) Initiate supplemental oxygen at 4 L/min via nasal cannula and obtain a 12-lead EKG.
C) Perform a rapid neurological assessment and activate the emergency medical services (EMS) system for transport to the nearest stroke-ready hospital.
D) Obtain a fingerstick glucose to rule out hypoglycemia as the cause of symptoms.
E) Document the patient's vital signs and current medication list in the electronic health record.
F) Obtain a detailed patient history from family members regarding recent travel or sick contacts.
CORRECT ANSWER
C) Perform a rapid neurological assessment and activate the emergency medical services (EMS) system for transport to the nearest stroke-ready hospital.
D) Obtain a fingerstick glucose to rule out hypoglycemia as the cause of symptoms.
RATIONALE
Acute neurological deficits in an older adult necessitate immediate evaluation for stroke, including ruling out metabolic causes like hypoglycemia, and activating the
appropriate transport system for time-sensitive interventions. While aspirin may be indicated later, it is not the first step, and oxygen/EKG are not primary interventions for
suspected stroke without other indicators.
Q3 QUESTION 3 OF 103
A 72-year-old male patient presents to the clinic with new-onset focal neurological deficits, including right-sided weakness and expressive aphasia. His medical
history is significant for hypertension, treated with lisinopril 20 mg daily. Given the patient's age and the acute nature of his symptoms, the primary care nurse
practitioner must consider the most probable underlying neurological etiology causing a seizure, if one were to occur.
A) Alzheimer's disease
B) Stroke
C) Multiple sclerosis
D) Peripheral neuropathy
CORRECT ANSWER
B) Stroke
Page 2
, RATIONALE
Cerebrovascular events, such as ischemic or hemorrhagic strokes, are the most common cause of acute neurological events, including seizures, in older adults due to age-
related changes in cerebral vasculature and increased risk factors. Alzheimer's disease and multiple sclerosis are chronic conditions less frequently presenting with acute
seizure activity, and peripheral neuropathy does not typically cause central neurological deficits leading to seizures.
Q4 QUESTION 4 OF 103
A 78-year-old male diagnosed with moderate Alzheimer's disease presents with progressive memory loss and difficulty with complex tasks, impacting his ability
to manage his finances independently. His neurologist has initiated pharmacotherapy. Which of the following drug classes directly targets the neurotransmitter
deficit implicated in the cognitive decline of Alzheimer's disease?
A) Selective serotonin reuptake inhibitors
B) Dopamine agonists
C) Cholinesterase inhibitors
D) Benzodiazepines
CORRECT ANSWER
C) Cholinesterase inhibitors
RATIONALE
Cholinesterase inhibitors increase acetylcholine levels in the synaptic cleft, thereby enhancing cholinergic neurotransmission which is diminished in Alzheimer's disease and
improves cognitive function. These agents are the primary symptomatic treatment for mild to moderate Alzheimer's disease.
Q5 QUESTION 5 OF 103
A 72-year-old male presents to the neurology clinic reporting a tremor that began approximately 1 year ago. He states, "It started in my right hand when I try to
eat, but now it's in both hands and sometimes my head." The nurse practitioner observes a rhythmic, 4- to 6-Hz tremor that is most noticeable when the patient
attempts to pick up a pen from the examination table and when he holds his arms outstretched. The tremor slightly diminishes when he brings the pen to his
mouth. Which of the following findings, if elicited during the examination, would *most strongly* suggest this tremor is consistent with essential tremor rather
than Parkinson's disease? (Select all that apply.)
A) The tremor is markedly reduced when the patient is asked to perform rapid alternating movements of the hands.
B) The tremor is absent at rest but becomes evident with voluntary postural maintenance.
C) The patient reports a family history of similar tremors, with onset in his 40s.
D) The tremor is amplified when the patient is asked to write his name.
E) The tremor is observed to be a pill-rolling motion of the thumb and forefinger at rest.
CORRECT ANSWER
B) The tremor is absent at rest but becomes evident with voluntary postural maintenance.
C) The patient reports a family history of similar tremors, with onset in his 40s.
RATIONALE
Essential tremor is typically action-induced, manifesting during voluntary movements and postural maintenance, and often has a positive family history; these features
distinguish it from the resting tremor characteristic of Parkinson's disease.
Q6 QUESTION 6 OF 103
The charge nurse reviews a new admission, a 78-year-old male presenting with acute confusion and fluctuating attention over the past 48 hours. His family
reports this is a marked change from his baseline cognitive function, which they describe as generally stable. He has a history of hypertension and mild cognitive
impairment, but no prior psychiatric diagnoses. Which of the following clinical features, if present, would be MOST consistent with a diagnosis of delirium?
A) Gradual decline in memory and executive function over 6 months
B) Aphasia and apraxia as predominant symptoms
C) Hyperactive state with agitation and hallucinations
D) Somnolence and lethargy with minimal psychomotor activity
Page 3
, E) Insidious onset of disorientation and social withdrawal
F) Fluctuating course of confusion and inattention
CORRECT ANSWER
C) Hyperactive state with agitation and hallucinations
D) Somnolence and lethargy with minimal psychomotor activity
F) Fluctuating course of confusion and inattention
RATIONALE
Delirium is characterized by acute onset, fluctuating course, inattention, and altered level of consciousness, which can manifest as either hyperactive (agitation, hallucinations)
or hypoactive (somnolence, lethargy) states, or a mixed presentation; gradual decline suggests dementia.
Q7 QUESTION 7 OF 103
A 78-year-old male patient presenting with sudden onset confusion, disorientation, and visual hallucinations requires immediate assessment for potential
underlying causes. Given his recent history of a urinary tract infection treated with broad-spectrum antibiotics, which of the following conditions is the most
likely precipitant of his acute change in mental status?
A) Chronic malnutrition
B) Acute infectious process
C) Multiple cerebrovascular accidents
D) Volume depletion
CORRECT ANSWER
B) Acute infectious process
RATIONALE
Acute infections are a primary, reversible cause of delirium in older adults, often manifesting as a sudden change in cognition due to the systemic inflammatory response
impacting cerebral function. Other factors like malnutrition, CVA, or dehydration can contribute but are less acutely likely to manifest as this specific presentation of delirium
without other preceding signs.
Q8 QUESTION 8 OF 103
The charge nurse is reviewing the care plan for a patient with advanced Alzheimer's disease who has recently been exhibiting increased agitation and confusion.
The patient's family reports that these episodes are most pronounced after 1600 hours. Which of the following interventions are most appropriate for managing
this patient's symptoms, considering the pattern described? (Select all that apply.)
A) Schedule complex cognitive stimulation activities between 1300 and 1500 hours.
B) Encourage a quiet environment with reduced lighting from 1700 hours onward.
C) Plan for medication administration to coincide with the peak symptom manifestation.
D) Increase the frequency of family visits during the late afternoon and early evening.
E) Initiate a structured evening routine that includes calming activities like soft music or a warm bath.
F) Advise the family to avoid any changes to the patient's daily schedule after 1500 hours.
CORRECT ANSWER
B) Encourage a quiet environment with reduced lighting from 1700 hours onward.
E) Initiate a structured evening routine that includes calming activities like soft music or a warm bath.
RATIONALE
"Sundowning," a phenomenon in late-stage dementia, causes cognitive disturbances to worsen toward evening; therefore, mitigating stimuli and establishing calming
routines during this period is indicated. Complex activities or medication administration during peak symptoms, or increased family visits, could exacerbate agitation rather
than alleviate it.
Q9 QUESTION 9 OF 103
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 Final Exam Questions & Answers |
Primary Care of the Maturing & Aged
Family | Comprehensive Case Study
Review | Chamberlain University |
2026/2027
Verified Answers Exam Ready With Rationales
103 QUESTIONS
DOCUMENT OVERVIEW
This document provides 103 comprehensive case study review questions with pre-filled correct answers
and detailed rationales for primary care of the maturing and aged family. It serves as a valuable resource for
students to study and review key concepts, prepare for comprehensive exams, or for certification review in
geriatric primary care.
CONTENTS
01 Neurological Disorders Q1–Q10
02 Endocrine & Metabolic Q11–Q30
03 Respiratory & Sleep Q31–Q37
04 Cardiovascular Health Q38–Q47
05 Genitourinary & Renal Q48–Q63
06 Geriatric Syndromes & Cognitive Q64–Q69
07 Palliative & End-of-Life Care Q70–Q80
08 Musculoskeletal & Pain Q81–Q85
09 Psychosocial & Safety Q86–Q95
10 Additional Questions Q96–Q103
E XA M Q U EST I O N S
Q1 QUESTION 1 OF 103
Page 1
,A 72-year-old male presents to the clinic reporting transient right-sided hemiparesis, dysarthria, and confusion that resolved within 3 hours yesterday. A non-
contrast head CT performed today is unremarkable. The on-call resident is developing the diagnostic and management plan. Which of the following are indicated
next? (Select all that apply.)
A) Administer aspirin 81 mg orally immediately.
B) Discharge home with instructions to return if symptoms recur.
C) Initiate a 24-hour Holter monitor to assess for atrial fibrillation.
D) Order carotid Doppler ultrasound to evaluate for stenosis.
E) Reassure the patient that this event is unlikely to recur given the normal CT.
F) Schedule a fasting lipid profile and HbA1c.
CORRECT ANSWER
C) Initiate a 24-hour Holter monitor to assess for atrial fibrillation.
D) Order carotid Doppler ultrasound to evaluate for stenosis.
F) Schedule a fasting lipid profile and HbA1c.
RATIONALE
Transient ischemic attacks (TIAs) require urgent evaluation to identify underlying causes and reduce future stroke risk, even with a normal CT; therefore, cardiac rhythm
monitoring, vascular imaging, and assessment for diabetes and dyslipidemia are indicated. Reassurance and immediate aspirin without further workup are inappropriate given
the potential for recurrence and stroke.
Q2 QUESTION 2 OF 103
The community health nurse practitioner is assessing a 78-year-old male who presents with a sudden onset of left-sided facial droop, difficulty articulating
words, and confusion that began approximately 1 hour prior to arrival. His last known well time was this morning. Which of the following immediate actions are
most appropriate? (Select all that apply.)
A) Administer 325 mg of aspirin orally to reduce clot formation.
B) Initiate supplemental oxygen at 4 L/min via nasal cannula and obtain a 12-lead EKG.
C) Perform a rapid neurological assessment and activate the emergency medical services (EMS) system for transport to the nearest stroke-ready hospital.
D) Obtain a fingerstick glucose to rule out hypoglycemia as the cause of symptoms.
E) Document the patient's vital signs and current medication list in the electronic health record.
F) Obtain a detailed patient history from family members regarding recent travel or sick contacts.
CORRECT ANSWER
C) Perform a rapid neurological assessment and activate the emergency medical services (EMS) system for transport to the nearest stroke-ready hospital.
D) Obtain a fingerstick glucose to rule out hypoglycemia as the cause of symptoms.
RATIONALE
Acute neurological deficits in an older adult necessitate immediate evaluation for stroke, including ruling out metabolic causes like hypoglycemia, and activating the
appropriate transport system for time-sensitive interventions. While aspirin may be indicated later, it is not the first step, and oxygen/EKG are not primary interventions for
suspected stroke without other indicators.
Q3 QUESTION 3 OF 103
A 72-year-old male patient presents to the clinic with new-onset focal neurological deficits, including right-sided weakness and expressive aphasia. His medical
history is significant for hypertension, treated with lisinopril 20 mg daily. Given the patient's age and the acute nature of his symptoms, the primary care nurse
practitioner must consider the most probable underlying neurological etiology causing a seizure, if one were to occur.
A) Alzheimer's disease
B) Stroke
C) Multiple sclerosis
D) Peripheral neuropathy
CORRECT ANSWER
B) Stroke
Page 2
, RATIONALE
Cerebrovascular events, such as ischemic or hemorrhagic strokes, are the most common cause of acute neurological events, including seizures, in older adults due to age-
related changes in cerebral vasculature and increased risk factors. Alzheimer's disease and multiple sclerosis are chronic conditions less frequently presenting with acute
seizure activity, and peripheral neuropathy does not typically cause central neurological deficits leading to seizures.
Q4 QUESTION 4 OF 103
A 78-year-old male diagnosed with moderate Alzheimer's disease presents with progressive memory loss and difficulty with complex tasks, impacting his ability
to manage his finances independently. His neurologist has initiated pharmacotherapy. Which of the following drug classes directly targets the neurotransmitter
deficit implicated in the cognitive decline of Alzheimer's disease?
A) Selective serotonin reuptake inhibitors
B) Dopamine agonists
C) Cholinesterase inhibitors
D) Benzodiazepines
CORRECT ANSWER
C) Cholinesterase inhibitors
RATIONALE
Cholinesterase inhibitors increase acetylcholine levels in the synaptic cleft, thereby enhancing cholinergic neurotransmission which is diminished in Alzheimer's disease and
improves cognitive function. These agents are the primary symptomatic treatment for mild to moderate Alzheimer's disease.
Q5 QUESTION 5 OF 103
A 72-year-old male presents to the neurology clinic reporting a tremor that began approximately 1 year ago. He states, "It started in my right hand when I try to
eat, but now it's in both hands and sometimes my head." The nurse practitioner observes a rhythmic, 4- to 6-Hz tremor that is most noticeable when the patient
attempts to pick up a pen from the examination table and when he holds his arms outstretched. The tremor slightly diminishes when he brings the pen to his
mouth. Which of the following findings, if elicited during the examination, would *most strongly* suggest this tremor is consistent with essential tremor rather
than Parkinson's disease? (Select all that apply.)
A) The tremor is markedly reduced when the patient is asked to perform rapid alternating movements of the hands.
B) The tremor is absent at rest but becomes evident with voluntary postural maintenance.
C) The patient reports a family history of similar tremors, with onset in his 40s.
D) The tremor is amplified when the patient is asked to write his name.
E) The tremor is observed to be a pill-rolling motion of the thumb and forefinger at rest.
CORRECT ANSWER
B) The tremor is absent at rest but becomes evident with voluntary postural maintenance.
C) The patient reports a family history of similar tremors, with onset in his 40s.
RATIONALE
Essential tremor is typically action-induced, manifesting during voluntary movements and postural maintenance, and often has a positive family history; these features
distinguish it from the resting tremor characteristic of Parkinson's disease.
Q6 QUESTION 6 OF 103
The charge nurse reviews a new admission, a 78-year-old male presenting with acute confusion and fluctuating attention over the past 48 hours. His family
reports this is a marked change from his baseline cognitive function, which they describe as generally stable. He has a history of hypertension and mild cognitive
impairment, but no prior psychiatric diagnoses. Which of the following clinical features, if present, would be MOST consistent with a diagnosis of delirium?
A) Gradual decline in memory and executive function over 6 months
B) Aphasia and apraxia as predominant symptoms
C) Hyperactive state with agitation and hallucinations
D) Somnolence and lethargy with minimal psychomotor activity
Page 3
, E) Insidious onset of disorientation and social withdrawal
F) Fluctuating course of confusion and inattention
CORRECT ANSWER
C) Hyperactive state with agitation and hallucinations
D) Somnolence and lethargy with minimal psychomotor activity
F) Fluctuating course of confusion and inattention
RATIONALE
Delirium is characterized by acute onset, fluctuating course, inattention, and altered level of consciousness, which can manifest as either hyperactive (agitation, hallucinations)
or hypoactive (somnolence, lethargy) states, or a mixed presentation; gradual decline suggests dementia.
Q7 QUESTION 7 OF 103
A 78-year-old male patient presenting with sudden onset confusion, disorientation, and visual hallucinations requires immediate assessment for potential
underlying causes. Given his recent history of a urinary tract infection treated with broad-spectrum antibiotics, which of the following conditions is the most
likely precipitant of his acute change in mental status?
A) Chronic malnutrition
B) Acute infectious process
C) Multiple cerebrovascular accidents
D) Volume depletion
CORRECT ANSWER
B) Acute infectious process
RATIONALE
Acute infections are a primary, reversible cause of delirium in older adults, often manifesting as a sudden change in cognition due to the systemic inflammatory response
impacting cerebral function. Other factors like malnutrition, CVA, or dehydration can contribute but are less acutely likely to manifest as this specific presentation of delirium
without other preceding signs.
Q8 QUESTION 8 OF 103
The charge nurse is reviewing the care plan for a patient with advanced Alzheimer's disease who has recently been exhibiting increased agitation and confusion.
The patient's family reports that these episodes are most pronounced after 1600 hours. Which of the following interventions are most appropriate for managing
this patient's symptoms, considering the pattern described? (Select all that apply.)
A) Schedule complex cognitive stimulation activities between 1300 and 1500 hours.
B) Encourage a quiet environment with reduced lighting from 1700 hours onward.
C) Plan for medication administration to coincide with the peak symptom manifestation.
D) Increase the frequency of family visits during the late afternoon and early evening.
E) Initiate a structured evening routine that includes calming activities like soft music or a warm bath.
F) Advise the family to avoid any changes to the patient's daily schedule after 1500 hours.
CORRECT ANSWER
B) Encourage a quiet environment with reduced lighting from 1700 hours onward.
E) Initiate a structured evening routine that includes calming activities like soft music or a warm bath.
RATIONALE
"Sundowning," a phenomenon in late-stage dementia, causes cognitive disturbances to worsen toward evening; therefore, mitigating stimuli and establishing calming
routines during this period is indicated. Complex activities or medication administration during peak symptoms, or increased family visits, could exacerbate agitation rather
than alleviate it.
Q9 QUESTION 9 OF 103
Page 4
