NR 601 Final Examination
Primary Care of the Maturing & Aged Family Practicum
Questions & Verified Answers (2026 – 2027)
Course: NR 601
Total Questions: 100
Curriculum Period: 2026 – 2027
Competency Alignment: AGNP / FNP Certification
VERIFIED ANSW ERS • EVID ENCE-BASED GUID ELINES
,Section 1: Geriatric Assessment and Preventive Care (Q1-Q12)
Q1: A 72-year-old female presents for her annual wellness visit. She has no personal or family
history of colorectal cancer. According to the USPSTF 2026 guidelines, what is the recommended
approach for colorectal cancer screening in this patient?
A. Colonoscopy every 10 years until age 85
B. Colonoscopy through age 75; shared decision-making for ages 76-85 [CORRECT]
C. CT colonography every 5 years indefinitely
D. Fecal immunochemical test annually until age 80
Correct Answer: B
Rationale: The USPSTF recommends screening for colorectal cancer in adults aged 45 to 75 years using colonoscopy, FIT,
or other approved modalities. For adults aged 76 to 85 years, the decision should be individualized through shared
decision-making, considering the patient's overall health, prior screening history, and personal preferences. Routine
screening is not recommended after age 85.
Q2: A 68-year-old postmenopausal woman with no risk factors for osteoporosis asks about bone
density screening. When should she receive her initial DEXA scan according to current preventive
care guidelines?
A. At age 60 regardless of risk factors
B. At age 65 for women with no risk factors [CORRECT]
C. At age 70 regardless of gender
D. Only if she has already sustained a fragility fracture
Correct Answer: B
Rationale: Current guidelines recommend DEXA screening for osteoporosis in women aged 65 years and older and in men
aged 70 years and older, regardless of additional risk factors. For postmenopausal women younger than 65 and men younger
than 70, screening should be considered based on clinical risk factor assessment using tools such as FRAX.
Q3: A 70-year-old male patient asks about prostate cancer screening. He has no family history of
prostate cancer and no symptoms. According to evidence-based guidelines, what is the
recommended approach?
A. Annual PSA screening starting at age 50
B. Shared decision-making for PSA screening between ages 55-69 [CORRECT]
C. PSA screening is no longer recommended at any age
D. PSA screening every 2 years starting at age 70
Correct Answer: B
Rationale: The USPSTF recommends individualized, shared decision-making regarding PSA-based screening for prostate
cancer in men aged 55 to 69 years. The decision should incorporate the patient's values and preferences regarding the
potential benefits (reduced prostate cancer mortality) and harms (false positives, overdiagnosis, and treatment
complications). Routine screening is not recommended for men 70 years and older.
Q4: A 78-year-old patient presents for a comprehensive geriatric assessment (CGA). Which of the
following components is NOT a standard part of a CGA?
, A. Functional status assessment using ADLs and IADLs
B. Nutritional status evaluation including BMI and weight history
C. Genetic screening for hereditary cancer syndromes [CORRECT]
D. Cognitive assessment using a validated screening tool
Correct Answer: C
Rationale: A comprehensive geriatric assessment includes functional assessment (ADLs and IADLs), cognitive screening,
nutritional evaluation, fall risk assessment, medication review, psychosocial evaluation, and advance care planning. Genetic
screening for hereditary cancer syndromes is not a standard component of the CGA and is reserved for patients with specific
risk factors or family histories warranting such evaluation.
Q5: A 66-year-old patient is due for immunization updates. Which of the following vaccinations is
recommended for this patient according to the ACIP 2026 schedule?
A. Zoster (Shingrix): single dose at age 60
B. PCV13 only for all adults over 65
C. Influenza vaccine annually regardless of age [CORRECT]
D. Tdap booster every 5 years after age 65
Correct Answer: C
Rationale: Annual influenza vaccination is recommended for all adults aged 6 months and older, including older adults,
because of their increased risk for complications from influenza. For adults aged 65 and older, both PCV15 (or PCV20) and
PPSV23 are recommended in sequence. The recombinant zoster vaccine (Shingrix) is recommended as a 2-dose series for
adults aged 50 years and older, and Tdap is recommended once followed by Td boosters every 10 years.
Q6: An 80-year-old female with a history of a fall in the past year is being evaluated. Which
screening tool is most appropriate for assessing her fall risk in the primary care setting?
A. Mini-Cog
B. Timed Up and Go (TUG) test [CORRECT]
C. PHQ-9
D. Charlson Comorbidity Index
Correct Answer: B
Rationale: The Timed Up and Go (TUG) test is a widely recommended, validated screening tool for assessing fall risk in
older adults in the primary care setting. It measures the time it takes for a patient to rise from a chair, walk 3 meters, turn,
walk back, and sit down. A time of 12 seconds or more indicates increased fall risk. The Mini-Cog assesses cognition, the
PHQ-9 screens for depression, and the Charlson Comorbidity Index estimates mortality risk.
Q7: A 62-year-old patient who has smoked one pack of cigarettes per day for 40 years is motivated
to quit. The nurse practitioner counsels that smoking cessation in older adults provides significant
benefits. Which statement is most accurate regarding smoking cessation benefits in this population?
A. Benefits are not seen until 5-10 years after cessation
B. Mortality and morbidity benefits are seen within months of quitting [CORRECT]
C. Smoking cessation after age 60 has minimal impact on health outcomes
D. Benefits are limited to respiratory improvements only
Correct Answer: B
Rationale: Smoking cessation provides the greatest single mortality and morbidity benefit for older adults, with benefits seen
within months of quitting. These benefits include improved respiratory function, reduced cardiovascular risk, decreased
cancer risk, and enhanced overall quality of life. Even older adults who have smoked for decades derive meaningful health
, improvements from cessation.
Q8: A 72-year-old woman wants to begin an exercise program but has been sedentary for several
years. What is the recommended approach to initiating physical activity in this patient?
A. Begin with high-intensity interval training 3 times per week
B. Start low and go slow; aim for 150 minutes of moderate-intensity activity per week [CORRECT]
C. Restrict activity to walking only, no more than 10 minutes per day
D. Delay exercise until a cardiac stress test is performed
Correct Answer: B
Rationale: The recommended approach for initiating physical activity in older adults is to start low and go slow, gradually
building toward a goal of at least 150 minutes per week of moderate-intensity aerobic activity, or 75 minutes of
vigorous-intensity activity. Muscle-strengthening activities involving all major muscle groups should be performed at least 2
days per week. Balance training is also recommended for older adults at risk for falls.
Q9: A 69-year-old female presents for her annual mammogram discussion. She has no personal
history of breast cancer and average risk. What is the current screening recommendation for this
patient?
A. Annual mammogram starting at age 40 and continuing indefinitely
B. Biennial mammogram for women aged 50-74 years [CORRECT]
C. Mammogram every 3 years after age 65
D. MRI screening is preferred over mammography in this age group
Correct Answer: B
Rationale: The USPSTF recommends biennial screening mammography for women aged 50 to 74 years. The decision to start
screening mammography in women aged 40 to 49 years should be an individual one, considering the patient's values and
preferences regarding the benefits and harms. For women aged 75 and older, current evidence is insufficient to assess the
balance of benefits and harms.
Q10: A 75-year-old patient who received the Tdap vaccine at age 64 presents for a routine visit.
Which vaccination should be administered today according to the current ACIP schedule?
A. Tdap booster
B. Td (tetanus, diphtheria) booster [CORRECT]
C. PCV13 only
D. No vaccinations are indicated at this visit
Correct Answer: B
Rationale: After the initial Tdap dose, adults should receive a Td booster every 10 years. Since this patient received Tdap at
age 64, she is now due for a Td booster at age 74. A single dose of Tdap is recommended for all adults, followed by Td
boosters every 10 years for ongoing protection against tetanus and diphtheria.
Q11: The nurse practitioner is performing a nutritional assessment on an 82-year-old patient who
has experienced unintentional weight loss of 10 pounds over the past 6 months. Which laboratory
study is most appropriate as the initial screening test for nutritional deficiency in this patient?
A. Serum prealbumin level [CORRECT]
B. Serum albumin level
C. Complete blood count
D. Serum ferritin only