NR601 MIDTERM EXAM WITH VERIFIED QUESTIONS WITH CORRECT
ANSWERS 2025/2026 NEWEST EXAM
SECTION 1: PHYSIOLOGICAL AGING & GERIATRIC ASSESSMENT (Questions 1-25)
Question 1: What are the three primary physiological changes of aging?
A) Decreased appetite, decreased mobility, and decreased cognition
B) Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological function
C) Increased blood pressure, increased cholesterol, and decreased bone density
D) Loss of hearing, loss of vision, and loss of taste
Correct Answer: B - 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 (increased infection risk and
more prevalent autoimmune diseases).
Question 2: Which one of the following is most true about the "rule of fourths"?
A) One-fourth of geriatric problems are iatrogenic
B) Little can be done to prevent three-fourths of the problems of aging
C) For every medical complaint a patient presents with, a careful assessment can identify three
other diagnoses
D) What used to be called normal aging can be largely explained by processes that are not
normal
Correct Answer: D - The "rule of fourths" suggests that what was traditionally attributed to
normal aging can often be explained by pathological processes that are not normal. This
concept emphasizes that many age-related changes are actually due to underlying disease
processes rather than inevitable aging.
Question 3: Geriatric assessments encompass four main domains. Which of the following
correctly lists these domains?
A) Cardiac, pulmonary, renal, and neurological
B) Mental, physical, functional, and social/economic
C) Psychological, emotional, behavioral, and cognitive
D) Preventive, curative, rehabilitative, and palliative
Correct Answer: B - The four main domains of geriatric assessment are mental, physical,
functional, and social/economic. This comprehensive approach ensures holistic evaluation of
the older adult patient.
Question 4: When should a geriatric assessment be performed?
A) Only when a patient is acutely ill
,B) When a patient is stable and at the time of the initial visit when the patient is establishing
care
C) Only annually after age 80
D) Only when a family member requests it
Correct Answer: B - A geriatric assessment should be performed when a patient is stable and at
the time of the initial visit when the patient is establishing care. This allows for baseline
documentation and comprehensive evaluation.
Question 5: The major impact of the physiological changes that occur with aging is:
A) Decreased cognitive function
B) Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological response
C) Increased susceptibility to fractures
D) Decreased appetite and nutritional status
Correct Answer: B - The major impact of physiological aging changes includes reduced
physiological reserve of most body systems, reduced homeostatic mechanisms that fail to adjust
regulatory systems, and impaired immunological function.
Question 6: The strongest evidence regarding normal physiological aging is available through:
A) Cross-sectional studies
B) Longitudinal studies
C) Case-control studies
D) Retrospective chart reviews
Correct Answer: B - Longitudinal studies provide the strongest evidence regarding normal
physiological aging because they follow the same individuals over time, allowing researchers to
distinguish between aging effects and cohort effects.
Question 7: Which statement about aging changes is most true?
A) Stage 3 and 4 sleep decreases
B) Renal perfusion is not reduced, but renal function is reduced
C) Hearing acuity declines beginning in middle age
D) Prostatic enlargement occurs only in a minority of men
Correct Answer: A - Stage 3 and 4 (deep) sleep decreases with aging. Older adults spend less
time in slow-wave sleep, which contributes to sleep fragmentation and complaints of poor sleep
quality.
Question 8: Which one of the following is most true about psychological aging?
A) Disengagement tends to promote better psychological health than continued engagement
B) Most older adults do not worry about memory loss
,C) Happiness declines starting in middle age
D) Ageism can lead to isolation and depression
Correct Answer: D - Ageism (discrimination or prejudice against individuals based on age) can
lead to social isolation and depression in older adults. This highlights the importance of
addressing societal attitudes toward aging.
Question 9: Biochemical individuality is best described as:
A) Each individual's lab values fall within the same range as the general population
B) Each individual's variation is often much smaller than that of a larger group
C) All individuals respond identically to medications
D) Genetic testing is required to determine biochemical status
Correct Answer: B - Biochemical individuality refers to the concept that each individual's
physiological and biochemical variation is often much smaller than that of a larger group. This
emphasizes the importance of personalized medicine and understanding each patient's unique
baseline.
Question 10: What is the preferred amount of exercise recommended for elderly adults?
A) 15 minutes of aerobic activity 3 days a week
B) 30 minutes of aerobic activity 5 days a week
C) 60 minutes of aerobic activity daily
D) No formal exercise; just activities of daily living
Correct Answer: B - The preferred amount of exercise for elderly adults is 30 minutes of
moderate aerobic activity per day, 5 days per week. If trying to lose weight, 60 minutes per day
is recommended.
Question 11: Exercise recommended for elderly should include activities that:
A) Only focus on cardiovascular fitness
B) Strengthen muscles
C) Are limited to walking only
D) Are performed in a group setting exclusively
Correct Answer: B - Exercise recommended for elderly should include activities that strengthen
muscles. A comprehensive exercise program for older adults should include aerobic, strength,
balance, and flexibility training.
Question 12: When recommending exercise for elderly patients, which piece of advice should
be considered for all types of exercise?
A) Exercise at maximum intensity immediately
B) Start low and go slow
C) Exercise only in the morning
D) Avoid any exercise that causes mild discomfort
, Correct Answer: B - "Start low and go slow" is the recommended approach for initiating
exercise in elderly patients. This minimizes the risk of injury and allows for gradual adaptation to
increased activity levels.
Question 13: All of the following statements are true about lab values in the elderly EXCEPT:
A) Lab values may vary from younger adult norms
B) Abnormal findings are often due to physiological aging
C) Age-related changes can affect laboratory results
D) Reference ranges may need to be adjusted for older adults
Correct Answer: B - Abnormal findings are often due to pathological processes rather than
physiological aging. While lab values may vary with age, significant abnormalities should be
investigated rather than attributed solely to aging.
Question 14: An older woman who is cared for by attentive, cautious, concerned family is
particularly likely to suffer from which complication after an episode of gastroenteritis?
A) Immobility related to overconcern
B) Continued vomiting caused by too-rapid feeding
C) Diarrhea resulting from administration of milk products
D) Constipation related to overtreatment of diarrhea
Correct Answer: A - Overly cautious and concerned family members may restrict activity out of
fear, leading to immobility and its associated complications (deconditioning, pressure ulcers,
thrombosis) after an acute illness like gastroenteritis.
Question 15: Which of the following medical conditions is NOT considered restrictive for
engaging in physical activity?
A) Severe heart failure
B) Unstable angina
C) Depression
D) Severe aortic stenosis
Correct Answer: C - Depression is not considered a restrictive condition for engaging in physical
activity. In fact, exercise is often recommended as part of depression treatment. Conditions like
severe heart failure, unstable angina, and severe aortic stenosis require medical clearance
before exercise.
Question 16: The aging process causes what normal physiological changes in the heart?
A) The heart valve becomes thinner and more pliable
B) The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis
C) The heart decreases in size
D) Cardiac output increases
ANSWERS 2025/2026 NEWEST EXAM
SECTION 1: PHYSIOLOGICAL AGING & GERIATRIC ASSESSMENT (Questions 1-25)
Question 1: What are the three primary physiological changes of aging?
A) Decreased appetite, decreased mobility, and decreased cognition
B) Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological function
C) Increased blood pressure, increased cholesterol, and decreased bone density
D) Loss of hearing, loss of vision, and loss of taste
Correct Answer: B - 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 (increased infection risk and
more prevalent autoimmune diseases).
Question 2: Which one of the following is most true about the "rule of fourths"?
A) One-fourth of geriatric problems are iatrogenic
B) Little can be done to prevent three-fourths of the problems of aging
C) For every medical complaint a patient presents with, a careful assessment can identify three
other diagnoses
D) What used to be called normal aging can be largely explained by processes that are not
normal
Correct Answer: D - The "rule of fourths" suggests that what was traditionally attributed to
normal aging can often be explained by pathological processes that are not normal. This
concept emphasizes that many age-related changes are actually due to underlying disease
processes rather than inevitable aging.
Question 3: Geriatric assessments encompass four main domains. Which of the following
correctly lists these domains?
A) Cardiac, pulmonary, renal, and neurological
B) Mental, physical, functional, and social/economic
C) Psychological, emotional, behavioral, and cognitive
D) Preventive, curative, rehabilitative, and palliative
Correct Answer: B - The four main domains of geriatric assessment are mental, physical,
functional, and social/economic. This comprehensive approach ensures holistic evaluation of
the older adult patient.
Question 4: When should a geriatric assessment be performed?
A) Only when a patient is acutely ill
,B) When a patient is stable and at the time of the initial visit when the patient is establishing
care
C) Only annually after age 80
D) Only when a family member requests it
Correct Answer: B - A geriatric assessment should be performed when a patient is stable and at
the time of the initial visit when the patient is establishing care. This allows for baseline
documentation and comprehensive evaluation.
Question 5: The major impact of the physiological changes that occur with aging is:
A) Decreased cognitive function
B) Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological response
C) Increased susceptibility to fractures
D) Decreased appetite and nutritional status
Correct Answer: B - The major impact of physiological aging changes includes reduced
physiological reserve of most body systems, reduced homeostatic mechanisms that fail to adjust
regulatory systems, and impaired immunological function.
Question 6: The strongest evidence regarding normal physiological aging is available through:
A) Cross-sectional studies
B) Longitudinal studies
C) Case-control studies
D) Retrospective chart reviews
Correct Answer: B - Longitudinal studies provide the strongest evidence regarding normal
physiological aging because they follow the same individuals over time, allowing researchers to
distinguish between aging effects and cohort effects.
Question 7: Which statement about aging changes is most true?
A) Stage 3 and 4 sleep decreases
B) Renal perfusion is not reduced, but renal function is reduced
C) Hearing acuity declines beginning in middle age
D) Prostatic enlargement occurs only in a minority of men
Correct Answer: A - Stage 3 and 4 (deep) sleep decreases with aging. Older adults spend less
time in slow-wave sleep, which contributes to sleep fragmentation and complaints of poor sleep
quality.
Question 8: Which one of the following is most true about psychological aging?
A) Disengagement tends to promote better psychological health than continued engagement
B) Most older adults do not worry about memory loss
,C) Happiness declines starting in middle age
D) Ageism can lead to isolation and depression
Correct Answer: D - Ageism (discrimination or prejudice against individuals based on age) can
lead to social isolation and depression in older adults. This highlights the importance of
addressing societal attitudes toward aging.
Question 9: Biochemical individuality is best described as:
A) Each individual's lab values fall within the same range as the general population
B) Each individual's variation is often much smaller than that of a larger group
C) All individuals respond identically to medications
D) Genetic testing is required to determine biochemical status
Correct Answer: B - Biochemical individuality refers to the concept that each individual's
physiological and biochemical variation is often much smaller than that of a larger group. This
emphasizes the importance of personalized medicine and understanding each patient's unique
baseline.
Question 10: What is the preferred amount of exercise recommended for elderly adults?
A) 15 minutes of aerobic activity 3 days a week
B) 30 minutes of aerobic activity 5 days a week
C) 60 minutes of aerobic activity daily
D) No formal exercise; just activities of daily living
Correct Answer: B - The preferred amount of exercise for elderly adults is 30 minutes of
moderate aerobic activity per day, 5 days per week. If trying to lose weight, 60 minutes per day
is recommended.
Question 11: Exercise recommended for elderly should include activities that:
A) Only focus on cardiovascular fitness
B) Strengthen muscles
C) Are limited to walking only
D) Are performed in a group setting exclusively
Correct Answer: B - Exercise recommended for elderly should include activities that strengthen
muscles. A comprehensive exercise program for older adults should include aerobic, strength,
balance, and flexibility training.
Question 12: When recommending exercise for elderly patients, which piece of advice should
be considered for all types of exercise?
A) Exercise at maximum intensity immediately
B) Start low and go slow
C) Exercise only in the morning
D) Avoid any exercise that causes mild discomfort
, Correct Answer: B - "Start low and go slow" is the recommended approach for initiating
exercise in elderly patients. This minimizes the risk of injury and allows for gradual adaptation to
increased activity levels.
Question 13: All of the following statements are true about lab values in the elderly EXCEPT:
A) Lab values may vary from younger adult norms
B) Abnormal findings are often due to physiological aging
C) Age-related changes can affect laboratory results
D) Reference ranges may need to be adjusted for older adults
Correct Answer: B - Abnormal findings are often due to pathological processes rather than
physiological aging. While lab values may vary with age, significant abnormalities should be
investigated rather than attributed solely to aging.
Question 14: An older woman who is cared for by attentive, cautious, concerned family is
particularly likely to suffer from which complication after an episode of gastroenteritis?
A) Immobility related to overconcern
B) Continued vomiting caused by too-rapid feeding
C) Diarrhea resulting from administration of milk products
D) Constipation related to overtreatment of diarrhea
Correct Answer: A - Overly cautious and concerned family members may restrict activity out of
fear, leading to immobility and its associated complications (deconditioning, pressure ulcers,
thrombosis) after an acute illness like gastroenteritis.
Question 15: Which of the following medical conditions is NOT considered restrictive for
engaging in physical activity?
A) Severe heart failure
B) Unstable angina
C) Depression
D) Severe aortic stenosis
Correct Answer: C - Depression is not considered a restrictive condition for engaging in physical
activity. In fact, exercise is often recommended as part of depression treatment. Conditions like
severe heart failure, unstable angina, and severe aortic stenosis require medical clearance
before exercise.
Question 16: The aging process causes what normal physiological changes in the heart?
A) The heart valve becomes thinner and more pliable
B) The heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis
C) The heart decreases in size
D) Cardiac output increases
