NR601 / NR 601 FINAL EXAM QS & ANS (LATEST
) : PRIMARY CARE OF THE MATURING
& AGED FAMILY PRACTICUM (VERIFIED
ANSWERS)
Primary Care of the Maturing & Aged Adult — Practice Exam
100 Questions with Answers and Rationales
A general geriatric primary care review covering physiologic aging,
pharmacology, cognitive disorders, falls, sensory and genitourinary issues,
cardiometabolic disease, nutrition/skin, palliative care, and health promotion. This
is an original study resource, not affiliated with or reproducing any specific
university course exam.
Table of Contents
Section Topic Questions
1 Physiologic Changes of Aging 1–10
2 Pharmacology & Polypharmacy 11–20
3 Cognitive Disorders: Dementia, Delirium & Depression 21–30
4 Falls, Mobility & Frailty 31–40
5 Sensory Impairment (Vision & Hearing) 41–50
6 Urinary Incontinence & Genitourinary Issues 51–60
7 Cardiovascular & Metabolic Conditions 61–70
8 Nutrition, GI, and Skin Issues 71–80
9 Palliative Care, End-of-Life & Ethical/Legal Issues 81–90
10 Health Promotion, Screening, Elder Abuse & Social Issues 91–100
,Section 1: Physiologic Changes of Aging
1. Which renal change is expected with normal aging? A) Increased glomerular filtration rate
B) Decreased renal mass and nephron number C) Increased renal blood flow D) Enhanced ability
to concentrate urine
Answer: B Rationale: Aging is associated with a progressive loss of nephrons and reduced renal
mass, leading to a gradual decline in GFR (roughly 1 mL/min/1.73m² per year after age 40) and a
reduced ability to concentrate urine, making older adults more prone to dehydration and drug
accumulation.
2. Age-related changes in the cardiovascular system typically include: A) Increased arterial
compliance B) Left ventricular wall thinning C) Increased arterial stiffness and afterload D)
Decreased sensitivity to catecholamines
Answer: C Rationale: Arteries stiffen with age due to collagen cross-linking and loss of elastin,
increasing systemic vascular resistance and afterload. This contributes to isolated systolic
hypertension and left ventricular hypertrophy, not thinning.
3. Which pulmonary change is normal with aging? A) Increased chest wall compliance B)
Decreased residual volume C) Decreased forced expiratory volume and vital capacity D)
Increased alveolar surface area
Answer: C Rationale: Loss of elastic recoil, respiratory muscle weakening, and chest wall
stiffening reduce vital capacity and FEV1 with age, while residual volume increases — the
opposite of options A, B, and D.
4. Total body water and lean muscle mass with aging typically: A) Increase B) Remain
unchanged C) Decrease, while fat mass proportionally increases D) Decrease equally with fat
mass
Answer: C Rationale: Sarcopenia and decreased total body water occur with aging, while fat
mass proportionally increases even if total weight stays stable. This changes the volume of
distribution for hydrophilic and lipophilic drugs.
5. Which best describes age-related change in hepatic drug metabolism? A) Increased
hepatic blood flow and liver mass B) Decreased hepatic blood flow, mass, and Phase I
metabolism C) No change in first-pass metabolism D) Enhanced Phase II conjugation reactions
Answer: B Rationale: Liver mass and hepatic blood flow decline with age, reducing Phase I
(oxidative) metabolism and first-pass effect; Phase II (conjugation) reactions are relatively
preserved.
6. Presbycusis refers to: A) Age-related farsightedness B) Age-related high-frequency
sensorineural hearing loss C) Age-related loss of taste D) Age-related joint stiffness
, Answer: B Rationale: Presbycusis is the gradual, bilateral, high-frequency sensorineural
hearing loss associated with aging, caused by degeneration of cochlear hair cells and the auditory
nerve.
7. Immune system changes with aging (immunosenescence) result in: A) Improved response
to vaccines B) Decreased inflammation C) Blunted response to new antigens and increased
susceptibility to infection D) Increased T-cell production by the thymus
Answer: C Rationale: Immunosenescence involves thymic involution and reduced naïve T-cell
output, leading to a weaker response to new antigens/vaccines and increased vulnerability to
infection, alongside chronic low-grade inflammation ("inflammaging").
8. Which is a normal age-related musculoskeletal change? A) Increased bone density B)
Increased cartilage thickness C) Decreased bone density and muscle mass (sarcopenia) D)
Increased joint synovial fluid
Answer: C Rationale: Bone remodeling favors resorption over formation with age, leading to
decreased bone density, while sarcopenia describes progressive age-related loss of muscle mass
and strength.
9. Thermoregulation in older adults is often impaired due to: A) Increased sweat gland
activity B) Enhanced peripheral vasoconstriction C) Diminished sweat response and altered
vasomotor response D) Increased subcutaneous fat improving insulation
Answer: C Rationale: Reduced sweat gland function and blunted vasomotor responses impair
the ability to dissipate or conserve heat, increasing risk for both hyperthermia and hypothermia.
10. Which statement about gastrointestinal aging is accurate? A) Gastric acid production
typically increases B) Colonic transit time speeds up C) Esophageal motility and gastric
emptying may slow, and atrophic gastritis is more common D) Liver size increases significantly
Answer: C Rationale: Aging is associated with slower esophageal motility, delayed gastric
emptying, and a higher prevalence of atrophic gastritis, which can reduce B12 and iron
absorption; colonic transit tends to slow, not speed up.
Section 2: Pharmacology & Polypharmacy
11. The Beers Criteria are used to: A) Calculate creatinine clearance B) Identify potentially
inappropriate medications in older adults C) Screen for cognitive impairment D) Assess fall risk
Answer: B Rationale: The American Geriatrics Society Beers Criteria list medications that are
potentially inappropriate for older adults due to higher risk of adverse effects relative to benefit,
guiding safer prescribing.
) : PRIMARY CARE OF THE MATURING
& AGED FAMILY PRACTICUM (VERIFIED
ANSWERS)
Primary Care of the Maturing & Aged Adult — Practice Exam
100 Questions with Answers and Rationales
A general geriatric primary care review covering physiologic aging,
pharmacology, cognitive disorders, falls, sensory and genitourinary issues,
cardiometabolic disease, nutrition/skin, palliative care, and health promotion. This
is an original study resource, not affiliated with or reproducing any specific
university course exam.
Table of Contents
Section Topic Questions
1 Physiologic Changes of Aging 1–10
2 Pharmacology & Polypharmacy 11–20
3 Cognitive Disorders: Dementia, Delirium & Depression 21–30
4 Falls, Mobility & Frailty 31–40
5 Sensory Impairment (Vision & Hearing) 41–50
6 Urinary Incontinence & Genitourinary Issues 51–60
7 Cardiovascular & Metabolic Conditions 61–70
8 Nutrition, GI, and Skin Issues 71–80
9 Palliative Care, End-of-Life & Ethical/Legal Issues 81–90
10 Health Promotion, Screening, Elder Abuse & Social Issues 91–100
,Section 1: Physiologic Changes of Aging
1. Which renal change is expected with normal aging? A) Increased glomerular filtration rate
B) Decreased renal mass and nephron number C) Increased renal blood flow D) Enhanced ability
to concentrate urine
Answer: B Rationale: Aging is associated with a progressive loss of nephrons and reduced renal
mass, leading to a gradual decline in GFR (roughly 1 mL/min/1.73m² per year after age 40) and a
reduced ability to concentrate urine, making older adults more prone to dehydration and drug
accumulation.
2. Age-related changes in the cardiovascular system typically include: A) Increased arterial
compliance B) Left ventricular wall thinning C) Increased arterial stiffness and afterload D)
Decreased sensitivity to catecholamines
Answer: C Rationale: Arteries stiffen with age due to collagen cross-linking and loss of elastin,
increasing systemic vascular resistance and afterload. This contributes to isolated systolic
hypertension and left ventricular hypertrophy, not thinning.
3. Which pulmonary change is normal with aging? A) Increased chest wall compliance B)
Decreased residual volume C) Decreased forced expiratory volume and vital capacity D)
Increased alveolar surface area
Answer: C Rationale: Loss of elastic recoil, respiratory muscle weakening, and chest wall
stiffening reduce vital capacity and FEV1 with age, while residual volume increases — the
opposite of options A, B, and D.
4. Total body water and lean muscle mass with aging typically: A) Increase B) Remain
unchanged C) Decrease, while fat mass proportionally increases D) Decrease equally with fat
mass
Answer: C Rationale: Sarcopenia and decreased total body water occur with aging, while fat
mass proportionally increases even if total weight stays stable. This changes the volume of
distribution for hydrophilic and lipophilic drugs.
5. Which best describes age-related change in hepatic drug metabolism? A) Increased
hepatic blood flow and liver mass B) Decreased hepatic blood flow, mass, and Phase I
metabolism C) No change in first-pass metabolism D) Enhanced Phase II conjugation reactions
Answer: B Rationale: Liver mass and hepatic blood flow decline with age, reducing Phase I
(oxidative) metabolism and first-pass effect; Phase II (conjugation) reactions are relatively
preserved.
6. Presbycusis refers to: A) Age-related farsightedness B) Age-related high-frequency
sensorineural hearing loss C) Age-related loss of taste D) Age-related joint stiffness
, Answer: B Rationale: Presbycusis is the gradual, bilateral, high-frequency sensorineural
hearing loss associated with aging, caused by degeneration of cochlear hair cells and the auditory
nerve.
7. Immune system changes with aging (immunosenescence) result in: A) Improved response
to vaccines B) Decreased inflammation C) Blunted response to new antigens and increased
susceptibility to infection D) Increased T-cell production by the thymus
Answer: C Rationale: Immunosenescence involves thymic involution and reduced naïve T-cell
output, leading to a weaker response to new antigens/vaccines and increased vulnerability to
infection, alongside chronic low-grade inflammation ("inflammaging").
8. Which is a normal age-related musculoskeletal change? A) Increased bone density B)
Increased cartilage thickness C) Decreased bone density and muscle mass (sarcopenia) D)
Increased joint synovial fluid
Answer: C Rationale: Bone remodeling favors resorption over formation with age, leading to
decreased bone density, while sarcopenia describes progressive age-related loss of muscle mass
and strength.
9. Thermoregulation in older adults is often impaired due to: A) Increased sweat gland
activity B) Enhanced peripheral vasoconstriction C) Diminished sweat response and altered
vasomotor response D) Increased subcutaneous fat improving insulation
Answer: C Rationale: Reduced sweat gland function and blunted vasomotor responses impair
the ability to dissipate or conserve heat, increasing risk for both hyperthermia and hypothermia.
10. Which statement about gastrointestinal aging is accurate? A) Gastric acid production
typically increases B) Colonic transit time speeds up C) Esophageal motility and gastric
emptying may slow, and atrophic gastritis is more common D) Liver size increases significantly
Answer: C Rationale: Aging is associated with slower esophageal motility, delayed gastric
emptying, and a higher prevalence of atrophic gastritis, which can reduce B12 and iron
absorption; colonic transit tends to slow, not speed up.
Section 2: Pharmacology & Polypharmacy
11. The Beers Criteria are used to: A) Calculate creatinine clearance B) Identify potentially
inappropriate medications in older adults C) Screen for cognitive impairment D) Assess fall risk
Answer: B Rationale: The American Geriatrics Society Beers Criteria list medications that are
potentially inappropriate for older adults due to higher risk of adverse effects relative to benefit,
guiding safer prescribing.
