NR 601 PRIMARY CARE OF THE MATURING AND AGED FAMILY CHAMBERLAIN
UNIVERSITY QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES
Course
Family nurse practitioner
Question 1
A 68-year-old man presents for an annual wellness visit. Which screening is recommended for all
adults aged 65 years and older?
A. Abdominal ultrasound for all adults
B. Osteoporosis screening in women only
C. Annual fall risk assessment
D. Annual ECG
Answer: C. Annual fall risk assessment
Rationale:
Adults ≥65 years should undergo annual assessment for fall risk, including questions about
previous falls, gait, balance, and medications. Abdominal aortic aneurysm screening is
recommended only for certain high-risk individuals, not everyone.
Question 2
Which blood pressure goal is generally recommended for most community-dwelling adults aged
65 years and older?
A. <160/100 mmHg
B. <150/90 mmHg for everyone
C. <130/80 mmHg when tolerated
D. <110/70 mmHg
Answer: C. <130/80 mmHg when tolerated
Rationale:
Current hypertension guidelines generally recommend a BP target of <130/80 mmHg for most
older adults if treatment is well tolerated, while individualizing goals based on frailty and
comorbidities.
Question 3
,A 72-year-old woman reports urinary leakage when coughing or sneezing. Which type of urinary
incontinence is most likely?
A. Overflow
B. Stress
C. Functional
D. Urge
Answer: B. Stress
Rationale:
Stress incontinence occurs with increased intra-abdominal pressure, such as coughing, laughing,
or lifting, due to pelvic floor weakness or urethral sphincter insufficiency.
Question 4
Which medication is included in the Beers Criteria as potentially inappropriate for many older
adults due to increased risk of falls and cognitive impairment?
A. Acetaminophen
B. Lorazepam
C. Lisinopril
D. Metformin
Answer: B. Lorazepam
Rationale:
Benzodiazepines increase the risk of falls, delirium, sedation, and cognitive impairment in older
adults and should generally be avoided unless clinically necessary.
Question 5
Which laboratory test is most appropriate to evaluate newly diagnosed hypothyroidism in an
older adult?
A. TSH
B. CK-MB
C. Troponin
,D. BNP
Answer: A. TSH
Rationale:
Thyroid-stimulating hormone (TSH) is the preferred initial screening test for thyroid
dysfunction.
Question 6
An older adult suddenly develops confusion over several hours after hospitalization. Which
diagnosis is most likely?
A. Dementia
B. Depression
C. Delirium
D. Mild cognitive impairment
Answer: C. Delirium
Rationale:
Delirium has an acute onset, fluctuating course, altered attention, and is often triggered by
illness, medications, infection, or hospitalization.
Question 7
Which vaccine is routinely recommended for adults aged 65 years and older?
A. Rotavirus
B. Pneumococcal vaccine
C. Hib vaccine
D. Varicella vaccine
Answer: B. Pneumococcal vaccine
Rationale:
Adults ≥65 years should receive pneumococcal vaccination according to current CDC
recommendations based on vaccine history and risk factors.
, Question 8
A Mini-Cog score indicating cognitive impairment should prompt:
A. Immediate diagnosis of Alzheimer's disease
B. Further cognitive evaluation
C. Psychiatric hospitalization
D. No additional assessment
Answer: B. Further cognitive evaluation
Rationale:
The Mini-Cog is a screening tool and does not establish a diagnosis. Abnormal results require
additional cognitive assessment.
Question 9
Which finding is a normal age-related cardiovascular change?
A. Increased maximum heart rate
B. Increased arterial stiffness
C. Increased cardiac output
D. Increased ventricular compliance
Answer: B. Increased arterial stiffness
Rationale:
Normal aging causes arterial stiffening, contributing to isolated systolic hypertension.
Question 10
The best initial treatment for uncomplicated hypertension in an older adult with diabetes
includes:
A. Lifestyle modification plus antihypertensive therapy when indicated
B. Bed rest
C. Sodium supplementation
D. Daily aspirin only
UNIVERSITY QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
RATIONALES
Course
Family nurse practitioner
Question 1
A 68-year-old man presents for an annual wellness visit. Which screening is recommended for all
adults aged 65 years and older?
A. Abdominal ultrasound for all adults
B. Osteoporosis screening in women only
C. Annual fall risk assessment
D. Annual ECG
Answer: C. Annual fall risk assessment
Rationale:
Adults ≥65 years should undergo annual assessment for fall risk, including questions about
previous falls, gait, balance, and medications. Abdominal aortic aneurysm screening is
recommended only for certain high-risk individuals, not everyone.
Question 2
Which blood pressure goal is generally recommended for most community-dwelling adults aged
65 years and older?
A. <160/100 mmHg
B. <150/90 mmHg for everyone
C. <130/80 mmHg when tolerated
D. <110/70 mmHg
Answer: C. <130/80 mmHg when tolerated
Rationale:
Current hypertension guidelines generally recommend a BP target of <130/80 mmHg for most
older adults if treatment is well tolerated, while individualizing goals based on frailty and
comorbidities.
Question 3
,A 72-year-old woman reports urinary leakage when coughing or sneezing. Which type of urinary
incontinence is most likely?
A. Overflow
B. Stress
C. Functional
D. Urge
Answer: B. Stress
Rationale:
Stress incontinence occurs with increased intra-abdominal pressure, such as coughing, laughing,
or lifting, due to pelvic floor weakness or urethral sphincter insufficiency.
Question 4
Which medication is included in the Beers Criteria as potentially inappropriate for many older
adults due to increased risk of falls and cognitive impairment?
A. Acetaminophen
B. Lorazepam
C. Lisinopril
D. Metformin
Answer: B. Lorazepam
Rationale:
Benzodiazepines increase the risk of falls, delirium, sedation, and cognitive impairment in older
adults and should generally be avoided unless clinically necessary.
Question 5
Which laboratory test is most appropriate to evaluate newly diagnosed hypothyroidism in an
older adult?
A. TSH
B. CK-MB
C. Troponin
,D. BNP
Answer: A. TSH
Rationale:
Thyroid-stimulating hormone (TSH) is the preferred initial screening test for thyroid
dysfunction.
Question 6
An older adult suddenly develops confusion over several hours after hospitalization. Which
diagnosis is most likely?
A. Dementia
B. Depression
C. Delirium
D. Mild cognitive impairment
Answer: C. Delirium
Rationale:
Delirium has an acute onset, fluctuating course, altered attention, and is often triggered by
illness, medications, infection, or hospitalization.
Question 7
Which vaccine is routinely recommended for adults aged 65 years and older?
A. Rotavirus
B. Pneumococcal vaccine
C. Hib vaccine
D. Varicella vaccine
Answer: B. Pneumococcal vaccine
Rationale:
Adults ≥65 years should receive pneumococcal vaccination according to current CDC
recommendations based on vaccine history and risk factors.
, Question 8
A Mini-Cog score indicating cognitive impairment should prompt:
A. Immediate diagnosis of Alzheimer's disease
B. Further cognitive evaluation
C. Psychiatric hospitalization
D. No additional assessment
Answer: B. Further cognitive evaluation
Rationale:
The Mini-Cog is a screening tool and does not establish a diagnosis. Abnormal results require
additional cognitive assessment.
Question 9
Which finding is a normal age-related cardiovascular change?
A. Increased maximum heart rate
B. Increased arterial stiffness
C. Increased cardiac output
D. Increased ventricular compliance
Answer: B. Increased arterial stiffness
Rationale:
Normal aging causes arterial stiffening, contributing to isolated systolic hypertension.
Question 10
The best initial treatment for uncomplicated hypertension in an older adult with diabetes
includes:
A. Lifestyle modification plus antihypertensive therapy when indicated
B. Bed rest
C. Sodium supplementation
D. Daily aspirin only
