NR 601 Week 1–4 Study Guide Primary Care of
the Maturing and Aged Family Questions with
Answers and Rationales
Exam Coverage Content Areas:
• Week 1: The Maturing Adult Client (Foundations of Aging, Comprehensive
Geriatric Assessment, Beers Criteria)
• Week 2: Coronary and Peripheral Vascular Disease
• Week 3: Cardiac Arrhythmias and Valvular Disorders
• Week 4: Respiratory Disorders
SECTION I: WEEK 1 – THE MATURING ADULT CLIENT (Questions 1–
30)
1. According to Erikson's developmental theory, the primary developmental
task of late adulthood is:
A. Generativity vs. stagnation
B. Industry vs. inferiority
C. Ego integrity vs. despair
D. Intimacy vs. isolation
Rationale: Erikson's theory identifies ego integrity vs. despair as the
developmental task of late adulthood.During this stage, individuals reflect on their
lives. Successful resolution leads to satisfaction and fulfillment, while unsuccessful
resolution may result in depression, loneliness, or withdrawal.
2. Which of the following is a normal physiological change associated with
aging?
A. Increased glomerular filtration rate
B. Increased renal blood flow
,C. Increased brain weight
D. Decreased adaptation to light and dark
Rationale: Normal age-related changes include decreased visual acuity and
decreased adaptation to light/dark.The aging kidney demonstrates decreased GFR
and renal blood flow, and brain weight decreases with age.
3. A 79-year-old male scores 6/30 on the PHQ-9 and 22/30 on the MoCA. He
reports fatigue and poor appetite for 2 months with no acute confusion. What
is the most likely diagnosis?
A. Delirium
B. Major depressive disorder
C. Mild cognitive impairment (MCI)
D. Normal aging
Rationale: A MoCA score of 18–25 suggests mild cognitive impairment (MCI)
with objective cognitive deficit without significant functional loss.A PHQ-9 score
of 6 indicates mild depressive symptoms, not major depressive disorder. Delirium
is characterized by acute onset and fluctuating course.
4. Which of the following is NOT one of the 5 Ms of geriatric care?
A. Mind
B. Mobility
C. Medications
D. Metabolism
Rationale: The 5 Ms of geriatric care are Mind, Mobility, Medications,
Multicomplexity, and Matters Most."Metabolism" is not one of the 5 Ms. This
framework provides a patient-centered approach to caring for older adults.
5. Which assessment tool is best for evaluating fall risk related to gait and
balance in an older adult?
A. Katz Index of Independence in Activities of Daily Living
B. Lawton Instrumental Activities of Daily Living Scale
,C. Timed Up and Go (TUG) test
D. Mini-Cog
Rationale: The Timed Up and Go (TUG) test assesses gait and balance.A TUG
time > 12 seconds indicates increased fall risk. The Katz ADL assesses basic self-
care, the Lawton IADL assesses more complex daily activities, and the Mini-Cog
assesses cognitive function.
6. A comprehensive geriatric assessment (CGA) includes evaluation of which
of the following domains?
A. Physical health only
B. Cognitive function only
C. Physical, cognitive, functional, social, and environmental domains
D. Financial status only
Rationale: A comprehensive geriatric assessment is a multidimensional process
designed to assess functional ability, physical health, cognitive and mental health,
social support, financial status, and environmental factors.
7. According to the Rule of Fourths, functional decline in older adults can be
attributed to all of the following EXCEPT:
A. Disease
B. Disuse
C. Misuse
D. Genetics
Rationale: The Rule of Fourths attributes functional decline to four causes:
disease, disuse, misuse, and physiologic aging.Genetics is not one of the four
categories in this framework.
8. The Error Theory of aging suggests that:
A. Aging results from a programmed reduction in nervous system function
B. Aging results from cumulative mistakes in DNA and RNA over time
, C. Aging results from the accumulation of free radicals
D. Aging results from telomere shortening
Rationale: The Error Theory suggests that aging results from cumulative mistakes
in DNA and RNA over time, which impair cell function.The Free Radical Theory
involves accumulation of free radicals, and the Neuroendocrine Theory involves
programmed reduction in nervous, immune, and endocrine system function.
9. A patient with urinary incontinence reports leakage with coughing,
sneezing, and laughing. This is best described as:
A. Urge incontinence
B. Stress incontinence
C. Overflow incontinence
D. Functional incontinence
Rationale: Stress incontinence is characterized by leakage with activities that
increase intra-abdominal pressure (coughing, sneezing, laughing, exercise).Urge
incontinence involves leakage with a sudden, strong urge to void.
10. Which of the following is the first-line behavioral treatment for urge
incontinence?
A. Timed voiding every 2 hours
B. Kegel exercises 3 times daily
C. Bladder training with scheduled voiding
D. Decrease fluid intake after 6 PM
Rationale: Bladder training with scheduled voiding, combined with pelvic floor
muscle exercises (Kegel exercises), is first-line behavioral treatment for urge
incontinence.Fluid restriction may worsen dehydration and is not recommended as
a primary intervention.
11. According to the Beers Criteria, which of the following medications is
potentially inappropriate in older adults?
the Maturing and Aged Family Questions with
Answers and Rationales
Exam Coverage Content Areas:
• Week 1: The Maturing Adult Client (Foundations of Aging, Comprehensive
Geriatric Assessment, Beers Criteria)
• Week 2: Coronary and Peripheral Vascular Disease
• Week 3: Cardiac Arrhythmias and Valvular Disorders
• Week 4: Respiratory Disorders
SECTION I: WEEK 1 – THE MATURING ADULT CLIENT (Questions 1–
30)
1. According to Erikson's developmental theory, the primary developmental
task of late adulthood is:
A. Generativity vs. stagnation
B. Industry vs. inferiority
C. Ego integrity vs. despair
D. Intimacy vs. isolation
Rationale: Erikson's theory identifies ego integrity vs. despair as the
developmental task of late adulthood.During this stage, individuals reflect on their
lives. Successful resolution leads to satisfaction and fulfillment, while unsuccessful
resolution may result in depression, loneliness, or withdrawal.
2. Which of the following is a normal physiological change associated with
aging?
A. Increased glomerular filtration rate
B. Increased renal blood flow
,C. Increased brain weight
D. Decreased adaptation to light and dark
Rationale: Normal age-related changes include decreased visual acuity and
decreased adaptation to light/dark.The aging kidney demonstrates decreased GFR
and renal blood flow, and brain weight decreases with age.
3. A 79-year-old male scores 6/30 on the PHQ-9 and 22/30 on the MoCA. He
reports fatigue and poor appetite for 2 months with no acute confusion. What
is the most likely diagnosis?
A. Delirium
B. Major depressive disorder
C. Mild cognitive impairment (MCI)
D. Normal aging
Rationale: A MoCA score of 18–25 suggests mild cognitive impairment (MCI)
with objective cognitive deficit without significant functional loss.A PHQ-9 score
of 6 indicates mild depressive symptoms, not major depressive disorder. Delirium
is characterized by acute onset and fluctuating course.
4. Which of the following is NOT one of the 5 Ms of geriatric care?
A. Mind
B. Mobility
C. Medications
D. Metabolism
Rationale: The 5 Ms of geriatric care are Mind, Mobility, Medications,
Multicomplexity, and Matters Most."Metabolism" is not one of the 5 Ms. This
framework provides a patient-centered approach to caring for older adults.
5. Which assessment tool is best for evaluating fall risk related to gait and
balance in an older adult?
A. Katz Index of Independence in Activities of Daily Living
B. Lawton Instrumental Activities of Daily Living Scale
,C. Timed Up and Go (TUG) test
D. Mini-Cog
Rationale: The Timed Up and Go (TUG) test assesses gait and balance.A TUG
time > 12 seconds indicates increased fall risk. The Katz ADL assesses basic self-
care, the Lawton IADL assesses more complex daily activities, and the Mini-Cog
assesses cognitive function.
6. A comprehensive geriatric assessment (CGA) includes evaluation of which
of the following domains?
A. Physical health only
B. Cognitive function only
C. Physical, cognitive, functional, social, and environmental domains
D. Financial status only
Rationale: A comprehensive geriatric assessment is a multidimensional process
designed to assess functional ability, physical health, cognitive and mental health,
social support, financial status, and environmental factors.
7. According to the Rule of Fourths, functional decline in older adults can be
attributed to all of the following EXCEPT:
A. Disease
B. Disuse
C. Misuse
D. Genetics
Rationale: The Rule of Fourths attributes functional decline to four causes:
disease, disuse, misuse, and physiologic aging.Genetics is not one of the four
categories in this framework.
8. The Error Theory of aging suggests that:
A. Aging results from a programmed reduction in nervous system function
B. Aging results from cumulative mistakes in DNA and RNA over time
, C. Aging results from the accumulation of free radicals
D. Aging results from telomere shortening
Rationale: The Error Theory suggests that aging results from cumulative mistakes
in DNA and RNA over time, which impair cell function.The Free Radical Theory
involves accumulation of free radicals, and the Neuroendocrine Theory involves
programmed reduction in nervous, immune, and endocrine system function.
9. A patient with urinary incontinence reports leakage with coughing,
sneezing, and laughing. This is best described as:
A. Urge incontinence
B. Stress incontinence
C. Overflow incontinence
D. Functional incontinence
Rationale: Stress incontinence is characterized by leakage with activities that
increase intra-abdominal pressure (coughing, sneezing, laughing, exercise).Urge
incontinence involves leakage with a sudden, strong urge to void.
10. Which of the following is the first-line behavioral treatment for urge
incontinence?
A. Timed voiding every 2 hours
B. Kegel exercises 3 times daily
C. Bladder training with scheduled voiding
D. Decrease fluid intake after 6 PM
Rationale: Bladder training with scheduled voiding, combined with pelvic floor
muscle exercises (Kegel exercises), is first-line behavioral treatment for urge
incontinence.Fluid restriction may worsen dehydration and is not recommended as
a primary intervention.
11. According to the Beers Criteria, which of the following medications is
potentially inappropriate in older adults?
