NRNP 6531 MIDTERM PRACTICE 2026/2027 EXAM VERIFIED WITH CORRECT
ANSWERS PLUS RATIONALES
1.Which approach is most appropriate when performing a comprehensive health
assessment of an adult patient?
A. Focus only on the patient's chief complaint
B. Combine history, physical examination, preventive screening, and risk assessment
C. Perform laboratory testing before obtaining a history
D. Focus only on chronic diseases
Correct Answer: B
Rationale: A comprehensive assessment integrates the patient's history, physical examination,
health risks, preventive needs, medications, psychosocial factors, and relevant screening.
2.A 68-year-old patient reports several new medications from different providers. What
should the nurse practitioner prioritize?
A. Medication reconciliation
B. Discontinuing all medications
C. Increasing medication doses
D. Reviewing only prescription medications
Correct Answer: A
Rationale: Medication reconciliation identifies duplicate therapies, interactions, omissions, and
potentially inappropriate medications.
3.What is an important component of an older adult's functional assessment?
A. Ability to perform activities of daily living
B. Hair color
C. Blood type
D. Eye color
Correct Answer: A
Rationale: Functional assessment evaluates independence with activities of daily living (ADLs)
and instrumental activities of daily living (IADLs).
4.Which finding should raise concern for possible cognitive impairment in an older adult?
A. Progressive difficulty managing medications and finances
B. Occasional forgetfulness with intact functioning
,C. Preference for a quiet environment
D. Sleeping eight hours nightly
Correct Answer: A
Rationale: Declining ability to manage complex activities such as medications and finances can
indicate clinically significant cognitive impairment.
5.What is the purpose of screening for depression in older adults?
A. Identify symptoms that may otherwise be overlooked or attributed to aging
B. Diagnose dementia in every patient
C. Replace the physical examination
D. Determine blood pressure treatment
Correct Answer: A
Rationale: Depression is common in older adults and can present with cognitive, physical, and
functional symptoms.
6.An older adult reports dizziness when standing. Which assessment is especially
appropriate?
A. Orthostatic vital signs
B. Visual acuity only
C. Hearing test only
D. Abdominal circumference
Correct Answer: A
Rationale: Orthostatic blood-pressure and pulse measurements can help identify orthostatic
hypotension as a potential contributor to dizziness and falls.
7.Which medication-related factor increases the risk of falls in older adults?
A. Use of sedating medications
B. Taking a daily multivitamin
C. Drinking adequate water
D. Wearing corrective lenses
Correct Answer: A
Rationale: Sedatives and other medications that affect alertness, blood pressure, or balance can
increase fall risk.
8.What is the most appropriate initial response when an older adult reports a recent fall?
, A. Assess circumstances, injuries, medications, gait, balance, and contributing medical
conditions
B. Tell the patient falls are normal with aging
C. Immediately recommend bed rest
D. Ignore the event if there was no injury
Correct Answer: A
Rationale: Falls are multifactorial and warrant evaluation for environmental, medication-
related, neurologic, cardiovascular, visual, and musculoskeletal contributors.
9.Which finding is most consistent with delirium rather than dementia?
A. Acute onset with fluctuating attention and awareness
B. Gradual progressive memory decline over years
C. Stable cognitive impairment
D. Long-standing difficulty with executive function
Correct Answer: A
Rationale: Delirium typically develops rapidly and is characterized by fluctuating attention and
awareness, often due to an underlying medical cause.
10.What is an important first step when delirium is suspected?
A. Search for an underlying medical or medication-related cause
B. Assume the patient has dementia
C. Begin long-term dementia therapy immediately
D. Ignore the change in mental status
Correct Answer: A
Rationale: Delirium is usually a manifestation of an underlying condition such as infection,
medication effect, metabolic disturbance, dehydration, or organ dysfunction.
11.Which finding is most characteristic of Parkinson disease?
A. Bradykinesia with rigidity and resting tremor
B. Sudden complete paralysis
C. Severe peripheral edema
D. Persistent high fever
Correct Answer: A
Rationale: Parkinson disease commonly involves bradykinesia, rigidity, resting tremor, and
postural instability.
ANSWERS PLUS RATIONALES
1.Which approach is most appropriate when performing a comprehensive health
assessment of an adult patient?
A. Focus only on the patient's chief complaint
B. Combine history, physical examination, preventive screening, and risk assessment
C. Perform laboratory testing before obtaining a history
D. Focus only on chronic diseases
Correct Answer: B
Rationale: A comprehensive assessment integrates the patient's history, physical examination,
health risks, preventive needs, medications, psychosocial factors, and relevant screening.
2.A 68-year-old patient reports several new medications from different providers. What
should the nurse practitioner prioritize?
A. Medication reconciliation
B. Discontinuing all medications
C. Increasing medication doses
D. Reviewing only prescription medications
Correct Answer: A
Rationale: Medication reconciliation identifies duplicate therapies, interactions, omissions, and
potentially inappropriate medications.
3.What is an important component of an older adult's functional assessment?
A. Ability to perform activities of daily living
B. Hair color
C. Blood type
D. Eye color
Correct Answer: A
Rationale: Functional assessment evaluates independence with activities of daily living (ADLs)
and instrumental activities of daily living (IADLs).
4.Which finding should raise concern for possible cognitive impairment in an older adult?
A. Progressive difficulty managing medications and finances
B. Occasional forgetfulness with intact functioning
,C. Preference for a quiet environment
D. Sleeping eight hours nightly
Correct Answer: A
Rationale: Declining ability to manage complex activities such as medications and finances can
indicate clinically significant cognitive impairment.
5.What is the purpose of screening for depression in older adults?
A. Identify symptoms that may otherwise be overlooked or attributed to aging
B. Diagnose dementia in every patient
C. Replace the physical examination
D. Determine blood pressure treatment
Correct Answer: A
Rationale: Depression is common in older adults and can present with cognitive, physical, and
functional symptoms.
6.An older adult reports dizziness when standing. Which assessment is especially
appropriate?
A. Orthostatic vital signs
B. Visual acuity only
C. Hearing test only
D. Abdominal circumference
Correct Answer: A
Rationale: Orthostatic blood-pressure and pulse measurements can help identify orthostatic
hypotension as a potential contributor to dizziness and falls.
7.Which medication-related factor increases the risk of falls in older adults?
A. Use of sedating medications
B. Taking a daily multivitamin
C. Drinking adequate water
D. Wearing corrective lenses
Correct Answer: A
Rationale: Sedatives and other medications that affect alertness, blood pressure, or balance can
increase fall risk.
8.What is the most appropriate initial response when an older adult reports a recent fall?
, A. Assess circumstances, injuries, medications, gait, balance, and contributing medical
conditions
B. Tell the patient falls are normal with aging
C. Immediately recommend bed rest
D. Ignore the event if there was no injury
Correct Answer: A
Rationale: Falls are multifactorial and warrant evaluation for environmental, medication-
related, neurologic, cardiovascular, visual, and musculoskeletal contributors.
9.Which finding is most consistent with delirium rather than dementia?
A. Acute onset with fluctuating attention and awareness
B. Gradual progressive memory decline over years
C. Stable cognitive impairment
D. Long-standing difficulty with executive function
Correct Answer: A
Rationale: Delirium typically develops rapidly and is characterized by fluctuating attention and
awareness, often due to an underlying medical cause.
10.What is an important first step when delirium is suspected?
A. Search for an underlying medical or medication-related cause
B. Assume the patient has dementia
C. Begin long-term dementia therapy immediately
D. Ignore the change in mental status
Correct Answer: A
Rationale: Delirium is usually a manifestation of an underlying condition such as infection,
medication effect, metabolic disturbance, dehydration, or organ dysfunction.
11.Which finding is most characteristic of Parkinson disease?
A. Bradykinesia with rigidity and resting tremor
B. Sudden complete paralysis
C. Severe peripheral edema
D. Persistent high fever
Correct Answer: A
Rationale: Parkinson disease commonly involves bradykinesia, rigidity, resting tremor, and
postural instability.
