NR 601 Final Exam: Primary Care Practicum
Comprehensive Practice Guide Questions &
Answers Plus Rationales Latest 2026/27
Updates
1. An 82-year-old patient presents for a Medicare Annual
Wellness Visit. Which of the following is the single most effective
intervention to reduce mortality and morbidity in this patient?
A) Initiation of a daily multivitamin
B) Screening for colorectal cancer
C) Counseling on smoking cessation
D) Referral for hearing screening
Answer C: Counseling on smoking cessation
Rationale: Smoking cessation provides the greatest single mortality
and morbidity benefit for older adults; even in later life, quitting
smoking reduces cardiovascular and cancer risk significantly within
months to years. ---
2. An 80-year-old female widow asks her nurse practitioner about
her end-of-life options. Her diagnoses include CHF, HTN, and
T2DM. She has noticed in the last month she has lower extremity
edema and is finding it difficult to walk to the grocery store. She
,does not wish to be admitted to the hospital again. How should the
NP address this patient's concerns today?
A) Start her on a medication for depression
B) Provide her with information for senior day care services
C) Offer the patient a palliative care referral
D) Refer to hospice services
Answer C: Offer the patient a palliative care referral
Rationale: Palliative care services focus on symptom management,
quality of life, and goal-concordant care for patients with serious
illness, regardless of prognosis. They can be provided alongside
curative treatments. Hospice is for patients with a prognosis of 6
months or less. ---
3. An 86-year-old female comes to your office for a wellness visit.
She introduces her partner of 35 years whom she would like to
make medical decisions for her in case she becomes unable to
make decisions for herself. She reports they are not married.
Which one of the following would be the most appropriate
recommendation for this patient and her partner?
A) Advise them to complete a POLST
B) Advise them that they have adequate documentation to be
recognized legally
C) Advise them to file an advance directive (durable power of attorney
for healthcare)
D) Respond that although they lack documentation, her partner will be
recognized de facto
Answer C: Advise them to file an advance directive (durable
power of attorney for healthcare)
,Rationale: An advance directive (durable power of attorney for
healthcare) is required to legally designate an unmarried partner as a
healthcare surrogate. Without this legal documentation, unmarried
partners lack standing to make medical decisions, whereas a POLST
only addresses specific medical interventions for serious illness. ---
4. The NP is performing a functional assessment on an 75-year-old
patient. Which of the following assessment tools is most
appropriate to evaluate the patient's risk of falls?
A) Mini-Mental Status Examination (MMSE)
B) Timed Up and Go (TUG) Test
C) Katz Activities of Daily Living (ADL) Scale
D) Geriatric Depression Scale (GDS)
Answer B: Timed Up and Go (TUG) Test
Rationale: The Timed Up and Go Test is a simple, validated screening
tool for fall risk in older adults. It measures the time it takes for a
patient to stand up from a chair, walk 10 feet, turn, walk back, and sit
down. A time >12 seconds indicates increased fall risk. ADL scales
measure function, MMSE measures cognition, and GDS measures
depression. ---
5. A 78-year-old female presents to the office stating she feels
restless and has a poor appetite. She states she is worried about
her health but has no other symptoms. The physical exam is
normal. The NP diagnoses depression. The NP prescribes a first-
line treatment for depression in this patient, which is:
A) Sertraline
, B) Diazepam
C) Amitriptyline
D) Bupropion
Answer A: Sertraline
Rationale: SSRIs such as sertraline are first-line treatment for
depression in the elderly due to their favorable side effect profile.
Benzodiazepines are not for depression. TCAs have significant
anticholinergic side effects in the elderly. ---
6. An 82-year-old woman presents with intermittent mild
confusion. She denies dysuria, frequency, urgency, or other
urinary symptoms. Urinalysis results are unremarkable. Which of
the following is the MOST appropriate next step?
A) Treat empirically for UTI
B) Assess for other causes of confusion
C) Start chronic antibiotic prophylaxis
D) Order hormone therapy
Answer B: Assess for other causes of confusion
Rationale: Confusion without urinary symptoms and with an
unremarkable urinalysis should prompt evaluation for non-UTI causes
such as medications, dehydration, metabolic issues, or neurologic
conditions. Empirical antibiotics would be inappropriate and may
cause harm. ---
7. According to the 2017 HTN guidelines, what treatment is
recommended for a healthy 54-year-old African American woman
Comprehensive Practice Guide Questions &
Answers Plus Rationales Latest 2026/27
Updates
1. An 82-year-old patient presents for a Medicare Annual
Wellness Visit. Which of the following is the single most effective
intervention to reduce mortality and morbidity in this patient?
A) Initiation of a daily multivitamin
B) Screening for colorectal cancer
C) Counseling on smoking cessation
D) Referral for hearing screening
Answer C: Counseling on smoking cessation
Rationale: Smoking cessation provides the greatest single mortality
and morbidity benefit for older adults; even in later life, quitting
smoking reduces cardiovascular and cancer risk significantly within
months to years. ---
2. An 80-year-old female widow asks her nurse practitioner about
her end-of-life options. Her diagnoses include CHF, HTN, and
T2DM. She has noticed in the last month she has lower extremity
edema and is finding it difficult to walk to the grocery store. She
,does not wish to be admitted to the hospital again. How should the
NP address this patient's concerns today?
A) Start her on a medication for depression
B) Provide her with information for senior day care services
C) Offer the patient a palliative care referral
D) Refer to hospice services
Answer C: Offer the patient a palliative care referral
Rationale: Palliative care services focus on symptom management,
quality of life, and goal-concordant care for patients with serious
illness, regardless of prognosis. They can be provided alongside
curative treatments. Hospice is for patients with a prognosis of 6
months or less. ---
3. An 86-year-old female comes to your office for a wellness visit.
She introduces her partner of 35 years whom she would like to
make medical decisions for her in case she becomes unable to
make decisions for herself. She reports they are not married.
Which one of the following would be the most appropriate
recommendation for this patient and her partner?
A) Advise them to complete a POLST
B) Advise them that they have adequate documentation to be
recognized legally
C) Advise them to file an advance directive (durable power of attorney
for healthcare)
D) Respond that although they lack documentation, her partner will be
recognized de facto
Answer C: Advise them to file an advance directive (durable
power of attorney for healthcare)
,Rationale: An advance directive (durable power of attorney for
healthcare) is required to legally designate an unmarried partner as a
healthcare surrogate. Without this legal documentation, unmarried
partners lack standing to make medical decisions, whereas a POLST
only addresses specific medical interventions for serious illness. ---
4. The NP is performing a functional assessment on an 75-year-old
patient. Which of the following assessment tools is most
appropriate to evaluate the patient's risk of falls?
A) Mini-Mental Status Examination (MMSE)
B) Timed Up and Go (TUG) Test
C) Katz Activities of Daily Living (ADL) Scale
D) Geriatric Depression Scale (GDS)
Answer B: Timed Up and Go (TUG) Test
Rationale: The Timed Up and Go Test is a simple, validated screening
tool for fall risk in older adults. It measures the time it takes for a
patient to stand up from a chair, walk 10 feet, turn, walk back, and sit
down. A time >12 seconds indicates increased fall risk. ADL scales
measure function, MMSE measures cognition, and GDS measures
depression. ---
5. A 78-year-old female presents to the office stating she feels
restless and has a poor appetite. She states she is worried about
her health but has no other symptoms. The physical exam is
normal. The NP diagnoses depression. The NP prescribes a first-
line treatment for depression in this patient, which is:
A) Sertraline
, B) Diazepam
C) Amitriptyline
D) Bupropion
Answer A: Sertraline
Rationale: SSRIs such as sertraline are first-line treatment for
depression in the elderly due to their favorable side effect profile.
Benzodiazepines are not for depression. TCAs have significant
anticholinergic side effects in the elderly. ---
6. An 82-year-old woman presents with intermittent mild
confusion. She denies dysuria, frequency, urgency, or other
urinary symptoms. Urinalysis results are unremarkable. Which of
the following is the MOST appropriate next step?
A) Treat empirically for UTI
B) Assess for other causes of confusion
C) Start chronic antibiotic prophylaxis
D) Order hormone therapy
Answer B: Assess for other causes of confusion
Rationale: Confusion without urinary symptoms and with an
unremarkable urinalysis should prompt evaluation for non-UTI causes
such as medications, dehydration, metabolic issues, or neurologic
conditions. Empirical antibiotics would be inappropriate and may
cause harm. ---
7. According to the 2017 HTN guidelines, what treatment is
recommended for a healthy 54-year-old African American woman
