NR 509 Exam Questions With Accurate Answers
2025\2026 A+ Grade
1. Which of the following changes are expected in vision as part of the normal
aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
- accurate answers-Ans: D
The lens loses its elasticity over time as part of the normal aging process, and
the eye is less able to accommodate and focus on near objects; therefore, the
patient will be expected to have blurring of near vision.
2. A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear what
his wife and grandchildren are saying to him. He admits to lip-reading more.
He has a history of noise exposure in his young adult years: He worked as a
sound engineer at a local arena and had to attend a lot of concerts. Based on
this information, what is the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds
- accurate answers-Ans: A
Human speech is considered to be a middle-range sound. During the aging
process there is a loss of acuity, starting with high-pitched sounds but
extending to the middle range and then into the low range.
3. A 79-year-old retired banker comes to your office for evaluation of difficulty
with urination; he gets up five to six times per night to urinate and has to go at
least that often in the daytime. He does not feel as if his bladder empties
completely; the strength of the urinary stream is diminished. He denies
dysuria or hematuria. This problem has been present for several years but has
worsened over the last 8 months. You palpate his prostate. What is your
expected physical examination finding, based on this description?
A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
, D) Enlarged size, boggy
- accurate answers-Ans: C
This is the expected physical examination finding in benign prostatic
hyperplasia (BPH).
4. A 70-year-old retired auto mechanic comes to your office because his
neighbor is concerned about his memory. The patient himself admits to
misplacing his keys more often and forgets what he is supposed to buy from
the grocery store and where he has parked the car. He denies getting lost in
familiar places. Upon further questioning, he states that his wife of 40 years
died 8 months ago; his three children live in three different states; and he has
limited his activities because the people he interacted with were "his wife's
friends, not his." He drinks a six-pack of beer daily; he does not smoke or use
illicit drugs. You perform a mini-mental state examination and obtain a total
score of 24 out of 28. Based on this information, what is your most likely
diagnosis?
A) Benign forgetfulness
B) Dementia
C) Meningitis
D) Depression
- accurate answers-Ans: D
The patient has symptoms of depression: His wife died, he has no real social
support system, and he has isolated himself from his usual activities. He also
drinks a considerable amount of alcohol on a daily basis, which can further
depress his mood. Depression can masquerade as dementia in the elderly and
must be considered in a patient with memory loss.
5. An 85-year-old retired teacher comes to your office for evaluation of
weakness. You obtain a complete history, perform a thorough physical
examination, and order laboratory tests. You diagnose her with
hyperthyroidism. Based on her age, which of the atypical symptoms of
hyperthyroidism is more likely to be seen?
A) Fatigue
B) Weight loss
C) Tachycardia
D) Anorexia
- accurate answers-Ans: D
This is an atypical symptom of hyperthyroidism that is more likely to be seen
in the older patient.
2025\2026 A+ Grade
1. Which of the following changes are expected in vision as part of the normal
aging process?
A) Cataracts
B) Glaucoma
C) Macular degeneration
D) Blurring of near vision
- accurate answers-Ans: D
The lens loses its elasticity over time as part of the normal aging process, and
the eye is less able to accommodate and focus on near objects; therefore, the
patient will be expected to have blurring of near vision.
2. A 72-year-old retired truck driver comes to the clinic with his wife for
evaluation of hearing loss. He has noticed some decreased ability to hear what
his wife and grandchildren are saying to him. He admits to lip-reading more.
He has a history of noise exposure in his young adult years: He worked as a
sound engineer at a local arena and had to attend a lot of concerts. Based on
this information, what is the most likely finding regarding his hearing acuity?
A) Loss of acuity for middle-range sounds
B) Increase of acuity for low-range sounds
C) Loss of acuity for high-range sounds
D) Increase of acuity for high-range sounds
- accurate answers-Ans: A
Human speech is considered to be a middle-range sound. During the aging
process there is a loss of acuity, starting with high-pitched sounds but
extending to the middle range and then into the low range.
3. A 79-year-old retired banker comes to your office for evaluation of difficulty
with urination; he gets up five to six times per night to urinate and has to go at
least that often in the daytime. He does not feel as if his bladder empties
completely; the strength of the urinary stream is diminished. He denies
dysuria or hematuria. This problem has been present for several years but has
worsened over the last 8 months. You palpate his prostate. What is your
expected physical examination finding, based on this description?
A) Normal size, smooth
B) Normal size, boggy
C) Enlarged size, smooth
, D) Enlarged size, boggy
- accurate answers-Ans: C
This is the expected physical examination finding in benign prostatic
hyperplasia (BPH).
4. A 70-year-old retired auto mechanic comes to your office because his
neighbor is concerned about his memory. The patient himself admits to
misplacing his keys more often and forgets what he is supposed to buy from
the grocery store and where he has parked the car. He denies getting lost in
familiar places. Upon further questioning, he states that his wife of 40 years
died 8 months ago; his three children live in three different states; and he has
limited his activities because the people he interacted with were "his wife's
friends, not his." He drinks a six-pack of beer daily; he does not smoke or use
illicit drugs. You perform a mini-mental state examination and obtain a total
score of 24 out of 28. Based on this information, what is your most likely
diagnosis?
A) Benign forgetfulness
B) Dementia
C) Meningitis
D) Depression
- accurate answers-Ans: D
The patient has symptoms of depression: His wife died, he has no real social
support system, and he has isolated himself from his usual activities. He also
drinks a considerable amount of alcohol on a daily basis, which can further
depress his mood. Depression can masquerade as dementia in the elderly and
must be considered in a patient with memory loss.
5. An 85-year-old retired teacher comes to your office for evaluation of
weakness. You obtain a complete history, perform a thorough physical
examination, and order laboratory tests. You diagnose her with
hyperthyroidism. Based on her age, which of the atypical symptoms of
hyperthyroidism is more likely to be seen?
A) Fatigue
B) Weight loss
C) Tachycardia
D) Anorexia
- accurate answers-Ans: D
This is an atypical symptom of hyperthyroidism that is more likely to be seen
in the older patient.
