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NR 601 MIDTERM EXAM 2026 COMPLETE (105) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NR 601
Prepare for the NR 601 Midterm Exam with this comprehensive practice resource
designed to strengthen your clinical knowledge and exam readiness. It features exam-
style questions covering advanced health assessment, primary care management,
pharmacology, diagnostic reasoning, health promotion, and evidence-based practice.
Use it to reinforce essential concepts, assess your understanding, and build
confidence before your midterm exam. An excellent study aid for nurse practitioner
students preparing for the NR 601 course.
MULTIPLE CHOICE.
Question 1: A 75-year-old patient asks about normal physiological changes of
aging. The nurse practitioner (NP) should explain that normal aging includes
which of the following?
A. Increased glomerular filtration rate
B. Increased lung elasticity
C. Reduced lens accommodation
D. Increased brain weight
Correct answer: C. Reduced lens accommodation
Rationale: Normal physiological changes of aging include reduced lens
accommodation (presbyopia), decreased visual acuity, and slower
adaptation to light/dark changes . GFR decreases, lung elasticity
decreases, and brain weight decreases with normal aging.
Question 2: According to the "Rule of Fourths" in geriatric assessment,
functional decline in older adults is attributed to which four categories?
A. Disease, disuse, misuse, and physiologic aging
B. Dementia, depression, delirium, and drugs
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C. Diet, exercise, sleep, and stress
D. Genetic, environmental, social, and behavioral factors
Correct answer: A. Disease, disuse, misuse, and physiologic aging
Rationale: The "Rule of Fourths" describes varied causes of functional
decline in older adults: disease (pathology), disuse (sedentary lifestyle),
misuse (substance abuse, prior injuries), and physiologic aging .
Question 3: Which of the following is the strongest evidence regarding normal
physiological aging?
A. Cross-sectional studies
B. Case-control studies
C. Longitudinal studies
D. Retrospective chart reviews
Correct answer: C. Longitudinal studies
Rationale: The strongest evidence regarding normal physiological aging is
available through longitudinal studies, which track the same individuals
over time and account for cohort effects .
Question 4: The aging process causes which normal physiological change in
the heart?
A. Decreased valvular thickness
B. Heart valve thickening
C. Decreased risk of murmurs
D. Increased cardiac muscle mass
Correct answer: B. Heart valve thickening
Rationale: Normal aging causes heart valves to thicken and become more
rigid, increasing the risk of murmurs and valvular stenosis .
Question 5: A 72-year-old patient asks about the recommended amount of
exercise for older adults. The NP should recommend:
A. 30 minutes of aerobic activity, 5 days per week
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B. 60 minutes of aerobic activity, 3 days per week
C. 20 minutes of aerobic activity, 7 days per week
D. 45 minutes of vigorous activity, 2 days per week
Correct answer: A. 30 minutes of aerobic activity, 5 days per week
Rationale: The preferred amount of exercise for older adults is 30 minutes
of moderate aerobic activity per day, 5 days per week. For weight loss, 60
minutes per day is recommended . The principle is to "start low and go
slow" .
Question 6: A 78-year-old woman presents after a long day of driving with
sudden shortness of breath, chest pain, and a sense of panic. Which
diagnosis is most likely?
A. Myocardial infarction
B. Pulmonary embolism
C. Asthma exacerbation
D. Anxiety disorder
Correct answer: B. Pulmonary embolism
Rationale: Sudden-onset dyspnea, chest pain, and panic in the setting of
prolonged immobility (long car ride) are classic for pulmonary embolism.
Older adults with PE may present with atypical symptoms .
Question 7: Which of the following is NOT a sign of typical pneumonia
presentation in an elderly patient?
A. Altered mental status
B. Tachypnea
C. Bradycardia
D. Hypoxia
Correct answer: C. Bradycardia
Rationale: Elderly patients with pneumonia often present with atypical
signs: confusion, tachypnea, hypoxia, and lethargy. Bradycardia is NOT a
typical sign—tachycardia is more common with infection. A clustering of
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symptoms including altered mental status, fever, and tachypnea may
indicate pneumonia .
Question 8: A 68-year-old male has a blood pressure of 150/92 mmHg on
three separate occasions. He has no diabetes or CKD. According to ACC/AHA
2017 guidelines, what is his blood pressure goal?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/80 mmHg
Correct answer: C. <130/80 mmHg
Rationale: ACC/AHA 2017 guidelines recommend a blood pressure goal of
<130/80 mmHg for all adults with hypertension, regardless of age or
comorbidities . This represents a more aggressive target than previous
guidelines.
Question 9: A 75-year-old male on warfarin for atrial fibrillation has an INR of
1.2. He admits to missing several doses. What is the most appropriate next
step?
A. Increase warfarin dose by 50%
B. Give vitamin K 10 mg orally
C. Resume warfarin at same dose and recheck INR in 1 week
D. Switch to apixaban immediately
Correct answer: C. Resume warfarin at same dose and recheck INR in 1
week
Rationale: A subtherapeutic INR from missed doses is best corrected by
resuming the usual dose and rechecking in 1 week. Vitamin K is for high
INR with bleeding, and dose increases require more careful evaluation .
Question 10: A 79-year-old male has a new diagnosis of atrial fibrillation. His
CHA₂DS₂-VASc score is 4. Which anticoagulant is preferred?
NR 601 MIDTERM EXAM 2026 COMPLETE (105) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NR 601
Prepare for the NR 601 Midterm Exam with this comprehensive practice resource
designed to strengthen your clinical knowledge and exam readiness. It features exam-
style questions covering advanced health assessment, primary care management,
pharmacology, diagnostic reasoning, health promotion, and evidence-based practice.
Use it to reinforce essential concepts, assess your understanding, and build
confidence before your midterm exam. An excellent study aid for nurse practitioner
students preparing for the NR 601 course.
MULTIPLE CHOICE.
Question 1: A 75-year-old patient asks about normal physiological changes of
aging. The nurse practitioner (NP) should explain that normal aging includes
which of the following?
A. Increased glomerular filtration rate
B. Increased lung elasticity
C. Reduced lens accommodation
D. Increased brain weight
Correct answer: C. Reduced lens accommodation
Rationale: Normal physiological changes of aging include reduced lens
accommodation (presbyopia), decreased visual acuity, and slower
adaptation to light/dark changes . GFR decreases, lung elasticity
decreases, and brain weight decreases with normal aging.
Question 2: According to the "Rule of Fourths" in geriatric assessment,
functional decline in older adults is attributed to which four categories?
A. Disease, disuse, misuse, and physiologic aging
B. Dementia, depression, delirium, and drugs
, Page 2 of 41
C. Diet, exercise, sleep, and stress
D. Genetic, environmental, social, and behavioral factors
Correct answer: A. Disease, disuse, misuse, and physiologic aging
Rationale: The "Rule of Fourths" describes varied causes of functional
decline in older adults: disease (pathology), disuse (sedentary lifestyle),
misuse (substance abuse, prior injuries), and physiologic aging .
Question 3: Which of the following is the strongest evidence regarding normal
physiological aging?
A. Cross-sectional studies
B. Case-control studies
C. Longitudinal studies
D. Retrospective chart reviews
Correct answer: C. Longitudinal studies
Rationale: The strongest evidence regarding normal physiological aging is
available through longitudinal studies, which track the same individuals
over time and account for cohort effects .
Question 4: The aging process causes which normal physiological change in
the heart?
A. Decreased valvular thickness
B. Heart valve thickening
C. Decreased risk of murmurs
D. Increased cardiac muscle mass
Correct answer: B. Heart valve thickening
Rationale: Normal aging causes heart valves to thicken and become more
rigid, increasing the risk of murmurs and valvular stenosis .
Question 5: A 72-year-old patient asks about the recommended amount of
exercise for older adults. The NP should recommend:
A. 30 minutes of aerobic activity, 5 days per week
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B. 60 minutes of aerobic activity, 3 days per week
C. 20 minutes of aerobic activity, 7 days per week
D. 45 minutes of vigorous activity, 2 days per week
Correct answer: A. 30 minutes of aerobic activity, 5 days per week
Rationale: The preferred amount of exercise for older adults is 30 minutes
of moderate aerobic activity per day, 5 days per week. For weight loss, 60
minutes per day is recommended . The principle is to "start low and go
slow" .
Question 6: A 78-year-old woman presents after a long day of driving with
sudden shortness of breath, chest pain, and a sense of panic. Which
diagnosis is most likely?
A. Myocardial infarction
B. Pulmonary embolism
C. Asthma exacerbation
D. Anxiety disorder
Correct answer: B. Pulmonary embolism
Rationale: Sudden-onset dyspnea, chest pain, and panic in the setting of
prolonged immobility (long car ride) are classic for pulmonary embolism.
Older adults with PE may present with atypical symptoms .
Question 7: Which of the following is NOT a sign of typical pneumonia
presentation in an elderly patient?
A. Altered mental status
B. Tachypnea
C. Bradycardia
D. Hypoxia
Correct answer: C. Bradycardia
Rationale: Elderly patients with pneumonia often present with atypical
signs: confusion, tachypnea, hypoxia, and lethargy. Bradycardia is NOT a
typical sign—tachycardia is more common with infection. A clustering of
, Page 4 of 41
symptoms including altered mental status, fever, and tachypnea may
indicate pneumonia .
Question 8: A 68-year-old male has a blood pressure of 150/92 mmHg on
three separate occasions. He has no diabetes or CKD. According to ACC/AHA
2017 guidelines, what is his blood pressure goal?
A. <150/90 mmHg
B. <140/90 mmHg
C. <130/80 mmHg
D. <120/80 mmHg
Correct answer: C. <130/80 mmHg
Rationale: ACC/AHA 2017 guidelines recommend a blood pressure goal of
<130/80 mmHg for all adults with hypertension, regardless of age or
comorbidities . This represents a more aggressive target than previous
guidelines.
Question 9: A 75-year-old male on warfarin for atrial fibrillation has an INR of
1.2. He admits to missing several doses. What is the most appropriate next
step?
A. Increase warfarin dose by 50%
B. Give vitamin K 10 mg orally
C. Resume warfarin at same dose and recheck INR in 1 week
D. Switch to apixaban immediately
Correct answer: C. Resume warfarin at same dose and recheck INR in 1
week
Rationale: A subtherapeutic INR from missed doses is best corrected by
resuming the usual dose and rechecking in 1 week. Vitamin K is for high
INR with bleeding, and dose increases require more careful evaluation .
Question 10: A 79-year-old male has a new diagnosis of atrial fibrillation. His
CHA₂DS₂-VASc score is 4. Which anticoagulant is preferred?
