NR601 MIDTERM EXAM
STUDY GUIDE
Weeks 1-4 Content
Chamberlain University
VERIFIED QUESTIONS AND ANSWERS
A+ GRADED
2026/2027 Edition
120 Questions | 9 Sections | 75% Scenario-Based
Aligned with AANP Competencies & AGS Geriatric Standards
, NR601 Midterm Exam Study Guide
Weeks 1-4 Content | Chamberlain University | Verified Questions and Answers | A+ Graded | 2026/2027 Edition
Examination Overview: This comprehensive study guide contains 120 multiple-choice questions across 9 content areas aligned with Chamberlain University
NR601 course syllabus, AANP competencies, and AGS geriatric care standards. Cognitive levels: 20% recall, 50% application, 30% analysis. Question style:
75% scenario-based, 25% direct knowledge. Special inclusions: 15 pharmacology/medication management questions, 15 priority-setting questions, and 10
geriatric assessment tools and screening instruments questions.
Section 1: Health Promotion & Disease Prevention in the Older Adult
Question Range: Q1 - Q15
Q1: An 82-year-old female presents for her annual wellness visit. She received the influenza vaccine last year but has never
received the pneumococcal vaccination. According to the CDC/ACIP immunization schedule for adults aged 65 and older, what is
the recommended pneumococcal vaccination strategy?
A. Administer PCV15 only and no further pneumococcal vaccines are needed
B. Administer PCV20 alone, or PCV15 followed by PPSV23 one year later [CORRECT]
C. Administer PPSV23 only, as it covers more serotypes than PCV vaccines
D. Defer pneumococcal vaccination since she received the influenza vaccine
Correct Answer: B
Rationale: The current ACIP recommendation for adults >=65 is PCV20 alone OR PCV15 followed by PPSV23 at least 1 year later. This aligns with Chamberlain
NR601 curriculum on immunization guidelines for older adults. PCV15 alone is insufficient (option A), PPSV23 alone is no longer the standard (option C), and
influenza vaccination does not replace pneumococcal coverage (option D).
Q2: A 76-year-old male with a 40-pack-year smoking history asks about lung cancer screening. He quit smoking 8 months ago.
According to USPSTF recommendations, which statement is most accurate regarding his eligibility for lung cancer screening?
A. He is not eligible because he has already quit smoking
B. He is eligible for annual low-dose CT screening if he is aged 50-80, smoked >=20 pack-years, and quit within the past 15 years [CORRECT]
C. He should receive a chest X-ray annually instead of low-dose CT
D. He should be screened with sputum cytology every 6 months
Correct Answer: B
Rationale: USPSTF recommends annual low-dose CT lung cancer screening for adults 50-80 with >=20 pack-year smoking history who currently smoke or quit
within the past 15 years. Since this patient quit 8 months ago, he is within the 15-year window and remains eligible. Chest X-ray and sputum cytology are not
recommended screening modalities per NR601 curriculum.
Q3: A 68-year-old female is being seen for a well-woman exam. She had a total hysterectomy for benign fibroids at age 55, and
her last Pap smear 3 years ago was normal. What is the appropriate cervical cancer screening recommendation?
A. Continue Pap smears every 3 years until age 75
B. Discontinue cervical cancer screening; she does not need any further Pap or HPV testing [CORRECT]
C. Perform HPV co-testing every 5 years until age 65
D. Perform a Pap smear annually for the next 5 years
Correct Answer: B
Rationale: Per ACS/USPSTF guidelines, a woman with a total hysterectomy (cervix removed) for benign indications and no history of high-grade CIN does NOT
require cervical cancer screening. Additionally, screening is generally discontinued at age 65 if adequate prior screening has been negative. This patient meets both
criteria. The NR601 curriculum emphasizes avoiding unnecessary screening in older adults.
Q4: A 70-year-old male presents for a routine physical. His BMI is 31, blood pressure is 138/86, and he has no prior cancer
history. He asks which colorectal cancer screening test is most appropriate. Which of the following is the BEST
recommendation?
A. Annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT) is an acceptable option [CORRECT]
B. Colonoscopy every 5 years beginning at age 50 and continuing indefinitely
C. CT colonography every 3 years is the preferred modality for patients over 70
D. No colorectal cancer screening is recommended after age 70
Correct Answer: A
,NR601 Midterm Exam Study Guide | Chamberlain University | 2026/2027 Edition
Rationale: USPSTF recommends colorectal cancer screening from age 45-75 using stool-based tests (annual FIT/gFOBT),
colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or CT colonography every 5 years. For ages 76-85, screening is
individualized. Option B is incorrect (5-year interval is wrong). Option D is incorrect because screening continues through age 75.
NR601 emphasizes shared decision-making for older adults.
Q5: A 78-year-old female presents for osteoporosis screening. Her mother had a hip fracture at age 80.
The patient's last DEXA scan was 5 years ago with a T-score of -1.5 at the femoral neck. What is the most
appropriate next step?
A. No further screening is needed since she is under age 80
B. Repeat DEXA scan now, as she is over 65 with risk factors and her last scan was 5 years ago [CORRECT]
C. Start empirical bisphosphonate therapy without repeating DEXA
D. Recommend a quantitative heel ultrasound instead of DEXA
Correct Answer: B
Rationale: USPSTF recommends screening for osteoporosis in women >=65 and in younger postmenopausal women with increased
risk factors. Repeat screening intervals depend on T-score; for T-score -1.5 to -1.99, rescreening in 5 years is appropriate. Her
maternal hip fracture history is an additional risk factor. Empirical treatment without confirmation (C) and heel ultrasound (D) are
not standard. NR601 emphasizes appropriate DEXA interval screening.
Q6: A 74-year-old male with a 30-pack-year smoking history and moderate COPD is in your clinic for the
annual wellness visit. His immunization record shows he received Tdap 12 years ago, influenza vaccine
this season, and PCV20 three years ago. Which vaccination is most needed at this visit?
A. Repeat Tdap booster now, as it is recommended every 10 years for adults over 65
B. Administer the zoster recombinant vaccine (RZV) series if he has not received it [CORRECT]
C. Give a second dose of PCV20 since he has COPD
D. Administer MMR vaccine as he is at risk due to COPD
Correct Answer: B
Rationale: The recombinant zoster vaccine (Shingrix, RZV) is recommended for all adults >=50, including those who previously
received Zostavax, given as a 2-dose series 2-6 months apart. COPD and smoking increase shingles risk. Tdap is given every 10 years
(he is due in 2 years, but Td can be used for wound management). A second PCV20 is not recommended. MMR is not indicated based
on COPD alone. NR601 curriculum stresses zoster vaccination in older adults.
Q7: During a health promotion visit, an 81-year-old female reports feeling down for the past two months,
with decreased appetite and trouble sleeping after her husband's death 4 months ago. Which screening
tool is most appropriate to administer at this visit?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS-15), as it is validated for older adults and excludes somatic complaints that overlap
with normal aging [CORRECT]
C. Patient Health Questionnaire-2 (PHQ-2) only, as it is the shortest screen
D. Cognitive Assessment Scale (CAS)
Correct Answer: B
Rationale: The Geriatric Depression Scale (GDS-15) is specifically validated for older adults and excludes somatic items (like
appetite and sleep changes) that may overlap with normal aging or medical conditions, unlike the PHQ-9. A score >=5 suggests
depression. The MMSE assesses cognition, not mood. While PHQ-2 is a valid initial screen, GDS is preferred in geriatric populations
per AGS guidelines. NR601 curriculum emphasizes age-appropriate screening tools.
Q8: A 69-year-old male with hypertension and hyperlipidemia is being counseled on cardiovascular risk
reduction. His 10-year ASCVD risk is calculated at 12%. Which of the following lifestyle modifications has
the strongest evidence for reducing cardiovascular events in older adults?
A. Daily low-dose aspirin therapy regardless of bleeding risk
Page 3 | NR601 Midterm Study Guide | A+ Graded
, NR601 Midterm Exam Study Guide | Chamberlain University | 2026/2027 Edition
B. Smoking cessation, blood pressure control, and statin therapy for primary prevention in selected adults 40-75 with
elevated risk [CORRECT]
C. Vitamin E and omega-3 supplementation for primary prevention
D. Aggressive weight loss to achieve BMI <22 through caloric restriction
Correct Answer: B
Rationale: Per ACC/AHA guidelines, the strongest evidence for CV risk reduction in older adults comes from smoking cessation, BP
control (target <130/80 for most), and statin therapy for adults 40-75 with 10-year ASCVD risk >=7.5%. Aspirin primary prevention
in adults >=70 is generally NOT recommended due to bleeding risk (USPSTF). Vitamin E and omega-3 supplements lack strong
evidence. Aggressive weight loss can worsen sarcopenia. NR601 emphasizes evidence-based risk reduction in mature adults.
Q9: An 85-year-old female who lives alone is brought to clinic by her daughter, who is concerned about
her mother's alcohol intake. The patient admits to drinking 2-3 glasses of wine nightly to help her sleep.
Which screening tool is most appropriate for assessing alcohol use disorder in this older adult?
A. CAGE questionnaire, adapted as it has been validated in older adults [CORRECT]
B. AUDIT-C, which is the only validated tool for adults over 80
C. Alcohol Use Disorders Identification Test (AUDIT-10) in full
D. Single-item alcohol screening question only
Correct Answer: A
Rationale: The CAGE questionnaire (or CAGE-AID for substance use) has been specifically validated for older adults and is
recommended by AGS. The AUDIT and AUDIT-C have been validated in general adult populations but less specifically in geriatric
populations. A single-item screen may miss at-risk drinking in older adults. NR601 curriculum emphasizes the CAGE tool for geriatric
alcohol screening. Any positive response warrants further evaluation.
Q10: A 72-year-old male with type 2 diabetes and hypertension is due for his annual wellness visit. Which
of the following cancer screenings is recommended for him at this age, assuming average risk and
adequate prior screening?
A. Prostate-specific antigen (PSA) testing annually, as recommended for all men over 70
B. Colorectal cancer screening, as USPSTF recommends screening through age 75 for average-risk adults [CORRECT]
C. Annual chest X-ray for lung cancer screening
D. Routine bladder cancer screening with urine cytology
Correct Answer: B
Rationale: USPSTF recommends colorectal cancer screening for adults 45-75. PSA testing is not routinely recommended for men
over 70 (individual decision-making for 55-69; recommends against screening >=70). Chest X-ray is not a recommended screening
modality. Bladder cancer screening is not routinely recommended in average-risk individuals. NR601 curriculum aligns with USPSTF
age-appropriate cancer screening guidelines.
Q11: A 67-year-old male presents for smoking cessation counseling. He has tried to quit multiple times
and currently smokes 1 pack per day. He has a history of depression. Which pharmacotherapy is most
appropriate given his comorbidity?
A. Varenicline (Chantix), as it is the most effective monotherapy but requires monitoring for neuropsychiatric symptoms
B. Bupropion SR alone, which will treat both his depression and smoking cessation
C. Nicotine replacement therapy with a patch plus short-acting form, avoiding varenicline due to depression history
[CORRECT]
D. Clonidine, as it is the first-line treatment for smokers with psychiatric comorbidities
Correct Answer: C
Rationale: Combined NRT (long-acting patch plus short-acting gum/lozenge) is effective and safe in patients with depression history,
avoiding the neuropsychiatric concerns associated with varenicline and bupropion. While varenicline is effective, the FDA previously
warned about neuropsychiatric effects (though the boxed warning was removed in 2016, caution persists). Bupropion alone can
worsen depression monitoring needs. Clonidine is second-line. NR601 curriculum stresses individualized smoking cessation in older
Page 4 | NR601 Midterm Study Guide | A+ Graded
STUDY GUIDE
Weeks 1-4 Content
Chamberlain University
VERIFIED QUESTIONS AND ANSWERS
A+ GRADED
2026/2027 Edition
120 Questions | 9 Sections | 75% Scenario-Based
Aligned with AANP Competencies & AGS Geriatric Standards
, NR601 Midterm Exam Study Guide
Weeks 1-4 Content | Chamberlain University | Verified Questions and Answers | A+ Graded | 2026/2027 Edition
Examination Overview: This comprehensive study guide contains 120 multiple-choice questions across 9 content areas aligned with Chamberlain University
NR601 course syllabus, AANP competencies, and AGS geriatric care standards. Cognitive levels: 20% recall, 50% application, 30% analysis. Question style:
75% scenario-based, 25% direct knowledge. Special inclusions: 15 pharmacology/medication management questions, 15 priority-setting questions, and 10
geriatric assessment tools and screening instruments questions.
Section 1: Health Promotion & Disease Prevention in the Older Adult
Question Range: Q1 - Q15
Q1: An 82-year-old female presents for her annual wellness visit. She received the influenza vaccine last year but has never
received the pneumococcal vaccination. According to the CDC/ACIP immunization schedule for adults aged 65 and older, what is
the recommended pneumococcal vaccination strategy?
A. Administer PCV15 only and no further pneumococcal vaccines are needed
B. Administer PCV20 alone, or PCV15 followed by PPSV23 one year later [CORRECT]
C. Administer PPSV23 only, as it covers more serotypes than PCV vaccines
D. Defer pneumococcal vaccination since she received the influenza vaccine
Correct Answer: B
Rationale: The current ACIP recommendation for adults >=65 is PCV20 alone OR PCV15 followed by PPSV23 at least 1 year later. This aligns with Chamberlain
NR601 curriculum on immunization guidelines for older adults. PCV15 alone is insufficient (option A), PPSV23 alone is no longer the standard (option C), and
influenza vaccination does not replace pneumococcal coverage (option D).
Q2: A 76-year-old male with a 40-pack-year smoking history asks about lung cancer screening. He quit smoking 8 months ago.
According to USPSTF recommendations, which statement is most accurate regarding his eligibility for lung cancer screening?
A. He is not eligible because he has already quit smoking
B. He is eligible for annual low-dose CT screening if he is aged 50-80, smoked >=20 pack-years, and quit within the past 15 years [CORRECT]
C. He should receive a chest X-ray annually instead of low-dose CT
D. He should be screened with sputum cytology every 6 months
Correct Answer: B
Rationale: USPSTF recommends annual low-dose CT lung cancer screening for adults 50-80 with >=20 pack-year smoking history who currently smoke or quit
within the past 15 years. Since this patient quit 8 months ago, he is within the 15-year window and remains eligible. Chest X-ray and sputum cytology are not
recommended screening modalities per NR601 curriculum.
Q3: A 68-year-old female is being seen for a well-woman exam. She had a total hysterectomy for benign fibroids at age 55, and
her last Pap smear 3 years ago was normal. What is the appropriate cervical cancer screening recommendation?
A. Continue Pap smears every 3 years until age 75
B. Discontinue cervical cancer screening; she does not need any further Pap or HPV testing [CORRECT]
C. Perform HPV co-testing every 5 years until age 65
D. Perform a Pap smear annually for the next 5 years
Correct Answer: B
Rationale: Per ACS/USPSTF guidelines, a woman with a total hysterectomy (cervix removed) for benign indications and no history of high-grade CIN does NOT
require cervical cancer screening. Additionally, screening is generally discontinued at age 65 if adequate prior screening has been negative. This patient meets both
criteria. The NR601 curriculum emphasizes avoiding unnecessary screening in older adults.
Q4: A 70-year-old male presents for a routine physical. His BMI is 31, blood pressure is 138/86, and he has no prior cancer
history. He asks which colorectal cancer screening test is most appropriate. Which of the following is the BEST
recommendation?
A. Annual fecal occult blood test (FOBT) or fecal immunochemical test (FIT) is an acceptable option [CORRECT]
B. Colonoscopy every 5 years beginning at age 50 and continuing indefinitely
C. CT colonography every 3 years is the preferred modality for patients over 70
D. No colorectal cancer screening is recommended after age 70
Correct Answer: A
,NR601 Midterm Exam Study Guide | Chamberlain University | 2026/2027 Edition
Rationale: USPSTF recommends colorectal cancer screening from age 45-75 using stool-based tests (annual FIT/gFOBT),
colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or CT colonography every 5 years. For ages 76-85, screening is
individualized. Option B is incorrect (5-year interval is wrong). Option D is incorrect because screening continues through age 75.
NR601 emphasizes shared decision-making for older adults.
Q5: A 78-year-old female presents for osteoporosis screening. Her mother had a hip fracture at age 80.
The patient's last DEXA scan was 5 years ago with a T-score of -1.5 at the femoral neck. What is the most
appropriate next step?
A. No further screening is needed since she is under age 80
B. Repeat DEXA scan now, as she is over 65 with risk factors and her last scan was 5 years ago [CORRECT]
C. Start empirical bisphosphonate therapy without repeating DEXA
D. Recommend a quantitative heel ultrasound instead of DEXA
Correct Answer: B
Rationale: USPSTF recommends screening for osteoporosis in women >=65 and in younger postmenopausal women with increased
risk factors. Repeat screening intervals depend on T-score; for T-score -1.5 to -1.99, rescreening in 5 years is appropriate. Her
maternal hip fracture history is an additional risk factor. Empirical treatment without confirmation (C) and heel ultrasound (D) are
not standard. NR601 emphasizes appropriate DEXA interval screening.
Q6: A 74-year-old male with a 30-pack-year smoking history and moderate COPD is in your clinic for the
annual wellness visit. His immunization record shows he received Tdap 12 years ago, influenza vaccine
this season, and PCV20 three years ago. Which vaccination is most needed at this visit?
A. Repeat Tdap booster now, as it is recommended every 10 years for adults over 65
B. Administer the zoster recombinant vaccine (RZV) series if he has not received it [CORRECT]
C. Give a second dose of PCV20 since he has COPD
D. Administer MMR vaccine as he is at risk due to COPD
Correct Answer: B
Rationale: The recombinant zoster vaccine (Shingrix, RZV) is recommended for all adults >=50, including those who previously
received Zostavax, given as a 2-dose series 2-6 months apart. COPD and smoking increase shingles risk. Tdap is given every 10 years
(he is due in 2 years, but Td can be used for wound management). A second PCV20 is not recommended. MMR is not indicated based
on COPD alone. NR601 curriculum stresses zoster vaccination in older adults.
Q7: During a health promotion visit, an 81-year-old female reports feeling down for the past two months,
with decreased appetite and trouble sleeping after her husband's death 4 months ago. Which screening
tool is most appropriate to administer at this visit?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS-15), as it is validated for older adults and excludes somatic complaints that overlap
with normal aging [CORRECT]
C. Patient Health Questionnaire-2 (PHQ-2) only, as it is the shortest screen
D. Cognitive Assessment Scale (CAS)
Correct Answer: B
Rationale: The Geriatric Depression Scale (GDS-15) is specifically validated for older adults and excludes somatic items (like
appetite and sleep changes) that may overlap with normal aging or medical conditions, unlike the PHQ-9. A score >=5 suggests
depression. The MMSE assesses cognition, not mood. While PHQ-2 is a valid initial screen, GDS is preferred in geriatric populations
per AGS guidelines. NR601 curriculum emphasizes age-appropriate screening tools.
Q8: A 69-year-old male with hypertension and hyperlipidemia is being counseled on cardiovascular risk
reduction. His 10-year ASCVD risk is calculated at 12%. Which of the following lifestyle modifications has
the strongest evidence for reducing cardiovascular events in older adults?
A. Daily low-dose aspirin therapy regardless of bleeding risk
Page 3 | NR601 Midterm Study Guide | A+ Graded
, NR601 Midterm Exam Study Guide | Chamberlain University | 2026/2027 Edition
B. Smoking cessation, blood pressure control, and statin therapy for primary prevention in selected adults 40-75 with
elevated risk [CORRECT]
C. Vitamin E and omega-3 supplementation for primary prevention
D. Aggressive weight loss to achieve BMI <22 through caloric restriction
Correct Answer: B
Rationale: Per ACC/AHA guidelines, the strongest evidence for CV risk reduction in older adults comes from smoking cessation, BP
control (target <130/80 for most), and statin therapy for adults 40-75 with 10-year ASCVD risk >=7.5%. Aspirin primary prevention
in adults >=70 is generally NOT recommended due to bleeding risk (USPSTF). Vitamin E and omega-3 supplements lack strong
evidence. Aggressive weight loss can worsen sarcopenia. NR601 emphasizes evidence-based risk reduction in mature adults.
Q9: An 85-year-old female who lives alone is brought to clinic by her daughter, who is concerned about
her mother's alcohol intake. The patient admits to drinking 2-3 glasses of wine nightly to help her sleep.
Which screening tool is most appropriate for assessing alcohol use disorder in this older adult?
A. CAGE questionnaire, adapted as it has been validated in older adults [CORRECT]
B. AUDIT-C, which is the only validated tool for adults over 80
C. Alcohol Use Disorders Identification Test (AUDIT-10) in full
D. Single-item alcohol screening question only
Correct Answer: A
Rationale: The CAGE questionnaire (or CAGE-AID for substance use) has been specifically validated for older adults and is
recommended by AGS. The AUDIT and AUDIT-C have been validated in general adult populations but less specifically in geriatric
populations. A single-item screen may miss at-risk drinking in older adults. NR601 curriculum emphasizes the CAGE tool for geriatric
alcohol screening. Any positive response warrants further evaluation.
Q10: A 72-year-old male with type 2 diabetes and hypertension is due for his annual wellness visit. Which
of the following cancer screenings is recommended for him at this age, assuming average risk and
adequate prior screening?
A. Prostate-specific antigen (PSA) testing annually, as recommended for all men over 70
B. Colorectal cancer screening, as USPSTF recommends screening through age 75 for average-risk adults [CORRECT]
C. Annual chest X-ray for lung cancer screening
D. Routine bladder cancer screening with urine cytology
Correct Answer: B
Rationale: USPSTF recommends colorectal cancer screening for adults 45-75. PSA testing is not routinely recommended for men
over 70 (individual decision-making for 55-69; recommends against screening >=70). Chest X-ray is not a recommended screening
modality. Bladder cancer screening is not routinely recommended in average-risk individuals. NR601 curriculum aligns with USPSTF
age-appropriate cancer screening guidelines.
Q11: A 67-year-old male presents for smoking cessation counseling. He has tried to quit multiple times
and currently smokes 1 pack per day. He has a history of depression. Which pharmacotherapy is most
appropriate given his comorbidity?
A. Varenicline (Chantix), as it is the most effective monotherapy but requires monitoring for neuropsychiatric symptoms
B. Bupropion SR alone, which will treat both his depression and smoking cessation
C. Nicotine replacement therapy with a patch plus short-acting form, avoiding varenicline due to depression history
[CORRECT]
D. Clonidine, as it is the first-line treatment for smokers with psychiatric comorbidities
Correct Answer: C
Rationale: Combined NRT (long-acting patch plus short-acting gum/lozenge) is effective and safe in patients with depression history,
avoiding the neuropsychiatric concerns associated with varenicline and bupropion. While varenicline is effective, the FDA previously
warned about neuropsychiatric effects (though the boxed warning was removed in 2016, caution persists). Bupropion alone can
worsen depression monitoring needs. Clonidine is second-line. NR601 curriculum stresses individualized smoking cessation in older
Page 4 | NR601 Midterm Study Guide | A+ Graded
