NR 601 MIDTERM: PRIMARY CARE OF THE
MATURING AND AGED | 100 ORIGINAL PRACTICE
QUESTIONS AND DETAILED RATIONALES |
CHAMBERLAIN UNIVERSITY
Core Domains
1. Foundations of Geriatric Primary Care and Theories of Aging
2. Physiological Changes of Aging and Pharmacokinetics
3. Comprehensive Geriatric Assessment and Functional Status
4. Cardiovascular Disorders in Older Adults
5. Respiratory Disorders in Older Adults
6. Neurological, Cognitive, and Mental Health Disorders
7. Endocrine and Metabolic Disorders
8. Polypharmacy, Deprescribing, and Beers Criteria
9. Geriatric Syndromes: Falls, Frailty, Incontinence, and Pressure Injuries
10. Health Promotion, Immunizations, and Advance Care Planning
Introduction
This comprehensive examination assesses mastery of geriatric primary care
principles for the family nurse practitioner. The examination evaluates aging
theories, physiological changes, comprehensive geriatric assessment,
cardiovascular and respiratory disorders, cognitive and mental health conditions,
endocrine disorders, polypharmacy, geriatric syndromes, and health promotion.
Questions are structured in multiple-choice and scenario-based formats to
simulate real-world clinical decision-making. Emphasis is placed on applying
evidence-based practice, demonstrating critical thinking, and exercising
professional judgment in the primary care of maturing and aged adults. This
assessment prepares candidates for the NR 601 Midterm Examination.
,SECTION ONE: FOUNDATIONS OF GERIATRIC PRIMARY CARE AND THEORIES OF
AGING (QUESTIONS 1–15)
Question 1
A 72-year-old patient asks the nurse practitioner what "normal aging" means.
Which theory of aging proposes that the accumulation of random cellular damage
over time leads to the physiological decline associated with aging?
A. Disengagement theory
B. Genomic instability theory
C. Activity theory
D. Continuity theory
B. Genomic instability theory
RATIONALE: The genomic instability theory of aging proposes that the
accumulation of random cellular and molecular damage over time leads to the
physiological decline associated with aging. Disengagement theory is a
psychosocial theory suggesting older adults naturally withdraw from social roles.
Activity theory proposes that staying active leads to successful aging. Continuity
theory suggests personality and habits remain stable throughout life.
Question 2
Which of the following best defines the concept of "frailty" in geriatric primary
care?
A. A clinical syndrome characterized by decreased physiologic reserve and
increased vulnerability to stressors
B. A normal consequence of aging that requires no intervention
C. A temporary state of weakness following acute illness
D. A psychological condition characterized by social withdrawal
, A. A clinical syndrome characterized by decreased physiologic reserve and
increased vulnerability to stressors
RATIONALE: Frailty is a clinical syndrome characterized by decreased
physiologic reserve and increased vulnerability to stressors, leading to an
increased risk of adverse outcomes including falls, disability, hospitalization, and
mortality. It is not a normal consequence of aging, is not temporary, and is not
primarily psychological.
Question 3
A nurse practitioner is assessing an 80-year-old patient. Which of the following is
a normal age-related change in the gastrointestinal system that affects drug
absorption?
A. Increased gastric acid production
B. Decreased gastric acid production
C. Increased gastric motility
D. Increased hepatic blood flow
B. Decreased gastric acid production
RATIONALE: Decreased gastric acid production is a normal age-related change
that can affect the absorption of drugs requiring an acidic environment, such as
ketoconazole and iron supplements. Increased gastric acid, increased motility,
and increased hepatic blood flow are not normal age-related changes.
Question 4
Which assessment tool is specifically designed to evaluate instrumental activities
of daily living (IADLs) in older adults?
A. Katz Index of Independence in Activities of Daily Living
B. Lawton IADL Scale
, C. Mini-Mental State Examination (MMSE)
D. Geriatric Depression Scale (GDS)
B. Lawton IADL Scale
RATIONALE: The Lawton IADL Scale assesses instrumental activities of daily
living such as using the telephone, shopping, food preparation, housekeeping,
laundry, mode of transportation, responsibility for medications, and handling
finances. The Katz Index assesses basic ADLs. The MMSE assesses cognition. The
GDS assesses depression.
Question 5
A 75-year-old patient reports a decrease in thirst sensation. Which of the
following is the most important implication for the nurse practitioner?
A. The patient is at increased risk for dehydration
B. The patient is at decreased risk for fluid overload
C. The patient requires fluid restriction
D. The patient should increase sodium intake
A. The patient is at increased risk for dehydration
RATIONALE: Decreased thirst sensation is a normal age-related change that
places older adults at increased risk for dehydration, especially during illness or
hot weather. The patient is not at decreased risk for fluid overload, does not
require fluid restriction, and should not increase sodium intake.
Question 6
A comprehensive geriatric assessment (CGA) evaluates multiple domains. Which
of the following domains is NOT typically included in a CGA?
A. Physical health
B. Cognitive function
MATURING AND AGED | 100 ORIGINAL PRACTICE
QUESTIONS AND DETAILED RATIONALES |
CHAMBERLAIN UNIVERSITY
Core Domains
1. Foundations of Geriatric Primary Care and Theories of Aging
2. Physiological Changes of Aging and Pharmacokinetics
3. Comprehensive Geriatric Assessment and Functional Status
4. Cardiovascular Disorders in Older Adults
5. Respiratory Disorders in Older Adults
6. Neurological, Cognitive, and Mental Health Disorders
7. Endocrine and Metabolic Disorders
8. Polypharmacy, Deprescribing, and Beers Criteria
9. Geriatric Syndromes: Falls, Frailty, Incontinence, and Pressure Injuries
10. Health Promotion, Immunizations, and Advance Care Planning
Introduction
This comprehensive examination assesses mastery of geriatric primary care
principles for the family nurse practitioner. The examination evaluates aging
theories, physiological changes, comprehensive geriatric assessment,
cardiovascular and respiratory disorders, cognitive and mental health conditions,
endocrine disorders, polypharmacy, geriatric syndromes, and health promotion.
Questions are structured in multiple-choice and scenario-based formats to
simulate real-world clinical decision-making. Emphasis is placed on applying
evidence-based practice, demonstrating critical thinking, and exercising
professional judgment in the primary care of maturing and aged adults. This
assessment prepares candidates for the NR 601 Midterm Examination.
,SECTION ONE: FOUNDATIONS OF GERIATRIC PRIMARY CARE AND THEORIES OF
AGING (QUESTIONS 1–15)
Question 1
A 72-year-old patient asks the nurse practitioner what "normal aging" means.
Which theory of aging proposes that the accumulation of random cellular damage
over time leads to the physiological decline associated with aging?
A. Disengagement theory
B. Genomic instability theory
C. Activity theory
D. Continuity theory
B. Genomic instability theory
RATIONALE: The genomic instability theory of aging proposes that the
accumulation of random cellular and molecular damage over time leads to the
physiological decline associated with aging. Disengagement theory is a
psychosocial theory suggesting older adults naturally withdraw from social roles.
Activity theory proposes that staying active leads to successful aging. Continuity
theory suggests personality and habits remain stable throughout life.
Question 2
Which of the following best defines the concept of "frailty" in geriatric primary
care?
A. A clinical syndrome characterized by decreased physiologic reserve and
increased vulnerability to stressors
B. A normal consequence of aging that requires no intervention
C. A temporary state of weakness following acute illness
D. A psychological condition characterized by social withdrawal
, A. A clinical syndrome characterized by decreased physiologic reserve and
increased vulnerability to stressors
RATIONALE: Frailty is a clinical syndrome characterized by decreased
physiologic reserve and increased vulnerability to stressors, leading to an
increased risk of adverse outcomes including falls, disability, hospitalization, and
mortality. It is not a normal consequence of aging, is not temporary, and is not
primarily psychological.
Question 3
A nurse practitioner is assessing an 80-year-old patient. Which of the following is
a normal age-related change in the gastrointestinal system that affects drug
absorption?
A. Increased gastric acid production
B. Decreased gastric acid production
C. Increased gastric motility
D. Increased hepatic blood flow
B. Decreased gastric acid production
RATIONALE: Decreased gastric acid production is a normal age-related change
that can affect the absorption of drugs requiring an acidic environment, such as
ketoconazole and iron supplements. Increased gastric acid, increased motility,
and increased hepatic blood flow are not normal age-related changes.
Question 4
Which assessment tool is specifically designed to evaluate instrumental activities
of daily living (IADLs) in older adults?
A. Katz Index of Independence in Activities of Daily Living
B. Lawton IADL Scale
, C. Mini-Mental State Examination (MMSE)
D. Geriatric Depression Scale (GDS)
B. Lawton IADL Scale
RATIONALE: The Lawton IADL Scale assesses instrumental activities of daily
living such as using the telephone, shopping, food preparation, housekeeping,
laundry, mode of transportation, responsibility for medications, and handling
finances. The Katz Index assesses basic ADLs. The MMSE assesses cognition. The
GDS assesses depression.
Question 5
A 75-year-old patient reports a decrease in thirst sensation. Which of the
following is the most important implication for the nurse practitioner?
A. The patient is at increased risk for dehydration
B. The patient is at decreased risk for fluid overload
C. The patient requires fluid restriction
D. The patient should increase sodium intake
A. The patient is at increased risk for dehydration
RATIONALE: Decreased thirst sensation is a normal age-related change that
places older adults at increased risk for dehydration, especially during illness or
hot weather. The patient is not at decreased risk for fluid overload, does not
require fluid restriction, and should not increase sodium intake.
Question 6
A comprehensive geriatric assessment (CGA) evaluates multiple domains. Which
of the following domains is NOT typically included in a CGA?
A. Physical health
B. Cognitive function
