NR 603
Adult-Gerontology
Primary Care
Week 8 Final Exam
Verified Solutions Pack
Original 100-question
adult-gerontology primary-care
study resource
NR603 Adult-Gerontology Primary
Care Week 8 Final Exam Verified
Solutions Pack
Original practice resource for study use only — not an actual exam, leaked content, official
answer key, Examplify file, or institution-endorsed material. The explanations are
educational and should be verified against current NR603 course materials, instructor
guidance, evidence-based practice, and local protocols.
Adult-Gerontology Primary Care Final-Exam Review
One hundred original case-based questions covering assessment, prevention, chronic
disease, diagnostics, pharmacology, geriatric syndromes, mental health, ethics, safety, and
continuity of care.
Study strategy: Answer each case before reviewing the explanation, then verify changing
recommendations against current guidelines and local policy.
Original practice resource | Study use only
,1. Advanced Assessment and Clinical Reasoning
Section focus: Synthesize history, examination findings, risk factors, red flags, and diagnostic
priorities before selecting management.
Question 1. A 64-year-old with diabetes reports new fatigue, nausea, and mild epigastric
pressure. The patient denies sharp chest pain. Which action is the priority?
A. Obtain an ECG and assess for acute coronary syndrome.
B. Recommend an antacid and routine follow-up.
C. Encourage vigorous exercise.
D. Attribute symptoms to diabetic gastroparesis.
Correct answer: A. Obtain an ECG and assess for acute coronary syndrome.
Rationale: Diabetes can blunt or alter ischemic symptoms. Atypical nausea, fatigue, and
epigastric pressure require urgent cardiovascular assessment before a gastrointestinal
explanation is accepted.
Question 2. A 28-year-old reports sudden unilateral calf swelling after a long flight and uses
an estrogen-containing contraceptive. Which finding most increases concern for venous
thromboembolism?
A. Symmetric ankle swelling after standing
B. Unilateral warmth, tenderness, and increasing calf circumference
C. Mild bilateral foot tingling
D. Chronic knee crepitus
Correct answer: B. Unilateral warmth, tenderness, and increasing calf circumference
Rationale: Recent immobility and estrogen exposure increase thrombotic risk. Unilateral
swelling, warmth, and tenderness warrant prompt evaluation; the leg should not be
massaged.
Question 3. A 72-year-old presents with confusion, weakness, and a new irregular pulse.
Which assessment should occur first?
A. Review the patient’s favorite foods
B. Assess airway, breathing, circulation, glucose, and neurologic status
C. Schedule a routine cognitive screen next month
,D. Encourage the patient to walk independently
Correct answer: B. Assess airway, breathing, circulation, glucose, and neurologic status
Rationale: Acute confusion and weakness may reflect stroke, hypoglycemia, dysrhythmia,
infection, or shock. Immediate stabilization and focused assessment precede routine
evaluation.
Question 4. A 45-year-old has progressive fatigue, exertional dyspnea, and dark stools. Which
history question is most important?
A. “What is your preferred exercise?”
B. “Have you noticed black stools, gastrointestinal symptoms, or regular NSAID use?”
C. “Do you prefer morning or evening appointments?”
D. “Have you recently changed your hairstyle?”
Correct answer: B. “Have you noticed black stools, gastrointestinal symptoms, or regular
NSAID use?”
Rationale: Melena and NSAID exposure raise concern for gastrointestinal blood loss and iron-
deficiency anemia. The history should guide urgent testing and medication review.
Question 5. A 34-year-old has episodic palpitations, tremor, sweating, and weight loss. Which
additional finding would support hyperthyroidism?
A. Bradycardia and cold intolerance
B. Heat intolerance, frequent stools, and a fine tremor
C. Periorbital edema and slowed speech
D. Severe constipation and dry skin
Correct answer: B. Heat intolerance, frequent stools, and a fine tremor
Rationale: Increased thyroid hormone activity can produce heat intolerance, tremor, weight
loss, tachycardia, anxiety, and increased bowel frequency. Thyroid testing is needed to
confirm the cause.
Question 6. A 58-year-old with hypertension reports a sudden “worst headache of my life”
followed by vomiting and neck stiffness. What is the priority?
A. Recommend rest and reassessment in one week
B. Arrange emergency neurologic evaluation for possible subarachnoid hemorrhage
, C. Suggest a warm shower
D. Encourage neck stretching
Correct answer: B. Arrange emergency neurologic evaluation for possible subarachnoid
hemorrhage
Rationale: Abrupt maximal headache with vomiting and meningismus is a neurologic
emergency. Emergency imaging and specialist evaluation should not be delayed by
outpatient symptomatic treatment.
Question 7. A 39-year-old reports episodic right-upper-quadrant pain after fatty meals. Which
associated finding would require urgent escalation?
A. Pain lasting 20 minutes and resolving spontaneously
B. Fever, jaundice, and persistent abdominal pain
C. Mild bloating without tenderness
D. Improved symptoms after avoiding fried foods
Correct answer: B. Fever, jaundice, and persistent abdominal pain
Rationale: Fever, jaundice, and persistent right-upper-quadrant pain suggest biliary
obstruction or infection such as ascending cholangitis. Prompt laboratory, imaging, and
emergency evaluation are indicated.
Question 8. A 67-year-old taking warfarin reports dizziness and a new large bruise. Which
assessment is most important?
A. Medication reconciliation, bleeding review, and current coagulation results
B. Daily caffeine intake only
C. Whether the patient prefers tablets or capsules
D. Whether the patient has seasonal allergies
Correct answer: A. Medication reconciliation, bleeding review, and current coagulation
results
Rationale: Bruising and dizziness may signal excessive anticoagulation or occult bleeding.
Review interacting medicines, adherence, diet changes, fall risk, and laboratory monitoring.
Question 9. A 23-year-old has fever, pelvic pain, cervical motion tenderness, and purulent
discharge. Which management principle is best?
A. Delay treatment until symptoms resolve naturally
Adult-Gerontology
Primary Care
Week 8 Final Exam
Verified Solutions Pack
Original 100-question
adult-gerontology primary-care
study resource
NR603 Adult-Gerontology Primary
Care Week 8 Final Exam Verified
Solutions Pack
Original practice resource for study use only — not an actual exam, leaked content, official
answer key, Examplify file, or institution-endorsed material. The explanations are
educational and should be verified against current NR603 course materials, instructor
guidance, evidence-based practice, and local protocols.
Adult-Gerontology Primary Care Final-Exam Review
One hundred original case-based questions covering assessment, prevention, chronic
disease, diagnostics, pharmacology, geriatric syndromes, mental health, ethics, safety, and
continuity of care.
Study strategy: Answer each case before reviewing the explanation, then verify changing
recommendations against current guidelines and local policy.
Original practice resource | Study use only
,1. Advanced Assessment and Clinical Reasoning
Section focus: Synthesize history, examination findings, risk factors, red flags, and diagnostic
priorities before selecting management.
Question 1. A 64-year-old with diabetes reports new fatigue, nausea, and mild epigastric
pressure. The patient denies sharp chest pain. Which action is the priority?
A. Obtain an ECG and assess for acute coronary syndrome.
B. Recommend an antacid and routine follow-up.
C. Encourage vigorous exercise.
D. Attribute symptoms to diabetic gastroparesis.
Correct answer: A. Obtain an ECG and assess for acute coronary syndrome.
Rationale: Diabetes can blunt or alter ischemic symptoms. Atypical nausea, fatigue, and
epigastric pressure require urgent cardiovascular assessment before a gastrointestinal
explanation is accepted.
Question 2. A 28-year-old reports sudden unilateral calf swelling after a long flight and uses
an estrogen-containing contraceptive. Which finding most increases concern for venous
thromboembolism?
A. Symmetric ankle swelling after standing
B. Unilateral warmth, tenderness, and increasing calf circumference
C. Mild bilateral foot tingling
D. Chronic knee crepitus
Correct answer: B. Unilateral warmth, tenderness, and increasing calf circumference
Rationale: Recent immobility and estrogen exposure increase thrombotic risk. Unilateral
swelling, warmth, and tenderness warrant prompt evaluation; the leg should not be
massaged.
Question 3. A 72-year-old presents with confusion, weakness, and a new irregular pulse.
Which assessment should occur first?
A. Review the patient’s favorite foods
B. Assess airway, breathing, circulation, glucose, and neurologic status
C. Schedule a routine cognitive screen next month
,D. Encourage the patient to walk independently
Correct answer: B. Assess airway, breathing, circulation, glucose, and neurologic status
Rationale: Acute confusion and weakness may reflect stroke, hypoglycemia, dysrhythmia,
infection, or shock. Immediate stabilization and focused assessment precede routine
evaluation.
Question 4. A 45-year-old has progressive fatigue, exertional dyspnea, and dark stools. Which
history question is most important?
A. “What is your preferred exercise?”
B. “Have you noticed black stools, gastrointestinal symptoms, or regular NSAID use?”
C. “Do you prefer morning or evening appointments?”
D. “Have you recently changed your hairstyle?”
Correct answer: B. “Have you noticed black stools, gastrointestinal symptoms, or regular
NSAID use?”
Rationale: Melena and NSAID exposure raise concern for gastrointestinal blood loss and iron-
deficiency anemia. The history should guide urgent testing and medication review.
Question 5. A 34-year-old has episodic palpitations, tremor, sweating, and weight loss. Which
additional finding would support hyperthyroidism?
A. Bradycardia and cold intolerance
B. Heat intolerance, frequent stools, and a fine tremor
C. Periorbital edema and slowed speech
D. Severe constipation and dry skin
Correct answer: B. Heat intolerance, frequent stools, and a fine tremor
Rationale: Increased thyroid hormone activity can produce heat intolerance, tremor, weight
loss, tachycardia, anxiety, and increased bowel frequency. Thyroid testing is needed to
confirm the cause.
Question 6. A 58-year-old with hypertension reports a sudden “worst headache of my life”
followed by vomiting and neck stiffness. What is the priority?
A. Recommend rest and reassessment in one week
B. Arrange emergency neurologic evaluation for possible subarachnoid hemorrhage
, C. Suggest a warm shower
D. Encourage neck stretching
Correct answer: B. Arrange emergency neurologic evaluation for possible subarachnoid
hemorrhage
Rationale: Abrupt maximal headache with vomiting and meningismus is a neurologic
emergency. Emergency imaging and specialist evaluation should not be delayed by
outpatient symptomatic treatment.
Question 7. A 39-year-old reports episodic right-upper-quadrant pain after fatty meals. Which
associated finding would require urgent escalation?
A. Pain lasting 20 minutes and resolving spontaneously
B. Fever, jaundice, and persistent abdominal pain
C. Mild bloating without tenderness
D. Improved symptoms after avoiding fried foods
Correct answer: B. Fever, jaundice, and persistent abdominal pain
Rationale: Fever, jaundice, and persistent right-upper-quadrant pain suggest biliary
obstruction or infection such as ascending cholangitis. Prompt laboratory, imaging, and
emergency evaluation are indicated.
Question 8. A 67-year-old taking warfarin reports dizziness and a new large bruise. Which
assessment is most important?
A. Medication reconciliation, bleeding review, and current coagulation results
B. Daily caffeine intake only
C. Whether the patient prefers tablets or capsules
D. Whether the patient has seasonal allergies
Correct answer: A. Medication reconciliation, bleeding review, and current coagulation
results
Rationale: Bruising and dizziness may signal excessive anticoagulation or occult bleeding.
Review interacting medicines, adherence, diet changes, fall risk, and laboratory monitoring.
Question 9. A 23-year-old has fever, pelvic pain, cervical motion tenderness, and purulent
discharge. Which management principle is best?
A. Delay treatment until symptoms resolve naturally
