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NR 601 MIDTERM EXAM WITH COMPLETE QUESTIONS
AND CORRECT DETAILED SOLUTIONS ALL WITH
RATIONALES LATEST THIS YEAR
NR 601 Midterm Exam: 300 Randomized Scenario-Based MCQs
SECTION 1: PHYSIOLOGICAL AGING & GERIATRIC ASSESSMENT
Question 1
A 72-year-old patient presents for a routine wellness visit. The nurse practitioner understands
that which of the following is a normal physiological change associated with aging?
A) Increased hepatic blood flow
B) Reduced physiological reserve of most body systems
C) Increased renal function
D) Increased skin elasticity
Answer: B
The three primary physiological changes of aging are reduced physiological reserve, reduced
homeostatic mechanisms, and impaired immunological function.
Question 2
An 80-year-old patient reports difficulty reading fine print and driving at night. Which normal
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age-related visual change is most likely?
A) Cataract formation
B) Glaucoma
C) Presbyopia and decreased dark adaptation
D) Macular degeneration
Answer: C
Presbyopia (decreased near vision) and decreased dark adaptation are normal age-related
changes, whereas cataracts, glaucoma, and macular degeneration are pathologic.
Question 3
A nurse practitioner is assessing an older adult for functional decline. According to the Rule of
Fourths, which four factors contribute to functional decline?
A) Genetics, environment, lifestyle, and healthcare
B) Disease, disuse, misuse, and physiologic aging
C) Physical, cognitive, social, and emotional factors
D) Primary, secondary, tertiary, and quaternary aging
Answer: B
The Rule of Fourths describes disease, disuse, misuse, and physiologic aging as the four causes
of functional decline in older adults.
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Question 4
Which screening instrument is specifically designed to assist clinicians in identifying delirium?
A) PHQ-9
B) Confusion Assessment Method (CAM)
C) Mini-Cog
D) Geriatric Depression Scale
Answer: B
The CAM evaluates acute onset, fluctuating course, inattention, disorganized thinking, and
altered level of consciousness to identify delirium.
Question 5
A 78-year-old woman is brought by her daughter for a comprehensive geriatric assessment after
two recent falls and progressive difficulty managing medications and finances. Which pair of
instruments is most appropriate to evaluate basic self-care and higher-level independent living
skills?
A) Mini-Cog and PHQ-9
B) Katz ADL Index and Lawton IADL Scale
C) Get-Up-and-Go test and MMSE
D) Beers Criteria and STOPP/START criteria
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Answer: B
The Katz Index assesses basic ADLs, while the Lawton Scale assesses IADLs such as finances,
medications, and shopping.
Question 6
Which finding most strongly suggests delirium rather than dementia?
A) Gradual memory loss over several years
B) Stable difficulty naming familiar objects
C) Acute onset with fluctuating attention and awareness
D) Progressive impairment in executive functioning
Answer: C
Delirium is characterized by acute onset and fluctuating attention, whereas dementia is
generally chronic and progressive.
Question 7
An 82-year-old man scores 2 on the Mini-Cog. What is the most appropriate next step?
A) Reassure the family that memory loss is normal aging
B) Immediately prescribe a cholinesterase inhibitor
C) Perform a more detailed cognitive assessment and evaluate for reversible causes
NR 601 MIDTERM EXAM WITH COMPLETE QUESTIONS
AND CORRECT DETAILED SOLUTIONS ALL WITH
RATIONALES LATEST THIS YEAR
NR 601 Midterm Exam: 300 Randomized Scenario-Based MCQs
SECTION 1: PHYSIOLOGICAL AGING & GERIATRIC ASSESSMENT
Question 1
A 72-year-old patient presents for a routine wellness visit. The nurse practitioner understands
that which of the following is a normal physiological change associated with aging?
A) Increased hepatic blood flow
B) Reduced physiological reserve of most body systems
C) Increased renal function
D) Increased skin elasticity
Answer: B
The three primary physiological changes of aging are reduced physiological reserve, reduced
homeostatic mechanisms, and impaired immunological function.
Question 2
An 80-year-old patient reports difficulty reading fine print and driving at night. Which normal
, Page 2 of 158
age-related visual change is most likely?
A) Cataract formation
B) Glaucoma
C) Presbyopia and decreased dark adaptation
D) Macular degeneration
Answer: C
Presbyopia (decreased near vision) and decreased dark adaptation are normal age-related
changes, whereas cataracts, glaucoma, and macular degeneration are pathologic.
Question 3
A nurse practitioner is assessing an older adult for functional decline. According to the Rule of
Fourths, which four factors contribute to functional decline?
A) Genetics, environment, lifestyle, and healthcare
B) Disease, disuse, misuse, and physiologic aging
C) Physical, cognitive, social, and emotional factors
D) Primary, secondary, tertiary, and quaternary aging
Answer: B
The Rule of Fourths describes disease, disuse, misuse, and physiologic aging as the four causes
of functional decline in older adults.
, Page 3 of 158
Question 4
Which screening instrument is specifically designed to assist clinicians in identifying delirium?
A) PHQ-9
B) Confusion Assessment Method (CAM)
C) Mini-Cog
D) Geriatric Depression Scale
Answer: B
The CAM evaluates acute onset, fluctuating course, inattention, disorganized thinking, and
altered level of consciousness to identify delirium.
Question 5
A 78-year-old woman is brought by her daughter for a comprehensive geriatric assessment after
two recent falls and progressive difficulty managing medications and finances. Which pair of
instruments is most appropriate to evaluate basic self-care and higher-level independent living
skills?
A) Mini-Cog and PHQ-9
B) Katz ADL Index and Lawton IADL Scale
C) Get-Up-and-Go test and MMSE
D) Beers Criteria and STOPP/START criteria
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Answer: B
The Katz Index assesses basic ADLs, while the Lawton Scale assesses IADLs such as finances,
medications, and shopping.
Question 6
Which finding most strongly suggests delirium rather than dementia?
A) Gradual memory loss over several years
B) Stable difficulty naming familiar objects
C) Acute onset with fluctuating attention and awareness
D) Progressive impairment in executive functioning
Answer: C
Delirium is characterized by acute onset and fluctuating attention, whereas dementia is
generally chronic and progressive.
Question 7
An 82-year-old man scores 2 on the Mini-Cog. What is the most appropriate next step?
A) Reassure the family that memory loss is normal aging
B) Immediately prescribe a cholinesterase inhibitor
C) Perform a more detailed cognitive assessment and evaluate for reversible causes
