NR601 WEEK 4 MIDTERM EXAM
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
,GERIATRIC ASSESSMENT, AGING & HEALTH PROMOTION
CARDIOVASCULAR SYSTEM
RESPIRATORY SYSTEM
NEUROLOGIC, COGNITIVE & MENTAL HEALTH
ENDOCRINE & METABOLIC SYSTEM
MUSCULOSKELETAL, RHEUMATOLOGIC & PAIN
GASTROINTESTINAL & HEPATIC SYSTEM
GENITOURINARY & REPRODUCTIVE HEALTH
DERMATOLOGIC, SENSORY & INFECTIOUS CONDITIONS
PHARMACOLOGY, POLYPHARMACY, SAFETY & PREVENTIVE
CARE
This examination assesses the graduate nursing candidate's
readiness for advanced primary care of maturing and aged adults. It
evaluates geriatric assessment, age-related physiological changes,
chronic disease management, pharmacotherapeutics, health
promotion, and evidence-based decision-making. The test uses
multiple-choice and clinical scenario questions to measure
diagnostic reasoning and treatment planning. Emphasis is placed on
age-specific screening guidelines, safe prescribing in older adults,
and real-world application of primary care principles. Candidates
must demonstrate competency in all core domains to ensure safe and
effective care delivery.
SECTION ONE
1. A 76-year-old female with controlled hypertension and no
other chronic illnesses asks about colorectal cancer screening.
According to the U.S. Preventive Services Task Force (USPSTF)
guidelines, what is the most appropriate recommendation?
,A. Screening should continue automatically every 10 years until age
85 regardless of health status
B. Screening is contraindicated in all adults over age 70 due to
colonoscopy perforation risk
C. Screening should be individualized based on health status,
screening history, and life expectancy of at least 10 years
D. Annual fecal occult blood testing is mandatory for all adults over
75
Correct answer: C
RATIONALE: The USPSTF recommends that colorectal cancer
screening decisions for adults aged 76 to 85 be individualized,
considering prior screening history, overall health, and whether life
expectancy is at least 10 years to realize the benefit of screening.
2. An 82-year-old male with Type 2 Diabetes and Stage 3 Chronic
Kidney Disease (eGFR 44 mL/min) has a rising HbA1c of 8.2%.
He is currently taking metformin 500 mg twice daily. What is
the most appropriate prescriptive intervention?
A. Double the metformin dose to 1,000 mg twice daily and recheck
labs in 4 weeks
B. Discontinue metformin completely and initiate high-dose daily
basal glargine insulin
C. Maintain or lower metformin with close monitoring, ensuring it
is not initiated if eGFR drops below 30 mL/min, and target an
individual HbA1c of 7.5%–8.0%
D. Initiate an SGLT2 inhibitor without adjusting other medications
and target an aggressive HbA1c of less than 6.5%
, Correct answer: C
RATIONALE: For older adults with complex health states, tight
glycemic control increases hypoglycemia risk. A relaxed target of
7.5%–8.0% is appropriate. Metformin can be used if eGFR is
between 30–45 mL/min but requires caution; it is contraindicated
below 30 mL/min.
3. A 68-year-old male with a 40 pack-year smoking history
presents with progressive dyspnea on exertion and chronic
non-productive cough. Spirometry reveals an FEV1/FVC ratio
of 0.62 post-bronchodilator. How should the nurse
practitioner interpret this finding?
A. This ratio confirms a restrictive lung defect, indicating a need for
chest CT to rule out idiopathic pulmonary fibrosis
B. An FEV1/FVC ratio less than 0.70 confirms persistent airflow
limitation, establishing a diagnosis of COPD
C. The spirometry is inconclusive because the patient did not
demonstrate a 12% or greater reversible peak flow response
D. This represents normal age-related change in pulmonary
function
Correct answer: B
RATIONALE: An FEV1/FVC ratio less than 0.70 after
bronchodilator administration confirms persistent airflow
limitation and establishes a diagnosis of COPD in a patient with
compatible symptoms and risk factors.
4. Which finding most strongly suggests delirium rather than
dementia?
QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS)
PLUS RATIONALES 2026 Q&A |
INSTANT DOWNLOAD PDF.
,GERIATRIC ASSESSMENT, AGING & HEALTH PROMOTION
CARDIOVASCULAR SYSTEM
RESPIRATORY SYSTEM
NEUROLOGIC, COGNITIVE & MENTAL HEALTH
ENDOCRINE & METABOLIC SYSTEM
MUSCULOSKELETAL, RHEUMATOLOGIC & PAIN
GASTROINTESTINAL & HEPATIC SYSTEM
GENITOURINARY & REPRODUCTIVE HEALTH
DERMATOLOGIC, SENSORY & INFECTIOUS CONDITIONS
PHARMACOLOGY, POLYPHARMACY, SAFETY & PREVENTIVE
CARE
This examination assesses the graduate nursing candidate's
readiness for advanced primary care of maturing and aged adults. It
evaluates geriatric assessment, age-related physiological changes,
chronic disease management, pharmacotherapeutics, health
promotion, and evidence-based decision-making. The test uses
multiple-choice and clinical scenario questions to measure
diagnostic reasoning and treatment planning. Emphasis is placed on
age-specific screening guidelines, safe prescribing in older adults,
and real-world application of primary care principles. Candidates
must demonstrate competency in all core domains to ensure safe and
effective care delivery.
SECTION ONE
1. A 76-year-old female with controlled hypertension and no
other chronic illnesses asks about colorectal cancer screening.
According to the U.S. Preventive Services Task Force (USPSTF)
guidelines, what is the most appropriate recommendation?
,A. Screening should continue automatically every 10 years until age
85 regardless of health status
B. Screening is contraindicated in all adults over age 70 due to
colonoscopy perforation risk
C. Screening should be individualized based on health status,
screening history, and life expectancy of at least 10 years
D. Annual fecal occult blood testing is mandatory for all adults over
75
Correct answer: C
RATIONALE: The USPSTF recommends that colorectal cancer
screening decisions for adults aged 76 to 85 be individualized,
considering prior screening history, overall health, and whether life
expectancy is at least 10 years to realize the benefit of screening.
2. An 82-year-old male with Type 2 Diabetes and Stage 3 Chronic
Kidney Disease (eGFR 44 mL/min) has a rising HbA1c of 8.2%.
He is currently taking metformin 500 mg twice daily. What is
the most appropriate prescriptive intervention?
A. Double the metformin dose to 1,000 mg twice daily and recheck
labs in 4 weeks
B. Discontinue metformin completely and initiate high-dose daily
basal glargine insulin
C. Maintain or lower metformin with close monitoring, ensuring it
is not initiated if eGFR drops below 30 mL/min, and target an
individual HbA1c of 7.5%–8.0%
D. Initiate an SGLT2 inhibitor without adjusting other medications
and target an aggressive HbA1c of less than 6.5%
, Correct answer: C
RATIONALE: For older adults with complex health states, tight
glycemic control increases hypoglycemia risk. A relaxed target of
7.5%–8.0% is appropriate. Metformin can be used if eGFR is
between 30–45 mL/min but requires caution; it is contraindicated
below 30 mL/min.
3. A 68-year-old male with a 40 pack-year smoking history
presents with progressive dyspnea on exertion and chronic
non-productive cough. Spirometry reveals an FEV1/FVC ratio
of 0.62 post-bronchodilator. How should the nurse
practitioner interpret this finding?
A. This ratio confirms a restrictive lung defect, indicating a need for
chest CT to rule out idiopathic pulmonary fibrosis
B. An FEV1/FVC ratio less than 0.70 confirms persistent airflow
limitation, establishing a diagnosis of COPD
C. The spirometry is inconclusive because the patient did not
demonstrate a 12% or greater reversible peak flow response
D. This represents normal age-related change in pulmonary
function
Correct answer: B
RATIONALE: An FEV1/FVC ratio less than 0.70 after
bronchodilator administration confirms persistent airflow
limitation and establishes a diagnosis of COPD in a patient with
compatible symptoms and risk factors.
4. Which finding most strongly suggests delirium rather than
dementia?
