NR601 MIDTERM EXAM — PRACTICE
QUESTIONS WITH ANSWERS &
RATIONALES
Course: NR601 Primary Care of the Maturing and Aged Family Practicum (Chamberlain
University)
Format: Multiple Choice & Short Answer | Questions: 60+ | Includes: Correct Answers
+ Evidence-Based Rationales
Section 1: Geriatric Assessment, Aging & Health Promotion
1. 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
Rationale: Delirium is characterized by an acute change in attention and cognition that
often fluctuates during the day. Dementia is generally chronic and progressive. An acute
change in mental status in an older adult should prompt evaluation for reversible causes
such as infection, medication effects, metabolic abnormalities, dehydration, hypoxia, or
urinary retention.
,2. 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
Rationale: The Confusion Assessment Method (CAM) evaluates acute onset or
fluctuating course, inattention, disorganized thinking, and altered level of consciousness.
Delirium is strongly suggested when acute/fluctuating change and inattention are
present along with disorganized thinking or altered consciousness.
3. Define polypharmacy in the context of geriatric primary care.
Answer: Polypharmacy refers to the use of multiple medications, particularly when the
number or appropriateness of medications increases the risk of adverse effects,
interactions, prescribing cascades, or medication-related harm.
Rationale: There is no universally accepted medication-number cutoff that defines
clinically problematic polypharmacy. In older adults, the more important issue is whether
every medication has a current indication, appropriate dose, acceptable risk, and
meaningful benefit. Medication reconciliation and deprescribing when appropriate are
important components of geriatric care.
4. Which factor is one of the strongest predictors of a future fall in an older adult?
A. Age alone
, B. Prior history of falling
C. Mild hearing impairment
D. Controlled hypertension
Answer: B
Rationale: A prior history of falling is one of the strongest predictors of future falls.
Other risk factors include polypharmacy, use of diuretics or sedatives, orthostatic
hypotension, gait instability, and environmental hazards.
5. A 72-year-old patient presents for an annual wellness visit. Which screening tool
is most appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Answer: B
Rationale: The TUG test assesses mobility, balance, and fall risk, which are key
predictors of functional decline in older adults. The MMSE evaluates cognition, the GDS
screens for depression, and the MNA assesses nutrition.
6. A 68-year-old male patient reports that he has fallen twice in the past 6 months.
Which assessment finding would most increase his risk for future falls?
A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
QUESTIONS WITH ANSWERS &
RATIONALES
Course: NR601 Primary Care of the Maturing and Aged Family Practicum (Chamberlain
University)
Format: Multiple Choice & Short Answer | Questions: 60+ | Includes: Correct Answers
+ Evidence-Based Rationales
Section 1: Geriatric Assessment, Aging & Health Promotion
1. 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
Rationale: Delirium is characterized by an acute change in attention and cognition that
often fluctuates during the day. Dementia is generally chronic and progressive. An acute
change in mental status in an older adult should prompt evaluation for reversible causes
such as infection, medication effects, metabolic abnormalities, dehydration, hypoxia, or
urinary retention.
,2. 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
Rationale: The Confusion Assessment Method (CAM) evaluates acute onset or
fluctuating course, inattention, disorganized thinking, and altered level of consciousness.
Delirium is strongly suggested when acute/fluctuating change and inattention are
present along with disorganized thinking or altered consciousness.
3. Define polypharmacy in the context of geriatric primary care.
Answer: Polypharmacy refers to the use of multiple medications, particularly when the
number or appropriateness of medications increases the risk of adverse effects,
interactions, prescribing cascades, or medication-related harm.
Rationale: There is no universally accepted medication-number cutoff that defines
clinically problematic polypharmacy. In older adults, the more important issue is whether
every medication has a current indication, appropriate dose, acceptable risk, and
meaningful benefit. Medication reconciliation and deprescribing when appropriate are
important components of geriatric care.
4. Which factor is one of the strongest predictors of a future fall in an older adult?
A. Age alone
, B. Prior history of falling
C. Mild hearing impairment
D. Controlled hypertension
Answer: B
Rationale: A prior history of falling is one of the strongest predictors of future falls.
Other risk factors include polypharmacy, use of diuretics or sedatives, orthostatic
hypotension, gait instability, and environmental hazards.
5. A 72-year-old patient presents for an annual wellness visit. Which screening tool
is most appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Answer: B
Rationale: The TUG test assesses mobility, balance, and fall risk, which are key
predictors of functional decline in older adults. The MMSE evaluates cognition, the GDS
screens for depression, and the MNA assesses nutrition.
6. A 68-year-old male patient reports that he has fallen twice in the past 6 months.
Which assessment finding would most increase his risk for future falls?
A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
