NR 601 Primary Care of the Maturing and Aged Family Practicum
NR 601 Midterm Exam 2025/2026 Complete
Question and Answer 100% Accurate Summer-
Fall Semesters Exam (2024/2025 May Session)
A 79-year-old woman with a 1.5-cm breast cancer underwent
lumpectomy. Pathology revealed ductal carcinoma that is hormone
receptor negative (estrogen receptor 0%, progesterone receptor 1%) and
HER2/neu negative. Surgical margins were adequate and uninvolved with
cancer. Sentinel lymph node sampling was negative for lymph node
involvement. She has good performance status and no activities of daily
living (ADL) or instrumental (IADL) dependencies. What treatment would
you recommend?
Hormonal therapy only
An 86-year-old man with no ADL deficits who has stopped driving
because of macular degeneration is evaluated for a urinary tract infection
associated with urinary retention. The consulting urologist places a Foley
catheter and sends a prostate-specific antigen (PSA) level that comes
back 12 ng/mL. Three months later after the Foley has been removed and
he has had a good response to tamsulosin, his PSA is still 10 ng/mL. What
is the appropriate next step in managing this man's prostate problem?
Repeat PSA in 6 months
Chamberlain university
,NR 601 Primary Care of the Maturing and Aged Family Practicum
In which of the following patients is chemical or surgical castration likely
to prolong survival?
A 78-year-old man who had a radical prostatectomy and external beam
radiation therapy 10 years earlier now has a PSA level of 24.5 ng/mL. A CT
scan of the pelvis shows an enlarged pelvic lymph node, and a bone scan
is positive in the pelvis.
On admission to the hospital, an 85-year-old woman was found to have a
fungating mass on her right breast. The mass is 9 cm in diameter, partially
ulcerated, and associated with edema of the arm and obvious pain. The
patient has no children and had lived alone until recently, when a neighbor
became concerned for what appeared to be a progressive loss of memory
and neglect of the house. The patient appears confused and withdrawn;
her appearance is disheveled, but she seems to be independent in her
ADLs. The medical history is negative for any serious illnesses. She was
able to drive her own car until shortly before this admission. The nephew
does not wish to authorize hospice "right now." A positron-emission
tomography scan was negative for metastatic disease. In addition to
determining the cause of her delirium, which of the following is the best
way to address the breast mass?
The mass should be biopsied to study hormone receptor and HER2/neu
antigen status.
A 78-year-old man has an emergency partial colectomy for lower
gastrointestinal bleeding. A localized colonic adenocarcinoma is
completely resected. The surgeon did not dissect lymph nodes for
metastatic sampling. The patient wants to know if he should have
chemotherapy. Should he?
Chamberlain university
,NR 601 Primary Care of the Maturing and Aged Family Practicum
No because he can be followed with serial carcinoembryonic antigens and
CT scans.
An 80-year-old woman has no weight loss, no pain, and no distention but
over 2 years increasingly complains of constipation despite adequate
medical treatment. A colonoscopy is negative. An abdominal CT is
performed. It reveals well-circumscribed pelvic masses, the largest
adherent to the ovarian ligament. The best first step is:
Invite her to return with a family member and have a long talk about the
diagnostic and therapeutic options.
Chapter 3: Geriatric Assessment
An 86-year-old male who lives in an assisted living facility is at the clinic.
He has a history of hypertension and manages his own medications. He
admits he takes them sometimes. After speaking to him, you find it
unclear if he understands the questions and discussions. Which of the
following evidences that the patient has adequate health literacy?
He knows the names and doses of his medications and can explain why he
takes them.
You are performing a geriatric assessment on an 82-year-old female. At
the end of the visit, which of the following would require top priority over
the others?
The death of the patient's caregiver
Chamberlain university
, NR 601 Primary Care of the Maturing and Aged Family Practicum
Ms. M's family has noticed memory loss for the past 6 months. She
continues to drive but recently had a fender bender and was caught
speeding on a 35-mph road. She insists that she is safe and needs to drive
to church and for shopping. What is the best next step?
Get a driving evaluation.
The following are true statements about bipolar disorders in older
adults except
Bipolar disorder is the most commonly diagnosed psychiatric
disorder in older adults.
Chapter 5: Wellness and Prevention
The US Advisory Committee on Immunization Practices and the Centers
for Disease Control currently recommend which one of the following?
a. All older adults be immunized against influenza annually and that they
receive at least one pneumococcal vaccination.
Chamberlain university
NR 601 Midterm Exam 2025/2026 Complete
Question and Answer 100% Accurate Summer-
Fall Semesters Exam (2024/2025 May Session)
A 79-year-old woman with a 1.5-cm breast cancer underwent
lumpectomy. Pathology revealed ductal carcinoma that is hormone
receptor negative (estrogen receptor 0%, progesterone receptor 1%) and
HER2/neu negative. Surgical margins were adequate and uninvolved with
cancer. Sentinel lymph node sampling was negative for lymph node
involvement. She has good performance status and no activities of daily
living (ADL) or instrumental (IADL) dependencies. What treatment would
you recommend?
Hormonal therapy only
An 86-year-old man with no ADL deficits who has stopped driving
because of macular degeneration is evaluated for a urinary tract infection
associated with urinary retention. The consulting urologist places a Foley
catheter and sends a prostate-specific antigen (PSA) level that comes
back 12 ng/mL. Three months later after the Foley has been removed and
he has had a good response to tamsulosin, his PSA is still 10 ng/mL. What
is the appropriate next step in managing this man's prostate problem?
Repeat PSA in 6 months
Chamberlain university
,NR 601 Primary Care of the Maturing and Aged Family Practicum
In which of the following patients is chemical or surgical castration likely
to prolong survival?
A 78-year-old man who had a radical prostatectomy and external beam
radiation therapy 10 years earlier now has a PSA level of 24.5 ng/mL. A CT
scan of the pelvis shows an enlarged pelvic lymph node, and a bone scan
is positive in the pelvis.
On admission to the hospital, an 85-year-old woman was found to have a
fungating mass on her right breast. The mass is 9 cm in diameter, partially
ulcerated, and associated with edema of the arm and obvious pain. The
patient has no children and had lived alone until recently, when a neighbor
became concerned for what appeared to be a progressive loss of memory
and neglect of the house. The patient appears confused and withdrawn;
her appearance is disheveled, but she seems to be independent in her
ADLs. The medical history is negative for any serious illnesses. She was
able to drive her own car until shortly before this admission. The nephew
does not wish to authorize hospice "right now." A positron-emission
tomography scan was negative for metastatic disease. In addition to
determining the cause of her delirium, which of the following is the best
way to address the breast mass?
The mass should be biopsied to study hormone receptor and HER2/neu
antigen status.
A 78-year-old man has an emergency partial colectomy for lower
gastrointestinal bleeding. A localized colonic adenocarcinoma is
completely resected. The surgeon did not dissect lymph nodes for
metastatic sampling. The patient wants to know if he should have
chemotherapy. Should he?
Chamberlain university
,NR 601 Primary Care of the Maturing and Aged Family Practicum
No because he can be followed with serial carcinoembryonic antigens and
CT scans.
An 80-year-old woman has no weight loss, no pain, and no distention but
over 2 years increasingly complains of constipation despite adequate
medical treatment. A colonoscopy is negative. An abdominal CT is
performed. It reveals well-circumscribed pelvic masses, the largest
adherent to the ovarian ligament. The best first step is:
Invite her to return with a family member and have a long talk about the
diagnostic and therapeutic options.
Chapter 3: Geriatric Assessment
An 86-year-old male who lives in an assisted living facility is at the clinic.
He has a history of hypertension and manages his own medications. He
admits he takes them sometimes. After speaking to him, you find it
unclear if he understands the questions and discussions. Which of the
following evidences that the patient has adequate health literacy?
He knows the names and doses of his medications and can explain why he
takes them.
You are performing a geriatric assessment on an 82-year-old female. At
the end of the visit, which of the following would require top priority over
the others?
The death of the patient's caregiver
Chamberlain university
, NR 601 Primary Care of the Maturing and Aged Family Practicum
Ms. M's family has noticed memory loss for the past 6 months. She
continues to drive but recently had a fender bender and was caught
speeding on a 35-mph road. She insists that she is safe and needs to drive
to church and for shopping. What is the best next step?
Get a driving evaluation.
The following are true statements about bipolar disorders in older
adults except
Bipolar disorder is the most commonly diagnosed psychiatric
disorder in older adults.
Chapter 5: Wellness and Prevention
The US Advisory Committee on Immunization Practices and the Centers
for Disease Control currently recommend which one of the following?
a. All older adults be immunized against influenza annually and that they
receive at least one pneumococcal vaccination.
Chamberlain university
