NUNP 6531 Advanced Practice Care of
Adults Across the Lifespan
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. A 68-year-old male patient with type 2 diabetes presents with signs of
peripheral neuropathy. Which of the following is the most appropriate
initial assessment to evaluate the extent of neuropathy?
A) Nerve conduction studies
B) 10-g monofilament test
C) Lumbar puncture
D) MRI of the spine
ANS: B
Rationale: The 10-g monofilament test is a simple, validated tool for
assessing peripheral neuropathy in diabetic patients as part of routine
clinical evaluation.
2. An adult patient with chronic heart failure presents with worsening
symptoms. Which biomarker is most sensitive in diagnosing acute
decompensated heart failure?
A) Troponin I
B) Brain Natriuretic Peptide (BNP)
C) Creatinine kinase
D) C-reactive protein
ANS: B
Rationale: BNP levels increase in response to ventricular stretch and are
highly sensitive markers for diagnosing acute decompensated heart
failure.
3. In managing a 75-year-old patient with COPD and chronic hypoxia,
which of the following is the best indication for home oxygen therapy?
A) PaO2 < 60 mm Hg or SaO2 < 88%
B) PaCO2 > 50 mm Hg
C) FEV1 < 50% predicted
D) Frequent exacerbations
ANS: A
Rationale: Long-term oxygen therapy is indicated primarily by chronic
hypoxemia defined as PaO2 < 60 mm Hg or SaO2 < 88%.
©2025
, 4. A 50-year-old patient with moderate Alzheimer’s disease is losing the
ability to perform activities of daily living (ADLs). Which non-
pharmacological intervention has the most evidence for improving
quality of life?
A) Cognitive behavioral therapy
B) Aerobic exercise program
C) Reality orientation therapy
D) Social engagement activities
ANS: D
Rationale: Social engagement activities have been shown to improve
mood and quality of life in patients with Alzheimer’s disease.
5. In assessing nutritional status in older adults, which laboratory
parameter is most useful for evaluating protein-calorie malnutrition?
A) Serum albumin
B) Blood glucose
C) Serum calcium
D) Total cholesterol
ANS: A
Rationale: Serum albumin is a surrogate marker for protein malnutrition
and is frequently used to assess nutritional status in older adults.
Fill-in-the-Blank Questions
6. The first-line pharmacologic treatment for moderate to severe chronic
heart failure with reduced ejection fraction includes __________
inhibitors and beta-blockers.
ANS: ACE (Angiotensin-converting enzyme)
Rationale: ACE inhibitors and beta-blockers reduce mortality and
morbidity in heart failure with reduced ejection fraction.
7. The __________ score is commonly used to estimate stroke risk in
patients with atrial fibrillation.
ANS: CHA2DS2-VASc
Rationale: The CHA2DS2-VASc score helps guide anticoagulation
decisions in atrial fibrillation based on stroke risk factors.
©2025
Adults Across the Lifespan
Midterm Exam Review
(Questions & Solutions)
2025
©2025
,1. A 68-year-old male patient with type 2 diabetes presents with signs of
peripheral neuropathy. Which of the following is the most appropriate
initial assessment to evaluate the extent of neuropathy?
A) Nerve conduction studies
B) 10-g monofilament test
C) Lumbar puncture
D) MRI of the spine
ANS: B
Rationale: The 10-g monofilament test is a simple, validated tool for
assessing peripheral neuropathy in diabetic patients as part of routine
clinical evaluation.
2. An adult patient with chronic heart failure presents with worsening
symptoms. Which biomarker is most sensitive in diagnosing acute
decompensated heart failure?
A) Troponin I
B) Brain Natriuretic Peptide (BNP)
C) Creatinine kinase
D) C-reactive protein
ANS: B
Rationale: BNP levels increase in response to ventricular stretch and are
highly sensitive markers for diagnosing acute decompensated heart
failure.
3. In managing a 75-year-old patient with COPD and chronic hypoxia,
which of the following is the best indication for home oxygen therapy?
A) PaO2 < 60 mm Hg or SaO2 < 88%
B) PaCO2 > 50 mm Hg
C) FEV1 < 50% predicted
D) Frequent exacerbations
ANS: A
Rationale: Long-term oxygen therapy is indicated primarily by chronic
hypoxemia defined as PaO2 < 60 mm Hg or SaO2 < 88%.
©2025
, 4. A 50-year-old patient with moderate Alzheimer’s disease is losing the
ability to perform activities of daily living (ADLs). Which non-
pharmacological intervention has the most evidence for improving
quality of life?
A) Cognitive behavioral therapy
B) Aerobic exercise program
C) Reality orientation therapy
D) Social engagement activities
ANS: D
Rationale: Social engagement activities have been shown to improve
mood and quality of life in patients with Alzheimer’s disease.
5. In assessing nutritional status in older adults, which laboratory
parameter is most useful for evaluating protein-calorie malnutrition?
A) Serum albumin
B) Blood glucose
C) Serum calcium
D) Total cholesterol
ANS: A
Rationale: Serum albumin is a surrogate marker for protein malnutrition
and is frequently used to assess nutritional status in older adults.
Fill-in-the-Blank Questions
6. The first-line pharmacologic treatment for moderate to severe chronic
heart failure with reduced ejection fraction includes __________
inhibitors and beta-blockers.
ANS: ACE (Angiotensin-converting enzyme)
Rationale: ACE inhibitors and beta-blockers reduce mortality and
morbidity in heart failure with reduced ejection fraction.
7. The __________ score is commonly used to estimate stroke risk in
patients with atrial fibrillation.
ANS: CHA2DS2-VASc
Rationale: The CHA2DS2-VASc score helps guide anticoagulation
decisions in atrial fibrillation based on stroke risk factors.
©2025
