NR 601 FINAL EXAM LATEST CONTAINS
400 QUESTIONS & ANSWERS 2025/2026
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70
mmHg, pulse 69 beats per min, and respiratory rate 18 breaths per min. She is well
appearing and reports she is up to date on her routine vaccinations. She introduces her
partner of 35 years whom she would like to make medical decisions for her in case she
becomes unable to make decisions for herself. She reports that she and her partner are not
married. She asks if she needs any further documentation to ensure her goals of care are
followed. Which one of the following would be the most appropriate recommendation for
this patient and her partner? - correct answer Advise them to file an advanced directive.
. An 81-year-old transgender female with history of depression and hyperlipidemia presents
to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack
per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She
reports she takes atorvastatin 20 mg and subcutaneous estrogen therapy. - correct answer
Counseling on smoking cessation
An 84-year-old male with history of stroke without residual deficit, systolic heart failure, and
type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement
community and still works part time on a golf course. He currently takes aspirin 81 mg,
metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg
daily. He reports his last colonoscopy was 8 years ago, with no abnormality. He reports he is
sexually active with men and women, engaging in receptive oral, receptive anal, and
penetrative sex. He states he has had over three sexual partners in the last year with
intermittent condom use. What sexually transmitted infection testing should be offered? -
correct answer Urine testing, blood testing, anal swab, and oropharyngeal swab
Which of the following is true about tolterodine? - correct answer It has greater risk of
adverse effects with its twice-daily formulation.
An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per night.
His other lower urinary tract symptoms are slow stream, occasional urgency, and urgency-
related leakage once weekly. Medical problems include poorly controlled hypertension,
diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications
include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily,
metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg
daily. Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems,
Mr. A complains that nocturia is causing daytime fatigue, and he is more constipated.
, Physical examination is notable for blood pressure 162/83 mmHg, heart rate 60 beats per
minute, clear lungs, soft abdomen, enlarged prostate, and 21 pretibial edema. Your next step
in management should be: - correct answer Stop amlodipine and increase lisinopril.
The daughter of a 79-year-old woman notes that her mother, who has dementia and lives
with her, is wetting herself when she attends her new day program. Program staff have
requested that "something be done" as she is requiring a clothes change nearly every time
she is there. She cannot describe the circumstances of leakage, saying "it just comes."
Leakage is uncommon at home. Her medications include donepezil and acetaminophen.
Physical examination is normal. Initial treatment approach will require intervention by which
of the following? - correct answer Day program staff
. Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten
worse over the past year, and she rarely makes it through nine holes without feeling like she
needs to "run into the bushes and go." Leakage is usually small volume, but causes her
extreme embarrassment because she is afraid she will smell of urine. She has tried limiting
caffeine in the morning before she golfs and avoiding drinking water while playing, to no
effect. She also tried "those Kegler" exercises in the past without success. Which of the
following is the most appropriate recommendation for Ms. J? - correct answer Bladder
training
What is the most common cause of erectile dysfunction in older men? - correct answer
Atherosclerosis
Which is the most reasonable first step in the treatment of older men with erectile
dysfunction? - correct answer Sildenafil
A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history
includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide,
chlorthalidone, and acetaminophen. What would be your first step in therapy? - correct
answer Stop chlorthalidone
A 70-year-old woman reports sexual pain with deep penetration only. What is the most likely
cause of her problem? - correct answer High-tone pelvic floor dysfunction
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? - correct
answer 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
400 QUESTIONS & ANSWERS 2025/2026
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70
mmHg, pulse 69 beats per min, and respiratory rate 18 breaths per min. She is well
appearing and reports she is up to date on her routine vaccinations. She introduces her
partner of 35 years whom she would like to make medical decisions for her in case she
becomes unable to make decisions for herself. She reports that she and her partner are not
married. She asks if she needs any further documentation to ensure her goals of care are
followed. Which one of the following would be the most appropriate recommendation for
this patient and her partner? - correct answer Advise them to file an advanced directive.
. An 81-year-old transgender female with history of depression and hyperlipidemia presents
to your clinic for routine care. She endorses a history of smoking, currently smoking 1 pack
per day, and occasionally drinks a glass of wine, although she denies illicit drug use. She
reports she takes atorvastatin 20 mg and subcutaneous estrogen therapy. - correct answer
Counseling on smoking cessation
An 84-year-old male with history of stroke without residual deficit, systolic heart failure, and
type 2 diabetes presents to clinic for follow-up. He is independently living in a retirement
community and still works part time on a golf course. He currently takes aspirin 81 mg,
metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and lisinopril 10 mg
daily. He reports his last colonoscopy was 8 years ago, with no abnormality. He reports he is
sexually active with men and women, engaging in receptive oral, receptive anal, and
penetrative sex. He states he has had over three sexual partners in the last year with
intermittent condom use. What sexually transmitted infection testing should be offered? -
correct answer Urine testing, blood testing, anal swab, and oropharyngeal swab
Which of the following is true about tolterodine? - correct answer It has greater risk of
adverse effects with its twice-daily formulation.
An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per night.
His other lower urinary tract symptoms are slow stream, occasional urgency, and urgency-
related leakage once weekly. Medical problems include poorly controlled hypertension,
diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His medications
include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin 10 mg daily,
metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg
daily. Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems,
Mr. A complains that nocturia is causing daytime fatigue, and he is more constipated.
, Physical examination is notable for blood pressure 162/83 mmHg, heart rate 60 beats per
minute, clear lungs, soft abdomen, enlarged prostate, and 21 pretibial edema. Your next step
in management should be: - correct answer Stop amlodipine and increase lisinopril.
The daughter of a 79-year-old woman notes that her mother, who has dementia and lives
with her, is wetting herself when she attends her new day program. Program staff have
requested that "something be done" as she is requiring a clothes change nearly every time
she is there. She cannot describe the circumstances of leakage, saying "it just comes."
Leakage is uncommon at home. Her medications include donepezil and acetaminophen.
Physical examination is normal. Initial treatment approach will require intervention by which
of the following? - correct answer Day program staff
. Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten
worse over the past year, and she rarely makes it through nine holes without feeling like she
needs to "run into the bushes and go." Leakage is usually small volume, but causes her
extreme embarrassment because she is afraid she will smell of urine. She has tried limiting
caffeine in the morning before she golfs and avoiding drinking water while playing, to no
effect. She also tried "those Kegler" exercises in the past without success. Which of the
following is the most appropriate recommendation for Ms. J? - correct answer Bladder
training
What is the most common cause of erectile dysfunction in older men? - correct answer
Atherosclerosis
Which is the most reasonable first step in the treatment of older men with erectile
dysfunction? - correct answer Sildenafil
A 72-year-old woman reports vaginal dryness that interferes with coitus. Her medical history
includes type 2 diabetes, hypertension, and osteoarthritis. Medications are glyburide,
chlorthalidone, and acetaminophen. What would be your first step in therapy? - correct
answer Stop chlorthalidone
A 70-year-old woman reports sexual pain with deep penetration only. What is the most likely
cause of her problem? - correct answer High-tone pelvic floor dysfunction
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? - correct
answer 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
