NR580 Exam 3 Actual Exam Style V2 | NR
580 Adult-Gerontology Primary Care
Capstone and Intensive | Chamberlain
1. A 68-year-old male presents with persistent heartburn and regurgitation. He has been
taking OTC antacids with minimal relief. What is the next most appropriate step in
management?
A. Prescribe a 4-week trial of a Proton Pump Inhibitor (PPI).
B. Refer for an immediate upper endoscopy.
C. Order a 24-hour pH monitoring study.
D. Perform a barium swallow study.
Answer: A
Rationale: An initial trial of daily PPI therapy for 4-8 weeks is the standard first-line
management for suspected GERD without alarm symptoms. Alarm symptoms such as
dysphagia or weight loss would necessitate an immediate endoscopy. If symptoms persist
after the trial, further diagnostic testing or referral is warranted.
2. Which Medicare Part covers outpatient provider visits and preventative screenings for
older adults?
A. Medicare Part A
B. Medicare Part B
,C. Medicare Part C
D. Medicare Part D
Answer: B
Rationale: Medicare Part B is designed to cover medically necessary services like doctors’
services and outpatient care. It also includes preventive services to help maintain health
and catch illnesses early. Medicare Part A covers inpatient hospital stays, while Part D
covers prescription drugs.
3. An 82-year-old female presents with sudden onset confusion and fluctuating levels of
consciousness. Her family notes she was normal two days ago. What is the most likely
diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Depression
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and fluctuating course of cognitive
impairment. It is often triggered by an underlying medical condition like an infection or
medication change. Dementia typically involves a slow, progressive decline in cognition
rather than an abrupt shift.
, 4. When staging COPD using the GOLD criteria, a patient with an FEV1/FVC ratio < 0.70 and an
FEV1 of 65% predicted falls into which category?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 moderate COPD is defined as an FEV1 between 50% and 79% of the
predicted value. GOLD 1 is mild with FEV1 over 80%, while GOLD 3 is severe with FEV1
between 30% and 49%. These classifications help guide the pharmacological management
of chronic obstructive pulmonary disease.
5. A 75-year-old patient with heart failure reports increased shortness of breath with mild
activity but is comfortable at rest. Which NYHA Class best describes this patient?
A. Class I
B. Class III
C. Class II
D. Class IV
Answer: B
580 Adult-Gerontology Primary Care
Capstone and Intensive | Chamberlain
1. A 68-year-old male presents with persistent heartburn and regurgitation. He has been
taking OTC antacids with minimal relief. What is the next most appropriate step in
management?
A. Prescribe a 4-week trial of a Proton Pump Inhibitor (PPI).
B. Refer for an immediate upper endoscopy.
C. Order a 24-hour pH monitoring study.
D. Perform a barium swallow study.
Answer: A
Rationale: An initial trial of daily PPI therapy for 4-8 weeks is the standard first-line
management for suspected GERD without alarm symptoms. Alarm symptoms such as
dysphagia or weight loss would necessitate an immediate endoscopy. If symptoms persist
after the trial, further diagnostic testing or referral is warranted.
2. Which Medicare Part covers outpatient provider visits and preventative screenings for
older adults?
A. Medicare Part A
B. Medicare Part B
,C. Medicare Part C
D. Medicare Part D
Answer: B
Rationale: Medicare Part B is designed to cover medically necessary services like doctors’
services and outpatient care. It also includes preventive services to help maintain health
and catch illnesses early. Medicare Part A covers inpatient hospital stays, while Part D
covers prescription drugs.
3. An 82-year-old female presents with sudden onset confusion and fluctuating levels of
consciousness. Her family notes she was normal two days ago. What is the most likely
diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Depression
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute onset and fluctuating course of cognitive
impairment. It is often triggered by an underlying medical condition like an infection or
medication change. Dementia typically involves a slow, progressive decline in cognition
rather than an abrupt shift.
, 4. When staging COPD using the GOLD criteria, a patient with an FEV1/FVC ratio < 0.70 and an
FEV1 of 65% predicted falls into which category?
A. GOLD 1 (Mild)
B. GOLD 4 (Very Severe)
C. GOLD 3 (Severe)
D. GOLD 2 (Moderate)
Answer: D
Rationale: GOLD 2 moderate COPD is defined as an FEV1 between 50% and 79% of the
predicted value. GOLD 1 is mild with FEV1 over 80%, while GOLD 3 is severe with FEV1
between 30% and 49%. These classifications help guide the pharmacological management
of chronic obstructive pulmonary disease.
5. A 75-year-old patient with heart failure reports increased shortness of breath with mild
activity but is comfortable at rest. Which NYHA Class best describes this patient?
A. Class I
B. Class III
C. Class II
D. Class IV
Answer: B
