Chamberlain NR601 Midterm Exam – Primary Care of
the Maturing & Aged Family Practicum | Latest Update
2026/2027 | 200 Practice Questions & Detailed Answers
| NGNStyle Q&A with Rationales | A+ Graded
SECTION 1: FOUNDATIONS OF GERIATRIC CARE, 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
Correct Answer: C. Acute onset with fluctuating attention and awareness
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. PHQ9
B. Confusion Assessment Method
C. MiniCog
D. Geriatric Depression Scale
Correct Answer: B. Confusion Assessment Method
,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.
A. The use of any medication in an older adult
B. The use of multiple medications, particularly when the number or appropriateness increases risk of
adverse effects
C. The use of exactly five medications
D. The use of only overthecounter medications
Correct Answer: B. The use of multiple medications, particularly when the number or appropriateness
increases risk of adverse effects
Rationale: 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 medicationrelated harm. There is no universally accepted medicationnumber 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
Correct Answer: B. Prior history of falling
,Rationale: A prior history of falling is one of the strongest predictors of future falls. While age, sensory
impairment, and certain medical conditions contribute to fall risk, the single most robust predictor is a
previous fall.
5. The aging process causes what normal physiological changes in the heart?
A. The heart valve thickens and becomes more rigid
B. Cardiac output increases
C. Resting heart rate significantly increases
D. Heart muscle becomes more elastic
Correct Answer: A. The heart valve thickens and becomes more rigid
Rationale: Normal agerelated changes in the cardiovascular system include thickening and stiffening of
heart valves (aortic sclerosis), decreased cardiac output, and decreased compliance of the aorta and
large arteries. Resting heart rate typically remains unchanged. The heart muscle does not become more
elastic with aging; rather, it becomes stiffer.
6. Which theory of aging suggests that aging results from cumulative mistakes in DNA and RNA over
time, which impair cell function?
A. Free radical theory
B. Neuroendocrine theory
C. Error theory
D. Wear and tear theory
Correct Answer: C. Error theory
Rationale: The Error Theory suggests that aging results from cumulative mistakes in DNA and RNA over
time, which impair cell function. The Free Radical Theory (A) proposes that free radicals accumulate and
damage cells, and older adults cannot neutralize them effectively. The Neuroendocrine Theory (B)
, suggests aging results from a programmed reduction in the functioning of the nervous, immune, and
endocrine systems.
7. According to the Rule of Fourths, functional decline in older adults results from which four factors?
A. Disease, disuse, misuse, and physiologic aging
B. Genetics, environment, lifestyle, and healthcare
C. Physical, cognitive, social, and emotional factors
D. Primary, secondary, tertiary, and quaternary aging
Correct Answer: A. Disease, disuse, misuse, and physiologic aging
Rationale: The Rule of Fourths describes four causes of functional decline in older adults: disease
(pathologic conditions), disuse (sedentary lifestyle), misuse (iatrogenic causes), and physiologic aging
(normal agerelated changes). Understanding these factors helps the NP differentiate between normal
aging and pathologic processes.
8. A 72yearold patient reports difficulty reading fine print and driving at night. Which normal agerelated
visual change is most likely?
A. Presbyopia and decreased dark adaptation
B. Cataract formation
C. Glaucoma
D. Macular degeneration
Correct Answer: A. Presbyopia and decreased dark adaptation
Rationale: Normal agerelated visual changes include presbyopia (decreased near vision) and decreased
dark adaptation (difficulty seeing at night). Reduced light accommodation and higher visual threshold
are expected aging changes. While cataracts, glaucoma, and macular degeneration are common in older
adults, they represent pathologic conditions rather than normal aging.
the Maturing & Aged Family Practicum | Latest Update
2026/2027 | 200 Practice Questions & Detailed Answers
| NGNStyle Q&A with Rationales | A+ Graded
SECTION 1: FOUNDATIONS OF GERIATRIC CARE, 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
Correct Answer: C. Acute onset with fluctuating attention and awareness
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. PHQ9
B. Confusion Assessment Method
C. MiniCog
D. Geriatric Depression Scale
Correct Answer: B. Confusion Assessment Method
,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.
A. The use of any medication in an older adult
B. The use of multiple medications, particularly when the number or appropriateness increases risk of
adverse effects
C. The use of exactly five medications
D. The use of only overthecounter medications
Correct Answer: B. The use of multiple medications, particularly when the number or appropriateness
increases risk of adverse effects
Rationale: 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 medicationrelated harm. There is no universally accepted medicationnumber 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
Correct Answer: B. Prior history of falling
,Rationale: A prior history of falling is one of the strongest predictors of future falls. While age, sensory
impairment, and certain medical conditions contribute to fall risk, the single most robust predictor is a
previous fall.
5. The aging process causes what normal physiological changes in the heart?
A. The heart valve thickens and becomes more rigid
B. Cardiac output increases
C. Resting heart rate significantly increases
D. Heart muscle becomes more elastic
Correct Answer: A. The heart valve thickens and becomes more rigid
Rationale: Normal agerelated changes in the cardiovascular system include thickening and stiffening of
heart valves (aortic sclerosis), decreased cardiac output, and decreased compliance of the aorta and
large arteries. Resting heart rate typically remains unchanged. The heart muscle does not become more
elastic with aging; rather, it becomes stiffer.
6. Which theory of aging suggests that aging results from cumulative mistakes in DNA and RNA over
time, which impair cell function?
A. Free radical theory
B. Neuroendocrine theory
C. Error theory
D. Wear and tear theory
Correct Answer: C. Error theory
Rationale: The Error Theory suggests that aging results from cumulative mistakes in DNA and RNA over
time, which impair cell function. The Free Radical Theory (A) proposes that free radicals accumulate and
damage cells, and older adults cannot neutralize them effectively. The Neuroendocrine Theory (B)
, suggests aging results from a programmed reduction in the functioning of the nervous, immune, and
endocrine systems.
7. According to the Rule of Fourths, functional decline in older adults results from which four factors?
A. Disease, disuse, misuse, and physiologic aging
B. Genetics, environment, lifestyle, and healthcare
C. Physical, cognitive, social, and emotional factors
D. Primary, secondary, tertiary, and quaternary aging
Correct Answer: A. Disease, disuse, misuse, and physiologic aging
Rationale: The Rule of Fourths describes four causes of functional decline in older adults: disease
(pathologic conditions), disuse (sedentary lifestyle), misuse (iatrogenic causes), and physiologic aging
(normal agerelated changes). Understanding these factors helps the NP differentiate between normal
aging and pathologic processes.
8. A 72yearold patient reports difficulty reading fine print and driving at night. Which normal agerelated
visual change is most likely?
A. Presbyopia and decreased dark adaptation
B. Cataract formation
C. Glaucoma
D. Macular degeneration
Correct Answer: A. Presbyopia and decreased dark adaptation
Rationale: Normal agerelated visual changes include presbyopia (decreased near vision) and decreased
dark adaptation (difficulty seeing at night). Reduced light accommodation and higher visual threshold
are expected aging changes. While cataracts, glaucoma, and macular degeneration are common in older
adults, they represent pathologic conditions rather than normal aging.
