NR601 Primary Care of the Maturing & Aged
Family Midterm Exam Review | Questions &
Answers | 2026/2027
SECTION 1: Geriatric Assessment & Health Promotion
Q1: During a routine wellness visit for a healthy 72-year-old, which component is the
most critical for the NP to assess as part of a comprehensive geriatric assessment?
A. Detailed sexual history
B. Vaccination status (e.g., Shingrix, high-dose flu)
C. Formal cognitive screening with the MoCA
D. Functional status (ADLs and IADLs)
Correct Answer: D
Rationale: Functional status predicts morbidity, institutionalization, and quality of life
more powerfully than any single disease marker. While vaccination review (B) and
cognitive screening (C) are important sub-components, they do not replace ADL/IADL
assessment. A detailed sexual history (A) is situation-dependent.
Q2: According to the 2024 USPSTF, which screening recommendation is Grade A or B
for asymptomatic community-dwelling adults ≥70 years?
A. Abdominal aortic aneurysm ultrasound once (men who ever smoked)
, B. Lung cancer with low-dose CT (all adults ≥70)
C. Carotid duplex for bruit (Grade B)
D. Thyroid cancer with neck ultrasound
Correct Answer: A
Rationale: USPSTF still gives one-time AAA ultrasound Grade B for men 65-75 who ever
smoked; age 70 falls within this window. Lung-cancer screening (B) stops at 80 and
requires 20-pack-year history. Carotid stenosis (C) is Grade D (do not screen). Thyroid
(D) is Grade D.
Q3: Which age-related physiologic change most directly contributes to increased peak
plasma levels of water-soluble medications?
A. Decreased hepatic CYP3A4 activity
B. Reduced total body water → smaller volume of distribution
C. Increased gastric pH
D. Reduced renal blood flow
Correct Answer: B
Rationale: Total body water declines ~10-15 % with age; for hydrophilic drugs (e.g.,
lithium, digoxin) the Vd shrinks, yielding higher peak levels. CYP3A4 (A) affects
clearance, not peak. Gastric pH (C) alters absorption rate, not Vd. Renal flow (D) affects
elimination half-life.
Q4: The NP notes that an 80-year-old’s 5-times-sit-to-stand time is 16 s. This finding
correlates most strongly with:
Family Midterm Exam Review | Questions &
Answers | 2026/2027
SECTION 1: Geriatric Assessment & Health Promotion
Q1: During a routine wellness visit for a healthy 72-year-old, which component is the
most critical for the NP to assess as part of a comprehensive geriatric assessment?
A. Detailed sexual history
B. Vaccination status (e.g., Shingrix, high-dose flu)
C. Formal cognitive screening with the MoCA
D. Functional status (ADLs and IADLs)
Correct Answer: D
Rationale: Functional status predicts morbidity, institutionalization, and quality of life
more powerfully than any single disease marker. While vaccination review (B) and
cognitive screening (C) are important sub-components, they do not replace ADL/IADL
assessment. A detailed sexual history (A) is situation-dependent.
Q2: According to the 2024 USPSTF, which screening recommendation is Grade A or B
for asymptomatic community-dwelling adults ≥70 years?
A. Abdominal aortic aneurysm ultrasound once (men who ever smoked)
, B. Lung cancer with low-dose CT (all adults ≥70)
C. Carotid duplex for bruit (Grade B)
D. Thyroid cancer with neck ultrasound
Correct Answer: A
Rationale: USPSTF still gives one-time AAA ultrasound Grade B for men 65-75 who ever
smoked; age 70 falls within this window. Lung-cancer screening (B) stops at 80 and
requires 20-pack-year history. Carotid stenosis (C) is Grade D (do not screen). Thyroid
(D) is Grade D.
Q3: Which age-related physiologic change most directly contributes to increased peak
plasma levels of water-soluble medications?
A. Decreased hepatic CYP3A4 activity
B. Reduced total body water → smaller volume of distribution
C. Increased gastric pH
D. Reduced renal blood flow
Correct Answer: B
Rationale: Total body water declines ~10-15 % with age; for hydrophilic drugs (e.g.,
lithium, digoxin) the Vd shrinks, yielding higher peak levels. CYP3A4 (A) affects
clearance, not peak. Gastric pH (C) alters absorption rate, not Vd. Renal flow (D) affects
elimination half-life.
Q4: The NP notes that an 80-year-old’s 5-times-sit-to-stand time is 16 s. This finding
correlates most strongly with:
