NR 601 COMPREHENSIVE MIDTERM UPDATED Page 1 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
NR 601 COMPREHENSIVE MIDTERM
[UPDATED]
There are well described racial and socioeconomic disparities in diagnosis,
the following populations have the higher incidence and lower survival
black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory
loss and apathy. Which intervention can best improve the brain's functional
reserve?
decrease overstimulating the patient to avoid agitation
Which of the following considerations is necessary for the NP who is
evaluating the effectiveness of a prescribed opioid for an elderly patient
with chronic, debilitating pain?
personal or family history of substance use disorder
mental health conditions (e.g., anxiety or depression)
pregnancy
age 65 or older
chronic obstructive pulmonary disease or other underlying respiratory
conditions
All of the above
pg. 1
Page 1 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
,NR 601 COMPREHENSIVE MIDTERM UPDATED Page 2 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
The NP is providing chronic management for a 74-year-old male with
longstanding COPD. He presents to the primary care office with increased
shortness of breath to the point that he is unable to walk to the mailbox or
send a flight of stairs in his home. He reports that he still smokes 1/4 pack
of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's
physical function is due to:
disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to
50 years of age that indicate the new reading glasses are due to
reduced lens elasticity
-year-old male reports to the primary care office with a complaint of feeling
down since the death of his spouse eight months ago. He has suppressed
his depression through the use of alcohol. His medical history includes
gerd, atrial fibrillation, and chronic back pain. His medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams
daily, pantoprazole 40 milligrams daily, lisinopril 10 milligrams daily, Flomax
0.4 milligrams daily, multivitamin daily, vitamin C 500 milligrams daily, and
vitamin D 1000 IU daily. The MP decides to perform the cage assessment
to determine the patient's extent of alcohol dependency and obtains a
score of three which signifies alcohol use disorder. The NP also performs a
medication review and identifies that some of his medications metabolic
pg. 2
Page 2 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
,NR 601 COMPREHENSIVE MIDTERM UPDATED Page 3 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
effects are altered by alcohol. Which of the medications should be of
concern for the NP?
Cyclobenzaprine (Amrix), Warfarin, and Pantoprazole (Protonix)
A 68-year-old female presents to the primary care office as a new patient
who recently located from Florida. The patient reports a past medical
history of vitamin B12 deficiency, hypertension, hyperlipidemia, and gerd.
The patient reports that one year ago she was seen by gastroenterologist
for gerd symptoms where she was prescribed omeprazole 40 milligrams
daily. She reports that after being on the omeprazole for two months she
stopped having guard symptoms. Therefore an endoscopy was not
indicated. Despite having no symptoms she continued to take omeprazole
because she did not want her symptoms to return. She also reports that
diet modification has also helped him reduce and gerd symptoms. The MP
determines that omeprazole should be prescribed. The best prescribing
method for this patient is
Reducing the omeprazole from 40 mg to 20 mg
To ensure the older adults correct use of prescribed metered dose inhalers
that NP should
Recommend a spacer device
A 64 year old homeless female reports to the primary care clinic with
shortness of breath. Approximately one week the patient presented to the
emergency room with mild sternal chest pain. A cardiac workup revealed
pg. 3
Page 3 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
, NR 601 COMPREHENSIVE MIDTERM UPDATED Page 4 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
no abnormalities And the patient was released. Today the patient reports
that her breathlessness is worse. The pmh includes hypertension,
hyperlipidemia, atherosclerotic heart disease. The patient is also pack year
smoker. Other than seeking medical care at the ER last week the patient
has not seen a health care provider in five years period based on the
patient's age and condition what immunizations are most important for the
MP to administer today?
Influenza, Prevnar-13
A 65 year old male patient is a 36 pack year smoker who is seeing the MP
today for smoking cessation intervention. The MPP plans to use the 5 A's
in planning interventions for this patient. In addition to prescribing a nicotine
patch the patient has also agreed to participate in intensive cessation
counseling covered by Medicare. When the NP scheduled future follow up
visit for the patient which 5A is being utilized?
Arrange
The NP has diagnosed a 62-year-old female with Graves' disease. What
lab value below was used to diagnose?
Decreased TSH level
The NP is reviewing a 68-year-old males 2 fasting plasma glucose levels
completed on separate occasions. Diagnosing type 2 diabetes both plasma
glucose levels must be greater than
126 mg/dL
pg. 4
Page 4 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
NR 601 COMPREHENSIVE MIDTERM
[UPDATED]
There are well described racial and socioeconomic disparities in diagnosis,
the following populations have the higher incidence and lower survival
black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory
loss and apathy. Which intervention can best improve the brain's functional
reserve?
decrease overstimulating the patient to avoid agitation
Which of the following considerations is necessary for the NP who is
evaluating the effectiveness of a prescribed opioid for an elderly patient
with chronic, debilitating pain?
personal or family history of substance use disorder
mental health conditions (e.g., anxiety or depression)
pregnancy
age 65 or older
chronic obstructive pulmonary disease or other underlying respiratory
conditions
All of the above
pg. 1
Page 1 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
,NR 601 COMPREHENSIVE MIDTERM UPDATED Page 2 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
The NP is providing chronic management for a 74-year-old male with
longstanding COPD. He presents to the primary care office with increased
shortness of breath to the point that he is unable to walk to the mailbox or
send a flight of stairs in his home. He reports that he still smokes 1/4 pack
of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's
physical function is due to:
disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to
50 years of age that indicate the new reading glasses are due to
reduced lens elasticity
-year-old male reports to the primary care office with a complaint of feeling
down since the death of his spouse eight months ago. He has suppressed
his depression through the use of alcohol. His medical history includes
gerd, atrial fibrillation, and chronic back pain. His medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams
daily, pantoprazole 40 milligrams daily, lisinopril 10 milligrams daily, Flomax
0.4 milligrams daily, multivitamin daily, vitamin C 500 milligrams daily, and
vitamin D 1000 IU daily. The MP decides to perform the cage assessment
to determine the patient's extent of alcohol dependency and obtains a
score of three which signifies alcohol use disorder. The NP also performs a
medication review and identifies that some of his medications metabolic
pg. 2
Page 2 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
,NR 601 COMPREHENSIVE MIDTERM UPDATED Page 3 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
effects are altered by alcohol. Which of the medications should be of
concern for the NP?
Cyclobenzaprine (Amrix), Warfarin, and Pantoprazole (Protonix)
A 68-year-old female presents to the primary care office as a new patient
who recently located from Florida. The patient reports a past medical
history of vitamin B12 deficiency, hypertension, hyperlipidemia, and gerd.
The patient reports that one year ago she was seen by gastroenterologist
for gerd symptoms where she was prescribed omeprazole 40 milligrams
daily. She reports that after being on the omeprazole for two months she
stopped having guard symptoms. Therefore an endoscopy was not
indicated. Despite having no symptoms she continued to take omeprazole
because she did not want her symptoms to return. She also reports that
diet modification has also helped him reduce and gerd symptoms. The MP
determines that omeprazole should be prescribed. The best prescribing
method for this patient is
Reducing the omeprazole from 40 mg to 20 mg
To ensure the older adults correct use of prescribed metered dose inhalers
that NP should
Recommend a spacer device
A 64 year old homeless female reports to the primary care clinic with
shortness of breath. Approximately one week the patient presented to the
emergency room with mild sternal chest pain. A cardiac workup revealed
pg. 3
Page 3 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
, NR 601 COMPREHENSIVE MIDTERM UPDATED Page 4 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED
no abnormalities And the patient was released. Today the patient reports
that her breathlessness is worse. The pmh includes hypertension,
hyperlipidemia, atherosclerotic heart disease. The patient is also pack year
smoker. Other than seeking medical care at the ER last week the patient
has not seen a health care provider in five years period based on the
patient's age and condition what immunizations are most important for the
MP to administer today?
Influenza, Prevnar-13
A 65 year old male patient is a 36 pack year smoker who is seeing the MP
today for smoking cessation intervention. The MPP plans to use the 5 A's
in planning interventions for this patient. In addition to prescribing a nicotine
patch the patient has also agreed to participate in intensive cessation
counseling covered by Medicare. When the NP scheduled future follow up
visit for the patient which 5A is being utilized?
Arrange
The NP has diagnosed a 62-year-old female with Graves' disease. What
lab value below was used to diagnose?
Decreased TSH level
The NP is reviewing a 68-year-old males 2 fasting plasma glucose levels
completed on separate occasions. Diagnosing type 2 diabetes both plasma
glucose levels must be greater than
126 mg/dL
pg. 4
Page 4 of 39 NR 601 COMPREHENSIVE MIDTERM UPDATED.pdf 2026.
