NRNP 6540 Midterm Exam – Advanced Practice Care of Older Adults | 2026/2027 |Questions and Correct Answers | Complete Exam PDF

NRNP 6540 Midterm Exam – Advanced Practice Care of Older Adults | 2026/2027 |Questions and Correct Answers | Complete Exam PDF 2026 – 2027 EDITION | ACTUAL QUESTIONS + CORRECT ANSWERS | COMPLETE EXAM MATERIAL High-Yield • Fully Updated • 100% Verified • Board-Style Scenarios Includes: Geriatric Syndromes • Chronic Disease Management • Pharmacology • Cognitive Disorders • Functional Assessment • Acute & Long-Term Care Exam Overview Exam Structure • Total Questions • Multiple-Choice Format • Advanced, Case-Based Clinical Scenarios • Timed Assessment (Board-Style) • Designed to Identify Knowledge Gaps Key Domains Covered • Chronic Illness Management in Older Adults • Geriatric Pharmacology & Polypharmacy Risks • Cognitive Impairment & Dementia Care • Functional, Mobility, & Fall-Risk Assessment • End-of-Life & Palliative Considerations • Acute Geriatric Emergencies • Health Promotion & Disease Prevention 1 / 2 / Introduction The NRNP 6540 Final Exam provides a comprehensive review of advanced practice concepts specific to the older adult population. This exam mirrors the complexity and structure of graduate-level and certification-style assessments, ensuring that learners build the diagnostic reasoning, clinical judgment, and evidence-based decision-making required for excellence in geriatric care. Achieving strong performance on this exam is closely associated with success in graduate NP coursework, clinical rotations, and certification readiness. Answer Format • Questions are presented in bold, ensuring clarity and easy readability. • Correct answers are displayed in GREEN, providing instant recognition. • Reinforcing: Advanced geriatric assessment Pharmacologic reasoning Diagnostic accuracy Safe and effective patient care This structure strengthens mastery of core NRNP 6540 topics and prepares students for real-world advanced practice care. What are the physiological changes of aging 1. Reduced physiological reserve of most body systems 2. Reduced homeostatic mechanisms that fail to adjust 3. Changes in the sympathetic response 4. Impaired immunological function- infection risk is greater and autoimmune diseases are more prevalent. What factors influence lab value interpretation in the older adult 1. physiological changes with aging 2. the prevalence of chronic disease 3. changes in nutritional and fluid intake 4. Lifestyle What lab values is important Creatinine clearance, GFR and renal function What are examples of drugs are eliminated renally Digoxin, H2 blockers, lithium and water-soluable antibiotics What are the two formulas to evaluate the kidney function The Cockcroft-Gault formula and the Modification of Diet in Renal Disease (MDRD) What neurological conditions commonly have an initial onset in older age? Parkinson's, dementia, stroke, and complex partial seizures 3 / What are geriatric syndromes Diseases that involve multiple systems and have more than one underlying cause What are the geriatric syndrome giants currently Frailty, anorexia of aging, sarcopenia and cognitive impariment What are bimodal presentations of disease Diseases that can present in a younger age and an older age. What are examples of bimodal diseases? Psoriasis, Inflammatory bowel disease, Ulcerative Colitis, Crohn's disease, Hodgkin's lymphoma, and myasthenia gravis What is primary prevention? Activities to prevent the occurrence of a disease or adverse, including mental health What is secondary prevention Tasks directed towards detection of a disease or adverse health condition in an asymptomatic individual who has risk factors What is tertiary prevention The management of existing conditions to prevent disability and minimize complications to prevent disability for optimal function What is the key to increasing geriatric physical activity motivation What is the nutrition screening tool for community dwelling older adults Mini-Nutritional Assessment (MNA) What factors affect maintaining a healthy balanced diet in 1. Chronic illness and disability-related to ADLs like shopping and meal preparation, geriatrics? 2. Financial hardships-limit food choices 3. Prescribed medications-affects absorption of nutrients, sense of taste or appetite 4. Depression or social isolation 5. Obesity What is a big influence of geriatric functionality and quality of life? Injury prevention What are important 6 areas of geriatric safety prevention 1. Safe storage and removal of firearms 2. Fall prevention 3. Wearing seatbelts 4. no drinking and driving 5. Having a working smoke detector 6. Keeping hot water set below 120 degrees Periodic screening of gums and mouth can screen for what? 1. Oral cancer 2. ill-fitting or poorly functioning dentures 3. Periodontal disease 4. Erosion of dentin 5. dependence on others for dental resources 4 / What screening tools are covered by Medicare? 1. HIV 2. Alcohol misuse 3. Smoking cessation 4. Depression 5. High blood pressure 6. Blood glucose r/t cardiovascular risk assessment 7. Lipids screening 8. Mammography until aged 75 9. Osteoporosis 10. Colorectal cancer What are the immunizations recommended for geriatrics? 1. influenza- annually for all over 50 2. Tetanus-diphtheria (Tdap)-once in a lifetime booster, then every 10 years 3. Pneumococcal -1 time dose of PCV13 at 65 years old then PPSV23 1 year (12 months) later 4. Hep B for high risk persons 1st dose then 6 months later 2nd dose, the 4-6 mos later the 3rd dose 5. Shingrix for zoster What are contraindications for exercise therapy 1. unstable angina 2. uncompensated heart failure 3. Severe anemia 4. Uncontrolled blood glucose 5. Unstable aortic aneurysm 6. Uncontrolled hypertension or tachycardia 7. Severe dehydration or heat stroke 8. Low oxygen saturation What are the benefits of exercise? Strengthen muscles Maintain flexibility Promote balance Build and maintain bone mass Prevent injury Improve daily functioning, especially in elderly Prevent chronic disease What assessment screening tool evaluates functional decline? How long is the time frame? The Timed Get up and go Test 16 seconds. What screening tool is used for domestic violence? HITS What screening tool is used for cognitive and affective disorders like dementia, delirium,depression and spiritual health 1. Mini-Mental SE, 2. The mini-Cog and 3. the Montreal Cognitive (MoCA), 4. Geriatric Depression scale 5. HOPE, and SPIRIT agitation Change in behavior,-repeating questions, arguing, Labs- CBC, CMP, B12, TSH Tx-Psychotropic meds ( Abilify, Risperdal) - antiseizure meds (Tegretol, Lamictal) anxiolytics- alprazolam, diazepam Alcoholism alcohol misuse-tachycardia, peripheral neuropathy, tremors Labs- SBIRT Tx- sobriety or total abstinence what is anxiety? what labs? what meds? excessive worry difficult to control-poor health, financial insecurity, etc. Labs- CBC, CMP, TSH Geriatric Anxiety Inventory screening TX- start low and go slow-SSRIs-Escitalopram, sertraline, citalopram 5 / What are the 5 domains of a comprehensive geriatric assessment 1. Physical health, 2. functional health 3. psychological health 4. socioenvironmental supports 5. quality of life What 3 things do a comprehensive geriatric assessment do? 1. Identifies care needs 2. Plans care 3. Improves outcomes What is the most frequently used criteria for evaluating drug use? The BEERS criteria, the STOPP criteria and the START criteria What are 9 biomarkers of nutritional deficiency? 1. Prealbumin, 2. transferrin, 3. albumin, 4. chemistries, 5. cbc, 6. vitamin B12, 7. folate, 8. vitamin D and 9. thyroid panel What bipolar disorder? What labs? What meds? S and Sx: Euphoria or irritability, depression, hypomania, rapid speech and irritability, can begin after 50, assess with DIGFAST or SIGECAPS Labs- cbc, cmp, tox screen, u/a, thyroid function, rpr Meds: Mood stabilizers-lithium valproic acid, and the antipsychotics- quetiapine and olanzapine Depression symptoms? Labs? Tx? SIGECAPS measures the disturbance in: Sleep Interest Guilt Energy Concentration Appetite Psychomotor slowing Suicidal Ideation Labs assist in causative factors Tx-Beahvior stabilizer-Haldol, mood stabilizer- olanzapine, risperidone, quetiapine Dementia, Iabs and, Tx A slowly progressive global cognitive decline- confusion, disorientation Labs: cbc, electrolytes, glucose, BUN, Cr. LFTs, TSH, folate, syphilis serology and UA, Mini mental or MoCA Tx- Cholinesterase inhibitors - donepezil, rivastigmine, galantamine or Namenda Depression, labs, tx? A pervasive feeling of sadness, discouragement, can start at age 60. Labs- electrolytes, hormone levels, nutritional deficiency, B13 and vitamin D deficiency Tx- SNRI's- duloxetine, Effexor, SNRIs-citalopram, escitalipram, sertraline elder abuse Any knowing, intentional, or negligent act by a caregiver or any other person to an older adult; the act causes harm or serious risk of harm Labs-? Tx-call the elder abuse hot line