NR601 Exam 3: Primary Care of the Maturing & Aged Family Practicum
Questions and Answers and Explanations | Latest - Chamberlain
1. According to the Beers Criteria, which class of medications should be avoided
in older adults due to the high risk of orthostatic hypotension and bradycardia?
A. Selective Serotonin Reuptake Inhibitors
B. Proton pump inhibitors
C. Alpha-1 blockers (e.g., doxazosin)
D. Biguanides (e.g., metformin)
Answer: C
Explanation: Alpha-1 blockers are associated with a high risk of orthostatic hypotension
and are not recommended as routine treatment for hypertension in older adults.
2. Which of the following tools is specifically designed to assess Instrumental
Activities of Daily Living (IADLs) in older adults?
A. Katz Index
B. Mini-Mental State Exam
C. Lawton Scale
D. Get Up and Go Test
Answer: C
,Explanation: The Lawton IADL scale assesses more complex tasks such as using a
telephone, shopping, and managing finances, whereas the Katz Index focuses on basic
ADLs.
3. An 82-year-old patient presents with acute onset of confusion, fluctuating
level of consciousness, and inattention. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Delirium
Answer: D
Explanation: Acute onset and fluctuating consciousness are hallmark symptoms of
delirium, distinguishing it from the gradual decline seen in dementia.
4. What is the recommended HbA1c target for a ‘frail’ older adult with multiple
chronic illnesses and limited life expectancy?
A. Less than 6.5%
B. Less than 7.0%
C. Between 7.5% and 8.0%
D. Between 8.0% and 9.0%
Answer: D
,Explanation: For very frail patients or those with limited life expectancy, a higher HbA1c
target (8.0-9.0%) is appropriate to avoid the risks of hypoglycemia.
5. In the management of heart failure with reduced ejection fraction (HFrEF) in
an older adult, which medication class is known to decrease mortality?
A. Loop diuretics
B. Calcium Channel Blockers
C. NSAIDs
D. Beta-Blockers
Answer: D
Explanation: Beta-blockers, ACE inhibitors, and ARBs are evidence-based treatments
shown to reduce mortality in HFrEF patients.
6. A patient complains of leaking urine when they cough or sneeze. This is
characteristic of which type of incontinence?
A. Urge incontinence
B. Stress incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: B
Explanation: Stress incontinence occurs due to increased intra-abdominal pressure
(coughing, sneezing, lifting) overcoming the urethral sphincter.
, 7. According to the USPSTF, at what age is it generally recommended to stop
routine screening for colorectal cancer for most adults?
A. 65 years old
B. 90 years old
C. 85 years old
D. 75 years old
Answer: D
Explanation: USPSTF recommends screening through age 75. For adults 76-85, the
decision should be individualized based on health status and screening history.
8. Which of the following is a physical sign often associated with Vitamin B12
deficiency in older adults?
A. Hyperreflexia
B. Exophthalmos
C. Loss of vibratory sense
D. Koilonychia
Answer: C
Explanation: Vitamin B12 deficiency commonly causes peripheral neuropathy, specifically
affecting the dorsal columns, leading to loss of vibratory sense and proprioception.
Questions and Answers and Explanations | Latest - Chamberlain
1. According to the Beers Criteria, which class of medications should be avoided
in older adults due to the high risk of orthostatic hypotension and bradycardia?
A. Selective Serotonin Reuptake Inhibitors
B. Proton pump inhibitors
C. Alpha-1 blockers (e.g., doxazosin)
D. Biguanides (e.g., metformin)
Answer: C
Explanation: Alpha-1 blockers are associated with a high risk of orthostatic hypotension
and are not recommended as routine treatment for hypertension in older adults.
2. Which of the following tools is specifically designed to assess Instrumental
Activities of Daily Living (IADLs) in older adults?
A. Katz Index
B. Mini-Mental State Exam
C. Lawton Scale
D. Get Up and Go Test
Answer: C
,Explanation: The Lawton IADL scale assesses more complex tasks such as using a
telephone, shopping, and managing finances, whereas the Katz Index focuses on basic
ADLs.
3. An 82-year-old patient presents with acute onset of confusion, fluctuating
level of consciousness, and inattention. What is the most likely diagnosis?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Major Depressive Disorder
D. Delirium
Answer: D
Explanation: Acute onset and fluctuating consciousness are hallmark symptoms of
delirium, distinguishing it from the gradual decline seen in dementia.
4. What is the recommended HbA1c target for a ‘frail’ older adult with multiple
chronic illnesses and limited life expectancy?
A. Less than 6.5%
B. Less than 7.0%
C. Between 7.5% and 8.0%
D. Between 8.0% and 9.0%
Answer: D
,Explanation: For very frail patients or those with limited life expectancy, a higher HbA1c
target (8.0-9.0%) is appropriate to avoid the risks of hypoglycemia.
5. In the management of heart failure with reduced ejection fraction (HFrEF) in
an older adult, which medication class is known to decrease mortality?
A. Loop diuretics
B. Calcium Channel Blockers
C. NSAIDs
D. Beta-Blockers
Answer: D
Explanation: Beta-blockers, ACE inhibitors, and ARBs are evidence-based treatments
shown to reduce mortality in HFrEF patients.
6. A patient complains of leaking urine when they cough or sneeze. This is
characteristic of which type of incontinence?
A. Urge incontinence
B. Stress incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: B
Explanation: Stress incontinence occurs due to increased intra-abdominal pressure
(coughing, sneezing, lifting) overcoming the urethral sphincter.
, 7. According to the USPSTF, at what age is it generally recommended to stop
routine screening for colorectal cancer for most adults?
A. 65 years old
B. 90 years old
C. 85 years old
D. 75 years old
Answer: D
Explanation: USPSTF recommends screening through age 75. For adults 76-85, the
decision should be individualized based on health status and screening history.
8. Which of the following is a physical sign often associated with Vitamin B12
deficiency in older adults?
A. Hyperreflexia
B. Exophthalmos
C. Loss of vibratory sense
D. Koilonychia
Answer: C
Explanation: Vitamin B12 deficiency commonly causes peripheral neuropathy, specifically
affecting the dorsal columns, leading to loss of vibratory sense and proprioception.
