NR 601 Final Exam: Primary Care for Older Adults 2026 Chamberlain
College
1. According to the Beers Criteria, which medication should be avoided in older
adults due to the high risk of falls and fractures?
A. Zolpidem
B. Lisinopril
C. Metformin
D. Atorvastatin
Answer: A
Rationale: Zolpidem is a sedative-hypnotic listed in the Beers Criteria to be avoided in
older adults because it increases the risk of delirium, falls, and fractures.
2. Which of the following is considered an Instrumental Activity of Daily Living
(IADL)?
A. Managing finances
B. Bathing
C. Dressing
D. Toileting
Answer: A
Rationale: IADLs are more complex tasks necessary for living independently in the
community, such as managing money, shopping, and meal preparation, whereas ADLs are
basic self-care tasks.
,3. In a 75-year-old patient with multiple chronic comorbidities and a limited life
expectancy, what is the recommended HbA1c goal?
A. < 6.5%
B. < 7.0%
C. 8.0% - 9.0%
D. 7.5% - 8.0%
Answer: C
Rationale: For older adults with very complex health issues or limited life expectancy, the
ADA recommends a less stringent goal of <8.0% or <9.0% to avoid hypoglycemia.
4. What is the primary difference between dementia and delirium?
A. Dementia is acute, while delirium is chronic.
B. Delirium involves a stable level of consciousness.
C. Dementia is always reversible.
D. Delirium has an abrupt onset and fluctuates over time.
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in attention, while dementia is a progressive, chronic decline in cognition.
5. A 68-year-old male presents with a T-score of -2.6 on a DXA scan. How is this
interpreted?
A. Normal bone density
B. Osteoporosis
C. Osteopenia
D. Severe Osteoarthritis
Answer: B
Rationale: According to WHO criteria, a T-score of -2.5 or lower is diagnostic of
osteoporosis.
, 6. Which class of medication is the first-line treatment for an older adult with
newly diagnosed hypertension and no other comorbidities?
A. Beta-blockers
B. Alpha-blockers
C. Thiazide diuretics
D. Loop diuretics
Answer: C
Rationale: Thiazide-type diuretics (like Chlorthalidone) are recommended as first-line
therapy for most older adults with hypertension.
7. Which screening tool is most commonly used to detect depression in the
geriatric population?
A. PHQ-9
B. MMSE
C. GDS (Geriatric Depression Scale)
D. CAGE Questionnaire
Answer: C
Rationale: The Geriatric Depression Scale (GDS) is specifically designed and validated for
older adults to identify depressive symptoms.
8. Which finding is a hallmark symptom of Parkinson’s Disease?
A. Hyperreflexia
B. Resting tremor
C. Choreiform movements
D. Nystagmus
Answer: B
Rationale: The classic tetrad of Parkinson’s includes resting tremor, bradykinesia, rigidity,
and postural instability.
College
1. According to the Beers Criteria, which medication should be avoided in older
adults due to the high risk of falls and fractures?
A. Zolpidem
B. Lisinopril
C. Metformin
D. Atorvastatin
Answer: A
Rationale: Zolpidem is a sedative-hypnotic listed in the Beers Criteria to be avoided in
older adults because it increases the risk of delirium, falls, and fractures.
2. Which of the following is considered an Instrumental Activity of Daily Living
(IADL)?
A. Managing finances
B. Bathing
C. Dressing
D. Toileting
Answer: A
Rationale: IADLs are more complex tasks necessary for living independently in the
community, such as managing money, shopping, and meal preparation, whereas ADLs are
basic self-care tasks.
,3. In a 75-year-old patient with multiple chronic comorbidities and a limited life
expectancy, what is the recommended HbA1c goal?
A. < 6.5%
B. < 7.0%
C. 8.0% - 9.0%
D. 7.5% - 8.0%
Answer: C
Rationale: For older adults with very complex health issues or limited life expectancy, the
ADA recommends a less stringent goal of <8.0% or <9.0% to avoid hypoglycemia.
4. What is the primary difference between dementia and delirium?
A. Dementia is acute, while delirium is chronic.
B. Delirium involves a stable level of consciousness.
C. Dementia is always reversible.
D. Delirium has an abrupt onset and fluctuates over time.
Answer: D
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
disturbances in attention, while dementia is a progressive, chronic decline in cognition.
5. A 68-year-old male presents with a T-score of -2.6 on a DXA scan. How is this
interpreted?
A. Normal bone density
B. Osteoporosis
C. Osteopenia
D. Severe Osteoarthritis
Answer: B
Rationale: According to WHO criteria, a T-score of -2.5 or lower is diagnostic of
osteoporosis.
, 6. Which class of medication is the first-line treatment for an older adult with
newly diagnosed hypertension and no other comorbidities?
A. Beta-blockers
B. Alpha-blockers
C. Thiazide diuretics
D. Loop diuretics
Answer: C
Rationale: Thiazide-type diuretics (like Chlorthalidone) are recommended as first-line
therapy for most older adults with hypertension.
7. Which screening tool is most commonly used to detect depression in the
geriatric population?
A. PHQ-9
B. MMSE
C. GDS (Geriatric Depression Scale)
D. CAGE Questionnaire
Answer: C
Rationale: The Geriatric Depression Scale (GDS) is specifically designed and validated for
older adults to identify depressive symptoms.
8. Which finding is a hallmark symptom of Parkinson’s Disease?
A. Hyperreflexia
B. Resting tremor
C. Choreiform movements
D. Nystagmus
Answer: B
Rationale: The classic tetrad of Parkinson’s includes resting tremor, bradykinesia, rigidity,
and postural instability.
