NR 601 Midterm Exam: Primary Care of the Aging Family 2026
Chamberlain College
1. Which of the following Medicare parts covers outpatient provider visits and
laboratory services?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: B
Rationale: Medicare Part B covers outpatient services, including provider visits, durable
medical equipment, and laboratory tests.
2. When assessing an older adult, which of the following is considered an
Instrumental Activity of Daily Living (IADL)?
A. Bathing
B. Dressing
C. Managing finances
D. Toileting
Answer: C
Rationale: IADLs are more complex tasks necessary for living independently, such as
managing finances, shopping, and preparing meals, whereas ADLs are basic self-care tasks
like bathing and dressing.
,3. A 78-year-old patient presents with a sudden onset of confusion and
fluctuating consciousness. What is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Major depression
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute, sudden onset of confusion and fluctuating
levels of consciousness, often triggered by an underlying medical condition.
4. According to the Beers Criteria, which class of medication should be avoided
in older adults due to the high risk of orthostatic hypotension and falls?
A. ACE inhibitors
B. Proton pump inhibitors
C. Alpha-1 blockers
D. Biguanides
Answer: C
Rationale: Alpha-1 blockers (like doxazosin) are on the Beers Criteria list because they
carry a high risk of orthostatic hypotension in the elderly.
5. What is the recommended age to begin screening for osteoporosis with a
DEXA scan in women with no additional risk factors?
A. 50
B. 65
C. 60
D. 55
Answer: B
Rationale: The USPSTF recommends screening for osteoporosis with bone measurement
testing to prevent osteoporotic fractures in women 65 years and older.
, 6. An older adult presents with bilateral high-frequency hearing loss. This is
most consistent with:
A. Otosclerosis
B. Meniere’s disease
C. Presbycusis
D. Cerumen impaction
Answer: C
Rationale: Presbycusis is the most common cause of sensorineural hearing loss in older
adults, typically presenting as bilateral, symmetrical high-frequency loss.
7. Which screening tool is most appropriate for a quick assessment of cognitive
impairment in a busy primary care setting?
A. PHQ-2
B. Epworth Sleepiness Scale
C. Zarit Burden Interview
D. Mini-Cog
Answer: D
Rationale: The Mini-Cog is a rapid screening tool consisting of a three-item recall and a
clock-drawing test, making it ideal for primary care settings.
8. A 70-year-old patient reports leaking urine when sneezing or coughing. This is
characteristic of:
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: A
Rationale: Stress incontinence occurs when physical movement or activity (such as
coughing, sneezing, or lifting) puts pressure on the bladder, causing leakage.
Chamberlain College
1. Which of the following Medicare parts covers outpatient provider visits and
laboratory services?
A. Medicare Part A
B. Medicare Part B
C. Medicare Part C
D. Medicare Part D
Answer: B
Rationale: Medicare Part B covers outpatient services, including provider visits, durable
medical equipment, and laboratory tests.
2. When assessing an older adult, which of the following is considered an
Instrumental Activity of Daily Living (IADL)?
A. Bathing
B. Dressing
C. Managing finances
D. Toileting
Answer: C
Rationale: IADLs are more complex tasks necessary for living independently, such as
managing finances, shopping, and preparing meals, whereas ADLs are basic self-care tasks
like bathing and dressing.
,3. A 78-year-old patient presents with a sudden onset of confusion and
fluctuating consciousness. What is the most likely diagnosis?
A. Alzheimer’s disease
B. Vascular dementia
C. Major depression
D. Delirium
Answer: D
Rationale: Delirium is characterized by an acute, sudden onset of confusion and fluctuating
levels of consciousness, often triggered by an underlying medical condition.
4. According to the Beers Criteria, which class of medication should be avoided
in older adults due to the high risk of orthostatic hypotension and falls?
A. ACE inhibitors
B. Proton pump inhibitors
C. Alpha-1 blockers
D. Biguanides
Answer: C
Rationale: Alpha-1 blockers (like doxazosin) are on the Beers Criteria list because they
carry a high risk of orthostatic hypotension in the elderly.
5. What is the recommended age to begin screening for osteoporosis with a
DEXA scan in women with no additional risk factors?
A. 50
B. 65
C. 60
D. 55
Answer: B
Rationale: The USPSTF recommends screening for osteoporosis with bone measurement
testing to prevent osteoporotic fractures in women 65 years and older.
, 6. An older adult presents with bilateral high-frequency hearing loss. This is
most consistent with:
A. Otosclerosis
B. Meniere’s disease
C. Presbycusis
D. Cerumen impaction
Answer: C
Rationale: Presbycusis is the most common cause of sensorineural hearing loss in older
adults, typically presenting as bilateral, symmetrical high-frequency loss.
7. Which screening tool is most appropriate for a quick assessment of cognitive
impairment in a busy primary care setting?
A. PHQ-2
B. Epworth Sleepiness Scale
C. Zarit Burden Interview
D. Mini-Cog
Answer: D
Rationale: The Mini-Cog is a rapid screening tool consisting of a three-item recall and a
clock-drawing test, making it ideal for primary care settings.
8. A 70-year-old patient reports leaking urine when sneezing or coughing. This is
characteristic of:
A. Stress incontinence
B. Urge incontinence
C. Overflow incontinence
D. Functional incontinence
Answer: A
Rationale: Stress incontinence occurs when physical movement or activity (such as
coughing, sneezing, or lifting) puts pressure on the bladder, causing leakage.
