NR 601 PRIMARY CARE OF THE MATURING AND
OLDER ADULT ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
(100% VERIFIED ANSWERS) |ALREADY GRADED A+|
||PROFESSOR VERIFIED||
||BRANDNEW!!!||2026/2027!!!!!!!!
Mr. A, experienced a brief onset of right sided weakness, slurred speech and confusion
yesterday. The symptoms have resolved and the CT is normal. What is the next step of the
plan for Mr. A?
a. assure the patient that he will not experience the symptoms again
b. identify modifiable cardiovascular risk factors
c. order ASA 81mg stat
d. order a stat EEG and administer O2 by mask
Correct Answer: b. identify modifiable cardiovascular risk factors
Expert Rationale:
The patient’s presentation is consistent with a transient ischemic attack (TIA), which is a
warning sign for future ischemic stroke. Even when symptoms resolve and imaging is normal,
the priority is secondary prevention. This includes identifying and aggressively managing
modifiable cardiovascular risk factors such as hypertension, diabetes, smoking, hyperlipidemia,
and atrial fibrillation to reduce stroke risk.
Option a is incorrect because reassurance alone ignores the high risk of subsequent stroke.
Option c is incorrect because aspirin may be part of long-term prevention, but risk factor
modification is the broader and most critical next step. Option d is incorrect because EEG and
oxygen are not indicated for resolved TIA symptoms without seizure or hypoxia.
NCLEX Focus: Stroke prevention and TIA management.
DIF: Application
REF: Neurological Disorders / TIA and Stroke Prevention
OBJ: Identify priority management after TIA
TOP: Physiological Integrity
A 56-year old male patient screened for diabetes has a fasting plasma glucose level of 96
mg/dl. The nurse practitioner management plan includes:
,a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam
Correct Answer: a. repeat fasting plasma glucose in three years
Expert Rationale:
A fasting plasma glucose of 96 mg/dL is within the normal range (70–99 mg/dL). For individuals
without risk factors or abnormal findings, routine diabetes screening is typically repeated every
three years. No pharmacologic intervention or specialty referral is required at this time.
Option b is incorrect because metformin is not indicated in a normoglycemic patient. Option c is
unnecessary because more frequent screening is reserved for patients with risk factors or
prediabetes. Option d is incorrect because ophthalmology referral is indicated for diagnosed
diabetes, not screening-only patients.
NCLEX Focus: Diabetes screening and prevention.
DIF: Knowledge
REF: Endocrine Disorders / Diabetes Screening
OBJ: Identify appropriate screening intervals for normal glucose levels
TOP: Health Promotion and Maintenance
RW, a 57 year old Native American female, presents to the office. RW states she feels
irritable and has difficulty concentrating as well as falling asleep and staying asleep. She
states she is worried about her finances, her husband has just lost his job. The NP
diagnoses anxiety. The NP prescribes a first line treatment which is:
a. Diazepam
b. Clonazepam
c. Aripiprazole
d. Paroxetine
Correct Answer: d. Paroxetine
Expert Rationale:
Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, are considered first-line
pharmacologic treatment for generalized anxiety disorder. They are effective for long-term
symptom control and are preferred over benzodiazepines due to lower risk of dependence and
tolerance.
,Option a and b are incorrect because benzodiazepines are typically reserved for short-term or
acute symptom relief due to risk of dependence. Option c is incorrect because aripiprazole is an
antipsychotic and not a first-line treatment for anxiety disorders.
NCLEX Focus: Anxiety disorder pharmacologic management.
DIF: Application
REF: Psychiatric Pharmacology / Anxiety Disorders
OBJ: Identify first-line medication for generalized anxiety
TOP: Psychosocial Integrity
The most common sustained rhythmic disorder, which consists of fibrillatory P waves is:
a. AV block
b. atrial tachycardia
c. atrial fibrillation
d. atrial flutter
Correct Answer: c. atrial fibrillation
Expert Rationale:
Atrial fibrillation is characterized by disorganized atrial electrical activity, resulting in absent
distinct P waves and a fibrillatory baseline. It is the most common sustained cardiac arrhythmia
and significantly increases the risk of thromboembolic stroke.
Option a is incorrect because AV block involves impaired conduction, not fibrillatory activity.
Option b is incorrect because atrial tachycardia typically has identifiable P waves. Option d is
incorrect because atrial flutter has sawtooth flutter waves rather than fibrillatory P waves.
NCLEX Focus: Cardiac dysrhythmias recognition.
DIF: Knowledge
REF: Cardiovascular Disorders / Arrhythmias
OBJ: Identify ECG characteristics of atrial fibrillation
TOP: Physiological Integrity
According to the sex-related presentation, atrophic vaginitis:
a. the symptoms are the same for each woman
b. creates a more acidic vaginal environment
c. is a contributing factor for frequent urinary tract infections
d. is not treated with vaginal lubricants
Correct Answer: c. is a contributing factor for frequent urinary tract infections
, Expert Rationale:
Atrophic vaginitis occurs due to decreased estrogen levels, leading to thinning of the vaginal
epithelium and reduced protective flora. This increases susceptibility to irritation and recurrent
urinary tract infections due to loss of protective barriers.
Option a is incorrect because symptoms vary among individuals. Option b is incorrect because
vaginal pH becomes more alkaline, not acidic. Option d is incorrect because vaginal lubricants
and topical estrogen therapies are commonly used for symptom relief.
NCLEX Focus: Genitourinary changes in aging women.
DIF: Knowledge
REF: Reproductive Health / Menopause
OBJ: Identify complications of atrophic vaginitis
TOP: Physiological Adaptation
Which of the following is the most appropriate screening tool for delirium?
a. St Louis University Mental Status Exam (SLUMS)
b. Montreal Cognitive Assessment
c. Lawton Scale of Instrumental Activities of Daily Living
d. Confusion Assessment Model
Correct Answer: d. Confusion Assessment Model
Expert Rationale:
The Confusion Assessment Method (CAM) is specifically designed to detect delirium. It
assesses acute onset, inattention, disorganized thinking, and altered level of consciousness,
making it the gold standard screening tool for delirium.
Option a and b are incorrect because SLUMS and MoCA are cognitive screening tools for
dementia, not acute delirium. Option c is incorrect because the Lawton Scale evaluates
functional ability in daily living, not mental status.
NCLEX Focus: Delirium assessment and recognition.
DIF: Knowledge
REF: Neurological Disorders / Delirium
OBJ: Identify appropriate delirium screening tool
TOP: Physiological Integrity
A drug that can be used to treat two very common symptoms in a dying patient (pain and
dyspnea) is:
OLDER ADULT ACTUAL EXAM WITH COMPLETE
QUESTIONS AND CORRECT DETAILED ANSWERS
(100% VERIFIED ANSWERS) |ALREADY GRADED A+|
||PROFESSOR VERIFIED||
||BRANDNEW!!!||2026/2027!!!!!!!!
Mr. A, experienced a brief onset of right sided weakness, slurred speech and confusion
yesterday. The symptoms have resolved and the CT is normal. What is the next step of the
plan for Mr. A?
a. assure the patient that he will not experience the symptoms again
b. identify modifiable cardiovascular risk factors
c. order ASA 81mg stat
d. order a stat EEG and administer O2 by mask
Correct Answer: b. identify modifiable cardiovascular risk factors
Expert Rationale:
The patient’s presentation is consistent with a transient ischemic attack (TIA), which is a
warning sign for future ischemic stroke. Even when symptoms resolve and imaging is normal,
the priority is secondary prevention. This includes identifying and aggressively managing
modifiable cardiovascular risk factors such as hypertension, diabetes, smoking, hyperlipidemia,
and atrial fibrillation to reduce stroke risk.
Option a is incorrect because reassurance alone ignores the high risk of subsequent stroke.
Option c is incorrect because aspirin may be part of long-term prevention, but risk factor
modification is the broader and most critical next step. Option d is incorrect because EEG and
oxygen are not indicated for resolved TIA symptoms without seizure or hypoxia.
NCLEX Focus: Stroke prevention and TIA management.
DIF: Application
REF: Neurological Disorders / TIA and Stroke Prevention
OBJ: Identify priority management after TIA
TOP: Physiological Integrity
A 56-year old male patient screened for diabetes has a fasting plasma glucose level of 96
mg/dl. The nurse practitioner management plan includes:
,a. repeat fasting plasma glucose in three years
b. prescribe Metformin 500mg po BID
c. repeat fasting plasma glucose in one year
d. refer to ophthalmology for eye exam
Correct Answer: a. repeat fasting plasma glucose in three years
Expert Rationale:
A fasting plasma glucose of 96 mg/dL is within the normal range (70–99 mg/dL). For individuals
without risk factors or abnormal findings, routine diabetes screening is typically repeated every
three years. No pharmacologic intervention or specialty referral is required at this time.
Option b is incorrect because metformin is not indicated in a normoglycemic patient. Option c is
unnecessary because more frequent screening is reserved for patients with risk factors or
prediabetes. Option d is incorrect because ophthalmology referral is indicated for diagnosed
diabetes, not screening-only patients.
NCLEX Focus: Diabetes screening and prevention.
DIF: Knowledge
REF: Endocrine Disorders / Diabetes Screening
OBJ: Identify appropriate screening intervals for normal glucose levels
TOP: Health Promotion and Maintenance
RW, a 57 year old Native American female, presents to the office. RW states she feels
irritable and has difficulty concentrating as well as falling asleep and staying asleep. She
states she is worried about her finances, her husband has just lost his job. The NP
diagnoses anxiety. The NP prescribes a first line treatment which is:
a. Diazepam
b. Clonazepam
c. Aripiprazole
d. Paroxetine
Correct Answer: d. Paroxetine
Expert Rationale:
Selective serotonin reuptake inhibitors (SSRIs), such as paroxetine, are considered first-line
pharmacologic treatment for generalized anxiety disorder. They are effective for long-term
symptom control and are preferred over benzodiazepines due to lower risk of dependence and
tolerance.
,Option a and b are incorrect because benzodiazepines are typically reserved for short-term or
acute symptom relief due to risk of dependence. Option c is incorrect because aripiprazole is an
antipsychotic and not a first-line treatment for anxiety disorders.
NCLEX Focus: Anxiety disorder pharmacologic management.
DIF: Application
REF: Psychiatric Pharmacology / Anxiety Disorders
OBJ: Identify first-line medication for generalized anxiety
TOP: Psychosocial Integrity
The most common sustained rhythmic disorder, which consists of fibrillatory P waves is:
a. AV block
b. atrial tachycardia
c. atrial fibrillation
d. atrial flutter
Correct Answer: c. atrial fibrillation
Expert Rationale:
Atrial fibrillation is characterized by disorganized atrial electrical activity, resulting in absent
distinct P waves and a fibrillatory baseline. It is the most common sustained cardiac arrhythmia
and significantly increases the risk of thromboembolic stroke.
Option a is incorrect because AV block involves impaired conduction, not fibrillatory activity.
Option b is incorrect because atrial tachycardia typically has identifiable P waves. Option d is
incorrect because atrial flutter has sawtooth flutter waves rather than fibrillatory P waves.
NCLEX Focus: Cardiac dysrhythmias recognition.
DIF: Knowledge
REF: Cardiovascular Disorders / Arrhythmias
OBJ: Identify ECG characteristics of atrial fibrillation
TOP: Physiological Integrity
According to the sex-related presentation, atrophic vaginitis:
a. the symptoms are the same for each woman
b. creates a more acidic vaginal environment
c. is a contributing factor for frequent urinary tract infections
d. is not treated with vaginal lubricants
Correct Answer: c. is a contributing factor for frequent urinary tract infections
, Expert Rationale:
Atrophic vaginitis occurs due to decreased estrogen levels, leading to thinning of the vaginal
epithelium and reduced protective flora. This increases susceptibility to irritation and recurrent
urinary tract infections due to loss of protective barriers.
Option a is incorrect because symptoms vary among individuals. Option b is incorrect because
vaginal pH becomes more alkaline, not acidic. Option d is incorrect because vaginal lubricants
and topical estrogen therapies are commonly used for symptom relief.
NCLEX Focus: Genitourinary changes in aging women.
DIF: Knowledge
REF: Reproductive Health / Menopause
OBJ: Identify complications of atrophic vaginitis
TOP: Physiological Adaptation
Which of the following is the most appropriate screening tool for delirium?
a. St Louis University Mental Status Exam (SLUMS)
b. Montreal Cognitive Assessment
c. Lawton Scale of Instrumental Activities of Daily Living
d. Confusion Assessment Model
Correct Answer: d. Confusion Assessment Model
Expert Rationale:
The Confusion Assessment Method (CAM) is specifically designed to detect delirium. It
assesses acute onset, inattention, disorganized thinking, and altered level of consciousness,
making it the gold standard screening tool for delirium.
Option a and b are incorrect because SLUMS and MoCA are cognitive screening tools for
dementia, not acute delirium. Option c is incorrect because the Lawton Scale evaluates
functional ability in daily living, not mental status.
NCLEX Focus: Delirium assessment and recognition.
DIF: Knowledge
REF: Neurological Disorders / Delirium
OBJ: Identify appropriate delirium screening tool
TOP: Physiological Integrity
A drug that can be used to treat two very common symptoms in a dying patient (pain and
dyspnea) is:
