NR 601 MIDTERM EXAM PRIMARY CARE OF MATURING
AND AGED FAMILY PRACTICUM 100+ QUESTIONS WITH
CORRECT ANSWERS WEEK 1-4 LATEST EDITION 2026
GRADED A+
1. The NP is analyzing a patient’s symptoms for a possible asthma diagnosis.
The patient describes nocturnal symptoms alone. Before confirming an asthma
diagnosis, what other diagnoses should the NP consider based on the patient’s
nocturnal symptoms alone:
A. Postnasal drip and gastroesophageal reflux disease (GERD)
B. Pulmonary embolism and lung cancer
C. Pneumothorax and tuberculosis
D. Acute bronchitis and pneumonia
Correct Answer
: A. Postnasal drip and gastroesophageal reflux disease (GERD)
Rationale:
Nocturnal cough or breathing symptoms may occur with asthma, but postnasal drip and
GERD are common alternative causes that should be considered before confirming
asthma.
2. Which of the following tools is MOST effective in uncovering geriatric
syndromes that may go unrecognized:
A. Chest x-ray
B. Structured geriatric review of systems
C. Lipid panel only
D. Spirometry only
Correct Answer:
B. Structured geriatric review of systems
Rationale:
A structured geriatric review of systems helps identify falls, frailty, cognitive changes,
incontinence, polypharmacy, functional decline, and other syndromes that may not be
volunteered by older adults.
,3. A patient describes chest discomfort that occurs with activity and resolves
with rest. What is the PRIORITY differential diagnosis based on this
presentation:
A. Stable angina
B. Costochondritis
C. GERD only
D. Panic disorder
Correct Answer:
A. Stable angina
Rationale:
Chest discomfort triggered by exertion and relieved by rest is classic for stable angina
caused by myocardial oxygen demand exceeding supply.
4. A 78-year-old man with a history of hypertension is found to have left
ventricular hypertrophy on echocardiogram. Why is this finding clinically
significant:
A. It increases the risk of stroke, heart failure, and sudden death
B. It confirms pneumonia
C. It rules out cardiovascular disease
D. It is always a benign aging change
Correct Answer:
A. It increases the risk of stroke, heart failure, and sudden death
Rationale:
Long-standing hypertension can cause left ventricular hypertrophy, which increases
myocardial workload and is associated with higher cardiovascular morbidity and
mortality.
5. During a physical exam, the NP suspects right-sided heart failure in a 78-
year-old patient with fatigue and bilateral lower extremity swelling. Which of
the following findings MOST strongly supports this suspicion:
A. Elevated jugular venous pressure
B. Dry mucous membranes
,C. Hyperactive bowel sounds
D. Unilateral wheezing
Correct Answer:
A. Elevated jugular venous pressure
Rationale:
Right-sided heart failure causes systemic venous congestion, commonly presenting
with elevated JVP, peripheral edema, hepatomegaly, and ascites.
6. The NP is examining an older adult patient with suspected mitral stenosis
(MS). Which of the following is the MOST common cause of MS:
A. Rheumatic fever
B. Viral pneumonia
C. Hyperthyroidism
D. Acute kidney injury
Correct Answer
: A. Rheumatic fever
Rationale:
Rheumatic heart disease remains the most common cause of mitral stenosis because chronic
valvular scarring narrows the mitral valve orifice.
7. A 65-year-old patient with stable COPD presents for a follow-up visit. The patient has a
CAT score of 18 and an mMRC score of 2. Based on these scores, which initial
pharmacological therapy should the NP prescribe:
A. Long-acting bronchodilator
B. Short course of antibiotics only
C. Immediate oral corticosteroids for life
D. No inhaled therapy
Correct Answer:
A. Long-acting bronchodilator
Rationale:
, A CAT score ≥10 and mMRC ≥2 indicate significant COPD symptoms. Long-acting
bronchodilator therapy improves dyspnea, exercise tolerance, and daily symptoms.
8. The NP is evaluating several patients for resistant hypertension. Which patient is
MOST likely to have resistant hypertension:
A. A 65-year-old patient with a blood pressure of 145/90 mmHg, taking three antihypertensive
agents, including a diuretic, with no identifiable causes of hypertension
B. A patient with one elevated reading during stress
C. A patient controlled on one medication
D. A patient with white-coat hypertension only
Correct Answer:
A. A 65-year-old patient with a blood pressure of 145/90 mmHg, taking three antihypertensive
agents, including a diuretic, with no identifiable causes of hypertension
Rationale:
Resistant hypertension is suggested when blood pressure remains elevated despite treatment
with multiple antihypertensive agents, including a diuretic, without an identifiable secondary
cause.
9. Which of the following considerations is necessary for the NP who is evaluating the
effectiveness of a prescribed opioid for an elderly patient with chronic, debilitating pain?
A. Assess pain relief, functional improvement, and adverse effects
B. Evaluate only the patient's pain score
C. Discontinue the opioid if pain is not completely eliminated
D. Assume that elderly patients cannot safely receive opioids
Correct Answer:
A. Assess pain relief, functional improvement, and adverse effects
Rationale:
When evaluating opioid therapy in an older adult, the NP should assess the medication's
effectiveness in relieving pain and improving function while monitoring for adverse effects such
as sedation,
AND AGED FAMILY PRACTICUM 100+ QUESTIONS WITH
CORRECT ANSWERS WEEK 1-4 LATEST EDITION 2026
GRADED A+
1. The NP is analyzing a patient’s symptoms for a possible asthma diagnosis.
The patient describes nocturnal symptoms alone. Before confirming an asthma
diagnosis, what other diagnoses should the NP consider based on the patient’s
nocturnal symptoms alone:
A. Postnasal drip and gastroesophageal reflux disease (GERD)
B. Pulmonary embolism and lung cancer
C. Pneumothorax and tuberculosis
D. Acute bronchitis and pneumonia
Correct Answer
: A. Postnasal drip and gastroesophageal reflux disease (GERD)
Rationale:
Nocturnal cough or breathing symptoms may occur with asthma, but postnasal drip and
GERD are common alternative causes that should be considered before confirming
asthma.
2. Which of the following tools is MOST effective in uncovering geriatric
syndromes that may go unrecognized:
A. Chest x-ray
B. Structured geriatric review of systems
C. Lipid panel only
D. Spirometry only
Correct Answer:
B. Structured geriatric review of systems
Rationale:
A structured geriatric review of systems helps identify falls, frailty, cognitive changes,
incontinence, polypharmacy, functional decline, and other syndromes that may not be
volunteered by older adults.
,3. A patient describes chest discomfort that occurs with activity and resolves
with rest. What is the PRIORITY differential diagnosis based on this
presentation:
A. Stable angina
B. Costochondritis
C. GERD only
D. Panic disorder
Correct Answer:
A. Stable angina
Rationale:
Chest discomfort triggered by exertion and relieved by rest is classic for stable angina
caused by myocardial oxygen demand exceeding supply.
4. A 78-year-old man with a history of hypertension is found to have left
ventricular hypertrophy on echocardiogram. Why is this finding clinically
significant:
A. It increases the risk of stroke, heart failure, and sudden death
B. It confirms pneumonia
C. It rules out cardiovascular disease
D. It is always a benign aging change
Correct Answer:
A. It increases the risk of stroke, heart failure, and sudden death
Rationale:
Long-standing hypertension can cause left ventricular hypertrophy, which increases
myocardial workload and is associated with higher cardiovascular morbidity and
mortality.
5. During a physical exam, the NP suspects right-sided heart failure in a 78-
year-old patient with fatigue and bilateral lower extremity swelling. Which of
the following findings MOST strongly supports this suspicion:
A. Elevated jugular venous pressure
B. Dry mucous membranes
,C. Hyperactive bowel sounds
D. Unilateral wheezing
Correct Answer:
A. Elevated jugular venous pressure
Rationale:
Right-sided heart failure causes systemic venous congestion, commonly presenting
with elevated JVP, peripheral edema, hepatomegaly, and ascites.
6. The NP is examining an older adult patient with suspected mitral stenosis
(MS). Which of the following is the MOST common cause of MS:
A. Rheumatic fever
B. Viral pneumonia
C. Hyperthyroidism
D. Acute kidney injury
Correct Answer
: A. Rheumatic fever
Rationale:
Rheumatic heart disease remains the most common cause of mitral stenosis because chronic
valvular scarring narrows the mitral valve orifice.
7. A 65-year-old patient with stable COPD presents for a follow-up visit. The patient has a
CAT score of 18 and an mMRC score of 2. Based on these scores, which initial
pharmacological therapy should the NP prescribe:
A. Long-acting bronchodilator
B. Short course of antibiotics only
C. Immediate oral corticosteroids for life
D. No inhaled therapy
Correct Answer:
A. Long-acting bronchodilator
Rationale:
, A CAT score ≥10 and mMRC ≥2 indicate significant COPD symptoms. Long-acting
bronchodilator therapy improves dyspnea, exercise tolerance, and daily symptoms.
8. The NP is evaluating several patients for resistant hypertension. Which patient is
MOST likely to have resistant hypertension:
A. A 65-year-old patient with a blood pressure of 145/90 mmHg, taking three antihypertensive
agents, including a diuretic, with no identifiable causes of hypertension
B. A patient with one elevated reading during stress
C. A patient controlled on one medication
D. A patient with white-coat hypertension only
Correct Answer:
A. A 65-year-old patient with a blood pressure of 145/90 mmHg, taking three antihypertensive
agents, including a diuretic, with no identifiable causes of hypertension
Rationale:
Resistant hypertension is suggested when blood pressure remains elevated despite treatment
with multiple antihypertensive agents, including a diuretic, without an identifiable secondary
cause.
9. Which of the following considerations is necessary for the NP who is evaluating the
effectiveness of a prescribed opioid for an elderly patient with chronic, debilitating pain?
A. Assess pain relief, functional improvement, and adverse effects
B. Evaluate only the patient's pain score
C. Discontinue the opioid if pain is not completely eliminated
D. Assume that elderly patients cannot safely receive opioids
Correct Answer:
A. Assess pain relief, functional improvement, and adverse effects
Rationale:
When evaluating opioid therapy in an older adult, the NP should assess the medication's
effectiveness in relieving pain and improving function while monitoring for adverse effects such
as sedation,
