NR 601 FINAL EXAM PREP (PDF) | (2026) QUESTIONS | PRIMARY CARE QUESTIONS AND ANSWERS ALREADY
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
An 82-year-old man presents with worsening nocturia, occurring four times per night. His other lower urinary
tract symptoms include a slow stream, occasional urgency, and urgency-related leakage once weekly. His
medical history includes poorly controlled hypertension, diastolic heart failure, hyperlipidemia, osteoarthritis,
and prediabetes. His medications include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin
10 mg daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg.
Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems, he complains that nocturia
is causing daytime fatigue, and he is more constipated. Physical examination is notable for blood pressure
162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 2+ pretibial
edema. What is the next best step in management?
A. Stop hydrocodone-acetaminophen and add pelvic floor exercises
B. Stop amlodipine and increase lisinopril
C. Add afternoon diuretic dosing
D. Add tamsulosin
🟢 Correct Answer:
B. Stop amlodipine and increase lisinopril
🔴 RATIONALE:
Amlodipine, a calcium channel blocker, commonly causes peripheral edema and can worsen lower urinary tract
symptoms by increasing fluid retention and exacerbating nocturia. The patient's blood pressure is elevated
,despite multiple antihypertensives, indicating the current regimen is ineffective. Stopping amlodipine and
increasing the ACE inhibitor (lisinopril) addresses both the edema and the poorly controlled blood pressure
without adding a new medication that could further complicate the regimen . Adding tamsulosin for BPH may
be considered later but is not the priority.
Question 2
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70 mmHg, pulse 69
beats per minute, and respiratory rate 18 breaths per minute. She is well-appearing and reports she is up to
date on her routine vaccinations. She introduces her partner of 35 years whom she would like to make medical
decisions for her in case she becomes unable to make decisions for herself. She reports that she and her partner
are not married. She asks if she needs any further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for this patient and her partner?
A. Advise them to complete a POLST.
B. Advise them that they have adequate documentation to be recognized legally.
C. Advise them to file an advance directive.
D. Respond that although they lack documentation, her partner will be recognized de facto.
🟢 Correct Answer:
C. Advise them to file an advance directive.
🔴 RATIONALE:
An advance directive, specifically a durable power of attorney for healthcare, is required to legally designate an
unmarried partner as a healthcare surrogate. Without this legal documentation, unmarried partners lack
standing to make medical decisions . A POLST addresses specific medical interventions for serious illness, but
,does not establish a healthcare proxy. Since they are not married, the partner will not be automatically
recognized as a decision-maker .
Question 3
According to the genitourinary presentation, which is the number one risk factor for urinary incontinence in
older adults?
A. Smoking and caffeine levels
B. Uncontrolled diabetes
C. Aging
D. Obesity
🟢 Correct Answer:
C. Aging
🔴 RATIONALE:
Aging is the primary risk factor for urinary incontinence. Age-related changes in the lower urinary tract,
including decreased bladder capacity, involuntary detrusor contractions, and weakened pelvic floor muscles,
contribute to the high prevalence of incontinence in the older adult population .
Question 4
The NP knows that medications can trigger or worsen heart failure. With this knowledge in mind, the NP will
avoid prescribing which of the following classes of medications?
, A. Benzodiazepines
B. Macrolides
C. Muscle relaxants
D. Thiazolidinediones
🟢 Correct Answer:
D. Thiazolidinediones
🔴 RATIONALE:
Thiazolidinediones (TZDs) such as pioglitazone and rosiglitazone are known to cause fluid retention, which can
precipitate or worsen heart failure in susceptible patients. They are generally contraindicated in patients with
NYHA Class III or IV heart failure. While some medications can affect heart failure, TZDs have a well-established
causal link to fluid overload .
Question 5
A 58-year-old Caucasian male with type 2 diabetes mellitus presents with BP 142/96. According to ACC 2017
guidelines, what is the most appropriate first-line medication for hypertension in this patient?
A. Lisinopril
B. Furosemide
C. Amlodipine
D. Clonidine
🟢 Correct Answer:
A. Lisinopril
GRADED A+. 100% VERIFIED SOLUTIONS | UPDATED PER LATEST GUIDELINES | GRADED A+
Question 1
An 82-year-old man presents with worsening nocturia, occurring four times per night. His other lower urinary
tract symptoms include a slow stream, occasional urgency, and urgency-related leakage once weekly. His
medical history includes poorly controlled hypertension, diastolic heart failure, hyperlipidemia, osteoarthritis,
and prediabetes. His medications include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin
10 mg daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and aspirin 81 mg.
Amlodipine 5 mg daily was recently added by his cardiologist. On review of systems, he complains that nocturia
is causing daytime fatigue, and he is more constipated. Physical examination is notable for blood pressure
162/83 mmHg, heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 2+ pretibial
edema. What is the next best step in management?
A. Stop hydrocodone-acetaminophen and add pelvic floor exercises
B. Stop amlodipine and increase lisinopril
C. Add afternoon diuretic dosing
D. Add tamsulosin
🟢 Correct Answer:
B. Stop amlodipine and increase lisinopril
🔴 RATIONALE:
Amlodipine, a calcium channel blocker, commonly causes peripheral edema and can worsen lower urinary tract
symptoms by increasing fluid retention and exacerbating nocturia. The patient's blood pressure is elevated
,despite multiple antihypertensives, indicating the current regimen is ineffective. Stopping amlodipine and
increasing the ACE inhibitor (lisinopril) addresses both the edema and the poorly controlled blood pressure
without adding a new medication that could further complicate the regimen . Adding tamsulosin for BPH may
be considered later but is not the priority.
Question 2
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is 125/70 mmHg, pulse 69
beats per minute, and respiratory rate 18 breaths per minute. She is well-appearing and reports she is up to
date on her routine vaccinations. She introduces her partner of 35 years whom she would like to make medical
decisions for her in case she becomes unable to make decisions for herself. She reports that she and her partner
are not married. She asks if she needs any further documentation to ensure her goals of care are followed.
Which one of the following would be the most appropriate recommendation for this patient and her partner?
A. Advise them to complete a POLST.
B. Advise them that they have adequate documentation to be recognized legally.
C. Advise them to file an advance directive.
D. Respond that although they lack documentation, her partner will be recognized de facto.
🟢 Correct Answer:
C. Advise them to file an advance directive.
🔴 RATIONALE:
An advance directive, specifically a durable power of attorney for healthcare, is required to legally designate an
unmarried partner as a healthcare surrogate. Without this legal documentation, unmarried partners lack
standing to make medical decisions . A POLST addresses specific medical interventions for serious illness, but
,does not establish a healthcare proxy. Since they are not married, the partner will not be automatically
recognized as a decision-maker .
Question 3
According to the genitourinary presentation, which is the number one risk factor for urinary incontinence in
older adults?
A. Smoking and caffeine levels
B. Uncontrolled diabetes
C. Aging
D. Obesity
🟢 Correct Answer:
C. Aging
🔴 RATIONALE:
Aging is the primary risk factor for urinary incontinence. Age-related changes in the lower urinary tract,
including decreased bladder capacity, involuntary detrusor contractions, and weakened pelvic floor muscles,
contribute to the high prevalence of incontinence in the older adult population .
Question 4
The NP knows that medications can trigger or worsen heart failure. With this knowledge in mind, the NP will
avoid prescribing which of the following classes of medications?
, A. Benzodiazepines
B. Macrolides
C. Muscle relaxants
D. Thiazolidinediones
🟢 Correct Answer:
D. Thiazolidinediones
🔴 RATIONALE:
Thiazolidinediones (TZDs) such as pioglitazone and rosiglitazone are known to cause fluid retention, which can
precipitate or worsen heart failure in susceptible patients. They are generally contraindicated in patients with
NYHA Class III or IV heart failure. While some medications can affect heart failure, TZDs have a well-established
causal link to fluid overload .
Question 5
A 58-year-old Caucasian male with type 2 diabetes mellitus presents with BP 142/96. According to ACC 2017
guidelines, what is the most appropriate first-line medication for hypertension in this patient?
A. Lisinopril
B. Furosemide
C. Amlodipine
D. Clonidine
🟢 Correct Answer:
A. Lisinopril
