NR 601 Primary Care of the Maturing and Aged Family |
Comprehensive Exam 4 Review Questions and Answers
with Rationales 2026/2027
This comprehensive examination is designed to reinforce advanced primary-care knowledge for
the maturing and older adult population. The questions emphasize assessment, differential
diagnosis, evidence-based management, pharmacology, preventive care, geriatric syndromes,
chronic disease management, health promotion, and patient safety.
The questions are organized as single-best-answer multiple-choice items. Each question
includes the correct answer and a concise rationale to support clinical reasoning and exam
preparation.
1.
An older adult reports gradually worsening difficulty hearing
conversations, particularly when several people are speaking. Which
finding is most consistent with presbycusis?
A. Conductive hearing loss from cerumen
B. Bilateral high-frequency sensorineural hearing loss
C. Unilateral low-frequency conductive loss
D. Sudden unilateral sensorineural loss
Answer: B
Rationale: Presbycusis is age-related sensorineural hearing loss that
typically affects higher frequencies first and is usually bilateral and
progressive.
2.
Which finding in an older adult with hearing loss requires the most
urgent evaluation?
,A. Difficulty hearing high-pitched voices
B. Gradual bilateral hearing impairment
C. Sudden unilateral hearing loss
D. Needing the television volume increased
Answer: C
Rationale: Sudden sensorineural hearing loss is an otologic emergency
because prompt evaluation and treatment may improve hearing
recovery.
3.
Which intervention is most appropriate when communicating with an
older adult who has hearing impairment?
A. Speak loudly from another room
B. Face the patient directly while speaking
C. Exaggerate lip movements
D. Speak rapidly to minimize conversation time
Answer: B
Rationale: Facing the patient allows use of visual cues and improves
communication. Clear, normal-volume speech is preferable to shouting.
4.
An older adult has difficulty reading small print but has no visual loss at
distance. Which age-related change is most likely?
A. Presbyopia
B. Glaucoma
C. Cataract
D. Retinal detachment
Answer: A
,Rationale: Presbyopia results from age-related loss of lens
accommodation and causes difficulty focusing on near objects.
5.
Which symptom is most characteristic of cataracts?
A. Sudden severe eye pain
B. Progressive painless visual clouding
C. Flashes with a curtain-like visual defect
D. Acute unilateral blindness
Answer: B
Rationale: Cataracts commonly cause gradual, painless loss of visual
clarity, glare, and decreased contrast sensitivity.
6.
Which presentation is most concerning for acute angle-closure
glaucoma?
A. Gradual painless peripheral vision loss
B. Eye pain, headache, halos, nausea, and a red eye
C. Slowly progressive difficulty reading
D. Bilateral mild blurred vision
Answer: B
Rationale: Acute angle-closure glaucoma can present with severe eye
pain, headache, halos around lights, nausea/vomiting, and ocular
redness and requires urgent treatment.
7.
A patient reports seeing flashes of light followed by a sudden increase
in floaters and a curtain over part of the visual field. What is the
priority?
, A. Reassurance
B. Routine optometry referral
C. Emergency ophthalmologic evaluation
D. Trial of artificial tears
Answer: C
Rationale: These symptoms suggest retinal detachment, which can
cause permanent vision loss without urgent intervention.
8.
Which preventive measure is particularly important for an older adult
at risk for age-related macular degeneration?
A. Smoking cessation
B. Avoiding all dietary fats
C. Restricting calcium intake
D. Avoiding physical activity
Answer: A
Rationale: Smoking is a major modifiable risk factor for age-related
macular degeneration and should be addressed.
9.
Which symptom is most characteristic of benign prostatic hyperplasia?
A. Painless gross hematuria as the only symptom
B. Urinary hesitancy and weak stream
C. Sudden complete anuria
D. Severe flank pain
Answer: B
Comprehensive Exam 4 Review Questions and Answers
with Rationales 2026/2027
This comprehensive examination is designed to reinforce advanced primary-care knowledge for
the maturing and older adult population. The questions emphasize assessment, differential
diagnosis, evidence-based management, pharmacology, preventive care, geriatric syndromes,
chronic disease management, health promotion, and patient safety.
The questions are organized as single-best-answer multiple-choice items. Each question
includes the correct answer and a concise rationale to support clinical reasoning and exam
preparation.
1.
An older adult reports gradually worsening difficulty hearing
conversations, particularly when several people are speaking. Which
finding is most consistent with presbycusis?
A. Conductive hearing loss from cerumen
B. Bilateral high-frequency sensorineural hearing loss
C. Unilateral low-frequency conductive loss
D. Sudden unilateral sensorineural loss
Answer: B
Rationale: Presbycusis is age-related sensorineural hearing loss that
typically affects higher frequencies first and is usually bilateral and
progressive.
2.
Which finding in an older adult with hearing loss requires the most
urgent evaluation?
,A. Difficulty hearing high-pitched voices
B. Gradual bilateral hearing impairment
C. Sudden unilateral hearing loss
D. Needing the television volume increased
Answer: C
Rationale: Sudden sensorineural hearing loss is an otologic emergency
because prompt evaluation and treatment may improve hearing
recovery.
3.
Which intervention is most appropriate when communicating with an
older adult who has hearing impairment?
A. Speak loudly from another room
B. Face the patient directly while speaking
C. Exaggerate lip movements
D. Speak rapidly to minimize conversation time
Answer: B
Rationale: Facing the patient allows use of visual cues and improves
communication. Clear, normal-volume speech is preferable to shouting.
4.
An older adult has difficulty reading small print but has no visual loss at
distance. Which age-related change is most likely?
A. Presbyopia
B. Glaucoma
C. Cataract
D. Retinal detachment
Answer: A
,Rationale: Presbyopia results from age-related loss of lens
accommodation and causes difficulty focusing on near objects.
5.
Which symptom is most characteristic of cataracts?
A. Sudden severe eye pain
B. Progressive painless visual clouding
C. Flashes with a curtain-like visual defect
D. Acute unilateral blindness
Answer: B
Rationale: Cataracts commonly cause gradual, painless loss of visual
clarity, glare, and decreased contrast sensitivity.
6.
Which presentation is most concerning for acute angle-closure
glaucoma?
A. Gradual painless peripheral vision loss
B. Eye pain, headache, halos, nausea, and a red eye
C. Slowly progressive difficulty reading
D. Bilateral mild blurred vision
Answer: B
Rationale: Acute angle-closure glaucoma can present with severe eye
pain, headache, halos around lights, nausea/vomiting, and ocular
redness and requires urgent treatment.
7.
A patient reports seeing flashes of light followed by a sudden increase
in floaters and a curtain over part of the visual field. What is the
priority?
, A. Reassurance
B. Routine optometry referral
C. Emergency ophthalmologic evaluation
D. Trial of artificial tears
Answer: C
Rationale: These symptoms suggest retinal detachment, which can
cause permanent vision loss without urgent intervention.
8.
Which preventive measure is particularly important for an older adult
at risk for age-related macular degeneration?
A. Smoking cessation
B. Avoiding all dietary fats
C. Restricting calcium intake
D. Avoiding physical activity
Answer: A
Rationale: Smoking is a major modifiable risk factor for age-related
macular degeneration and should be addressed.
9.
Which symptom is most characteristic of benign prostatic hyperplasia?
A. Painless gross hematuria as the only symptom
B. Urinary hesitancy and weak stream
C. Sudden complete anuria
D. Severe flank pain
Answer: B
