NR 601 Midterm Exams 1–4 Primary Care Of The
Maturing & Aged Family Practicum | Multiple-Choice
Questions And Answers With Rationale | 2026/2027
Updates
DOCUMENT ENTAILS;
Exam 1: Geriatric Assessment & Physiological Aging
Exam 2: Polypharmacy, Pharmacology & Chronic Disease Management
Exam 3: Cardiovascular, Respiratory & Endocrine Disorders
Exam 4: Geriatric Syndromes, Palliative Care & Health Promotion
Question 1.
A 72-year-old patient presents for an annual wellness visit. The nurse practitioner is
conducting a comprehensive geriatric assessment. Which screening tool is most
appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Correct Answer: B
Rationale:
The TUG test assesses mobility, balance, and fall risk, which are key predictors of functional
decline in older adults. While the MMSE (A) evaluates cognition and the GDS (C) screens for
depression, the TUG directly measures physical function and independence in activities of daily
living.
Question 2.
A 68-year-old male patient reports that he has fallen twice in the past 6 months but did
not seek medical attention. Which assessment finding would most increase his risk for
future falls?
,A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
Correct Answer: B
Rationale:
Polypharmacy (≥5 medications) and specific drug classes including diuretics, sedatives, and
antihypertensives significantly increase fall risk through orthostatic hypotension, sedation, or
electrolyte disturbances. Normal gait speed (D) and tandem stance ability (C) are protective
factors, not risks.
Question 3.
A nurse practitioner is performing a hearing assessment on an 80-year-old patient. The
patient has difficulty hearing high-frequency sounds and understanding speech in noisy
environments. Which type of hearing loss is most consistent with these findings?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Correct Answer: B
Rationale:
Presbycusis (age-related hearing loss) is a sensorineural loss characterized by high-frequency
hearing loss and difficulty with speech discrimination, particularly in background noise. It results
from degeneration of cochlear hair cells and neural pathways. Conductive loss (A) involves the
outer or middle ear.
Question 4.
During a geriatric assessment, a patient scores 24 on the Mini-Mental State Examination
(MMSE). Which interpretation is most accurate?
A. Normal cognitive function
B. Mild cognitive impairment
,C. Moderate cognitive impairment
D. Severe cognitive impairment
Correct Answer: B
Rationale:
MMSE scores of 24–30 suggest mild cognitive impairment or normal function depending on
education level; however, in the context of geriatric assessment, a score of 24 typically falls at
the lower threshold of normal or indicates mild impairment warranting further evaluation.
Scores below 24 are more definitively abnormal.
Question 5.
A 75-year-old patient is being screened for malnutrition. Which finding is most specific
for protein-energy malnutrition in older adults?
A. Body mass index of 28 kg/m²
B. Serum albumin level of 2.8 g/dL
C. Total cholesterol of 220 mg/dL
D. Hemoglobin of 13.5 g/dL
Correct Answer: B
Rationale:
Hypoalbuminemia (<3.5 g/dL) is a sensitive marker of protein-energy malnutrition and is
associated with increased morbidity and mortality in older adults. While BMI (A) may be normal
or elevated in malnourished elderly due to edema or sarcopenic obesity, albumin reflects
visceral protein status.
Question 6.
What are the three primary physiological changes of aging?
A. Decreased appetite, increased sleep needs, and reduced muscle mass
B. Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological function
C. Increased blood pressure, decreased bone density, and memory loss
D. Weight gain, decreased vision, and hearing loss
Correct Answer: B
, Rationale:
The three hallmark changes of aging include: (1) Reduced physiological reserve of most body
systems (particularly cardiac, respiratory, and renal), (2) Reduced homeostatic mechanisms
affecting temperature regulation and fluid/electrolyte balance, and (3) Impaired immunological
function that increases infection risk and autoimmune disease prevalence.
Question 7.
According to current guidelines, what is the preferred amount of exercise recommended
for older adults?
A. 15 minutes/day, 3 days/week
B. 30 minutes/day, 5 days/week of moderate exercise
C. 60 minutes/day, 7 days/week of vigorous exercise
D. No specific recommendation for older adults
Correct Answer: B
Rationale:
Current guidelines recommend that older adults engage in 30 minutes of moderate-intensity
aerobic activity at least 5 days per week. If weight management is a goal, 60 minutes per day is
advised. To maintain flexibility, older adults should perform activities that maintain or increase
flexibility on at least 2 days each week.
Question 8.
What is the primary purpose of a Comprehensive Geriatric Assessment (CGA)?
A. To diagnose acute illnesses only
B. To evaluate physical health, functional ability, psychosocial health, and environmental safety
C. To determine eligibility for nursing home placement
D. To assess medication side effects exclusively
Correct Answer: B
Rationale:
The comprehensive approach to geriatric assessment is recommended because the physical
health of the older adult is inextricably related to functional ability, psychosocial health, and a
Maturing & Aged Family Practicum | Multiple-Choice
Questions And Answers With Rationale | 2026/2027
Updates
DOCUMENT ENTAILS;
Exam 1: Geriatric Assessment & Physiological Aging
Exam 2: Polypharmacy, Pharmacology & Chronic Disease Management
Exam 3: Cardiovascular, Respiratory & Endocrine Disorders
Exam 4: Geriatric Syndromes, Palliative Care & Health Promotion
Question 1.
A 72-year-old patient presents for an annual wellness visit. The nurse practitioner is
conducting a comprehensive geriatric assessment. Which screening tool is most
appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Correct Answer: B
Rationale:
The TUG test assesses mobility, balance, and fall risk, which are key predictors of functional
decline in older adults. While the MMSE (A) evaluates cognition and the GDS (C) screens for
depression, the TUG directly measures physical function and independence in activities of daily
living.
Question 2.
A 68-year-old male patient reports that he has fallen twice in the past 6 months but did
not seek medical attention. Which assessment finding would most increase his risk for
future falls?
,A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
Correct Answer: B
Rationale:
Polypharmacy (≥5 medications) and specific drug classes including diuretics, sedatives, and
antihypertensives significantly increase fall risk through orthostatic hypotension, sedation, or
electrolyte disturbances. Normal gait speed (D) and tandem stance ability (C) are protective
factors, not risks.
Question 3.
A nurse practitioner is performing a hearing assessment on an 80-year-old patient. The
patient has difficulty hearing high-frequency sounds and understanding speech in noisy
environments. Which type of hearing loss is most consistent with these findings?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Correct Answer: B
Rationale:
Presbycusis (age-related hearing loss) is a sensorineural loss characterized by high-frequency
hearing loss and difficulty with speech discrimination, particularly in background noise. It results
from degeneration of cochlear hair cells and neural pathways. Conductive loss (A) involves the
outer or middle ear.
Question 4.
During a geriatric assessment, a patient scores 24 on the Mini-Mental State Examination
(MMSE). Which interpretation is most accurate?
A. Normal cognitive function
B. Mild cognitive impairment
,C. Moderate cognitive impairment
D. Severe cognitive impairment
Correct Answer: B
Rationale:
MMSE scores of 24–30 suggest mild cognitive impairment or normal function depending on
education level; however, in the context of geriatric assessment, a score of 24 typically falls at
the lower threshold of normal or indicates mild impairment warranting further evaluation.
Scores below 24 are more definitively abnormal.
Question 5.
A 75-year-old patient is being screened for malnutrition. Which finding is most specific
for protein-energy malnutrition in older adults?
A. Body mass index of 28 kg/m²
B. Serum albumin level of 2.8 g/dL
C. Total cholesterol of 220 mg/dL
D. Hemoglobin of 13.5 g/dL
Correct Answer: B
Rationale:
Hypoalbuminemia (<3.5 g/dL) is a sensitive marker of protein-energy malnutrition and is
associated with increased morbidity and mortality in older adults. While BMI (A) may be normal
or elevated in malnourished elderly due to edema or sarcopenic obesity, albumin reflects
visceral protein status.
Question 6.
What are the three primary physiological changes of aging?
A. Decreased appetite, increased sleep needs, and reduced muscle mass
B. Reduced physiological reserve, reduced homeostatic mechanisms, and impaired
immunological function
C. Increased blood pressure, decreased bone density, and memory loss
D. Weight gain, decreased vision, and hearing loss
Correct Answer: B
, Rationale:
The three hallmark changes of aging include: (1) Reduced physiological reserve of most body
systems (particularly cardiac, respiratory, and renal), (2) Reduced homeostatic mechanisms
affecting temperature regulation and fluid/electrolyte balance, and (3) Impaired immunological
function that increases infection risk and autoimmune disease prevalence.
Question 7.
According to current guidelines, what is the preferred amount of exercise recommended
for older adults?
A. 15 minutes/day, 3 days/week
B. 30 minutes/day, 5 days/week of moderate exercise
C. 60 minutes/day, 7 days/week of vigorous exercise
D. No specific recommendation for older adults
Correct Answer: B
Rationale:
Current guidelines recommend that older adults engage in 30 minutes of moderate-intensity
aerobic activity at least 5 days per week. If weight management is a goal, 60 minutes per day is
advised. To maintain flexibility, older adults should perform activities that maintain or increase
flexibility on at least 2 days each week.
Question 8.
What is the primary purpose of a Comprehensive Geriatric Assessment (CGA)?
A. To diagnose acute illnesses only
B. To evaluate physical health, functional ability, psychosocial health, and environmental safety
C. To determine eligibility for nursing home placement
D. To assess medication side effects exclusively
Correct Answer: B
Rationale:
The comprehensive approach to geriatric assessment is recommended because the physical
health of the older adult is inextricably related to functional ability, psychosocial health, and a
