NR601 EXAM 2: ADVANCED PRIMARY
CARE OF THE MATURING AND AGED
FAMILY QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A 78-year-old male with a history of HFrEF (LVEF 35%) presents for a routine visit.
According to current guidelines, which of the following medication classes is considered the
‘foundational’ therapy to reduce mortality?
A. ARNI (Sacubitril/Valsartan)
B. Loop diuretics
C. Calcium channel blockers
D. Alpha-blockers
Answer: A
Conceptual Explanation: ARNI, along with Beta-blockers, Mineralocorticoid Receptor
Antagonists (MRAs), and SGLT2 inhibitors, form the four pillars of HFrEF management to
reduce mortality and hospitalizations.
2. Which physical examination finding is most indicative of severe aortic stenosis in an 82-
year-old patient?
A. Early diastolic decrescendo murmur
,B. Pulsus alternans
C. Pulsus parvus et tardus
D. Mid-systolic click
Answer: C
Conceptual Explanation: Pulsus parvus et tardus (a weak and delayed pulse) is a classic
finding of significant aortic stenosis. Mid-systolic click is associated with MVP.
3. According to the JNC 8 guidelines, what is the blood pressure goal for a healthy 70-year-old
without diabetes or CKD?
A. < 150/90 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
D. < 120/80 mmHg
Answer: A
Conceptual Explanation: JNC 8 recommends a threshold and goal of <150/90 mmHg for
individuals aged 60 and older, though ACC/AHA 2017 guidelines suggest <130/80 for all.
4. Which of the following is the most appropriate initial diagnostic test for a patient
suspected of having Giant Cell Arteritis (GCA)?
A. Temporal artery biopsy
B. Erythrocyte Sedimentation Rate (ESR)
, C. Head CT
D. Brain MRI
Answer: B
Conceptual Explanation: While temporal artery biopsy is the gold standard for diagnosis,
the ESR (or CRP) is the most appropriate initial screening test due to its high sensitivity.
5. A 68-year-old female presents with acute onset of severe eye pain, blurred vision, and
seeing ‘halos’ around lights. On exam, the pupil is mid-dilated and non-reactive. What is the
most likely diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Cataracts
D. Macular degeneration
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is an ophthalmic emergency
presenting with sudden pain, vision changes, and a fixed mid-dilated pupil.
6. An 80-year-old patient with multiple comorbidities and a life expectancy of less than 5
years has a current A1C of 7.9%. What is the most appropriate management plan?
A. Intensify therapy to reach A1C < 7.0%
B. Switch to insulin for tighter control
CARE OF THE MATURING AND AGED
FAMILY QUESTIONS WITH CORRECT
ANSWERS (LATEST ), (A+
GUARANTEE).
1. A 78-year-old male with a history of HFrEF (LVEF 35%) presents for a routine visit.
According to current guidelines, which of the following medication classes is considered the
‘foundational’ therapy to reduce mortality?
A. ARNI (Sacubitril/Valsartan)
B. Loop diuretics
C. Calcium channel blockers
D. Alpha-blockers
Answer: A
Conceptual Explanation: ARNI, along with Beta-blockers, Mineralocorticoid Receptor
Antagonists (MRAs), and SGLT2 inhibitors, form the four pillars of HFrEF management to
reduce mortality and hospitalizations.
2. Which physical examination finding is most indicative of severe aortic stenosis in an 82-
year-old patient?
A. Early diastolic decrescendo murmur
,B. Pulsus alternans
C. Pulsus parvus et tardus
D. Mid-systolic click
Answer: C
Conceptual Explanation: Pulsus parvus et tardus (a weak and delayed pulse) is a classic
finding of significant aortic stenosis. Mid-systolic click is associated with MVP.
3. According to the JNC 8 guidelines, what is the blood pressure goal for a healthy 70-year-old
without diabetes or CKD?
A. < 150/90 mmHg
B. < 130/80 mmHg
C. < 140/90 mmHg
D. < 120/80 mmHg
Answer: A
Conceptual Explanation: JNC 8 recommends a threshold and goal of <150/90 mmHg for
individuals aged 60 and older, though ACC/AHA 2017 guidelines suggest <130/80 for all.
4. Which of the following is the most appropriate initial diagnostic test for a patient
suspected of having Giant Cell Arteritis (GCA)?
A. Temporal artery biopsy
B. Erythrocyte Sedimentation Rate (ESR)
, C. Head CT
D. Brain MRI
Answer: B
Conceptual Explanation: While temporal artery biopsy is the gold standard for diagnosis,
the ESR (or CRP) is the most appropriate initial screening test due to its high sensitivity.
5. A 68-year-old female presents with acute onset of severe eye pain, blurred vision, and
seeing ‘halos’ around lights. On exam, the pupil is mid-dilated and non-reactive. What is the
most likely diagnosis?
A. Open-angle glaucoma
B. Acute angle-closure glaucoma
C. Cataracts
D. Macular degeneration
Answer: B
Conceptual Explanation: Acute angle-closure glaucoma is an ophthalmic emergency
presenting with sudden pain, vision changes, and a fixed mid-dilated pupil.
6. An 80-year-old patient with multiple comorbidities and a life expectancy of less than 5
years has a current A1C of 7.9%. What is the most appropriate management plan?
A. Intensify therapy to reach A1C < 7.0%
B. Switch to insulin for tighter control
