NR 601 Midterm Exam Study Guide Weeks 1-4 Content
Actual Exam 2026/2027 | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Week 1: Geriatric Assessment, Health Promotion & Age-Related Changes
Q1: When you sit down to complete a comprehensive geriatric assessment on a new
patient, which set of domains best reflects what that evaluation should cover?
A. Physical health, laboratory values, and vital signs
B. Cognitive function, medication adherence, and immunization status
C. Physical health, functional status, cognition, psychological health, social support, and
environmental safety [CORRECT]
D. Cardiovascular, respiratory, gastrointestinal, and neurologic review of systems
Correct Answer: C
Rationale: The best answer is C because a comprehensive geriatric assessment is
multidimensional by design, moving well beyond body systems to capture how the person
actually functions and lives. This aligns with the core principle that older adults are best
evaluated through physical, functional, cognitive, psychological, social, and environmental
lenses together.
Q2: A colleague asks you which standardized tool is used to evaluate higher-order tasks like
managing finances, shopping, and taking medications correctly in an older adult.
A. Katz Index of Independence in Activities of Daily Living
B. Braden Scale for Pressure Injury Risk
C. Lawton Instrumental Activities of Daily Living Scale [CORRECT]
D. Geriatric Depression Scale
Correct Answer: C
Rationale: This choice is correct because the Lawton IADL Scale specifically measures
instrumental activities such as finances, medication management, shopping, and
transportation. Remember, for older adults, IADL losses are often the earliest functional
warning signs we see.
Q3: Which of the following best describes what the Katz Index of Activities of Daily Living
measures?
A. Higher-order tasks such as shopping and managing finances
B. Basic self-care tasks including bathing, dressing, toileting, transferring, continence, and
feeding [CORRECT]
C. Cognitive domains including memory, language, and orientation
D. Risk factors for skin breakdown and pressure injury
Correct Answer: C
,Rationale: The Katz Index zeroes in on basic self-care, the fundamental ADLs that allow a
person to remain independent at home. This matches the principle that basic self-care
function and higher-order instrumental function are assessed separately.
Q4: A 71-year-old man comes in worried about his memory. He is fully independent, works
part-time, and scores 23 out of 30 on the MoCA. What is the best interpretation and next
step?
A. The score is normal for his age, so no further action is needed
B. The findings confirm Alzheimer's disease, and donepezil should be started today
C. The score suggests mild cognitive impairment, so further evaluation including a
depression screen, B12, TSH, and reassessment is warranted [CORRECT]
D. Immediate full-time supervision and home care should be arranged
Correct Answer: C
Rationale: The best answer is C because a MoCA below the typical cutoff of 26 raises
concern for cognitive impairment but does not diagnose dementia, and reversible
contributors like depression, B12 deficiency, and thyroid disease must be ruled out first. The
geriatric pearl here is to evaluate before you label.
Q5: You are selecting a screening tool for an 80-year-old widow reporting fatigue, poor
appetite, and poor sleep. Why is the 15-item Geriatric Depression Scale a good fit?
A. It requires extensive training and several hours to administer
B. It relies heavily on somatic symptom items that overestimate physical illness
C. It uses simple yes/no questions, is quick to complete, and is well validated in older adults
[CORRECT]
D. It identifies the specific subtype of depression present
Correct Answer: C
Rationale: This choice is correct because the GDS-15 was built for older adults with its
yes/no format and brevity. This aligns with our goal of choosing screening tools older
patients can actually complete accurately in a busy clinic.
Q6: Which of the following cardiovascular changes represents a normal, expected age-
related change?
A. Decreased systolic blood pressure
B. Improved diastolic relaxation
C. Increased arterial stiffness leading to higher systolic readings [CORRECT]
D. Increased maximal heart rate
Correct Answer: C
Rationale: The geriatric pearl here is that stiffened large arteries raise systolic pressures with
age, which is why isolated systolic hypertension is so common in our older patients. The
other choices invert what actually happens physiologically.
Q7: A 79-year-old patient is starting a new medication. How should normal age-related
decline in glomerular filtration rate shape your prescribing?
A. All medications require inpatient monitoring before initiation
B. Kidney function is essentially unaffected by age
C. Renally cleared drugs may require dose reduction, with eGFR checked before prescribing
and monitored over time [CORRECT]
, D. Only antibiotics ever need renal dose adjustment
Correct Answer: C
Rationale: The best answer is C because decreased GFR slows drug clearance, so many
medications need dose adjustment and ongoing renal monitoring. Remember, for older
adults, kidney function is quiet until it isn't, so check it before every renally cleared
prescription.
Q8: Which finding in a 74-year-old patient reflects a normal age-related change rather than
disease?
A. Central vision distortion with straight lines appearing wavy
B. Sudden new floaters with a curtain over part of the vision
C. Needing to hold the newspaper at arm's length to read it [CORRECT]
D. Halos around lights accompanied by eye pain
Correct Answer: C
Rationale: This choice is correct because needing to stretch your arms to read is classic
presbyopia, an expected change in lens accommodation. The other findings describe urgent
pathologies like macular degeneration, retinal detachment, and angle-closure glaucoma that
would need prompt attention.
Q9: Which statement best characterizes geriatric syndromes such as falls, frailty,
incontinence, and delirium?
A. They have a single identifiable cause in most cases
B. They are multifactorial, share common risk factors, and respond best to interdisciplinary
management [CORRECT]
C. They occur only in nursing home residents
D. They are an unavoidable and untreatable part of normal aging
Correct Answer: C
Rationale: The best answer is C because geriatric syndromes arise from multiple
accumulated impairments across domains and share risk factors, which is exactly why
interdisciplinary care works. This matches the principle that no single clinician or single fix
manages these well alone.
Q10: What is a key feature of the Medicare Annual Wellness Visit?
A. A complete head-to-toe physical examination
B. Development of a personalized prevention plan, a health risk assessment, and cognitive
screening [CORRECT]
C. Routine annual chest x-ray and EKG
D. It is available only during the first year of Medicare enrollment
Correct Answer: C
Rationale: This choice is correct because the Annual Wellness Visit is built around
prevention planning, risk assessment, and cognitive screening rather than a physical exam.
The visit focusing on the first year of enrollment describes the Welcome to Medicare exam,
a common point of confusion.
Q11: A healthy 68-year-old asks what she should do about shingles protection.
A. A single one-time dose of the live zoster vaccine
B. Vaccination is only appropriate if she has already had shingles
Actual Exam 2026/2027 | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass
Guaranteed – A+ Graded
Week 1: Geriatric Assessment, Health Promotion & Age-Related Changes
Q1: When you sit down to complete a comprehensive geriatric assessment on a new
patient, which set of domains best reflects what that evaluation should cover?
A. Physical health, laboratory values, and vital signs
B. Cognitive function, medication adherence, and immunization status
C. Physical health, functional status, cognition, psychological health, social support, and
environmental safety [CORRECT]
D. Cardiovascular, respiratory, gastrointestinal, and neurologic review of systems
Correct Answer: C
Rationale: The best answer is C because a comprehensive geriatric assessment is
multidimensional by design, moving well beyond body systems to capture how the person
actually functions and lives. This aligns with the core principle that older adults are best
evaluated through physical, functional, cognitive, psychological, social, and environmental
lenses together.
Q2: A colleague asks you which standardized tool is used to evaluate higher-order tasks like
managing finances, shopping, and taking medications correctly in an older adult.
A. Katz Index of Independence in Activities of Daily Living
B. Braden Scale for Pressure Injury Risk
C. Lawton Instrumental Activities of Daily Living Scale [CORRECT]
D. Geriatric Depression Scale
Correct Answer: C
Rationale: This choice is correct because the Lawton IADL Scale specifically measures
instrumental activities such as finances, medication management, shopping, and
transportation. Remember, for older adults, IADL losses are often the earliest functional
warning signs we see.
Q3: Which of the following best describes what the Katz Index of Activities of Daily Living
measures?
A. Higher-order tasks such as shopping and managing finances
B. Basic self-care tasks including bathing, dressing, toileting, transferring, continence, and
feeding [CORRECT]
C. Cognitive domains including memory, language, and orientation
D. Risk factors for skin breakdown and pressure injury
Correct Answer: C
,Rationale: The Katz Index zeroes in on basic self-care, the fundamental ADLs that allow a
person to remain independent at home. This matches the principle that basic self-care
function and higher-order instrumental function are assessed separately.
Q4: A 71-year-old man comes in worried about his memory. He is fully independent, works
part-time, and scores 23 out of 30 on the MoCA. What is the best interpretation and next
step?
A. The score is normal for his age, so no further action is needed
B. The findings confirm Alzheimer's disease, and donepezil should be started today
C. The score suggests mild cognitive impairment, so further evaluation including a
depression screen, B12, TSH, and reassessment is warranted [CORRECT]
D. Immediate full-time supervision and home care should be arranged
Correct Answer: C
Rationale: The best answer is C because a MoCA below the typical cutoff of 26 raises
concern for cognitive impairment but does not diagnose dementia, and reversible
contributors like depression, B12 deficiency, and thyroid disease must be ruled out first. The
geriatric pearl here is to evaluate before you label.
Q5: You are selecting a screening tool for an 80-year-old widow reporting fatigue, poor
appetite, and poor sleep. Why is the 15-item Geriatric Depression Scale a good fit?
A. It requires extensive training and several hours to administer
B. It relies heavily on somatic symptom items that overestimate physical illness
C. It uses simple yes/no questions, is quick to complete, and is well validated in older adults
[CORRECT]
D. It identifies the specific subtype of depression present
Correct Answer: C
Rationale: This choice is correct because the GDS-15 was built for older adults with its
yes/no format and brevity. This aligns with our goal of choosing screening tools older
patients can actually complete accurately in a busy clinic.
Q6: Which of the following cardiovascular changes represents a normal, expected age-
related change?
A. Decreased systolic blood pressure
B. Improved diastolic relaxation
C. Increased arterial stiffness leading to higher systolic readings [CORRECT]
D. Increased maximal heart rate
Correct Answer: C
Rationale: The geriatric pearl here is that stiffened large arteries raise systolic pressures with
age, which is why isolated systolic hypertension is so common in our older patients. The
other choices invert what actually happens physiologically.
Q7: A 79-year-old patient is starting a new medication. How should normal age-related
decline in glomerular filtration rate shape your prescribing?
A. All medications require inpatient monitoring before initiation
B. Kidney function is essentially unaffected by age
C. Renally cleared drugs may require dose reduction, with eGFR checked before prescribing
and monitored over time [CORRECT]
, D. Only antibiotics ever need renal dose adjustment
Correct Answer: C
Rationale: The best answer is C because decreased GFR slows drug clearance, so many
medications need dose adjustment and ongoing renal monitoring. Remember, for older
adults, kidney function is quiet until it isn't, so check it before every renally cleared
prescription.
Q8: Which finding in a 74-year-old patient reflects a normal age-related change rather than
disease?
A. Central vision distortion with straight lines appearing wavy
B. Sudden new floaters with a curtain over part of the vision
C. Needing to hold the newspaper at arm's length to read it [CORRECT]
D. Halos around lights accompanied by eye pain
Correct Answer: C
Rationale: This choice is correct because needing to stretch your arms to read is classic
presbyopia, an expected change in lens accommodation. The other findings describe urgent
pathologies like macular degeneration, retinal detachment, and angle-closure glaucoma that
would need prompt attention.
Q9: Which statement best characterizes geriatric syndromes such as falls, frailty,
incontinence, and delirium?
A. They have a single identifiable cause in most cases
B. They are multifactorial, share common risk factors, and respond best to interdisciplinary
management [CORRECT]
C. They occur only in nursing home residents
D. They are an unavoidable and untreatable part of normal aging
Correct Answer: C
Rationale: The best answer is C because geriatric syndromes arise from multiple
accumulated impairments across domains and share risk factors, which is exactly why
interdisciplinary care works. This matches the principle that no single clinician or single fix
manages these well alone.
Q10: What is a key feature of the Medicare Annual Wellness Visit?
A. A complete head-to-toe physical examination
B. Development of a personalized prevention plan, a health risk assessment, and cognitive
screening [CORRECT]
C. Routine annual chest x-ray and EKG
D. It is available only during the first year of Medicare enrollment
Correct Answer: C
Rationale: This choice is correct because the Annual Wellness Visit is built around
prevention planning, risk assessment, and cognitive screening rather than a physical exam.
The visit focusing on the first year of enrollment describes the Welcome to Medicare exam,
a common point of confusion.
Q11: A healthy 68-year-old asks what she should do about shingles protection.
A. A single one-time dose of the live zoster vaccine
B. Vaccination is only appropriate if she has already had shingles
