NR601 Week 4 Midterm Exam 2026 (Due
August 2nd) – Complete Actual Exam
Questions 1-150 | NR 601 Primary Care
of the Maturing and Aged Family
Practicum | Verified Answers +
Rationales | Instant PDF Download.
Question 1
Which of the following is considered a normal age-related change in the cardiovascular
system of an older adult?
A. Resting tachycardia
B. Increased arterial stiffness
C. New systolic murmur
D. Persistent orthostatic hypotension
Answer: B. Increased arterial stiffness
Rationale: Arterial stiffness increases with age and contributes to higher systolic blood
pressure and a widened pulse pressure. Resting tachycardia, new murmurs, and
persistent orthostatic hypotension are not normal aging changes and require evaluation
.
Question 2
An 80-year-old patient presents with acute onset of confusion, fluctuating attention, and
disorientation. The symptoms developed over the past 24 hours. What is the most likely
diagnosis?
A. Alzheimer's disease
B. Delirium
,C. Normal aging
D. Vascular dementia
Answer: B. Delirium
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
inattention. Dementia (such as Alzheimer's) typically has an insidious and progressive
onset. Delirium is a medical emergency and requires a search for the underlying cause
(e.g., infection, medication, metabolic disturbance) .
Question 3
Which medication is on the Beers Criteria list of potentially inappropriate medications
for older adults due to its strong anticholinergic effects and risk of confusion?
A. Lisinopril
B. Metformin
C. Diphenhydramine
D. Atorvastatin
Answer: C. Diphenhydramine
Rationale: Diphenhydramine is a first-generation antihistamine with strong
anticholinergic properties. In older adults, it can cause confusion, delirium, dry mouth,
urinary retention, and falls, and is therefore listed on the Beers Criteria as potentially
inappropriate .
Question 4
A 78-year-old male is diagnosed with herpes zoster (shingles). What is the most
appropriate treatment approach?
A. Start acyclovir 7 days after rash onset
B. Start valacyclovir within 72 hours of rash onset
C. Apply topical corticosteroids only
D. Prescribe antibiotics
,Answer: B. Start valacyclovir within 72 hours of rash onset
Rationale: Antiviral therapy (acyclovir, valacyclovir, or famciclovir) is most effective when
initiated within 72 hours of rash onset. It reduces the duration and severity of the illness
and lowers the risk of postherpetic neuralgia .
Question 5
What is the recommended amount of moderate-intensity physical activity for older
adults?
A. 10 minutes daily
B. 30 minutes, 5 days per week
C. 60 minutes of vigorous activity daily
D. No exercise is recommended after age 75
Answer: B. 30 minutes, 5 days per week
Rationale: The general recommendation for older adults is at least 150 minutes of
moderate-intensity aerobic activity per week (e.g., 30 minutes on 5 days). For weight
loss, up to 60 minutes per day may be needed .
Question 6
A 76-year-old patient has a Mini-Mental State Examination (MMSE) score of 22/30.
What does this score most likely indicate?
A. Normal cognition
B. Mild cognitive impairment or mild dementia
C. Severe dementia
D. Delirium
Answer: B. Mild cognitive impairment or mild dementia
, Rationale: An MMSE score of 24–30 is generally considered normal. Scores of 18–23
typically indicate mild cognitive impairment or mild dementia. Scores below 18 usually
suggest severe impairment .
Question 7
Which of the following is the most common cause of community-acquired pneumonia
in older adults?
A. Legionella
B. Mycoplasma
C. Streptococcus pneumoniae
D. Viral pneumonia
Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae remains the most common cause of community-
acquired pneumonia in older adults .
Question 8
An older adult with hypertension is started on a new medication and subsequently
develops dizziness and gait instability. Which principle should guide the clinician's
medication review?
A. Start low and go slow
B. Start high and titrate down quickly
C. Use the same dose as a younger adult
D. Avoid all antihypertensive medications in the elderly
Answer: A. Start low and go slow
Rationale: Older adults have altered pharmacokinetics and pharmacodynamics,
increased sensitivity to medications, and reduced physiological reserve. The principle of
"start low and go slow" minimizes the risk of adverse drug events .
August 2nd) – Complete Actual Exam
Questions 1-150 | NR 601 Primary Care
of the Maturing and Aged Family
Practicum | Verified Answers +
Rationales | Instant PDF Download.
Question 1
Which of the following is considered a normal age-related change in the cardiovascular
system of an older adult?
A. Resting tachycardia
B. Increased arterial stiffness
C. New systolic murmur
D. Persistent orthostatic hypotension
Answer: B. Increased arterial stiffness
Rationale: Arterial stiffness increases with age and contributes to higher systolic blood
pressure and a widened pulse pressure. Resting tachycardia, new murmurs, and
persistent orthostatic hypotension are not normal aging changes and require evaluation
.
Question 2
An 80-year-old patient presents with acute onset of confusion, fluctuating attention, and
disorientation. The symptoms developed over the past 24 hours. What is the most likely
diagnosis?
A. Alzheimer's disease
B. Delirium
,C. Normal aging
D. Vascular dementia
Answer: B. Delirium
Rationale: Delirium is characterized by an acute onset, fluctuating course, and
inattention. Dementia (such as Alzheimer's) typically has an insidious and progressive
onset. Delirium is a medical emergency and requires a search for the underlying cause
(e.g., infection, medication, metabolic disturbance) .
Question 3
Which medication is on the Beers Criteria list of potentially inappropriate medications
for older adults due to its strong anticholinergic effects and risk of confusion?
A. Lisinopril
B. Metformin
C. Diphenhydramine
D. Atorvastatin
Answer: C. Diphenhydramine
Rationale: Diphenhydramine is a first-generation antihistamine with strong
anticholinergic properties. In older adults, it can cause confusion, delirium, dry mouth,
urinary retention, and falls, and is therefore listed on the Beers Criteria as potentially
inappropriate .
Question 4
A 78-year-old male is diagnosed with herpes zoster (shingles). What is the most
appropriate treatment approach?
A. Start acyclovir 7 days after rash onset
B. Start valacyclovir within 72 hours of rash onset
C. Apply topical corticosteroids only
D. Prescribe antibiotics
,Answer: B. Start valacyclovir within 72 hours of rash onset
Rationale: Antiviral therapy (acyclovir, valacyclovir, or famciclovir) is most effective when
initiated within 72 hours of rash onset. It reduces the duration and severity of the illness
and lowers the risk of postherpetic neuralgia .
Question 5
What is the recommended amount of moderate-intensity physical activity for older
adults?
A. 10 minutes daily
B. 30 minutes, 5 days per week
C. 60 minutes of vigorous activity daily
D. No exercise is recommended after age 75
Answer: B. 30 minutes, 5 days per week
Rationale: The general recommendation for older adults is at least 150 minutes of
moderate-intensity aerobic activity per week (e.g., 30 minutes on 5 days). For weight
loss, up to 60 minutes per day may be needed .
Question 6
A 76-year-old patient has a Mini-Mental State Examination (MMSE) score of 22/30.
What does this score most likely indicate?
A. Normal cognition
B. Mild cognitive impairment or mild dementia
C. Severe dementia
D. Delirium
Answer: B. Mild cognitive impairment or mild dementia
, Rationale: An MMSE score of 24–30 is generally considered normal. Scores of 18–23
typically indicate mild cognitive impairment or mild dementia. Scores below 18 usually
suggest severe impairment .
Question 7
Which of the following is the most common cause of community-acquired pneumonia
in older adults?
A. Legionella
B. Mycoplasma
C. Streptococcus pneumoniae
D. Viral pneumonia
Answer: C. Streptococcus pneumoniae
Rationale: Streptococcus pneumoniae remains the most common cause of community-
acquired pneumonia in older adults .
Question 8
An older adult with hypertension is started on a new medication and subsequently
develops dizziness and gait instability. Which principle should guide the clinician's
medication review?
A. Start low and go slow
B. Start high and titrate down quickly
C. Use the same dose as a younger adult
D. Avoid all antihypertensive medications in the elderly
Answer: A. Start low and go slow
Rationale: Older adults have altered pharmacokinetics and pharmacodynamics,
increased sensitivity to medications, and reduced physiological reserve. The principle of
"start low and go slow" minimizes the risk of adverse drug events .
