NR601 / NR 601 MidteRM exaM PRiMaRy CaRe of the MatuRiNg aNd
aged faMily aCtual exaM 2026/2027 | CoMPlete exaM-Style
QueStioNS | 100% VeRified – detailed RatioNaleS – PaSS
guaRaNteed – a+ gRaded
Section 1: Geriatric Assessment and Age-Related Changes (Questions 1 to 12)
**Question 1 of 25**
A 78-year-old woman presents for her annual wellness visit. She lives independently, drives
locally, and manages her own finances. Her daughter reports that over the past year, the patient
has had increasing difficulty remembering appointments, managing her medications, and
preparing complex meals. The patient scores 24/30 on the Montreal Cognitive Assessment
(MoCA), missing points on delayed recall, abstraction, and orientation to date. Her PHQ-9 is 4.
She takes lisinopril and atorvastatin. Which screening tool is most appropriate to formally
assess her functional status and determine if she can continue living independently?
A. The Confusion Assessment Method (CAM) to rule out acute delirium
B. The Mini-Mental State Examination (MMSE) to quantify global cognition
C. A comprehensive assessment of both basic activities of daily living (ADLs) and instrumental
activities of daily living (IADLs) ✓
D. The Geriatric Depression Scale (GDS-15) to evaluate for masked depression
**Correct Answer: C ✓**
Rationale: The AGS recommends evaluating both ADLs and IADLs as the cornerstone of
geriatric functional assessment. IADL impairment (medication management, finances, meal
preparation) often precedes ADL decline and predicts the need for supportive services. The
MoCA already identified cognitive concerns. CAM (A) is for delirium. MMSE (B) is redundant.
GDS-15 (D) is less relevant with PHQ-9 of 4 (not depressed).
---
**Question 2 of 25**
, Which of the following is a normal age-related change in the cardiovascular system?
A. Increased compliance (decreased stiffness) of the aorta
B. Decreased resting heart rate
C. Increased left ventricular wall thickness and decreased early diastolic filling ✓
D. Increased cardiac output at rest
**Correct Answer: C ✓**
Rationale: Normal aging causes increased left ventricular wall thickness, decreased early
diastolic filling (due to decreased compliance), and increased aortic stiffness (not decreased,
A). Resting heart rate (B) remains relatively unchanged. Cardiac output at rest (D) is preserved
but peak exercise output decreases.
---
**Question 3 of 25**
A 72-year-old male reports occasional difficulty remembering names and misplacing keys. He is
able to manage all IADLs independently. His MoCA score is 27/30. The nurse practitioner's best
response is:
A. "You likely have early Alzheimer's disease and need a specialist referral."
B. "These changes are consistent with normal age-related cognitive decline. We will monitor
annually." ✓
C. "You should stop driving immediately."
D. "A head CT is urgently needed."
**Correct Answer: B ✓**
Rationale: Normal age-related cognitive changes include slower processing speed, difficulty
with word finding, and occasional memory lapses without functional impairment. MoCA 27/30 is
within normal range (normal ≥26). Dementia (A) involves impairment in ADLs/IADLs. Driving
cessation (C) and urgent CT (D) are not indicated.
---
aged faMily aCtual exaM 2026/2027 | CoMPlete exaM-Style
QueStioNS | 100% VeRified – detailed RatioNaleS – PaSS
guaRaNteed – a+ gRaded
Section 1: Geriatric Assessment and Age-Related Changes (Questions 1 to 12)
**Question 1 of 25**
A 78-year-old woman presents for her annual wellness visit. She lives independently, drives
locally, and manages her own finances. Her daughter reports that over the past year, the patient
has had increasing difficulty remembering appointments, managing her medications, and
preparing complex meals. The patient scores 24/30 on the Montreal Cognitive Assessment
(MoCA), missing points on delayed recall, abstraction, and orientation to date. Her PHQ-9 is 4.
She takes lisinopril and atorvastatin. Which screening tool is most appropriate to formally
assess her functional status and determine if she can continue living independently?
A. The Confusion Assessment Method (CAM) to rule out acute delirium
B. The Mini-Mental State Examination (MMSE) to quantify global cognition
C. A comprehensive assessment of both basic activities of daily living (ADLs) and instrumental
activities of daily living (IADLs) ✓
D. The Geriatric Depression Scale (GDS-15) to evaluate for masked depression
**Correct Answer: C ✓**
Rationale: The AGS recommends evaluating both ADLs and IADLs as the cornerstone of
geriatric functional assessment. IADL impairment (medication management, finances, meal
preparation) often precedes ADL decline and predicts the need for supportive services. The
MoCA already identified cognitive concerns. CAM (A) is for delirium. MMSE (B) is redundant.
GDS-15 (D) is less relevant with PHQ-9 of 4 (not depressed).
---
**Question 2 of 25**
, Which of the following is a normal age-related change in the cardiovascular system?
A. Increased compliance (decreased stiffness) of the aorta
B. Decreased resting heart rate
C. Increased left ventricular wall thickness and decreased early diastolic filling ✓
D. Increased cardiac output at rest
**Correct Answer: C ✓**
Rationale: Normal aging causes increased left ventricular wall thickness, decreased early
diastolic filling (due to decreased compliance), and increased aortic stiffness (not decreased,
A). Resting heart rate (B) remains relatively unchanged. Cardiac output at rest (D) is preserved
but peak exercise output decreases.
---
**Question 3 of 25**
A 72-year-old male reports occasional difficulty remembering names and misplacing keys. He is
able to manage all IADLs independently. His MoCA score is 27/30. The nurse practitioner's best
response is:
A. "You likely have early Alzheimer's disease and need a specialist referral."
B. "These changes are consistent with normal age-related cognitive decline. We will monitor
annually." ✓
C. "You should stop driving immediately."
D. "A head CT is urgently needed."
**Correct Answer: B ✓**
Rationale: Normal age-related cognitive changes include slower processing speed, difficulty
with word finding, and occasional memory lapses without functional impairment. MoCA 27/30 is
within normal range (normal ≥26). Dementia (A) involves impairment in ADLs/IADLs. Driving
cessation (C) and urgent CT (D) are not indicated.
---
