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
TABLE OF CONTENTS
Section 1 | Health Promotion & Aging Theories | Q1 – Q10
Section 2 | Pharmacokinetics & Polypharmacy in Older Adults | Q11 – Q20
Section 3 | Cardiovascular & Respiratory Disorders | Q21 – Q30
Section 4 | Endocrine, Metabolic & Genitourinary Disorders | Q31 – Q40
Section 5 | Musculoskeletal, Neurologic & Integumentary Disorders | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: HEALTH PROMOTION & AGING THEORIES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old woman lives alone and manages her own medications, finances, and
transportation but recently stopped cooking because she finds it exhausting. Her
daughter asks whether she needs home care. What assessment best captures her
current functional status?
A. The Katz Index of Activities of Daily Living
B. The Lawton Instrumental Activities of Daily Living Scale ✓ CORRECT
C. The Mini-Mental State Examination
D. The Geriatric Depression Scale
Correct Answer: B
Rationale: The Lawton IADL scale evaluates complex skills like cooking, managing
finances, and using transportation, which are precisely the abilities this patient is
struggling to maintain. The Katz ADL index focuses on basic self-care tasks such as
bathing and dressing, which she currently handles independently. In primary care, a
,decline in IADLs often signals the earliest functional impairment in community-dwelling
older adults and prompts further safety evaluation.
Question 2 of 50
A 68-year-old man with well-controlled type 2 diabetes asks which vaccines he needs
before traveling to visit his grandchildren. He received influenza vaccine two months
ago and completed his primary COVID-19 series last year. What additional immunization
is most indicated for him today?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Tetanus-diphtheria booster only
C. Herpes zoster recombinant vaccine (RZV) only
D. Both pneumococcal conjugate vaccine (PCV20) and herpes zoster recombinant
vaccine (RZV) ✓ CORRECT
Correct Answer: D
Rationale: Adults aged 65 and older should receive both PCV20 or PCV15 followed by
PPSV23 for pneumococcal protection, and the two-dose RZV series for shingles
prevention regardless of prior varicella history. A tetanus booster is only indicated every
ten years unless a wound management scenario suggests earlier administration.
Keeping these adult immunizations current is a cornerstone of geriatric health
promotion and prevents significant morbidity in older adults with chronic conditions.
Question 3 of 50
During a routine wellness visit, a 72-year-old woman reports two falls in the past six
months, both occurring while rushing to the bathroom at night. She takes lisinopril and
occasionally diphenhydramine for sleep. What is the most appropriate first step in
evaluating her fall risk?
,A. Conduct a multifactorial fall risk assessment including orthostatic vital signs, gait
testing, and medication review ✓ CORRECT
B. Order lumbar spine imaging to rule out spinal stenosis
C. Prescribe a bedtime dose of vitamin D with calcium
D. Recommend immediate installation of grab bars and discharge from fall evaluation
Correct Answer: A
Rationale: The American Geriatrics Society recommends a multifactorial fall risk
assessment that examines gait, balance, orthostatic hypotension, vision, feet, and
medications, especially sedating agents like diphenhydramine. Lumbar imaging is not
indicated without neurologic deficits or red flags suggesting structural pathology. While
home modifications and vitamin D are reasonable adjuncts, they should follow a
structured clinical assessment that identifies and targets modifiable risk factors
specific to the patient.
Question 4 of 50
A 74-year-old man with a tenth-grade education is accompanied by his wife who reports
he has become increasingly forgetful over the past year, repeating questions and
misplacing items. He scores 24/30 on the Mini-Mental State Examination. What is the
most appropriate next step in cognitive assessment?
A. Reassure the wife that his score is normal for his educational level and schedule
routine follow-up
B. Immediately initiate donepezil 5 mg daily for probable Alzheimer's disease
C. Administer the Montreal Cognitive Assessment (MoCA) to better detect mild
cognitive impairment ✓ CORRECT
D. Order urgent brain MRI to evaluate for normal pressure hydrocephalus
Correct Answer: C
Rationale: The MoCA is more sensitive than the MMSE for detecting mild cognitive
impairment because it includes executive function and attention tasks that often
decline early in neurodegenerative processes. A score of 24/30 on the MMSE is below
, the typical cutoff of 27 and warrants further evaluation rather than reassurance alone.
Initiating cholinesterase inhibitors requires a more comprehensive diagnostic workup,
and urgent imaging is reserved for patients with rapidly progressive symptoms or focal
neurologic findings.
Question 5 of 50
A 79-year-old retired accountant is referred by the Department of Motor Vehicles after a
minor parking lot accident. He has mild Parkinson's disease, takes carbidopa-levodopa,
and denies any injuries. His physical examination reveals mild resting tremor but no
rigidity during the visit. What is the most appropriate recommendation regarding his
driving privileges?
A. Advise him to permanently surrender his license due to the Parkinson's diagnosis
B. Refer him for an on-road driving evaluation or occupational therapy driving
assessment ✓ CORRECT
C. Clear him to continue driving because he has no rigidity on today's examination
D. Report him immediately to the DMV as an unsafe driver without further evaluation
Correct Answer: B
Rationale: An on-road or occupational therapy driving evaluation objectively assesses
the complex cognitive, visual, and motor skills required for safe driving beyond what a
clinic examination can capture. A diagnosis of Parkinson's disease alone does not
automatically preclude driving, and the absence of rigidity during a single visit does not
guarantee safe performance. Clinicians should balance patient autonomy and public
safety by using formal driving assessments rather than making unilateral decisions
based solely on diagnosis.
Question 6 of 50
A 76-year-old woman with moderate dementia continues to live at home with her
78-year-old husband who has coronary artery disease and osteoarthritis. During a home
2026/2027: Complete Exam-Style Questions with Detailed Rationales
| 100% Verified | Pass Guaranteed – A+ Graded
TABLE OF CONTENTS
Section 1 | Health Promotion & Aging Theories | Q1 – Q10
Section 2 | Pharmacokinetics & Polypharmacy in Older Adults | Q11 – Q20
Section 3 | Cardiovascular & Respiratory Disorders | Q21 – Q30
Section 4 | Endocrine, Metabolic & Genitourinary Disorders | Q31 – Q40
Section 5 | Musculoskeletal, Neurologic & Integumentary Disorders | Q41 – Q50
Instructions: Choose the single best answer. Pass: 80% in 90 minutes.
══════════════════════════════════════
SECTION 1: HEALTH PROMOTION & AGING THEORIES Q1 – Q10
══════════════════════════════════════
Question 1 of 50
A 78-year-old woman lives alone and manages her own medications, finances, and
transportation but recently stopped cooking because she finds it exhausting. Her
daughter asks whether she needs home care. What assessment best captures her
current functional status?
A. The Katz Index of Activities of Daily Living
B. The Lawton Instrumental Activities of Daily Living Scale ✓ CORRECT
C. The Mini-Mental State Examination
D. The Geriatric Depression Scale
Correct Answer: B
Rationale: The Lawton IADL scale evaluates complex skills like cooking, managing
finances, and using transportation, which are precisely the abilities this patient is
struggling to maintain. The Katz ADL index focuses on basic self-care tasks such as
bathing and dressing, which she currently handles independently. In primary care, a
,decline in IADLs often signals the earliest functional impairment in community-dwelling
older adults and prompts further safety evaluation.
Question 2 of 50
A 68-year-old man with well-controlled type 2 diabetes asks which vaccines he needs
before traveling to visit his grandchildren. He received influenza vaccine two months
ago and completed his primary COVID-19 series last year. What additional immunization
is most indicated for him today?
A. Pneumococcal polysaccharide vaccine (PPSV23) only
B. Tetanus-diphtheria booster only
C. Herpes zoster recombinant vaccine (RZV) only
D. Both pneumococcal conjugate vaccine (PCV20) and herpes zoster recombinant
vaccine (RZV) ✓ CORRECT
Correct Answer: D
Rationale: Adults aged 65 and older should receive both PCV20 or PCV15 followed by
PPSV23 for pneumococcal protection, and the two-dose RZV series for shingles
prevention regardless of prior varicella history. A tetanus booster is only indicated every
ten years unless a wound management scenario suggests earlier administration.
Keeping these adult immunizations current is a cornerstone of geriatric health
promotion and prevents significant morbidity in older adults with chronic conditions.
Question 3 of 50
During a routine wellness visit, a 72-year-old woman reports two falls in the past six
months, both occurring while rushing to the bathroom at night. She takes lisinopril and
occasionally diphenhydramine for sleep. What is the most appropriate first step in
evaluating her fall risk?
,A. Conduct a multifactorial fall risk assessment including orthostatic vital signs, gait
testing, and medication review ✓ CORRECT
B. Order lumbar spine imaging to rule out spinal stenosis
C. Prescribe a bedtime dose of vitamin D with calcium
D. Recommend immediate installation of grab bars and discharge from fall evaluation
Correct Answer: A
Rationale: The American Geriatrics Society recommends a multifactorial fall risk
assessment that examines gait, balance, orthostatic hypotension, vision, feet, and
medications, especially sedating agents like diphenhydramine. Lumbar imaging is not
indicated without neurologic deficits or red flags suggesting structural pathology. While
home modifications and vitamin D are reasonable adjuncts, they should follow a
structured clinical assessment that identifies and targets modifiable risk factors
specific to the patient.
Question 4 of 50
A 74-year-old man with a tenth-grade education is accompanied by his wife who reports
he has become increasingly forgetful over the past year, repeating questions and
misplacing items. He scores 24/30 on the Mini-Mental State Examination. What is the
most appropriate next step in cognitive assessment?
A. Reassure the wife that his score is normal for his educational level and schedule
routine follow-up
B. Immediately initiate donepezil 5 mg daily for probable Alzheimer's disease
C. Administer the Montreal Cognitive Assessment (MoCA) to better detect mild
cognitive impairment ✓ CORRECT
D. Order urgent brain MRI to evaluate for normal pressure hydrocephalus
Correct Answer: C
Rationale: The MoCA is more sensitive than the MMSE for detecting mild cognitive
impairment because it includes executive function and attention tasks that often
decline early in neurodegenerative processes. A score of 24/30 on the MMSE is below
, the typical cutoff of 27 and warrants further evaluation rather than reassurance alone.
Initiating cholinesterase inhibitors requires a more comprehensive diagnostic workup,
and urgent imaging is reserved for patients with rapidly progressive symptoms or focal
neurologic findings.
Question 5 of 50
A 79-year-old retired accountant is referred by the Department of Motor Vehicles after a
minor parking lot accident. He has mild Parkinson's disease, takes carbidopa-levodopa,
and denies any injuries. His physical examination reveals mild resting tremor but no
rigidity during the visit. What is the most appropriate recommendation regarding his
driving privileges?
A. Advise him to permanently surrender his license due to the Parkinson's diagnosis
B. Refer him for an on-road driving evaluation or occupational therapy driving
assessment ✓ CORRECT
C. Clear him to continue driving because he has no rigidity on today's examination
D. Report him immediately to the DMV as an unsafe driver without further evaluation
Correct Answer: B
Rationale: An on-road or occupational therapy driving evaluation objectively assesses
the complex cognitive, visual, and motor skills required for safe driving beyond what a
clinic examination can capture. A diagnosis of Parkinson's disease alone does not
automatically preclude driving, and the absence of rigidity during a single visit does not
guarantee safe performance. Clinicians should balance patient autonomy and public
safety by using formal driving assessments rather than making unilateral decisions
based solely on diagnosis.
Question 6 of 50
A 76-year-old woman with moderate dementia continues to live at home with her
78-year-old husband who has coronary artery disease and osteoarthritis. During a home
