NR 601 Midterm Examination 2026 | Primary Care of the Maturing and Aged |
Complete Exam Study Guide with Verified Questions & Correct Answers |
Advanced Practice Nursing Review for Adult & Geriatric Care | Comprehensive
Preparation for Midterm Success | 2026
1. Which of the following is a normal physiologic change of aging that affects
pharmacokinetics?
A. Increased hepatic blood flow
B. Increased total body water
C. Decreased serum albumin
D. Increased glomerular filtration rate
Correct Answer: C. Decreased serum albumin
Rationale: Serum albumin decreases with age, affecting protein binding of medications
(e.g., warfarin, phenytoin), leading to increased free drug levels and risk of toxicity.
Hepatic blood flow and GFR decrease, and total body water decreases.
2. An 80-year-old patient has a new prescription for digoxin. Age-related decrease in
which organ function most affects digoxin clearance?
A. Hepatic metabolism
B. Renal excretion
C. Pulmonary diffusion
D. Gastric absorption
,Correct Answer: B. Renal excretion
Rationale: Digoxin is primarily renally excreted. Age-related decline in GFR reduces
clearance, increasing risk of toxicity. Dosage adjustment based on renal function is
critical.
3. Which change in the cardiovascular system is considered a normal part of aging?
A. Increased left ventricular ejection fraction
B. Decreased aortic compliance
C. Increased resting heart rate
D. Decreased systolic blood pressure
Correct Answer: B. Decreased aortic compliance
Rationale: Arterial stiffness increases with age due to elastin loss and collagen cross-
linking, leading to increased pulse wave velocity and isolated systolic hypertension.
Ejection fraction is preserved; resting heart rate does not significantly change.
4. An older adult reports feeling dizzy when standing up quickly. This is most likely due
to age-related impairment of:
A. Baroreceptor sensitivity
B. Myocardial contractility
C. Pulmonary gas exchange
D. Renal sodium retention
Correct Answer: A. Baroreceptor sensitivity
Rationale: Baroreceptor reflex sensitivity declines with age, reducing the ability to
compensate for rapid postural changes, leading to orthostatic hypotension.
,5. Which pulmonary change increases infection risk in older adults?
A. Increased ciliary motility
B. Increased macrophage activity
C. Decreased cough reflex
D. Increased surfactant production
Correct Answer: C. Decreased cough reflex
Rationale: Aging reduces cough reflex strength and sensitivity, impairing airway
clearance and increasing aspiration and pneumonia risk. Ciliary motility and
macrophage function decline.
6. An 85-year-old with normal cognition has a fasting glucose of 105 mg/dL and HbA1c
5.7%. This is most consistent with:
A. Type 2 diabetes mellitus
B. Impaired glucose tolerance
C. Normal aging changes
D. Prediabetes by ADA criteria
Correct Answer: C. Normal aging changes
Rationale: Mild increases in fasting glucose (up to ~110 mg/dL) and HbA1c (up to 5.9%)
can occur with normal aging due to peripheral insulin resistance, without meeting
prediabetes or diabetes criteria in the absence of other risk factors.
7. Which skin change in older adults increases risk of pressure injury?
A. Increased dermal thickness
B. Increased sebaceous gland activity
C. Flattening of the dermal-epidermal junction
D. Increased melanocyte activity
, Correct Answer: C. Flattening of the dermal-epidermal junction
Rationale: Flattening reduces shear strength, making skin more prone to blistering and
tearing. Dermis thins, sebaceous activity decreases, and melanocyte activity
decreases.
8. A 78-year-old has a temperature of 100.8°F (38.2°C) with cough and confusion. Which
statement about fever in older adults is true?
A. Fever is always blunted in older adults
B. A normal temperature excludes serious infection
C. Baseline body temperature is lower, so a low-grade fever may indicate infection
D. Hypothermia never occurs with sepsis
Correct Answer: C. Baseline body temperature is lower, so a low-grade fever may
indicate infection
Rationale: Mean core temperature decreases with age; thus, a temperature of 99-100°F
may be significant. Fever can be absent or blunted, but not always. Hypothermia can
occur with severe infection.
9. Age-related decrease in which substance contributes to osteoporosis in both sexes?
A. Testosterone
B. Estrogen
C. Vitamin D
D. Calcitonin
Correct Answer: B. Estrogen
Rationale: Estrogen decline in menopause (and age-related decline in men) increases
bone resorption. Vitamin D deficiency is common but secondary; estrogen loss is
primary.
Complete Exam Study Guide with Verified Questions & Correct Answers |
Advanced Practice Nursing Review for Adult & Geriatric Care | Comprehensive
Preparation for Midterm Success | 2026
1. Which of the following is a normal physiologic change of aging that affects
pharmacokinetics?
A. Increased hepatic blood flow
B. Increased total body water
C. Decreased serum albumin
D. Increased glomerular filtration rate
Correct Answer: C. Decreased serum albumin
Rationale: Serum albumin decreases with age, affecting protein binding of medications
(e.g., warfarin, phenytoin), leading to increased free drug levels and risk of toxicity.
Hepatic blood flow and GFR decrease, and total body water decreases.
2. An 80-year-old patient has a new prescription for digoxin. Age-related decrease in
which organ function most affects digoxin clearance?
A. Hepatic metabolism
B. Renal excretion
C. Pulmonary diffusion
D. Gastric absorption
,Correct Answer: B. Renal excretion
Rationale: Digoxin is primarily renally excreted. Age-related decline in GFR reduces
clearance, increasing risk of toxicity. Dosage adjustment based on renal function is
critical.
3. Which change in the cardiovascular system is considered a normal part of aging?
A. Increased left ventricular ejection fraction
B. Decreased aortic compliance
C. Increased resting heart rate
D. Decreased systolic blood pressure
Correct Answer: B. Decreased aortic compliance
Rationale: Arterial stiffness increases with age due to elastin loss and collagen cross-
linking, leading to increased pulse wave velocity and isolated systolic hypertension.
Ejection fraction is preserved; resting heart rate does not significantly change.
4. An older adult reports feeling dizzy when standing up quickly. This is most likely due
to age-related impairment of:
A. Baroreceptor sensitivity
B. Myocardial contractility
C. Pulmonary gas exchange
D. Renal sodium retention
Correct Answer: A. Baroreceptor sensitivity
Rationale: Baroreceptor reflex sensitivity declines with age, reducing the ability to
compensate for rapid postural changes, leading to orthostatic hypotension.
,5. Which pulmonary change increases infection risk in older adults?
A. Increased ciliary motility
B. Increased macrophage activity
C. Decreased cough reflex
D. Increased surfactant production
Correct Answer: C. Decreased cough reflex
Rationale: Aging reduces cough reflex strength and sensitivity, impairing airway
clearance and increasing aspiration and pneumonia risk. Ciliary motility and
macrophage function decline.
6. An 85-year-old with normal cognition has a fasting glucose of 105 mg/dL and HbA1c
5.7%. This is most consistent with:
A. Type 2 diabetes mellitus
B. Impaired glucose tolerance
C. Normal aging changes
D. Prediabetes by ADA criteria
Correct Answer: C. Normal aging changes
Rationale: Mild increases in fasting glucose (up to ~110 mg/dL) and HbA1c (up to 5.9%)
can occur with normal aging due to peripheral insulin resistance, without meeting
prediabetes or diabetes criteria in the absence of other risk factors.
7. Which skin change in older adults increases risk of pressure injury?
A. Increased dermal thickness
B. Increased sebaceous gland activity
C. Flattening of the dermal-epidermal junction
D. Increased melanocyte activity
, Correct Answer: C. Flattening of the dermal-epidermal junction
Rationale: Flattening reduces shear strength, making skin more prone to blistering and
tearing. Dermis thins, sebaceous activity decreases, and melanocyte activity
decreases.
8. A 78-year-old has a temperature of 100.8°F (38.2°C) with cough and confusion. Which
statement about fever in older adults is true?
A. Fever is always blunted in older adults
B. A normal temperature excludes serious infection
C. Baseline body temperature is lower, so a low-grade fever may indicate infection
D. Hypothermia never occurs with sepsis
Correct Answer: C. Baseline body temperature is lower, so a low-grade fever may
indicate infection
Rationale: Mean core temperature decreases with age; thus, a temperature of 99-100°F
may be significant. Fever can be absent or blunted, but not always. Hypothermia can
occur with severe infection.
9. Age-related decrease in which substance contributes to osteoporosis in both sexes?
A. Testosterone
B. Estrogen
C. Vitamin D
D. Calcitonin
Correct Answer: B. Estrogen
Rationale: Estrogen decline in menopause (and age-related decline in men) increases
bone resorption. Vitamin D deficiency is common but secondary; estrogen loss is
primary.
