NRNP 6540 MIDTERM EXAM –
2024 PRACTICE QUESTIONS &
VERIFIED ANSWERS A+ GUIDE
Cardiovascular Disorders in Older Adults Overview & Epidemiology
- Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in
older adults.
- Aging leads to structural and functional changes in the cardiovascular system (e.g.
increased arterial stiffness, left ventricular hypertrophy, endothelial dysfunction) that
predispose to disease states.
- Comorbid conditions (hypertension, diabetes, chronic kidney disease, dyslipidemia) are
common and influence presentation and management.
USPSTF Immunizations/Preventative Services
Annual influenza vaccine
Pneumococcal vaccines per CDC schedule
Shingles (herpes zoster) vaccination ≥50 years
Tdap booster every 10 years
USPSTF Additional Considerations and Clinical Pearls
Additional Considerations
Depression screening: older adults if resources available for diagnosis and follow-up
,Tobacco and alcohol use: screen and provide counseling
NP Exam Pearls
Screening decisions in older adults should consider life expectancy, comorbidities,
functional status, and patient preferences.
USPSTF provides evidence-based guidance, but individualization is key in adults ≥75.
Annual wellness visits are an ideal time to review all recommended screenings.
Immunizations for older adults.
Purpose:
Protect against vaccine-preventable diseases, reduce morbidity, hospitalizations, and
complications.
Older adults have weakened immune response (immunosenescence), making vaccination
essential.
Special Considerations
Comorbidities: chronic diseases may increase severity of infections; vaccinate accordingly
,Immunocompromised adults: some vaccines may be contraindicated (live vaccines)
Medication review: immunosuppressants may affect vaccine efficacy
Documentation: keep accurate immunization records
NP Exam Pearls
High-dose influenza vaccine preferred in adults ≥65
Shingrix is recommended for all adults ≥50, even if prior shingles episode
Pneumococcal vaccination: choose PCV20 alone or PCV15 + PPSV23 per guidelines
Review immunization status at every visit, including annual wellness visits
Vaccines prevent complications, hospitalizations, and improve quality of life in older adults
Dignity, Respect, and Credibility in Older Adults
1. Definitions
Dignity: recognition of an individual’s inherent worth, autonomy, and right to self-
determination.
, Respect: treating older adults with courtesy, consideration, and acknowledgment of their
values and experiences.
Credibility: taking older adults’ reports of symptoms, preferences, and concerns seriously.
2. Impact on Psychosocial Needs
A. Mental Health and Emotional Well-being
Preserving dignity and respect reduces feelings of helplessness, depression, and anxiety.
Acknowledging credibility improves self-esteem and trust in healthcare providers.
B. Engagement in Care
Older adults are more likely to participate in decision-making when their input is valued.
Leads to better adherence to treatment plans and health-promoting behaviors.
C. Social Relationships
Respectful treatment fosters stronger relationships with family, caregivers, and healthcare
teams.
Reduces social isolation and supports community engagement.
D. Autonomy and Independence
2024 PRACTICE QUESTIONS &
VERIFIED ANSWERS A+ GUIDE
Cardiovascular Disorders in Older Adults Overview & Epidemiology
- Cardiovascular disease (CVD) remains the leading cause of morbidity and mortality in
older adults.
- Aging leads to structural and functional changes in the cardiovascular system (e.g.
increased arterial stiffness, left ventricular hypertrophy, endothelial dysfunction) that
predispose to disease states.
- Comorbid conditions (hypertension, diabetes, chronic kidney disease, dyslipidemia) are
common and influence presentation and management.
USPSTF Immunizations/Preventative Services
Annual influenza vaccine
Pneumococcal vaccines per CDC schedule
Shingles (herpes zoster) vaccination ≥50 years
Tdap booster every 10 years
USPSTF Additional Considerations and Clinical Pearls
Additional Considerations
Depression screening: older adults if resources available for diagnosis and follow-up
,Tobacco and alcohol use: screen and provide counseling
NP Exam Pearls
Screening decisions in older adults should consider life expectancy, comorbidities,
functional status, and patient preferences.
USPSTF provides evidence-based guidance, but individualization is key in adults ≥75.
Annual wellness visits are an ideal time to review all recommended screenings.
Immunizations for older adults.
Purpose:
Protect against vaccine-preventable diseases, reduce morbidity, hospitalizations, and
complications.
Older adults have weakened immune response (immunosenescence), making vaccination
essential.
Special Considerations
Comorbidities: chronic diseases may increase severity of infections; vaccinate accordingly
,Immunocompromised adults: some vaccines may be contraindicated (live vaccines)
Medication review: immunosuppressants may affect vaccine efficacy
Documentation: keep accurate immunization records
NP Exam Pearls
High-dose influenza vaccine preferred in adults ≥65
Shingrix is recommended for all adults ≥50, even if prior shingles episode
Pneumococcal vaccination: choose PCV20 alone or PCV15 + PPSV23 per guidelines
Review immunization status at every visit, including annual wellness visits
Vaccines prevent complications, hospitalizations, and improve quality of life in older adults
Dignity, Respect, and Credibility in Older Adults
1. Definitions
Dignity: recognition of an individual’s inherent worth, autonomy, and right to self-
determination.
, Respect: treating older adults with courtesy, consideration, and acknowledgment of their
values and experiences.
Credibility: taking older adults’ reports of symptoms, preferences, and concerns seriously.
2. Impact on Psychosocial Needs
A. Mental Health and Emotional Well-being
Preserving dignity and respect reduces feelings of helplessness, depression, and anxiety.
Acknowledging credibility improves self-esteem and trust in healthcare providers.
B. Engagement in Care
Older adults are more likely to participate in decision-making when their input is valued.
Leads to better adherence to treatment plans and health-promoting behaviors.
C. Social Relationships
Respectful treatment fosters stronger relationships with family, caregivers, and healthcare
teams.
Reduces social isolation and supports community engagement.
D. Autonomy and Independence
