NR601 / NR 601 Final Exam Qs & Ans (Latest 2026/2027)
Primary Care of the Maturing & Aged Family Practicum
Chamberlain University - Verified Answers
150 Questions with Comprehensive Rationales
Section 1: Geriatric Assessment, Prevention, and Health Maintenance (Q1-Q20)
Q1: A 72-year-old female presents for her annual wellness visit. She reports no complaints and lives independently.
According to the USPSTF guidelines, which screening test is most appropriate for this patient at this time?
A. Annual low-dose CT chest for lung cancer screening
B. Colonoscopy every 10 years for colorectal cancer screening [CORRECT]
C. Bone density scan (DEXA) for osteoporosis screening
D. Annual Pap smear with HPV co-testing
Correct Answer: B
Rationale: The USPSTF recommends colorectal cancer screening with colonoscopy every 10 years for adults aged 45-75. Lung
cancer screening with low-dose CT is reserved for those with a significant smoking history. DEXA screening is recommended for
women 65 and older, but this patient is 72, so DEXA is also indicated; however, colonoscopy remains the most broadly applicable
screening recommendation. Pap smear with HPV co-testing is recommended every 5 years for women aged 21-65.
Q2: A 68-year-old woman asks about osteoporosis screening. She has no risk factors other than age. What is the
recommended screening approach according to current guidelines?
A. DEXA scan at age 60 for all women
B. DEXA scan starting at age 65 for women [CORRECT]
C. Calcium level blood test annually
D. Bone scan using nuclear imaging
Correct Answer: B
Rationale: Current guidelines recommend DEXA screening for osteoporosis in women aged 65 and older, and in men aged 70 and
older. For women under 65, screening is based on risk factors. A calcium blood test measures serum calcium, which does not assess
bone density, and nuclear bone scans are used for metastatic disease evaluation, not osteoporosis screening.
Q3: Which immunization recommendation is correct for a 66-year-old patient who has not previously received the
pneumococcal vaccine?
A. PCV13 only, followed by PPSV23 in one year
B. PCV15 followed by PPSV23 at least one year later [CORRECT]
C. PPSV23 only
D. No pneumococcal vaccination is needed after age 65
Correct Answer: B
Rationale: Current ACIP recommendations for adults aged 65 and older who have not previously received any pneumococcal
vaccine include PCV15 followed by PPSV23 at least one year later, or PCV20 alone. The old PCV13 followed by PPSV23 schedule
has been updated. PPSV23 alone is not the recommended initial approach for vaccine-naive older adults.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 1
,Q4: A 58-year-old patient is considering the recombinant zoster vaccine (Shingrix). Which statement is most accurate
regarding this vaccination?
A. It is a live attenuated vaccine given as a single dose
B. It is recommended for adults 50 and older as a two-dose series [CORRECT]
C. It provides lifelong protection after one dose
D. It is contraindicated in immunocompromised patients
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine) is recommended for adults aged 50 and older as a two-dose series separated by 2-6
months. Unlike the older Zostavax (live attenuated), Shingrix is not a live vaccine and can be used in immunocompromised patients. It
does not provide lifelong protection after one dose; the two-dose series is required for optimal efficacy.
Q5: When counseling a 75-year-old patient about smoking cessation, the nurse practitioner should emphasize which of the
following?
A. Benefits of cessation are not seen until 5 years after quitting
B. Smoking cessation provides the greatest single mortality and morbidity benefit [CORRECT]
C. Nicotine replacement therapy is contraindicated in older adults
D. The patient is too old to benefit from smoking cessation at this point
Correct Answer: B
Rationale: Smoking cessation provides the greatest single mortality and morbidity benefit among all preventive interventions. Benefits
begin within months of quitting, including improved circulation, reduced cough, and decreased cardiovascular risk. Nicotine
replacement therapy is safe in older adults when used appropriately. Age alone is not a contraindication to smoking cessation efforts.
Q6: A 70-year-old male with no history of prostate cancer asks about prostate-specific antigen (PSA) screening. What is the
most appropriate response?
A. Recommend PSA screening annually for all men over 70
B. Engage in shared decision-making about PSA screening for men aged 55-69 [CORRECT]
C. PSA screening is no longer recommended at any age
D. Recommend PSA only if the patient has symptoms of urinary obstruction
Correct Answer: B
Rationale: The USPSTF recommends individualized shared decision-making about PSA screening for men aged 55-69. For men 70
and older, the recommendation is against routine screening, as the potential harms generally outweigh the benefits. However, shared
decision-making should still occur, particularly if the patient has a strong preference for screening.
Q7: Which physical activity recommendation is most appropriate for a previously sedentary 74-year-old patient beginning
an exercise program?
A. 300 minutes of vigorous-intensity exercise per week
B. 150 minutes of moderate-intensity exercise per week, starting low and going slow [CORRECT]
C. High-intensity interval training three times per week
D. Bed rest with gradual progression to sitting exercises only
Correct Answer: B
Rationale: The recommended physical activity guideline for older adults is 150 minutes of moderate-intensity exercise per week. For
previously sedentary individuals, the approach should be 'start low and go slow' to prevent injury and promote adherence.
Vigorous-intensity exercise and HIIT are not appropriate initial recommendations for deconditioned older adults.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 2
,Q8: A comprehensive geriatric assessment (CGA) is performed on an 80-year-old patient. Which of the following domains
is NOT a standard component of the CGA?
A. Functional status assessment
B. Cognitive assessment
C. Genetic sequencing for hereditary diseases [CORRECT]
D. Nutritional assessment
Correct Answer: C
Rationale: The comprehensive geriatric assessment (CGA) is a multidimensional evaluation that includes functional status, cognitive
status, nutritional status, psychosocial status, and medical comorbidities. Genetic sequencing is not a standard component of the CGA.
The CGA focuses on assessing current functional and health status to guide care planning.
Q9: A 69-year-old woman is due for her mammogram. According to current guidelines, what is the recommended
screening interval?
A. Every 6 months
B. Every 1-2 years for women aged 50-74 [CORRECT]
C. Every 5 years
D. Only if a breast lump is detected
Correct Answer: B
Rationale: Current guidelines recommend mammography every 1-2 years for women aged 50-74. The decision to screen every year
versus every two years should be individualized based on patient preferences, breast density, and risk factors. Screening every 6
months is not recommended, and waiting for a lump to be detected before screening is not consistent with preventive care guidelines.
Q10: What is the recommended daily protein intake for older adults to maintain muscle mass and prevent sarcopenia?
A. 0.5-0.6 g/kg/day
B. 1.0-1.2 g/kg/day [CORRECT]
C. 2.0-2.5 g/kg/day
D. 0.8 g/kg/day, the same as younger adults
Correct Answer: B
Rationale: Current evidence supports a protein intake of 1.0-1.2 g/kg/day for older adults to maintain muscle mass and prevent
sarcopenia. This is higher than the standard 0.8 g/kg/day recommendation for younger adults. Older adults have anabolic resistance,
meaning they require more protein to stimulate muscle protein synthesis.
Q11: A 62-year-old female presents for cervical cancer screening. She has had normal Pap smears her entire life. What is
the most appropriate screening recommendation?
A. Pap smear every year
B. Pap smear every 3 years or HPV co-testing every 5 years [CORRECT]
C. Pap smear every 5 years without HPV testing
D. No further Pap smears needed after age 60
Correct Answer: B
Rationale: For women aged 21-65, cervical cancer screening options include Pap smear every 3 years or HPV co-testing every 5
years. Annual Pap smears are not recommended. After age 65, screening may be discontinued if the patient has had adequate
negative prior screening and is not at high risk.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 3
, Q12: Which of the following is the most appropriate initial workup for nutritional assessment in an older adult?
A. Full body MRI to assess muscle mass
B. Serum prealbumin and BMI calculation with dietary history [CORRECT]
C. 24-hour urine collection for nitrogen balance
D. Genetic testing for malabsorption syndromes
Correct Answer: B
Rationale: Nutritional assessment in older adults begins with a dietary history, BMI calculation, and serum prealbumin (which has a
short half-life and reflects recent nutritional status). Full body MRI, 24-hour urine nitrogen balance, and genetic testing are not
standard initial nutritional screening tools in primary care geriatric assessment.
Q13: A 71-year-old patient is found to have a Vitamin D level of 18 ng/mL. Which supplementation strategy is most
appropriate?
A. No supplementation needed; this is a normal level
B. Vitamin D 800-1000 IU daily with calcium supplementation [CORRECT]
C. High-dose Vitamin D 50,000 IU weekly for 6 months
D. Intramuscular Vitamin D injection monthly
Correct Answer: B
Rationale: A Vitamin D level below 20 ng/mL indicates deficiency. For older adults, supplementation with Vitamin D 800-1000 IU
daily along with calcium is the recommended approach to prevent fractures and maintain bone health. High-dose weekly therapy is
reserved for severe deficiency under specialist supervision.
Q14: Which influenza vaccination recommendation applies to all adults aged 65 and older?
A. Live attenuated intranasal influenza vaccine
B. Any age-appropriate influenza vaccine annually [CORRECT]
C. Influenza vaccine every other year only
D. No influenza vaccination needed after age 70
Correct Answer: B
Rationale: Annual influenza vaccination is recommended for all adults aged 6 months and older, including those 65 and older. The
live attenuated intranasal vaccine is contraindicated in adults 50 and older. There is no upper age limit for influenza vaccination.
High-dose or adjuvanted influenza vaccines may be preferred for adults 65 and older.
Q15: A 67-year-old patient received a Tdap vaccine 12 years ago. Which vaccination is needed now?
A. Another Tdap vaccine
B. Td booster every 10 years [CORRECT]
C. No further tetanus vaccination needed
D. Tdap followed immediately by another Tdap
Correct Answer: B
Rationale: After the initial Tdap vaccine, adults should receive a Td (tetanus and diphtheria) booster every 10 years. A second Tdap
is not routinely recommended every 10 years; Td is the standard booster. Tetanus protection must be maintained throughout life, so no
further vaccination is incorrect.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 4
Primary Care of the Maturing & Aged Family Practicum
Chamberlain University - Verified Answers
150 Questions with Comprehensive Rationales
Section 1: Geriatric Assessment, Prevention, and Health Maintenance (Q1-Q20)
Q1: A 72-year-old female presents for her annual wellness visit. She reports no complaints and lives independently.
According to the USPSTF guidelines, which screening test is most appropriate for this patient at this time?
A. Annual low-dose CT chest for lung cancer screening
B. Colonoscopy every 10 years for colorectal cancer screening [CORRECT]
C. Bone density scan (DEXA) for osteoporosis screening
D. Annual Pap smear with HPV co-testing
Correct Answer: B
Rationale: The USPSTF recommends colorectal cancer screening with colonoscopy every 10 years for adults aged 45-75. Lung
cancer screening with low-dose CT is reserved for those with a significant smoking history. DEXA screening is recommended for
women 65 and older, but this patient is 72, so DEXA is also indicated; however, colonoscopy remains the most broadly applicable
screening recommendation. Pap smear with HPV co-testing is recommended every 5 years for women aged 21-65.
Q2: A 68-year-old woman asks about osteoporosis screening. She has no risk factors other than age. What is the
recommended screening approach according to current guidelines?
A. DEXA scan at age 60 for all women
B. DEXA scan starting at age 65 for women [CORRECT]
C. Calcium level blood test annually
D. Bone scan using nuclear imaging
Correct Answer: B
Rationale: Current guidelines recommend DEXA screening for osteoporosis in women aged 65 and older, and in men aged 70 and
older. For women under 65, screening is based on risk factors. A calcium blood test measures serum calcium, which does not assess
bone density, and nuclear bone scans are used for metastatic disease evaluation, not osteoporosis screening.
Q3: Which immunization recommendation is correct for a 66-year-old patient who has not previously received the
pneumococcal vaccine?
A. PCV13 only, followed by PPSV23 in one year
B. PCV15 followed by PPSV23 at least one year later [CORRECT]
C. PPSV23 only
D. No pneumococcal vaccination is needed after age 65
Correct Answer: B
Rationale: Current ACIP recommendations for adults aged 65 and older who have not previously received any pneumococcal
vaccine include PCV15 followed by PPSV23 at least one year later, or PCV20 alone. The old PCV13 followed by PPSV23 schedule
has been updated. PPSV23 alone is not the recommended initial approach for vaccine-naive older adults.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 1
,Q4: A 58-year-old patient is considering the recombinant zoster vaccine (Shingrix). Which statement is most accurate
regarding this vaccination?
A. It is a live attenuated vaccine given as a single dose
B. It is recommended for adults 50 and older as a two-dose series [CORRECT]
C. It provides lifelong protection after one dose
D. It is contraindicated in immunocompromised patients
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine) is recommended for adults aged 50 and older as a two-dose series separated by 2-6
months. Unlike the older Zostavax (live attenuated), Shingrix is not a live vaccine and can be used in immunocompromised patients. It
does not provide lifelong protection after one dose; the two-dose series is required for optimal efficacy.
Q5: When counseling a 75-year-old patient about smoking cessation, the nurse practitioner should emphasize which of the
following?
A. Benefits of cessation are not seen until 5 years after quitting
B. Smoking cessation provides the greatest single mortality and morbidity benefit [CORRECT]
C. Nicotine replacement therapy is contraindicated in older adults
D. The patient is too old to benefit from smoking cessation at this point
Correct Answer: B
Rationale: Smoking cessation provides the greatest single mortality and morbidity benefit among all preventive interventions. Benefits
begin within months of quitting, including improved circulation, reduced cough, and decreased cardiovascular risk. Nicotine
replacement therapy is safe in older adults when used appropriately. Age alone is not a contraindication to smoking cessation efforts.
Q6: A 70-year-old male with no history of prostate cancer asks about prostate-specific antigen (PSA) screening. What is the
most appropriate response?
A. Recommend PSA screening annually for all men over 70
B. Engage in shared decision-making about PSA screening for men aged 55-69 [CORRECT]
C. PSA screening is no longer recommended at any age
D. Recommend PSA only if the patient has symptoms of urinary obstruction
Correct Answer: B
Rationale: The USPSTF recommends individualized shared decision-making about PSA screening for men aged 55-69. For men 70
and older, the recommendation is against routine screening, as the potential harms generally outweigh the benefits. However, shared
decision-making should still occur, particularly if the patient has a strong preference for screening.
Q7: Which physical activity recommendation is most appropriate for a previously sedentary 74-year-old patient beginning
an exercise program?
A. 300 minutes of vigorous-intensity exercise per week
B. 150 minutes of moderate-intensity exercise per week, starting low and going slow [CORRECT]
C. High-intensity interval training three times per week
D. Bed rest with gradual progression to sitting exercises only
Correct Answer: B
Rationale: The recommended physical activity guideline for older adults is 150 minutes of moderate-intensity exercise per week. For
previously sedentary individuals, the approach should be 'start low and go slow' to prevent injury and promote adherence.
Vigorous-intensity exercise and HIIT are not appropriate initial recommendations for deconditioned older adults.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 2
,Q8: A comprehensive geriatric assessment (CGA) is performed on an 80-year-old patient. Which of the following domains
is NOT a standard component of the CGA?
A. Functional status assessment
B. Cognitive assessment
C. Genetic sequencing for hereditary diseases [CORRECT]
D. Nutritional assessment
Correct Answer: C
Rationale: The comprehensive geriatric assessment (CGA) is a multidimensional evaluation that includes functional status, cognitive
status, nutritional status, psychosocial status, and medical comorbidities. Genetic sequencing is not a standard component of the CGA.
The CGA focuses on assessing current functional and health status to guide care planning.
Q9: A 69-year-old woman is due for her mammogram. According to current guidelines, what is the recommended
screening interval?
A. Every 6 months
B. Every 1-2 years for women aged 50-74 [CORRECT]
C. Every 5 years
D. Only if a breast lump is detected
Correct Answer: B
Rationale: Current guidelines recommend mammography every 1-2 years for women aged 50-74. The decision to screen every year
versus every two years should be individualized based on patient preferences, breast density, and risk factors. Screening every 6
months is not recommended, and waiting for a lump to be detected before screening is not consistent with preventive care guidelines.
Q10: What is the recommended daily protein intake for older adults to maintain muscle mass and prevent sarcopenia?
A. 0.5-0.6 g/kg/day
B. 1.0-1.2 g/kg/day [CORRECT]
C. 2.0-2.5 g/kg/day
D. 0.8 g/kg/day, the same as younger adults
Correct Answer: B
Rationale: Current evidence supports a protein intake of 1.0-1.2 g/kg/day for older adults to maintain muscle mass and prevent
sarcopenia. This is higher than the standard 0.8 g/kg/day recommendation for younger adults. Older adults have anabolic resistance,
meaning they require more protein to stimulate muscle protein synthesis.
Q11: A 62-year-old female presents for cervical cancer screening. She has had normal Pap smears her entire life. What is
the most appropriate screening recommendation?
A. Pap smear every year
B. Pap smear every 3 years or HPV co-testing every 5 years [CORRECT]
C. Pap smear every 5 years without HPV testing
D. No further Pap smears needed after age 60
Correct Answer: B
Rationale: For women aged 21-65, cervical cancer screening options include Pap smear every 3 years or HPV co-testing every 5
years. Annual Pap smears are not recommended. After age 65, screening may be discontinued if the patient has had adequate
negative prior screening and is not at high risk.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 3
, Q12: Which of the following is the most appropriate initial workup for nutritional assessment in an older adult?
A. Full body MRI to assess muscle mass
B. Serum prealbumin and BMI calculation with dietary history [CORRECT]
C. 24-hour urine collection for nitrogen balance
D. Genetic testing for malabsorption syndromes
Correct Answer: B
Rationale: Nutritional assessment in older adults begins with a dietary history, BMI calculation, and serum prealbumin (which has a
short half-life and reflects recent nutritional status). Full body MRI, 24-hour urine nitrogen balance, and genetic testing are not
standard initial nutritional screening tools in primary care geriatric assessment.
Q13: A 71-year-old patient is found to have a Vitamin D level of 18 ng/mL. Which supplementation strategy is most
appropriate?
A. No supplementation needed; this is a normal level
B. Vitamin D 800-1000 IU daily with calcium supplementation [CORRECT]
C. High-dose Vitamin D 50,000 IU weekly for 6 months
D. Intramuscular Vitamin D injection monthly
Correct Answer: B
Rationale: A Vitamin D level below 20 ng/mL indicates deficiency. For older adults, supplementation with Vitamin D 800-1000 IU
daily along with calcium is the recommended approach to prevent fractures and maintain bone health. High-dose weekly therapy is
reserved for severe deficiency under specialist supervision.
Q14: Which influenza vaccination recommendation applies to all adults aged 65 and older?
A. Live attenuated intranasal influenza vaccine
B. Any age-appropriate influenza vaccine annually [CORRECT]
C. Influenza vaccine every other year only
D. No influenza vaccination needed after age 70
Correct Answer: B
Rationale: Annual influenza vaccination is recommended for all adults aged 6 months and older, including those 65 and older. The
live attenuated intranasal vaccine is contraindicated in adults 50 and older. There is no upper age limit for influenza vaccination.
High-dose or adjuvanted influenza vaccines may be preferred for adults 65 and older.
Q15: A 67-year-old patient received a Tdap vaccine 12 years ago. Which vaccination is needed now?
A. Another Tdap vaccine
B. Td booster every 10 years [CORRECT]
C. No further tetanus vaccination needed
D. Tdap followed immediately by another Tdap
Correct Answer: B
Rationale: After the initial Tdap vaccine, adults should receive a Td (tetanus and diphtheria) booster every 10 years. A second Tdap
is not routinely recommended every 10 years; Td is the standard booster. Tetanus protection must be maintained throughout life, so no
further vaccination is incorrect.
NR601 Final Exam Qs & Ans (Latest 2026/2027) | Page 4
