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NR 601/NR 601 MIDTERM EXAM PRIMARY
CARE OF THE MATURING and AGED FAMILY
Final Exam Newest Exam Preparation With Complete
Questions And Correct Answers With Rationales |
Already Graded A+||Brand New Version!!
1. A 72-year-old patient asks the nurse practitioner what "normal
aging" means. Which statement accurately reflects physiological aging
changes?
A) Decreased gastric acid production leading to improved iron
absorption
B) Increased total body water percentage
C) Decreased lean body mass and increased fat tissue
D) Increased glomerular filtration rate
Answer: C
Rationale: Normal aging is associated with decreased lean body mass,
increased adipose tissue, decreased total body water, and reduced GFR.
Gastric acid production decreases, which can impair absorption of
certain nutrients like vitamin B12 and calcium.
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2. According to the genomic instability theory of aging, which process
contributes to cellular aging?
A) Shortening of telomeres to the point where cell division cannot
continue
B) Accumulation of DNA damage from stressors, mutations, and
chromosomal abnormalities
C) Loss of proteostasis leading to protein misfolding
D) Mitochondrial dysfunction resulting in decreased ATP production
Answer: B
Rationale: Genomic instability refers to the vulnerability of DNA
integrity to stressors, leading to mutations, translocations, and
chromosomal abnormalities. Telomere attrition is a separate theory of
aging.
3. Which functional assessment tool is most appropriate for evaluating
instrumental activities of daily living in a community-dwelling older
adult?
A) Katz Index of Independence
B) Lawton IADL Scale
C) Braden Scale
D) Mini-Mental State Examination
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Answer: B
Rationale: The Lawton IADL Scale measures more complex tasks such as
managing finances, transportation, and medication management,
which are essential for independent community living. The Katz Index
measures basic ADLs like bathing and dressing.
4. A 78-year-old patient reports dizziness when standing up from a
seated position. The NP notes a systolic drop of 22 mmHg upon
standing. Which initial intervention is most appropriate?
A) Start midodrine 5 mg three times daily
B) Instruct the patient to rise slowly and use ankle pump exercises
C) Increase dietary sodium to 8 grams per day
D) Order a 24-hour urine collection for catecholamines
Answer: B
Rationale: Orthostatic hypotension is common and non-
pharmacological measures such as slow positional changes and leg
exercises are first-line. Midodrine and high sodium are reserved for
refractory cases, and catecholamine testing is for suspected autonomic
neuropathy or pheochromocytoma.
5. Which pharmacokinetic change in aging has the greatest clinical
impact on drug dosing?
A) Increased hepatic first-pass metabolism
B) Decreased percentage of body fat
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C) Reduced renal clearance
D) Increased serum albumin levels
Answer: C
Rationale: Reduced renal clearance is the most clinically significant
change because it directly affects the elimination of many drugs. Renal
function declines with age even in the absence of disease, and
creatinine clearance should be estimated for dosing.
6. A frail 85-year-old with multiple comorbidities is prescribed a new
medication. The NP uses the Beers Criteria primarily to:
A) Identify drugs that may be inappropriate or potentially harmful in
older adults
B) Determine the correct starting dose based on weight
C) Screen for drug-drug interactions with herbal supplements
D) Assess the patient's ability to self-administer medications
Answer: A
Rationale: The Beers Criteria are explicitly designed to list potentially
inappropriate medications for older adults, considering risks like falls,
cognitive impairment, and delirium. It does not address dosing, herbals,
or self-administration directly.
7. Which finding on a comprehensive geriatric assessment is a red flag
for possible elder abuse?
NR 601/NR 601 MIDTERM EXAM PRIMARY
CARE OF THE MATURING and AGED FAMILY
Final Exam Newest Exam Preparation With Complete
Questions And Correct Answers With Rationales |
Already Graded A+||Brand New Version!!
1. A 72-year-old patient asks the nurse practitioner what "normal
aging" means. Which statement accurately reflects physiological aging
changes?
A) Decreased gastric acid production leading to improved iron
absorption
B) Increased total body water percentage
C) Decreased lean body mass and increased fat tissue
D) Increased glomerular filtration rate
Answer: C
Rationale: Normal aging is associated with decreased lean body mass,
increased adipose tissue, decreased total body water, and reduced GFR.
Gastric acid production decreases, which can impair absorption of
certain nutrients like vitamin B12 and calcium.
,2|Page
2. According to the genomic instability theory of aging, which process
contributes to cellular aging?
A) Shortening of telomeres to the point where cell division cannot
continue
B) Accumulation of DNA damage from stressors, mutations, and
chromosomal abnormalities
C) Loss of proteostasis leading to protein misfolding
D) Mitochondrial dysfunction resulting in decreased ATP production
Answer: B
Rationale: Genomic instability refers to the vulnerability of DNA
integrity to stressors, leading to mutations, translocations, and
chromosomal abnormalities. Telomere attrition is a separate theory of
aging.
3. Which functional assessment tool is most appropriate for evaluating
instrumental activities of daily living in a community-dwelling older
adult?
A) Katz Index of Independence
B) Lawton IADL Scale
C) Braden Scale
D) Mini-Mental State Examination
,3|Page
Answer: B
Rationale: The Lawton IADL Scale measures more complex tasks such as
managing finances, transportation, and medication management,
which are essential for independent community living. The Katz Index
measures basic ADLs like bathing and dressing.
4. A 78-year-old patient reports dizziness when standing up from a
seated position. The NP notes a systolic drop of 22 mmHg upon
standing. Which initial intervention is most appropriate?
A) Start midodrine 5 mg three times daily
B) Instruct the patient to rise slowly and use ankle pump exercises
C) Increase dietary sodium to 8 grams per day
D) Order a 24-hour urine collection for catecholamines
Answer: B
Rationale: Orthostatic hypotension is common and non-
pharmacological measures such as slow positional changes and leg
exercises are first-line. Midodrine and high sodium are reserved for
refractory cases, and catecholamine testing is for suspected autonomic
neuropathy or pheochromocytoma.
5. Which pharmacokinetic change in aging has the greatest clinical
impact on drug dosing?
A) Increased hepatic first-pass metabolism
B) Decreased percentage of body fat
, 4|Page
C) Reduced renal clearance
D) Increased serum albumin levels
Answer: C
Rationale: Reduced renal clearance is the most clinically significant
change because it directly affects the elimination of many drugs. Renal
function declines with age even in the absence of disease, and
creatinine clearance should be estimated for dosing.
6. A frail 85-year-old with multiple comorbidities is prescribed a new
medication. The NP uses the Beers Criteria primarily to:
A) Identify drugs that may be inappropriate or potentially harmful in
older adults
B) Determine the correct starting dose based on weight
C) Screen for drug-drug interactions with herbal supplements
D) Assess the patient's ability to self-administer medications
Answer: A
Rationale: The Beers Criteria are explicitly designed to list potentially
inappropriate medications for older adults, considering risks like falls,
cognitive impairment, and delirium. It does not address dosing, herbals,
or self-administration directly.
7. Which finding on a comprehensive geriatric assessment is a red flag
for possible elder abuse?
