NR601 Final Exam
Practice — Primary
Care of the Maturing &
Aged Family Practicum
2026/2027-style original questions, answers & rationales
Current online study materials describe the NR601 final as focusing primarily on Weeks 5–8, including
endocrine/hormonal, gastrointestinal/genitourinary, neuropsychiatric, and musculoskeletal conditions.
I can create an original practice exam based on those topics, but I can't reproduce purported
actual/verified Chamberlain exam questions.
Questions 1–30
1. Type 2 Diabetes
A 59-year-old patient has a fasting plasma glucose of 132 mg/dL on two separate occasions. Which
interpretation is most appropriate?
A. Normal glucose regulation
B. Prediabetes
C. Diabetes mellitus
D. Reactive hypoglycemia
Answer: C. Diabetes mellitus
Rationale: Repeated fasting plasma glucose values ≥126 mg/dL are consistent with diabetes when
appropriately confirmed.
2. Diabetes Complication
A patient with longstanding diabetes reports early satiety, bloating, and nausea after meals. Which
complication should the NP consider?
,A. Diabetic gastroparesis
B. Acute appendicitis
C. Peptic ulcer perforation
D. Cholecystitis
Answer: A. Diabetic gastroparesis
Rationale: Autonomic neuropathy can impair gastric motility, producing early satiety, bloating, nausea,
and vomiting.
3. Hypothyroidism
Which laboratory pattern is most consistent with primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. Low TSH, low free T4
D. High TSH, high free T4
Answer: B. High TSH, low free T4
Rationale: Primary thyroid failure reduces thyroid hormone production, causing compensatory elevation
of pituitary TSH.
4. Hyperthyroidism
Which finding is most consistent with hyperthyroidism?
A. Bradycardia
B. Cold intolerance
C. Weight gain
D. Heat intolerance
Answer: D. Heat intolerance
Rationale: Excess thyroid hormone increases metabolic activity and commonly causes heat intolerance,
sweating, tachycardia, and weight loss.
5. Menopause
A 52-year-old reports hot flashes, night sweats, and irregular menstrual cycles. These symptoms are
most directly associated with:
A. Increased progesterone
B. Declining ovarian estrogen production
,C. Increased insulin secretion
D. Increased cortisol production
Answer: B. Declining ovarian estrogen production
Rationale: The menopausal transition involves declining ovarian function and fluctuating, eventually
reduced, estrogen production.
6. Malnutrition
Which finding should raise concern for malnutrition in an older adult?
A. Stable weight over several years
B. Unintentional weight loss
C. Increased muscle mass
D. Increased appetite
Answer: B. Unintentional weight loss
Rationale: Unintentional weight loss is an important warning sign and should prompt nutritional
assessment and evaluation for underlying disease.
7. GERD
Which symptom is considered an alarm feature in a patient with suspected GERD?
A. Occasional heartburn
B. Belching
C. Dysphagia
D. Mild post-meal discomfort
Answer: C. Dysphagia
Rationale: Dysphagia can indicate a complication or alternative structural disease and warrants further
evaluation.
8. Peptic Ulcer Disease
Long-term NSAID use increases the risk of peptic ulcer disease primarily because NSAIDs:
A. Increase gastric mucus production
B. Inhibit protective prostaglandins
C. Increase pancreatic enzymes
D. Increase intestinal motility
Answer: B. Inhibit protective prostaglandins
, Rationale: Reduced prostaglandin synthesis decreases gastric mucosal protection and increases
susceptibility to injury.
9. Upper GI Bleeding
Which finding is most suggestive of an upper gastrointestinal bleed?
A. Hematuria
B. Melena
C. Clay-colored stool
D. Steatorrhea
Answer: B. Melena
Rationale: Black, tarry stool can result from digestion of blood originating in the upper gastrointestinal
tract.
10. Gallbladder Disease
A patient develops right-upper-quadrant pain after eating a fatty meal. Which condition should be
considered?
A. Cholelithiasis
B. Cystitis
C. Diverticulosis
D. Irritable bowel syndrome
Answer: A. Cholelithiasis
Rationale: Gallstones can cause episodic postprandial right-upper-quadrant pain, particularly after fatty
meals.
11. IBS
Which feature is characteristic of irritable bowel syndrome?
A. Recurrent abdominal pain associated with defecation
B. Progressive dysphagia
C. Persistent jaundice
D. Massive painless GI bleeding
Answer: A. Recurrent abdominal pain associated with defecation
Rationale: IBS is characterized by recurrent abdominal pain associated with bowel movements and
changes in stool frequency or form.
Practice — Primary
Care of the Maturing &
Aged Family Practicum
2026/2027-style original questions, answers & rationales
Current online study materials describe the NR601 final as focusing primarily on Weeks 5–8, including
endocrine/hormonal, gastrointestinal/genitourinary, neuropsychiatric, and musculoskeletal conditions.
I can create an original practice exam based on those topics, but I can't reproduce purported
actual/verified Chamberlain exam questions.
Questions 1–30
1. Type 2 Diabetes
A 59-year-old patient has a fasting plasma glucose of 132 mg/dL on two separate occasions. Which
interpretation is most appropriate?
A. Normal glucose regulation
B. Prediabetes
C. Diabetes mellitus
D. Reactive hypoglycemia
Answer: C. Diabetes mellitus
Rationale: Repeated fasting plasma glucose values ≥126 mg/dL are consistent with diabetes when
appropriately confirmed.
2. Diabetes Complication
A patient with longstanding diabetes reports early satiety, bloating, and nausea after meals. Which
complication should the NP consider?
,A. Diabetic gastroparesis
B. Acute appendicitis
C. Peptic ulcer perforation
D. Cholecystitis
Answer: A. Diabetic gastroparesis
Rationale: Autonomic neuropathy can impair gastric motility, producing early satiety, bloating, nausea,
and vomiting.
3. Hypothyroidism
Which laboratory pattern is most consistent with primary hypothyroidism?
A. Low TSH, high free T4
B. High TSH, low free T4
C. Low TSH, low free T4
D. High TSH, high free T4
Answer: B. High TSH, low free T4
Rationale: Primary thyroid failure reduces thyroid hormone production, causing compensatory elevation
of pituitary TSH.
4. Hyperthyroidism
Which finding is most consistent with hyperthyroidism?
A. Bradycardia
B. Cold intolerance
C. Weight gain
D. Heat intolerance
Answer: D. Heat intolerance
Rationale: Excess thyroid hormone increases metabolic activity and commonly causes heat intolerance,
sweating, tachycardia, and weight loss.
5. Menopause
A 52-year-old reports hot flashes, night sweats, and irregular menstrual cycles. These symptoms are
most directly associated with:
A. Increased progesterone
B. Declining ovarian estrogen production
,C. Increased insulin secretion
D. Increased cortisol production
Answer: B. Declining ovarian estrogen production
Rationale: The menopausal transition involves declining ovarian function and fluctuating, eventually
reduced, estrogen production.
6. Malnutrition
Which finding should raise concern for malnutrition in an older adult?
A. Stable weight over several years
B. Unintentional weight loss
C. Increased muscle mass
D. Increased appetite
Answer: B. Unintentional weight loss
Rationale: Unintentional weight loss is an important warning sign and should prompt nutritional
assessment and evaluation for underlying disease.
7. GERD
Which symptom is considered an alarm feature in a patient with suspected GERD?
A. Occasional heartburn
B. Belching
C. Dysphagia
D. Mild post-meal discomfort
Answer: C. Dysphagia
Rationale: Dysphagia can indicate a complication or alternative structural disease and warrants further
evaluation.
8. Peptic Ulcer Disease
Long-term NSAID use increases the risk of peptic ulcer disease primarily because NSAIDs:
A. Increase gastric mucus production
B. Inhibit protective prostaglandins
C. Increase pancreatic enzymes
D. Increase intestinal motility
Answer: B. Inhibit protective prostaglandins
, Rationale: Reduced prostaglandin synthesis decreases gastric mucosal protection and increases
susceptibility to injury.
9. Upper GI Bleeding
Which finding is most suggestive of an upper gastrointestinal bleed?
A. Hematuria
B. Melena
C. Clay-colored stool
D. Steatorrhea
Answer: B. Melena
Rationale: Black, tarry stool can result from digestion of blood originating in the upper gastrointestinal
tract.
10. Gallbladder Disease
A patient develops right-upper-quadrant pain after eating a fatty meal. Which condition should be
considered?
A. Cholelithiasis
B. Cystitis
C. Diverticulosis
D. Irritable bowel syndrome
Answer: A. Cholelithiasis
Rationale: Gallstones can cause episodic postprandial right-upper-quadrant pain, particularly after fatty
meals.
11. IBS
Which feature is characteristic of irritable bowel syndrome?
A. Recurrent abdominal pain associated with defecation
B. Progressive dysphagia
C. Persistent jaundice
D. Massive painless GI bleeding
Answer: A. Recurrent abdominal pain associated with defecation
Rationale: IBS is characterized by recurrent abdominal pain associated with bowel movements and
changes in stool frequency or form.
