NR 601 Midterm Exam – Primary Care of the Maturing and Aged Family Practicum – (2026)
Questions
Question 1
Which of the following is considered a normal age-related physiological change rather than a
pathological condition?
A) Decreased gastric acid production
B) Increased glomerular filtration rate
C) Increased skin elasticity
D) Increased baroreceptor sensitivity
Answer
Answer: A
Rationale
Decreased gastric acid production is a normal age-related change affecting medication and nutrient
absorption, whereas renal function, skin elasticity, and baroreceptor sensitivity all decline with age.
Question 2
Which assessment tool is most appropriate for evaluating an older adult’s ability to perform
instrumental activities of daily living (IADLs)?
A) Katz Index of Independence in ADLs
B) Lawton IADL Scale
C) Mini-Mental State Examination
D) Geriatric Depression Scale
Answer
Answer: B
Rationale
The Lawton IADL Scale assesses instrumental activities such as finances, meal preparation,
shopping, and medication management; the Katz Index evaluates basic ADLs, the MMSE assesses
cognition, and the GDS screens for depression.
,Question 3
A 72-year-old patient reports difficulty reading fine print and driving at night. Which normal
age-related visual change is most likely responsible?
A) Cataract formation
B) Glaucoma
C) Presbyopia and decreased dark adaptation
D) Macular degeneration
Answer
Answer: C
Rationale
Presbyopia is age-related loss of near vision from reduced lens elasticity, and decreased dark
adaptation impairs night driving; cataracts, glaucoma, and macular degeneration are pathological, not
normal aging changes.
Question 4
Which theory of aging proposes that aging results from cumulative mistakes in DNA and RNA
over time?
A) Free radical theory
B) Neuroendocrine theory
C) Error theory
D) Wear and tear theory
Answer
Answer: C
Rationale
The Error Theory attributes aging to cumulative DNA and RNA mistakes that impair cell function; the
free radical theory involves oxidative damage, and the neuroendocrine theory involves programmed
declines in neuroendocrine function.
Question 5
2
,An 82-year-old patient has a serum creatinine of 1.0 mg/dL. Which principle explains why this
value may mask reduced renal function?
A) Increased muscle mass elevates creatinine production
B) Decreased muscle mass lowers creatinine production despite reduced GFR
C) Creatinine is exclusively filtered without tubular secretion
D) Aging increases creatinine clearance independent of GFR
Answer
Answer: B
Rationale
Sarcopenia reduces creatinine production, so a “normal” serum creatinine may correspond to a
substantially reduced glomerular filtration rate in older adults.
Question 6
Which physiologic change contributes most directly to decreased maximum heart rate with
aging?
A) Increased sympathetic sensitivity
B) Reduced beta-adrenergic responsiveness
C) Increased cardiac reserve
D) Increased myocardial compliance
Answer
Answer: B
Rationale
Aging reduces beta-adrenergic responsiveness, lowering maximal heart rate and cardiovascular
reserve.
Question 7
Which change is expected in the aging cardiovascular system?
A) Increased arterial compliance
B) Reduced arterial stiffness
C) Increased left ventricular wall thickness
D) Increased maximum cardiac output
3
, Answer
Answer: C
Rationale
Age-related arterial stiffness increases afterload and contributes to compensatory left ventricular wall
thickening; arterial compliance decreases and maximum cardiac output falls.
Question 8
Which age-related change contributes to widened pulse pressure?
A) Increased arterial stiffness
B) Reduced systolic pressure
C) Increased venous compliance
D) Reduced vascular resistance
Answer
Answer: A
Rationale
Stiffening of large arteries impairs their ability to accommodate stroke volume, raising systolic pressure
and widening pulse pressure.
Question 9
An older adult reports dizziness when standing. Which assessment should the clinician
perform first?
A) Orthostatic vital signs
B) Pulmonary function testing
C) Abdominal ultrasound
D) Bone density testing
Answer
Answer: A
4
Questions
Question 1
Which of the following is considered a normal age-related physiological change rather than a
pathological condition?
A) Decreased gastric acid production
B) Increased glomerular filtration rate
C) Increased skin elasticity
D) Increased baroreceptor sensitivity
Answer
Answer: A
Rationale
Decreased gastric acid production is a normal age-related change affecting medication and nutrient
absorption, whereas renal function, skin elasticity, and baroreceptor sensitivity all decline with age.
Question 2
Which assessment tool is most appropriate for evaluating an older adult’s ability to perform
instrumental activities of daily living (IADLs)?
A) Katz Index of Independence in ADLs
B) Lawton IADL Scale
C) Mini-Mental State Examination
D) Geriatric Depression Scale
Answer
Answer: B
Rationale
The Lawton IADL Scale assesses instrumental activities such as finances, meal preparation,
shopping, and medication management; the Katz Index evaluates basic ADLs, the MMSE assesses
cognition, and the GDS screens for depression.
,Question 3
A 72-year-old patient reports difficulty reading fine print and driving at night. Which normal
age-related visual change is most likely responsible?
A) Cataract formation
B) Glaucoma
C) Presbyopia and decreased dark adaptation
D) Macular degeneration
Answer
Answer: C
Rationale
Presbyopia is age-related loss of near vision from reduced lens elasticity, and decreased dark
adaptation impairs night driving; cataracts, glaucoma, and macular degeneration are pathological, not
normal aging changes.
Question 4
Which theory of aging proposes that aging results from cumulative mistakes in DNA and RNA
over time?
A) Free radical theory
B) Neuroendocrine theory
C) Error theory
D) Wear and tear theory
Answer
Answer: C
Rationale
The Error Theory attributes aging to cumulative DNA and RNA mistakes that impair cell function; the
free radical theory involves oxidative damage, and the neuroendocrine theory involves programmed
declines in neuroendocrine function.
Question 5
2
,An 82-year-old patient has a serum creatinine of 1.0 mg/dL. Which principle explains why this
value may mask reduced renal function?
A) Increased muscle mass elevates creatinine production
B) Decreased muscle mass lowers creatinine production despite reduced GFR
C) Creatinine is exclusively filtered without tubular secretion
D) Aging increases creatinine clearance independent of GFR
Answer
Answer: B
Rationale
Sarcopenia reduces creatinine production, so a “normal” serum creatinine may correspond to a
substantially reduced glomerular filtration rate in older adults.
Question 6
Which physiologic change contributes most directly to decreased maximum heart rate with
aging?
A) Increased sympathetic sensitivity
B) Reduced beta-adrenergic responsiveness
C) Increased cardiac reserve
D) Increased myocardial compliance
Answer
Answer: B
Rationale
Aging reduces beta-adrenergic responsiveness, lowering maximal heart rate and cardiovascular
reserve.
Question 7
Which change is expected in the aging cardiovascular system?
A) Increased arterial compliance
B) Reduced arterial stiffness
C) Increased left ventricular wall thickness
D) Increased maximum cardiac output
3
, Answer
Answer: C
Rationale
Age-related arterial stiffness increases afterload and contributes to compensatory left ventricular wall
thickening; arterial compliance decreases and maximum cardiac output falls.
Question 8
Which age-related change contributes to widened pulse pressure?
A) Increased arterial stiffness
B) Reduced systolic pressure
C) Increased venous compliance
D) Reduced vascular resistance
Answer
Answer: A
Rationale
Stiffening of large arteries impairs their ability to accommodate stroke volume, raising systolic pressure
and widening pulse pressure.
Question 9
An older adult reports dizziness when standing. Which assessment should the clinician
perform first?
A) Orthostatic vital signs
B) Pulmonary function testing
C) Abdominal ultrasound
D) Bone density testing
Answer
Answer: A
4
