(NR-601 NR 601 – FNP I) Primary Care of
Adults Final Exam Questions and Correct
Answers (Verified Answers) Plus Rationales
2025
1. A 67-year-old male presents with complaints of urinary frequency, hesitancy,
and nocturia. What is the most likely diagnosis?
A. Urinary tract infection
B. Bladder cancer
C. Benign prostatic hyperplasia (BPH)
D. Prostatitis
BPH is a common condition in aging males due to prostate
gland enlargement, leading to obstructive urinary symptoms
such as hesitancy, frequency, and nocturia.
2. Which of the following vaccines is recommended annually for all adults aged
65 and older?
A. Hepatitis B
B. Herpes zoster
C. Influenza
,D. Pneumococcal conjugate
Annual influenza vaccination is recommended for all adults,
especially older adults who are at higher risk for complications.
3. An older adult with new-onset confusion and falls should first be assessed for:
A. Stroke
B. Urinary tract infection
C. Alzheimer’s disease
D. Hyperthyroidism
UTIs in older adults often present with atypical symptoms like
confusion and falls rather than classic urinary symptoms.
4. Which of the following antihypertensive medications is considered first-line
treatment for older adults with hypertension?
A. Beta blockers
B. Thiazide diuretics
C. Alpha blockers
D. Loop diuretics
Thiazide diuretics are effective and well-tolerated in older
adults, often used as first-line for managing hypertension.
,5. Which screening is recommended for a 55-year-old male smoker with a 35-
pack-year history?
A. Colonoscopy
B. Echocardiogram
C. Low-dose CT scan for lung cancer
D. PSA testing
Annual low-dose CT scans are recommended for individuals
aged 50–80 with a 20+ pack-year history who currently smoke
or quit within 15 years.
6. A 70-year-old female presents with osteoporosis. What is the best initial
treatment?
A. Parathyroid hormone therapy
B. Hormone replacement therapy
C. Bisphosphonates
D. Calcitonin nasal spray
Bisphosphonates are first-line treatment for osteoporosis due to
their ability to prevent bone loss and reduce fracture risk.
7. What is the most appropriate next step for an adult with a new diagnosis of
type 2 diabetes and an A1C of 9.0%?
A. Lifestyle modifications only
B. Start metformin and consider additional agents
, C. Delay treatment and recheck in 6 months
D. Begin insulin immediately
An A1C ≥9% warrants metformin and potentially dual therapy,
especially if symptomatic.
8. Which physical exam finding is most associated with temporal arteritis?
A. Palpable thyroid nodule
B. Tender temporal artery
C. Jugular venous distension
D. Decreased breath sounds
Temporal arteritis often presents with scalp tenderness, jaw
claudication, and a tender, thickened temporal artery.
9. A 58-year-old female has a TSH of 8.5 mIU/L and normal free T4. What is the
diagnosis?
A. Euthyroid
B. Subclinical hypothyroidism
C. Hyperthyroidism
D. Hashimoto’s thyroiditis
Elevated TSH with normal free T4 indicates subclinical
hypothyroidism.
Adults Final Exam Questions and Correct
Answers (Verified Answers) Plus Rationales
2025
1. A 67-year-old male presents with complaints of urinary frequency, hesitancy,
and nocturia. What is the most likely diagnosis?
A. Urinary tract infection
B. Bladder cancer
C. Benign prostatic hyperplasia (BPH)
D. Prostatitis
BPH is a common condition in aging males due to prostate
gland enlargement, leading to obstructive urinary symptoms
such as hesitancy, frequency, and nocturia.
2. Which of the following vaccines is recommended annually for all adults aged
65 and older?
A. Hepatitis B
B. Herpes zoster
C. Influenza
,D. Pneumococcal conjugate
Annual influenza vaccination is recommended for all adults,
especially older adults who are at higher risk for complications.
3. An older adult with new-onset confusion and falls should first be assessed for:
A. Stroke
B. Urinary tract infection
C. Alzheimer’s disease
D. Hyperthyroidism
UTIs in older adults often present with atypical symptoms like
confusion and falls rather than classic urinary symptoms.
4. Which of the following antihypertensive medications is considered first-line
treatment for older adults with hypertension?
A. Beta blockers
B. Thiazide diuretics
C. Alpha blockers
D. Loop diuretics
Thiazide diuretics are effective and well-tolerated in older
adults, often used as first-line for managing hypertension.
,5. Which screening is recommended for a 55-year-old male smoker with a 35-
pack-year history?
A. Colonoscopy
B. Echocardiogram
C. Low-dose CT scan for lung cancer
D. PSA testing
Annual low-dose CT scans are recommended for individuals
aged 50–80 with a 20+ pack-year history who currently smoke
or quit within 15 years.
6. A 70-year-old female presents with osteoporosis. What is the best initial
treatment?
A. Parathyroid hormone therapy
B. Hormone replacement therapy
C. Bisphosphonates
D. Calcitonin nasal spray
Bisphosphonates are first-line treatment for osteoporosis due to
their ability to prevent bone loss and reduce fracture risk.
7. What is the most appropriate next step for an adult with a new diagnosis of
type 2 diabetes and an A1C of 9.0%?
A. Lifestyle modifications only
B. Start metformin and consider additional agents
, C. Delay treatment and recheck in 6 months
D. Begin insulin immediately
An A1C ≥9% warrants metformin and potentially dual therapy,
especially if symptomatic.
8. Which physical exam finding is most associated with temporal arteritis?
A. Palpable thyroid nodule
B. Tender temporal artery
C. Jugular venous distension
D. Decreased breath sounds
Temporal arteritis often presents with scalp tenderness, jaw
claudication, and a tender, thickened temporal artery.
9. A 58-year-old female has a TSH of 8.5 mIU/L and normal free T4. What is the
diagnosis?
A. Euthyroid
B. Subclinical hypothyroidism
C. Hyperthyroidism
D. Hashimoto’s thyroiditis
Elevated TSH with normal free T4 indicates subclinical
hypothyroidism.
