NR 601 MIDTERM EXAM STUDY GUIDE QUESTIONS AND CORRECT
ANSWERS (2026) : PRIMARY CARE OF THE MATURING & AGED FAMILY
PRACTICUM (VERIFIED 300+ QUESTIONS & ANSWERS)
1. What are the 3 primary physiological changes of aging? 1. Reduced
physic-logical reserve of most body systems, esp. cardiac, resp, renal.
2. Reduced homeostatic mechanisms that fail to adjust regulatory systems (i.e. temp
control, fluid/Lyte balance, etc.).
3. Impaired immunological function (infection risk is greater, autoimmune d’s more
prevalent)
2. What is the preferred amount of exercise for elderly? 30min/day 5 days/wk.
of moderate exercise.
If trying to lose wt.: 60min/day.
3. What are PFTs? Group of tests that provide quantifiable measurement of lung
function, used to dx resp abnormalities or assess progression/resolution of lung dz.
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4. What is FEV1? Forced Expiratory Volume in 1 second (80-120%)
5. What is FVC? Forced Vital Capacity (80-120%)
6. What is normal FEV1/FVC ratio? <0.7 (70%)
7. What is GOLD 1 criteria? Mild
FEV1 >/= 80% predicted
8. What is GOLD 2 criteria? Moderate
FEV1 50-79% predicted
9. What is GOLD 3 criteria? Severe
FEV1 30-49% predicted
10. What is GOLD 4 criteria? Very severe
FEV1 <30% predicted
11. What are the signal symptoms of COPD? Dyspnea
Chronic cough w/sputum
Decreased activity tolerance
Wheezing
12. What are characteristics of COPD? Common, preventable, treatable.
Characterized by persistent airflow limitation.
Usually progressive, associated with enhanced chronic inflammatory response in
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airways and lungs to noxious particles/gases
Airway fibrosis, luminal plugs, airway inflammation, increased airway resistance,
small airway dz.
Decreased elastic recoil of alveoli.
13. What are risk factors for COPD? Smoking (increasing w/number of pack
years)
Second hand smoke
Environmental pollution (endotoxins, coal dust, mineral dust)
14. What is seen on Phys exam in COPD? May be normal in early states
As severity progresses: lung hyperinflation, decreased breath sounds, wheezes at
bases, distant heart tones (b/c of hyperinflation, so S1/S2 sounds off in distance),
accessory muscle use, pursed lip breathing, increased expiratory phase, neck vein
distention.
15. How is COPD diagnosed? Spirometry is gold standard (pre and post born-
Cho dilator).
Irreversible airflow limitation is hallmark.
16. How is COPD treated? Bronchodilators: beta agonists (long/short), antichain-
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erics (long/short), or combo.
17. What is the MOA of beta agonists? Stimulates beta-2-adrenergic receptors,
increasing cyclic AMP, resulting in relaxing airways.
18. What is the MOA of anticholinergics? Block the effect of acetylcholine on
muscarinic type 3 receptors, resulting in bronchodilation.
19. Why are long-acting beta agonists prescribed for COPD? They are for
moderate airflow limitation.
They relieve symptoms, increase exercise tolerance, reduce number of
exacerbate-tons, improve QOL.
20. What are some non-pulmonary diagnoses that result in COPD-type
sump-toms? CHF
Hyperventilation syndrome
Panic attacks
Vocal cord dysfunction
Obstructive sleep apnea
Aspergillosis
Chronic fatigue syndrome
21. What are signal symptoms of asthma? Wheezing