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NR 601/ NR 601 Midterm Exam V2 | Latest
2026/2027 Update |Questions & verified
Answers – Primary Care of Adults & Older
Adults |100 out of 100
Key Concepts Included:
Advanced Health Assessment • Chronic Disease Management • Geriatric Syndromes • Diagnostic
Reasoning • Pharmacology • Preventive Care • Evidence-Based Practice • Patient-Centered
Primary Care
Introduction
This 2026/2027 NR 601 Midterm Exam provides a fully updated and expertly organized collection
of realistic exam-style questions paired with 100% verified correct answers. Designed for students
in advanced practice and adult-gerontology primary care, this resource focuses on the most
important concepts tested in NR 601.
Content is structured for fast learning and deeper understanding—covering assessment techniques,
diagnostic prioritization, geriatric considerations, chronic and acute conditions, and pharmacologic
management essential for safe clinical practice. Each answer includes clear, concise rationales to
strengthen critical reasoning and support confident exam performance.
Answer Format
All correct answers are highlighted in bold, followed by rationales that explain key clinical
principles, reinforce safe practice, and prepare learners for real NR 601 exam scenarios.
,What is most true about the rule of fourths?
What used to be called normal aging can be largely explained by processes that are not normal
Which one of the following is true about aging changes?
stage 3 and stage 4 sleep decreases
An old woman who is cared for by attentive, cautious, concerned family is particularly likely to
suffer from which one of the following complications after an episode of gastroenteritis?
immobility related to over concern
Which one of the following is true about psychological aging?
ageism can lead to isolation and depression
Of the following conditions which one is most common and most often preventable
iatrogenic disease
The US advisory committee on immunization practices and the centers for disease control
currently recommend which one of the following?
All older adults be immunized against influenza annually and that they receive at least one
pneumococcal vaccination, all high risk older adults should receive an additional pneumococcal
vaccination 5 years or more after their first immunization, and older adults should receive a one-
time revaccination for pneumonia if they were initially vaccinated more than 5 years previously
and were less than 65 years of age at the time of the initial vaccination
Healthcare providers should recommend that older adults engage in:
150 minutes of moderate intensity physical activity weekly
Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of
the following?
individuals whose risk is high enough for the benefits to outweighs the risk
Older adults are less likely to get counseled for smoking cessation but they have what quit rates?
the same quit rates as younger individuals
What is true about cultural humility?
It places emphasis on power imbalances and promotes interpersonal sensitivity through
partnerships with and learning from patients
How are older black americans impacted by cultural disparities
reluctance to participate in medical research, underrepresentation of geriatric black physicians in
the work force, and cumulative effects of differences in access to healthcare providers
,Most appropriate description of personhood as it relates to people with dementia
the ability to relate to others as people rather than preserving cognitive independence, is an
important aspect of "personhood"
cultural beliefs in older adults
end of life care is sensitive to culture beliefs and should be explored carefully with the patient
and family as appropriate
Patient GG is an 82-year-old woman with complaints of dysuria and polyuria. A urinalysis is
positive for a urinary tract infection. She is 55 kg, her serum creatinine is 1.5 mg/dL, and she has
no known drug allergies. Which of the following is the most appropriate antibiotic regimen?
Sulfamethoxazole/trimethoprim 400/80 mg BID for 3 days
An older woman with a history of mild Alzheimer disease was recently started on oxybutynin 10
mg orally twice daily for urinary incontinence. Her family reports that she has been increasingly
disoriented over the past month and she notes some constipation on the review of systems during
her office visit. What management is best regarding her urinary incontinence?
Change oxybutynin to mirabegron 25 mg orally daily.
Patient SL is a 68-year-old man you are seeing for follow-up of uncontrolled hypertension. He is
currently prescribed amlodipine 10 mg daily, azilsartan 40 mg daily, metoprolol tartrate 50 mg
BID (twice daily), and hydrochlorothiazide (HCTZ) 25 mg daily, and his blood pressure is
consistently above target. Secondary causes of hypertension have been ruled out. You ask him
about missing doses and he tells you that it is difficult to take so many tablets and the brand-
name medication is very expensive. Select the best way to improve this patient's adherence. You
decide to discontinue brand name azilsartan and:
Initiate losartan/HCTZ 50/25 mg once daily; HCTZ is stopped.
An 80-year-old Black woman has a blood pressure (BP) of 168/102 mmHg and is started on
amlodipine 5 mg daily. The JNC 8 panel recommends treating this patient to a goal blood
pressure of less than
150 mmHg systolic and 90 mmHg diastolic
A 54-year-old Hispanic woman has home BP of 155/95 mmHg, confirmed by multiple similar
readings and office BP of 154/94 mmHg. She exercises, follows a low-salt diet, and rarely drinks
alcohol. Which one of the following medications would be most appropriate for this patient?
a. Chlorthalidone
A 72-year-old man with a history of hypertension recently had acute coronary syndrome for
which he was hospitalized and treated with a stent to one of his coronary arteries. In addition to
antiplatelet therapy, what antihypertensives are recommended to treat his BP and improve
outcomes regarding his ischemic heart disease?
Lisinopril and metoprolol
, The pathophysiology that underlies the formation of atherosclerotic plaque in coronary arteries is
primarily associated with which of the following mechanisms?
Inflammation
An 80-year-old woman is evaluated in your clinic for muscle aches. Her daughter, who is a
nurse, states that her symptoms worsened after recently starting atorvastatin 80 mg daily. This
medication and dose was selected based on the patient wanting to reduce her chance of a heart
attack or stroke. She has a known history of stable coronary artery disease (CAD), without prior
coronary revascularization. She takes low dose aspirin and her blood pressure is well controlled
on lisinopril 20 mg once daily. You recognize that myalgias and myopathic symptoms are dose
related and more common in older adults prescribed statins. Which of the following
recommendations would be appropriate at this time?
Discontinue atorvastatin until the myopathy has resolved, then consider restarting atorvastatin at
a low dose, such as 10 mg once daily or an alternative statin
A 75-year-old man with stable ischemic heart disease (SIHD) and moderate angina returns for
follow-up. Prior stress testing has documented myocardial ischemia. A coronary angiogram
performed 6 months ago showed that he has few options for revascularization and should be
managed medically, although high-risk percutaneous coronary intervention (PCI) can be
performed for lifestyle limiting symptoms. Reviewing his medications, it appears that he has
been taking amlodipine 10 mg daily, in addition to statin, aspirin, and as needed sublingual
nitroglycerin. What would be the most appropriate next step in his management?
His antianginal regimen should be improved to include the addition of a beta blocker and/or a
long acting nitrate.
An 88-year-old female patient with Parkinson disease presents to clinic for hospital follow-up for
atrial fibrillation (AF) with rapid ventricular response (RVR). Home heart rate monitoring shows
good rate control of her AF ventricular rates. She has a history of falls and labile international
normalized ratio (INR) with irregular adherence with blood draws. Her current medications
include carbidopa-levodopa, metoprolol, and warfarin and she has a robust drug plan that allows
for a variety of medication choices. What changes would you recommend to her medication
regimen?
Convert warfarin to a direct oral anticoagulant
In patients with heart failure, the most useful initial imaging modality is:
Transthoracic echocardiogram
Compared with angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blocker
are less likely to be associated with
Angioedema
Which class of drug has not been shown to provide a mortality benefit in heart failure patients
with reduced ejection fraction?
Diuretics
Which of the following would be consistent with the new onset of heart failure in an older
NR 601/ NR 601 Midterm Exam V2 | Latest
2026/2027 Update |Questions & verified
Answers – Primary Care of Adults & Older
Adults |100 out of 100
Key Concepts Included:
Advanced Health Assessment • Chronic Disease Management • Geriatric Syndromes • Diagnostic
Reasoning • Pharmacology • Preventive Care • Evidence-Based Practice • Patient-Centered
Primary Care
Introduction
This 2026/2027 NR 601 Midterm Exam provides a fully updated and expertly organized collection
of realistic exam-style questions paired with 100% verified correct answers. Designed for students
in advanced practice and adult-gerontology primary care, this resource focuses on the most
important concepts tested in NR 601.
Content is structured for fast learning and deeper understanding—covering assessment techniques,
diagnostic prioritization, geriatric considerations, chronic and acute conditions, and pharmacologic
management essential for safe clinical practice. Each answer includes clear, concise rationales to
strengthen critical reasoning and support confident exam performance.
Answer Format
All correct answers are highlighted in bold, followed by rationales that explain key clinical
principles, reinforce safe practice, and prepare learners for real NR 601 exam scenarios.
,What is most true about the rule of fourths?
What used to be called normal aging can be largely explained by processes that are not normal
Which one of the following is true about aging changes?
stage 3 and stage 4 sleep decreases
An old woman who is cared for by attentive, cautious, concerned family is particularly likely to
suffer from which one of the following complications after an episode of gastroenteritis?
immobility related to over concern
Which one of the following is true about psychological aging?
ageism can lead to isolation and depression
Of the following conditions which one is most common and most often preventable
iatrogenic disease
The US advisory committee on immunization practices and the centers for disease control
currently recommend which one of the following?
All older adults be immunized against influenza annually and that they receive at least one
pneumococcal vaccination, all high risk older adults should receive an additional pneumococcal
vaccination 5 years or more after their first immunization, and older adults should receive a one-
time revaccination for pneumonia if they were initially vaccinated more than 5 years previously
and were less than 65 years of age at the time of the initial vaccination
Healthcare providers should recommend that older adults engage in:
150 minutes of moderate intensity physical activity weekly
Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of
the following?
individuals whose risk is high enough for the benefits to outweighs the risk
Older adults are less likely to get counseled for smoking cessation but they have what quit rates?
the same quit rates as younger individuals
What is true about cultural humility?
It places emphasis on power imbalances and promotes interpersonal sensitivity through
partnerships with and learning from patients
How are older black americans impacted by cultural disparities
reluctance to participate in medical research, underrepresentation of geriatric black physicians in
the work force, and cumulative effects of differences in access to healthcare providers
,Most appropriate description of personhood as it relates to people with dementia
the ability to relate to others as people rather than preserving cognitive independence, is an
important aspect of "personhood"
cultural beliefs in older adults
end of life care is sensitive to culture beliefs and should be explored carefully with the patient
and family as appropriate
Patient GG is an 82-year-old woman with complaints of dysuria and polyuria. A urinalysis is
positive for a urinary tract infection. She is 55 kg, her serum creatinine is 1.5 mg/dL, and she has
no known drug allergies. Which of the following is the most appropriate antibiotic regimen?
Sulfamethoxazole/trimethoprim 400/80 mg BID for 3 days
An older woman with a history of mild Alzheimer disease was recently started on oxybutynin 10
mg orally twice daily for urinary incontinence. Her family reports that she has been increasingly
disoriented over the past month and she notes some constipation on the review of systems during
her office visit. What management is best regarding her urinary incontinence?
Change oxybutynin to mirabegron 25 mg orally daily.
Patient SL is a 68-year-old man you are seeing for follow-up of uncontrolled hypertension. He is
currently prescribed amlodipine 10 mg daily, azilsartan 40 mg daily, metoprolol tartrate 50 mg
BID (twice daily), and hydrochlorothiazide (HCTZ) 25 mg daily, and his blood pressure is
consistently above target. Secondary causes of hypertension have been ruled out. You ask him
about missing doses and he tells you that it is difficult to take so many tablets and the brand-
name medication is very expensive. Select the best way to improve this patient's adherence. You
decide to discontinue brand name azilsartan and:
Initiate losartan/HCTZ 50/25 mg once daily; HCTZ is stopped.
An 80-year-old Black woman has a blood pressure (BP) of 168/102 mmHg and is started on
amlodipine 5 mg daily. The JNC 8 panel recommends treating this patient to a goal blood
pressure of less than
150 mmHg systolic and 90 mmHg diastolic
A 54-year-old Hispanic woman has home BP of 155/95 mmHg, confirmed by multiple similar
readings and office BP of 154/94 mmHg. She exercises, follows a low-salt diet, and rarely drinks
alcohol. Which one of the following medications would be most appropriate for this patient?
a. Chlorthalidone
A 72-year-old man with a history of hypertension recently had acute coronary syndrome for
which he was hospitalized and treated with a stent to one of his coronary arteries. In addition to
antiplatelet therapy, what antihypertensives are recommended to treat his BP and improve
outcomes regarding his ischemic heart disease?
Lisinopril and metoprolol
, The pathophysiology that underlies the formation of atherosclerotic plaque in coronary arteries is
primarily associated with which of the following mechanisms?
Inflammation
An 80-year-old woman is evaluated in your clinic for muscle aches. Her daughter, who is a
nurse, states that her symptoms worsened after recently starting atorvastatin 80 mg daily. This
medication and dose was selected based on the patient wanting to reduce her chance of a heart
attack or stroke. She has a known history of stable coronary artery disease (CAD), without prior
coronary revascularization. She takes low dose aspirin and her blood pressure is well controlled
on lisinopril 20 mg once daily. You recognize that myalgias and myopathic symptoms are dose
related and more common in older adults prescribed statins. Which of the following
recommendations would be appropriate at this time?
Discontinue atorvastatin until the myopathy has resolved, then consider restarting atorvastatin at
a low dose, such as 10 mg once daily or an alternative statin
A 75-year-old man with stable ischemic heart disease (SIHD) and moderate angina returns for
follow-up. Prior stress testing has documented myocardial ischemia. A coronary angiogram
performed 6 months ago showed that he has few options for revascularization and should be
managed medically, although high-risk percutaneous coronary intervention (PCI) can be
performed for lifestyle limiting symptoms. Reviewing his medications, it appears that he has
been taking amlodipine 10 mg daily, in addition to statin, aspirin, and as needed sublingual
nitroglycerin. What would be the most appropriate next step in his management?
His antianginal regimen should be improved to include the addition of a beta blocker and/or a
long acting nitrate.
An 88-year-old female patient with Parkinson disease presents to clinic for hospital follow-up for
atrial fibrillation (AF) with rapid ventricular response (RVR). Home heart rate monitoring shows
good rate control of her AF ventricular rates. She has a history of falls and labile international
normalized ratio (INR) with irregular adherence with blood draws. Her current medications
include carbidopa-levodopa, metoprolol, and warfarin and she has a robust drug plan that allows
for a variety of medication choices. What changes would you recommend to her medication
regimen?
Convert warfarin to a direct oral anticoagulant
In patients with heart failure, the most useful initial imaging modality is:
Transthoracic echocardiogram
Compared with angiotensin-converting enzyme (ACE) inhibitors, angiotensin-receptor blocker
are less likely to be associated with
Angioedema
Which class of drug has not been shown to provide a mortality benefit in heart failure patients
with reduced ejection fraction?
Diuretics
Which of the following would be consistent with the new onset of heart failure in an older
