NR 601 (primary care of the maturing and older adult) COMPREHENSIVE
QUESTIONS AND VERIFIED ANSWERS (DETAILED & ELABORATED) ACTUAL EXAM
TEST/NEWEST UPDATE!!
Question 1
Mr. A experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday.
The symptoms have resolved and the CT is normal. What is the next step of the plan for Mr. A?
A) Assure the patient that he will not experience the symptoms again.
B) Identify modifiable cardiovascular risk factors.
C) Order ASA 81mg stat and discharge.
D) Order a stat EEG and administer O2 by mask.
E) Refer to neurosurgery for immediate intervention.
Correct Answer: B) identify modifiable cardiovascular risk factors
Rationale: The patient’s symptoms are classic for a Transient Ischemic Attack (TIA), which
is a significant warning sign of an impending stroke. Because the symptoms resolved and
the CT was normal, the immediate focus of the primary care provider is secondary
prevention. Identifying and managing modifiable risk factors—such as hypertension,
smoking, hyperlipidemia, and diabetes—is the gold standard for reducing the risk of a
future cerebrovascular accident (CVA).
Question 2
A 56-year-old male patient screened for diabetes has a fasting plasma glucose level of 96 mg/dl.
The nurse practitioner management plan includes:
A) Repeat fasting plasma glucose in three years.
B) Prescribe Metformin 500mg po BID.
C) Repeat fasting plasma glucose in one year.
D) Refer to ophthalmology for an eye exam.
E) Perform a 3-hour oral glucose tolerance test today.
Correct Answer: A) repeat fasting plasma glucose in three years
Rationale: According to the American Diabetes Association (ADA) guidelines, a fasting
plasma glucose (FPG) level of less than 100 mg/dL is considered normal. For individuals
with normal results, screening should be repeated at a minimum of 3-year intervals, unless
risk factors change significantly.
Question 3
RW, a 57-year-old Native American female, presents to the office stating she feels irritable, has
difficulty concentrating, and has trouble falling and staying asleep due to financial worries. The
NP diagnoses anxiety. Which of the following is a first-line pharmacological treatment?
A) Diazepam
B) Clonazepam
C) Aripiprazole
D) Paroxetine
E) Quetiapine
, 2
Correct Answer: D) Paroxetine
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs), such as Paroxetine, are
considered first-line pharmacological treatments for Generalized Anxiety Disorder (GAD)
in older adults. Benzodiazepines like Diazepam and Clonazepam are avoided as first-line
therapy due to the risk of falls, confusion, and dependency in the maturing adult
population.
Question 4
The most common sustained rhythmic disorder, which consists of fibrillatory p waves on an
EKG, is:
A) AV block
B) Atrial tachycardia
C) Atrial fibrillation
D) Atrial flutter
E) Ventricular tachycardia
Correct Answer: C) atrial fibrillation
Rationale: Atrial fibrillation (AFib) is characterized by the absence of discernible P waves,
replaced by rapid fibrillatory waves (f waves). It is the most common sustained arrhythmia
in the elderly and significantly increases the risk of embolic stroke, requiring assessment
for anticoagulation.
Question 5
Regarding atrophic vaginitis in the maturing female, which of the following is true?
A) The symptoms are the same for every woman.
B) It creates a more acidic vaginal environment.
C) It is a contributing factor for frequent urinary tract infections.
D) It is not treated with vaginal lubricants.
E) It is caused by an excess of progesterone.
Correct Answer: C) is a contributing factor for frequent urinary tract infections
Rationale: Atrophic vaginitis is caused by estrogen deficiency, which leads to thinning of the
vaginal epithelium and an increase in vaginal pH (making it more alkaline, not acidic). This
loss of local flora and change in pH makes the environment more susceptible to bacterial
colonization and subsequent urinary tract infections (UTIs).
Question 6
Which of the following is the most appropriate screening tool specifically for delirium?
A) St. Louis University Mental Status Exam (SLUMS)
B) Montreal Cognitive Assessment (MoCA)
C) Lawton Scale of Instrumental Activities of Daily Living
D) Confusion Assessment Model (CAM)
E) Mini-Mental State Exam (MMSE)
, 3
Correct Answer: D) Confusion Assessment Model
Rationale: While the MoCA, SLUMS, and MMSE are used to assess cognitive impairment
or dementia, the Confusion Assessment Model (CAM) is the gold standard for identifying
delirium. It specifically evaluates the acute onset, fluctuating course, inattention, and
disorganized thinking characteristic of delirium.
Question 7
A drug that can be used to treat two very common symptoms in a dying patient (pain and
dyspnea) is:
A) Lorazepam
B) Gabapentin
C) Methadone
D) Morphine
E) Haloperidol
Correct Answer: D) Morphine
Rationale: Morphine is a cornerstone of palliative care. It is highly effective for managing
moderate to severe pain and is also the gold standard for treating dyspnea (air hunger) at
the end of life by reducing the perception of respiratory distress.
Question 8
Which of the following would you recommend annually for an elderly type 2 diabetic?
A) Periodic visits to a gastroenterologist.
B) Colonoscopy.
C) Follow-up with a urologist.
D) Eye exam with an ophthalmologist.
E) Chest X-ray.
Correct Answer: D) eye exam with an ophthalmologist
Rationale: Diabetic retinopathy is a leading cause of blindness. Annual dilated eye exams by
an ophthalmologist or optometrist are required for diabetic patients to screen for
microvascular changes and ensure early intervention to preserve vision.
Question 9
Which characteristic of delirium helps to distinguish it most clearly from dementia?
A) Short-term memory impairment.
B) Personality changes.
C) Acute onset.
D) Impaired attention.
E) Sleep-wake cycle disturbance.
Correct Answer: C) acute onset
Rationale: Delirium is characterized by an acute onset (hours to days) and a fluctuating
QUESTIONS AND VERIFIED ANSWERS (DETAILED & ELABORATED) ACTUAL EXAM
TEST/NEWEST UPDATE!!
Question 1
Mr. A experienced a brief onset of right-sided weakness, slurred speech, and confusion yesterday.
The symptoms have resolved and the CT is normal. What is the next step of the plan for Mr. A?
A) Assure the patient that he will not experience the symptoms again.
B) Identify modifiable cardiovascular risk factors.
C) Order ASA 81mg stat and discharge.
D) Order a stat EEG and administer O2 by mask.
E) Refer to neurosurgery for immediate intervention.
Correct Answer: B) identify modifiable cardiovascular risk factors
Rationale: The patient’s symptoms are classic for a Transient Ischemic Attack (TIA), which
is a significant warning sign of an impending stroke. Because the symptoms resolved and
the CT was normal, the immediate focus of the primary care provider is secondary
prevention. Identifying and managing modifiable risk factors—such as hypertension,
smoking, hyperlipidemia, and diabetes—is the gold standard for reducing the risk of a
future cerebrovascular accident (CVA).
Question 2
A 56-year-old male patient screened for diabetes has a fasting plasma glucose level of 96 mg/dl.
The nurse practitioner management plan includes:
A) Repeat fasting plasma glucose in three years.
B) Prescribe Metformin 500mg po BID.
C) Repeat fasting plasma glucose in one year.
D) Refer to ophthalmology for an eye exam.
E) Perform a 3-hour oral glucose tolerance test today.
Correct Answer: A) repeat fasting plasma glucose in three years
Rationale: According to the American Diabetes Association (ADA) guidelines, a fasting
plasma glucose (FPG) level of less than 100 mg/dL is considered normal. For individuals
with normal results, screening should be repeated at a minimum of 3-year intervals, unless
risk factors change significantly.
Question 3
RW, a 57-year-old Native American female, presents to the office stating she feels irritable, has
difficulty concentrating, and has trouble falling and staying asleep due to financial worries. The
NP diagnoses anxiety. Which of the following is a first-line pharmacological treatment?
A) Diazepam
B) Clonazepam
C) Aripiprazole
D) Paroxetine
E) Quetiapine
, 2
Correct Answer: D) Paroxetine
Rationale: Selective Serotonin Reuptake Inhibitors (SSRIs), such as Paroxetine, are
considered first-line pharmacological treatments for Generalized Anxiety Disorder (GAD)
in older adults. Benzodiazepines like Diazepam and Clonazepam are avoided as first-line
therapy due to the risk of falls, confusion, and dependency in the maturing adult
population.
Question 4
The most common sustained rhythmic disorder, which consists of fibrillatory p waves on an
EKG, is:
A) AV block
B) Atrial tachycardia
C) Atrial fibrillation
D) Atrial flutter
E) Ventricular tachycardia
Correct Answer: C) atrial fibrillation
Rationale: Atrial fibrillation (AFib) is characterized by the absence of discernible P waves,
replaced by rapid fibrillatory waves (f waves). It is the most common sustained arrhythmia
in the elderly and significantly increases the risk of embolic stroke, requiring assessment
for anticoagulation.
Question 5
Regarding atrophic vaginitis in the maturing female, which of the following is true?
A) The symptoms are the same for every woman.
B) It creates a more acidic vaginal environment.
C) It is a contributing factor for frequent urinary tract infections.
D) It is not treated with vaginal lubricants.
E) It is caused by an excess of progesterone.
Correct Answer: C) is a contributing factor for frequent urinary tract infections
Rationale: Atrophic vaginitis is caused by estrogen deficiency, which leads to thinning of the
vaginal epithelium and an increase in vaginal pH (making it more alkaline, not acidic). This
loss of local flora and change in pH makes the environment more susceptible to bacterial
colonization and subsequent urinary tract infections (UTIs).
Question 6
Which of the following is the most appropriate screening tool specifically for delirium?
A) St. Louis University Mental Status Exam (SLUMS)
B) Montreal Cognitive Assessment (MoCA)
C) Lawton Scale of Instrumental Activities of Daily Living
D) Confusion Assessment Model (CAM)
E) Mini-Mental State Exam (MMSE)
, 3
Correct Answer: D) Confusion Assessment Model
Rationale: While the MoCA, SLUMS, and MMSE are used to assess cognitive impairment
or dementia, the Confusion Assessment Model (CAM) is the gold standard for identifying
delirium. It specifically evaluates the acute onset, fluctuating course, inattention, and
disorganized thinking characteristic of delirium.
Question 7
A drug that can be used to treat two very common symptoms in a dying patient (pain and
dyspnea) is:
A) Lorazepam
B) Gabapentin
C) Methadone
D) Morphine
E) Haloperidol
Correct Answer: D) Morphine
Rationale: Morphine is a cornerstone of palliative care. It is highly effective for managing
moderate to severe pain and is also the gold standard for treating dyspnea (air hunger) at
the end of life by reducing the perception of respiratory distress.
Question 8
Which of the following would you recommend annually for an elderly type 2 diabetic?
A) Periodic visits to a gastroenterologist.
B) Colonoscopy.
C) Follow-up with a urologist.
D) Eye exam with an ophthalmologist.
E) Chest X-ray.
Correct Answer: D) eye exam with an ophthalmologist
Rationale: Diabetic retinopathy is a leading cause of blindness. Annual dilated eye exams by
an ophthalmologist or optometrist are required for diabetic patients to screen for
microvascular changes and ensure early intervention to preserve vision.
Question 9
Which characteristic of delirium helps to distinguish it most clearly from dementia?
A) Short-term memory impairment.
B) Personality changes.
C) Acute onset.
D) Impaired attention.
E) Sleep-wake cycle disturbance.
Correct Answer: C) acute onset
Rationale: Delirium is characterized by an acute onset (hours to days) and a fluctuating
