NR601 WEEK 5 QUIZ: PRIMARY CARE OF THE MATURING & AGED FAMILY
COMPLETE QUESTIONS AND WELL-EXPLAINED ANSWERS | 2026/2027
Q1. According to JNC 8 guidelines, what is the recommended blood pressure target for
adults aged 60 years and older without diabetes or CKD?
A. <130/80 mmHg
B. <140/90 mmHg
C. <150/90 mmHg
D. <160/100 mmHg
ANSWER : C
Explanation: JNC 8 recommends a target of <150/90 mmHg for adults ≥60 years
without diabetes or CKD. AHA/ACC 2017 later lowered targets, but JNC 8 is
the classic reference for this population.
Q2. Which antihypertensive class is considered first-line for isolated systolic
hypertension in older adults?
A. Beta-blockers
B. ACE inhibitors
C. Thiazide diuretics or long-acting CCBs
D. ARBs
ANSWER : C
Explanation: Thiazide diuretics (chlorthalidone) and long-acting
dihydropyridine CCBs (amlodipine) have strong evidence for reducing CV
events in isolated systolic hypertension in older adults.
Q3. An 82-year-old patient has a BP of 165/70 mmHg. Which concern is most important
before aggressively lowering BP?
Page 1 of 55
, A. Renal artery stenosis
B. Orthostatic hypotension and fall risk
C. Hyperkalemia
D. Worsening GERD
ANSWER : B
Explanation: Aggressive BP lowering in older adults increases risk of orthostatic
hypotension and falls, which can result in fractures and hospitalization. Fall risk
must be carefully considered.
Q4. A 72-year-old Black patient has stage 2 hypertension. Which drug class has shown
superior outcomes in this population?
A. ACE inhibitors
B. Beta-blockers
C. Thiazide diuretics or CCBs
D. ARBs
ANSWER : C
Explanation: Evidence from ALLHAT and other trials shows that thiazide
diuretics and CCBs are more effective for BP control and CV outcomes in Black
patients compared to ACE inhibitors or ARBs used as monotherapy.
Q5. Pseudohypertension in older adults is caused by:
A. White coat effect
B. Arterial stiffness causing falsely elevated cuff readings
C. Renal artery stenosis
D. Aortic valve stenosis
ANSWER : B
Explanation: Pseudohypertension occurs when calcified, rigid arteries do not
compress adequately under the cuff, causing falsely elevated readings. The Osler
maneuver can help identify this.
Page 2 of 55
,Q6. Which medication should be avoided in older hypertensive patients due to increased
risk of cognitive impairment?
A. Amlodipine
B. Chlorthalidone
C. Clonidine
D. Lisinopril
ANSWER : C
Explanation: Clonidine is a centrally acting alpha-2 agonist on the Beers
Criteria. It can cause sedation, CNS depression, bradycardia, and cognitive
impairment in older adults.
Q7. The SPRINT trial demonstrated that targeting systolic BP <120 mmHg in older
adults without diabetes:
A. Increased mortality
B. Reduced CV events but increased adverse events like AKI and hypotension
C. Had no benefit
D. Primarily benefited women
ANSWER : B
Explanation: SPRINT showed intensive BP control (<120 mmHg) reduced CV
events and mortality, but also significantly increased adverse events including
acute kidney injury, syncope, and electrolyte abnormalities.
Q8. When initiating antihypertensive therapy in a frail 85-year-old, which principle is
most appropriate?
A. Start at full dose for rapid control
B. Start low, go slow
C. Avoid all antihypertensives
D. Target BP <120/80
ANSWER : B
Explanation: In frail older adults, 'start low, go slow' minimizes risk of
hypotension, syncope, and falls. Goals should be individualized based on
functional status and life expectancy.
Page 3 of 55
, Q9. A patient on lisinopril develops a persistent dry cough. What is the most appropriate
next step?
A. Add a cough suppressant
B. Switch to an ARB
C. Increase the dose
D. Add a thiazide diuretic
ANSWER : B
Explanation: ACE inhibitor-induced cough (due to bradykinin accumulation)
resolves when the medication is discontinued. ARBs (e.g., losartan) do not cause
this side effect and are an appropriate alternative.
Q10. Resistant hypertension is defined as BP above goal despite:
A. Two antihypertensives at any dose
B. Three antihypertensives of different classes at maximum tolerated doses, including
a diuretic
C. Four antihypertensives
D. Any antihypertensive therapy
ANSWER : B
Explanation: Resistant hypertension is defined as BP above goal despite
concurrent use of ≥3 antihypertensives of different classes at maximum tolerated
doses, one of which should be a diuretic.
HEART FAILURE IN OLDER ADULTS
Q11. HFpEF (heart failure with preserved ejection fraction) is most common in:
A. Young men with dilated cardiomyopathy
B. Older women with hypertension and obesity
C. Young athletes
Page 4 of 55
COMPLETE QUESTIONS AND WELL-EXPLAINED ANSWERS | 2026/2027
Q1. According to JNC 8 guidelines, what is the recommended blood pressure target for
adults aged 60 years and older without diabetes or CKD?
A. <130/80 mmHg
B. <140/90 mmHg
C. <150/90 mmHg
D. <160/100 mmHg
ANSWER : C
Explanation: JNC 8 recommends a target of <150/90 mmHg for adults ≥60 years
without diabetes or CKD. AHA/ACC 2017 later lowered targets, but JNC 8 is
the classic reference for this population.
Q2. Which antihypertensive class is considered first-line for isolated systolic
hypertension in older adults?
A. Beta-blockers
B. ACE inhibitors
C. Thiazide diuretics or long-acting CCBs
D. ARBs
ANSWER : C
Explanation: Thiazide diuretics (chlorthalidone) and long-acting
dihydropyridine CCBs (amlodipine) have strong evidence for reducing CV
events in isolated systolic hypertension in older adults.
Q3. An 82-year-old patient has a BP of 165/70 mmHg. Which concern is most important
before aggressively lowering BP?
Page 1 of 55
, A. Renal artery stenosis
B. Orthostatic hypotension and fall risk
C. Hyperkalemia
D. Worsening GERD
ANSWER : B
Explanation: Aggressive BP lowering in older adults increases risk of orthostatic
hypotension and falls, which can result in fractures and hospitalization. Fall risk
must be carefully considered.
Q4. A 72-year-old Black patient has stage 2 hypertension. Which drug class has shown
superior outcomes in this population?
A. ACE inhibitors
B. Beta-blockers
C. Thiazide diuretics or CCBs
D. ARBs
ANSWER : C
Explanation: Evidence from ALLHAT and other trials shows that thiazide
diuretics and CCBs are more effective for BP control and CV outcomes in Black
patients compared to ACE inhibitors or ARBs used as monotherapy.
Q5. Pseudohypertension in older adults is caused by:
A. White coat effect
B. Arterial stiffness causing falsely elevated cuff readings
C. Renal artery stenosis
D. Aortic valve stenosis
ANSWER : B
Explanation: Pseudohypertension occurs when calcified, rigid arteries do not
compress adequately under the cuff, causing falsely elevated readings. The Osler
maneuver can help identify this.
Page 2 of 55
,Q6. Which medication should be avoided in older hypertensive patients due to increased
risk of cognitive impairment?
A. Amlodipine
B. Chlorthalidone
C. Clonidine
D. Lisinopril
ANSWER : C
Explanation: Clonidine is a centrally acting alpha-2 agonist on the Beers
Criteria. It can cause sedation, CNS depression, bradycardia, and cognitive
impairment in older adults.
Q7. The SPRINT trial demonstrated that targeting systolic BP <120 mmHg in older
adults without diabetes:
A. Increased mortality
B. Reduced CV events but increased adverse events like AKI and hypotension
C. Had no benefit
D. Primarily benefited women
ANSWER : B
Explanation: SPRINT showed intensive BP control (<120 mmHg) reduced CV
events and mortality, but also significantly increased adverse events including
acute kidney injury, syncope, and electrolyte abnormalities.
Q8. When initiating antihypertensive therapy in a frail 85-year-old, which principle is
most appropriate?
A. Start at full dose for rapid control
B. Start low, go slow
C. Avoid all antihypertensives
D. Target BP <120/80
ANSWER : B
Explanation: In frail older adults, 'start low, go slow' minimizes risk of
hypotension, syncope, and falls. Goals should be individualized based on
functional status and life expectancy.
Page 3 of 55
, Q9. A patient on lisinopril develops a persistent dry cough. What is the most appropriate
next step?
A. Add a cough suppressant
B. Switch to an ARB
C. Increase the dose
D. Add a thiazide diuretic
ANSWER : B
Explanation: ACE inhibitor-induced cough (due to bradykinin accumulation)
resolves when the medication is discontinued. ARBs (e.g., losartan) do not cause
this side effect and are an appropriate alternative.
Q10. Resistant hypertension is defined as BP above goal despite:
A. Two antihypertensives at any dose
B. Three antihypertensives of different classes at maximum tolerated doses, including
a diuretic
C. Four antihypertensives
D. Any antihypertensive therapy
ANSWER : B
Explanation: Resistant hypertension is defined as BP above goal despite
concurrent use of ≥3 antihypertensives of different classes at maximum tolerated
doses, one of which should be a diuretic.
HEART FAILURE IN OLDER ADULTS
Q11. HFpEF (heart failure with preserved ejection fraction) is most common in:
A. Young men with dilated cardiomyopathy
B. Older women with hypertension and obesity
C. Young athletes
Page 4 of 55
