NR 601 Midterm Practice Exam Prep
NR 601 MIDTERM PRACTICE EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 100 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. Which of the following changes is considered a normal physiologic change
of aging rather than a pathological process?
A. Progressive decline in glomerular filtration rate (GFR) beginning in mid-
adulthood
B. Rapid onset of confusion and inattention over days to hours
C. New progressive memory loss interfering with daily tasks over months
D. Unexplained weight loss with decreased appetite
Answer: A
Rationale: A gradual decline in GFR is a common age-related physiologic
change. Rapid onset of confusion suggests delirium (pathologic),
progressive memory loss interfering with function suggests dementia, and
unexplained weight loss may indicate illness.
2. The Katz ADL scale is used primarily to assess which of the following?
A. Higher-order executive functioning
B. Basic activities of daily living such as bathing and dressing
C. Instrumental activities like managing finances and transportation
D. Risk of falls via gait assessment
Answer: B
Rationale: Katz ADL measures basic self-care tasks (bathing, dressing,
toileting, transferring, continence, feeding). Lawton IADL assesses higher-
level instrumental activities.
3. According to common immunization recommendations for older adults,
which vaccine is routinely recommended for adults ≥50 years to prevent
herpes zoster?
A. Pneumococcal conjugate vaccine (PCV13)
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, NR 601 Midterm Practice Exam Prep
B. Live attenuated zoster vaccine (Zostavax) for all adults ≥50
C. Recombinant zoster vaccine (Shingrix) for adults ≥50
D. Annual influenza vaccine only, zoster vaccination is optional
Answer: C
Rationale: The recombinant zoster vaccine (Shingrix) is recommended for
adults ≥50; Zostavax (live) is no longer preferred. Pneumococcal vaccines
and influenza are separate recommendations.
4. The “Rule of Fourths” in geriatric care generally suggests:
A. One quarter of older adults live in nursing homes, one quarter are
hospitalized yearly, one quarter die, and one quarter remain healthy
B. One quarter of clinical problems are caused by medications, one
quarter by chronic disease, one quarter by acute disease, one quarter are
psychosocial
C. One quarter of falls result in fracture, one quarter result in hospital
admission, one quarter in minor injury, one quarter in no injury
D. One quarter of cognitive decline is reversible, one quarter progressive,
one quarter medication-induced, one quarter psychiatric
Answer: A
Rationale: The Rule of Fourths is a heuristic sometimes cited to summarize
outcomes in geriatric populations. Option A reflects a common phrasing of
that rule; other choices are not standard formulations.
5. For most older adults with uncomplicated hypertension, current
ACC/AHA–based goals typically target a blood pressure less than:
A. 160/100 mm Hg
B. 150/90 mm Hg
C. 140/90 mm Hg
D. 120/80 mm Hg
Answer: C
Rationale: A common target for many older adults is <140/90 mm Hg,
individualized by comorbidity, frailty, and orthostatic risk. Targets may
vary by guideline and patient factors.
2|Page
, NR 601 Midterm Practice Exam Prep
1. Which statement correctly distinguishes HFrEF from HFpEF?
A. HFrEF is defined by preserved ejection fraction and mainly diastolic
dysfunction
B. HFpEF is characterized by reduced ejection fraction (EF <40%)
C. HFrEF involves reduced EF and often benefits from ACE inhibitors, beta-
blockers, and mineralocorticoid receptor antagonists
D. HFpEF responds well to the same evidence-based agents proven for
HFrEF
Answer: C
Rationale: HFrEF = heart failure with reduced EF and has evidence-based
therapies (ACEi/ARB/ARNI, beta-blockers, MRAs). HFpEF has preserved EF
and limited evidence for the same mortality-reducing agents.
2. An elderly patient presents with new-onset fatigue and confusion but
denies chest pain. Which consideration is most appropriate regarding
myocardial infarction (MI) in older adults?
A. Older adults always present with chest pain if they have MI
B. Atypical presentations such as confusion or fatigue can indicate MI and
warrant evaluation with ECG and cardiac biomarkers
C. Absence of chest pain reliably excludes ischemia in the elderly
D. Troponin testing is not useful in older adults because of chronic disease
Answer: B
Rationale: Elderly patients often have atypical MI presentations (fatigue,
confusion, syncope). ECG and troponins are appropriate when ischemia is
suspected.
3. In spirometry, an FEV1/FVC ratio less than 0.70 after bronchodilator
suggests:
A. Restrictive lung disease
B. Obstructive lung disease, consistent with COPD
C. Normal aging-related change only, no pathology
D. Primary pulmonary hypertension
Answer: B
Rationale: A post-bronchodilator FEV1/FVC <0.70 indicates airflow
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, NR 601 Midterm Practice Exam Prep
obstruction, consistent with COPD per GOLD definitions (with clinical
correlation).
4. The GOLD classification for COPD severity primarily uses which
spirometric measure?
A. Total lung capacity (TLC)
B. FEV1 percent predicted after bronchodilator
C. Diffusing capacity for carbon monoxide (DLCO)
D. Resting oxygen saturation
Answer: B
Rationale: GOLD uses post-bronchodilator FEV1 percent predicted to stage
airflow limitation severity (GOLD 1–4).
5. Which presentation is most typical for pneumonia in older adults
compared with younger adults?
A. High fever and pleuritic chest pain are the most consistent presenting
features
B. Classic productive cough is always present
C. Atypical signs such as tachypnea, confusion, or functional decline
without fever are common
D. Hemoptysis is the most sensitive indicator
Answer: C
Rationale: Older adults may present atypically (confusion, tachypnea,
decline in function) and may lack fever or classic respiratory symptoms.
6. Which of the following best differentiates delirium from dementia?
A. Delirium has a gradual onset over months; dementia has acute onset
B. Delirium features fluctuating attention and an acute change from
baseline; dementia is typically chronic and progressive
C. Dementia always resolves with treatment of underlying causes;
delirium is permanent
D. Both conditions present identically and require the same management
Answer: B
Rationale: Delirium is acute, fluctuating, and often reversible; dementia is
insidious, progressive, and generally persistent.
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NR 601 MIDTERM PRACTICE EXAM PREP NEWEST 2026/2027
ACTUAL EXAM COMPLETE 100 QUESTIONS AND CORRECT DETAILED
ANSWERS (VERIFIED ANSWERS) WITH DETAILED RATIONALES
|ALREADY GRADED A+||BRAND NEW VERSION!!
1. Which of the following changes is considered a normal physiologic change
of aging rather than a pathological process?
A. Progressive decline in glomerular filtration rate (GFR) beginning in mid-
adulthood
B. Rapid onset of confusion and inattention over days to hours
C. New progressive memory loss interfering with daily tasks over months
D. Unexplained weight loss with decreased appetite
Answer: A
Rationale: A gradual decline in GFR is a common age-related physiologic
change. Rapid onset of confusion suggests delirium (pathologic),
progressive memory loss interfering with function suggests dementia, and
unexplained weight loss may indicate illness.
2. The Katz ADL scale is used primarily to assess which of the following?
A. Higher-order executive functioning
B. Basic activities of daily living such as bathing and dressing
C. Instrumental activities like managing finances and transportation
D. Risk of falls via gait assessment
Answer: B
Rationale: Katz ADL measures basic self-care tasks (bathing, dressing,
toileting, transferring, continence, feeding). Lawton IADL assesses higher-
level instrumental activities.
3. According to common immunization recommendations for older adults,
which vaccine is routinely recommended for adults ≥50 years to prevent
herpes zoster?
A. Pneumococcal conjugate vaccine (PCV13)
1|Page
, NR 601 Midterm Practice Exam Prep
B. Live attenuated zoster vaccine (Zostavax) for all adults ≥50
C. Recombinant zoster vaccine (Shingrix) for adults ≥50
D. Annual influenza vaccine only, zoster vaccination is optional
Answer: C
Rationale: The recombinant zoster vaccine (Shingrix) is recommended for
adults ≥50; Zostavax (live) is no longer preferred. Pneumococcal vaccines
and influenza are separate recommendations.
4. The “Rule of Fourths” in geriatric care generally suggests:
A. One quarter of older adults live in nursing homes, one quarter are
hospitalized yearly, one quarter die, and one quarter remain healthy
B. One quarter of clinical problems are caused by medications, one
quarter by chronic disease, one quarter by acute disease, one quarter are
psychosocial
C. One quarter of falls result in fracture, one quarter result in hospital
admission, one quarter in minor injury, one quarter in no injury
D. One quarter of cognitive decline is reversible, one quarter progressive,
one quarter medication-induced, one quarter psychiatric
Answer: A
Rationale: The Rule of Fourths is a heuristic sometimes cited to summarize
outcomes in geriatric populations. Option A reflects a common phrasing of
that rule; other choices are not standard formulations.
5. For most older adults with uncomplicated hypertension, current
ACC/AHA–based goals typically target a blood pressure less than:
A. 160/100 mm Hg
B. 150/90 mm Hg
C. 140/90 mm Hg
D. 120/80 mm Hg
Answer: C
Rationale: A common target for many older adults is <140/90 mm Hg,
individualized by comorbidity, frailty, and orthostatic risk. Targets may
vary by guideline and patient factors.
2|Page
, NR 601 Midterm Practice Exam Prep
1. Which statement correctly distinguishes HFrEF from HFpEF?
A. HFrEF is defined by preserved ejection fraction and mainly diastolic
dysfunction
B. HFpEF is characterized by reduced ejection fraction (EF <40%)
C. HFrEF involves reduced EF and often benefits from ACE inhibitors, beta-
blockers, and mineralocorticoid receptor antagonists
D. HFpEF responds well to the same evidence-based agents proven for
HFrEF
Answer: C
Rationale: HFrEF = heart failure with reduced EF and has evidence-based
therapies (ACEi/ARB/ARNI, beta-blockers, MRAs). HFpEF has preserved EF
and limited evidence for the same mortality-reducing agents.
2. An elderly patient presents with new-onset fatigue and confusion but
denies chest pain. Which consideration is most appropriate regarding
myocardial infarction (MI) in older adults?
A. Older adults always present with chest pain if they have MI
B. Atypical presentations such as confusion or fatigue can indicate MI and
warrant evaluation with ECG and cardiac biomarkers
C. Absence of chest pain reliably excludes ischemia in the elderly
D. Troponin testing is not useful in older adults because of chronic disease
Answer: B
Rationale: Elderly patients often have atypical MI presentations (fatigue,
confusion, syncope). ECG and troponins are appropriate when ischemia is
suspected.
3. In spirometry, an FEV1/FVC ratio less than 0.70 after bronchodilator
suggests:
A. Restrictive lung disease
B. Obstructive lung disease, consistent with COPD
C. Normal aging-related change only, no pathology
D. Primary pulmonary hypertension
Answer: B
Rationale: A post-bronchodilator FEV1/FVC <0.70 indicates airflow
3|Page
, NR 601 Midterm Practice Exam Prep
obstruction, consistent with COPD per GOLD definitions (with clinical
correlation).
4. The GOLD classification for COPD severity primarily uses which
spirometric measure?
A. Total lung capacity (TLC)
B. FEV1 percent predicted after bronchodilator
C. Diffusing capacity for carbon monoxide (DLCO)
D. Resting oxygen saturation
Answer: B
Rationale: GOLD uses post-bronchodilator FEV1 percent predicted to stage
airflow limitation severity (GOLD 1–4).
5. Which presentation is most typical for pneumonia in older adults
compared with younger adults?
A. High fever and pleuritic chest pain are the most consistent presenting
features
B. Classic productive cough is always present
C. Atypical signs such as tachypnea, confusion, or functional decline
without fever are common
D. Hemoptysis is the most sensitive indicator
Answer: C
Rationale: Older adults may present atypically (confusion, tachypnea,
decline in function) and may lack fever or classic respiratory symptoms.
6. Which of the following best differentiates delirium from dementia?
A. Delirium has a gradual onset over months; dementia has acute onset
B. Delirium features fluctuating attention and an acute change from
baseline; dementia is typically chronic and progressive
C. Dementia always resolves with treatment of underlying causes;
delirium is permanent
D. Both conditions present identically and require the same management
Answer: B
Rationale: Delirium is acute, fluctuating, and often reversible; dementia is
insidious, progressive, and generally persistent.
4|Page
