NR 601 Midterm Exam: Primary Care of the Maturing and Aged Family
2026/2027 Chamberlain College
1. Which of the following is the most common cause of delirium in the elderly
population?
A. Alzheimer’s disease progression
B. Normal age-related memory loss
C. Unrecognized urinary tract infection
D. Vitamin D deficiency
Answer: C
Rationale: Acute changes in mental status (delirium) in the elderly are often triggered by
physiological stressors, with UTIs being a primary culprit.
2. According to the Beers Criteria, which medication class should be avoided in
older adults due to high risk of falls and fractures?
A. ACE inhibitors
B. Statins
C. Biguanides
D. Benzodiazepines
Answer: D
Rationale: Benzodiazepines increase the risk of cognitive impairment, delirium, falls, and
fractures in older adults.
,3. A 75-year-old patient presents with a ‘curtain falling’ over their vision in one
eye. This is most likely indicative of:
A. Cataracts
B. Macular degeneration
C. Retinal detachment
D. Presbyopia
Answer: C
Rationale: A sudden sensation of a curtain or shade coming down over the eye is a classic
symptom of retinal detachment.
4. The ‘Katz Index’ is a clinical tool used primarily to assess which of the
following?
A. Activities of Daily Living (ADLs)
B. Cognitive impairment level
C. Instrumental Activities of Daily Living (IADLs)
D. Nutritional risk
Answer: A
Rationale: The Katz Index of Independence in Activities of Daily Living assesses basic tasks
like bathing, dressing, and feeding.
5. Which physiological change of aging affects the distribution of lipophilic (fat-
soluble) drugs?
A. Increased percentage of body fat
B. Decreased total body water
C. Increased hepatic blood flow
D. Decreased gastric pH
Answer: A
Rationale: As body fat increases with age, lipophilic drugs have an increased volume of
distribution and a longer half-life.
, 6. For a healthy 72-year-old with few comorbidities, the recommended HbA1c
goal is typically:
A. Less than 6.0%
B. Less than 8.5%
C. Less than 7.5%
D. Less than 9.0%
Answer: C
Rationale: For older adults with good health and long life expectancy, the ADA
recommends an HbA1c goal of <7.5%.
7. An elderly patient complains of losing urine when coughing or sneezing. This
is known as:
A. Stress incontinence
B. Overflow incontinence
C. Urge incontinence
D. Functional incontinence
Answer: A
Rationale: Stress incontinence occurs when abdominal pressure (coughing, laughing)
exceeds urethral sphincter pressure.
8. What is the primary characteristic that distinguishes dementia from delirium?
A. Dementia is acute; delirium is chronic
B. Dementia affects attention; delirium does not
C. Dementia onset is gradual; delirium is acute
D. Dementia is always reversible
Answer: C
Rationale: Delirium has a sudden, acute onset and fluctuating course, while dementia
involves a gradual, progressive decline.
2026/2027 Chamberlain College
1. Which of the following is the most common cause of delirium in the elderly
population?
A. Alzheimer’s disease progression
B. Normal age-related memory loss
C. Unrecognized urinary tract infection
D. Vitamin D deficiency
Answer: C
Rationale: Acute changes in mental status (delirium) in the elderly are often triggered by
physiological stressors, with UTIs being a primary culprit.
2. According to the Beers Criteria, which medication class should be avoided in
older adults due to high risk of falls and fractures?
A. ACE inhibitors
B. Statins
C. Biguanides
D. Benzodiazepines
Answer: D
Rationale: Benzodiazepines increase the risk of cognitive impairment, delirium, falls, and
fractures in older adults.
,3. A 75-year-old patient presents with a ‘curtain falling’ over their vision in one
eye. This is most likely indicative of:
A. Cataracts
B. Macular degeneration
C. Retinal detachment
D. Presbyopia
Answer: C
Rationale: A sudden sensation of a curtain or shade coming down over the eye is a classic
symptom of retinal detachment.
4. The ‘Katz Index’ is a clinical tool used primarily to assess which of the
following?
A. Activities of Daily Living (ADLs)
B. Cognitive impairment level
C. Instrumental Activities of Daily Living (IADLs)
D. Nutritional risk
Answer: A
Rationale: The Katz Index of Independence in Activities of Daily Living assesses basic tasks
like bathing, dressing, and feeding.
5. Which physiological change of aging affects the distribution of lipophilic (fat-
soluble) drugs?
A. Increased percentage of body fat
B. Decreased total body water
C. Increased hepatic blood flow
D. Decreased gastric pH
Answer: A
Rationale: As body fat increases with age, lipophilic drugs have an increased volume of
distribution and a longer half-life.
, 6. For a healthy 72-year-old with few comorbidities, the recommended HbA1c
goal is typically:
A. Less than 6.0%
B. Less than 8.5%
C. Less than 7.5%
D. Less than 9.0%
Answer: C
Rationale: For older adults with good health and long life expectancy, the ADA
recommends an HbA1c goal of <7.5%.
7. An elderly patient complains of losing urine when coughing or sneezing. This
is known as:
A. Stress incontinence
B. Overflow incontinence
C. Urge incontinence
D. Functional incontinence
Answer: A
Rationale: Stress incontinence occurs when abdominal pressure (coughing, laughing)
exceeds urethral sphincter pressure.
8. What is the primary characteristic that distinguishes dementia from delirium?
A. Dementia is acute; delirium is chronic
B. Dementia affects attention; delirium does not
C. Dementia onset is gradual; delirium is acute
D. Dementia is always reversible
Answer: C
Rationale: Delirium has a sudden, acute onset and fluctuating course, while dementia
involves a gradual, progressive decline.
