NR 601: Primary Care of the Maturing and Aging Family Midterm
Exam Prep 2026 Chamberlain College
1. Which of the following is considered a normal physiological change of aging in
the cardiovascular system?
A. Increase in maximum heart rate
B. Increased sensitivity of baroreceptors
C. Decrease in left ventricular wall thickness
D. Decreased arterial compliance and increased stiffness
Answer: D
Rationale: Aging leads to structural changes including stiffening of the large arteries
(arteriosclerosis) and increased left ventricular wall thickness to maintain cardiac output.
2. An 80-year-old patient with multiple comorbidities and a life expectancy of
less than 5 years has an A1c of 7.9%. According to the American Diabetes
Association, what is the most appropriate action?
A. Aggressively increase insulin to reach a target of <7.0%
B. Discontinue all diabetic medications
C. Start a sliding scale insulin regimen immediately
D. Maintain the current regimen as the goal for this population is <8.0-8.5%
Answer: D
Rationale: For older adults with complex health issues and limited life expectancy, a less
stringent A1c goal (typically <8.0% or <8.5%) is recommended to avoid hypoglycemia.
,3. The Katz Index of Independence is used to assess which of the following?
A. Basic Activities of Daily Living (ADLs) such as bathing and dressing
B. Cognitive impairment and executive function
C. Instrumental Activities of Daily Living (IADLs) like using a phone
D. Risk of falls and gait stability
Answer: A
Rationale: The Katz Index focuses on basic activities of daily living (ADLs), including
bathing, dressing, toileting, transferring, continence, and feeding.
4. Which physical exam finding is typically associated with normal aging of the
respiratory system?
A. Increased vital capacity
B. Increased chest wall compliance
C. Increased residual volume
D. Decreased anteroposterior diameter
Answer: C
Rationale: Aging results in decreased elastic recoil of the lungs, which leads to an increase
in residual volume and a decrease in vital capacity.
5. According to the Beers Criteria, which medication should be avoided in older
adults due to high risk of orthostatic hypotension and falls?
A. Lisinopril
B. Metformin
C. Amitriptyline
D. Atorvastatin
Answer: C
Rationale: Amitriptyline is a tricyclic antidepressant with strong anticholinergic
properties and a high risk for sedation and orthostatic hypotension in the elderly.
, 6. A 72-year-old female presents with acute onset of confusion, agitation, and
visual hallucinations. Her daughter states she was ‘perfectly fine’ two days ago.
What is the most likely diagnosis?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Major Depressive Disorder
Answer: A
Rationale: Acute onset, fluctuating course, and disturbances in attention/awareness are
hallmarks of delirium, often triggered by an underlying medical issue like infection.
7. Which of the following is the ‘Gold Standard’ for diagnosing Chronic
Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray showing hyperinflation
B. Spirometry showing FEV1/FVC ratio < 0.70
C. Sputum culture and sensitivity
D. Arterial blood gas analysis
Answer: B
Rationale: Post-bronchodilator spirometry demonstrating an FEV1/FVC ratio of less than
0.70 confirms the presence of persistent airflow limitation.
8. What is the recommended first-line pharmacological treatment for an older
adult with Osteoarthritis?
A. Oral NSAIDs (e.g., Ibuprofen)
B. Topical NSAIDs or Acetaminophen
C. Systemic Corticosteroids
D. Chronic Opioid Therapy
Answer: B
Exam Prep 2026 Chamberlain College
1. Which of the following is considered a normal physiological change of aging in
the cardiovascular system?
A. Increase in maximum heart rate
B. Increased sensitivity of baroreceptors
C. Decrease in left ventricular wall thickness
D. Decreased arterial compliance and increased stiffness
Answer: D
Rationale: Aging leads to structural changes including stiffening of the large arteries
(arteriosclerosis) and increased left ventricular wall thickness to maintain cardiac output.
2. An 80-year-old patient with multiple comorbidities and a life expectancy of
less than 5 years has an A1c of 7.9%. According to the American Diabetes
Association, what is the most appropriate action?
A. Aggressively increase insulin to reach a target of <7.0%
B. Discontinue all diabetic medications
C. Start a sliding scale insulin regimen immediately
D. Maintain the current regimen as the goal for this population is <8.0-8.5%
Answer: D
Rationale: For older adults with complex health issues and limited life expectancy, a less
stringent A1c goal (typically <8.0% or <8.5%) is recommended to avoid hypoglycemia.
,3. The Katz Index of Independence is used to assess which of the following?
A. Basic Activities of Daily Living (ADLs) such as bathing and dressing
B. Cognitive impairment and executive function
C. Instrumental Activities of Daily Living (IADLs) like using a phone
D. Risk of falls and gait stability
Answer: A
Rationale: The Katz Index focuses on basic activities of daily living (ADLs), including
bathing, dressing, toileting, transferring, continence, and feeding.
4. Which physical exam finding is typically associated with normal aging of the
respiratory system?
A. Increased vital capacity
B. Increased chest wall compliance
C. Increased residual volume
D. Decreased anteroposterior diameter
Answer: C
Rationale: Aging results in decreased elastic recoil of the lungs, which leads to an increase
in residual volume and a decrease in vital capacity.
5. According to the Beers Criteria, which medication should be avoided in older
adults due to high risk of orthostatic hypotension and falls?
A. Lisinopril
B. Metformin
C. Amitriptyline
D. Atorvastatin
Answer: C
Rationale: Amitriptyline is a tricyclic antidepressant with strong anticholinergic
properties and a high risk for sedation and orthostatic hypotension in the elderly.
, 6. A 72-year-old female presents with acute onset of confusion, agitation, and
visual hallucinations. Her daughter states she was ‘perfectly fine’ two days ago.
What is the most likely diagnosis?
A. Delirium
B. Vascular Dementia
C. Alzheimer’s Disease
D. Major Depressive Disorder
Answer: A
Rationale: Acute onset, fluctuating course, and disturbances in attention/awareness are
hallmarks of delirium, often triggered by an underlying medical issue like infection.
7. Which of the following is the ‘Gold Standard’ for diagnosing Chronic
Obstructive Pulmonary Disease (COPD)?
A. Chest X-ray showing hyperinflation
B. Spirometry showing FEV1/FVC ratio < 0.70
C. Sputum culture and sensitivity
D. Arterial blood gas analysis
Answer: B
Rationale: Post-bronchodilator spirometry demonstrating an FEV1/FVC ratio of less than
0.70 confirms the presence of persistent airflow limitation.
8. What is the recommended first-line pharmacological treatment for an older
adult with Osteoarthritis?
A. Oral NSAIDs (e.g., Ibuprofen)
B. Topical NSAIDs or Acetaminophen
C. Systemic Corticosteroids
D. Chronic Opioid Therapy
Answer: B
