NR 601 Exam 1: Primary Care Aging - Chamberlain
University Updated and Latest Questions and Correct
Answers with Rationale
1. Which of the following is considered an Instrumental Activity of Daily Living (IADL) rather than a basic
Activity of Daily Living (ADL)?
A. Managing finances and bills
B. Bathing and showering
C. Feeding oneself
D. Transferring from bed to chair
Correct Answer: A
Rationale: Instrumental Activities of Daily Living (IADLs) involve more complex cognitive and
organizational skills needed to live independently. While ADLs focus on basic physical self-care like
bathing or feeding, IADLs include tasks such as managing money, shopping, and using a telephone.
Assessing IADLs helps a provider determine if an older adult requires support within their home
environment. Functional decline in IADLs often occurs before basic ADL impairment in the early stages of
cognitive decline. Therefore, documenting these abilities is a critical component of the comprehensive
geriatric assessment.
2. An 80-year-old patient presents with a new onset of confusion and agitation. What is the most common
atypical presentation of an infection in this age group?
A. Acute change in mental status (delirium)
B. Productive cough and chest pain
C. High-grade fever and chills
,D. Elevated white blood cell count
Correct Answer: A
Rationale: Older adults frequently exhibit atypical symptoms when dealing with acute infections such as
urinary tract infections or pneumonia. Instead of a fever, they may present with a sudden change in
mental status, commonly referred to as delirium. This occurs because the aging brain is more susceptible
to metabolic disturbances and systemic inflammation. Clinicians should always rule out infection when
an elderly patient experiences rapid cognitive or behavioral changes. Failure to recognize this atypical
presentation can lead to delayed treatment and increased morbidity in the geriatric population.
3. According to the Beer’s Criteria, which medication class should be avoided in older adults due to high risk
of falls and fractures?
A. Benzodiazepines
B. ACE inhibitors
C. Statin therapy
D. Proton pump inhibitors
Correct Answer: A
Rationale: Benzodiazepines are listed on the Beer’s Criteria as potentially inappropriate medications for
the elderly due to their side effect profile. They significantly increase the risk of cognitive impairment,
delirium, falls, and subsequent hip fractures in older patients. The aging body metabolizes these drugs
more slowly, leading to prolonged sedation and ataxia. Providers are encouraged to seek non-
pharmacological interventions for insomnia or anxiety before prescribing these agents. If they must be
used, they should be prescribed at the lowest possible dose for the shortest duration.
,4. Which physiological change of the respiratory system is commonly associated with normal aging?
A. Increased elastic recoil of the lungs
B. Increased chest wall compliance
C. Decreased surface area for gas exchange
D. Decreased residual volume
Correct Answer: C
Rationale: Normal aging leads to a reduction in the total surface area of the alveoli, which decreases the
efficiency of gas exchange. The lungs lose their elastic recoil, causing the airways to close prematurely
and increasing the residual volume. Additionally, the chest wall becomes stiffer and less compliant due to
calcification of the costal cartilages. These changes result in a decreased forced expiratory volume (FEV1)
and a lower partial pressure of arterial oxygen. Understanding these baseline changes is essential when
evaluating an older patient for respiratory distress or chronic lung disease.
5. The ‘Mini-Cog’ is a rapid screening tool for dementia. What are the two components of this assessment?
A. Orientation to time and place
B. Reading a sentence and copying a design
C. Serial 7s and naming objects
D. 3-item word recall and clock drawing
Correct Answer: D
Rationale: The Mini-Cog is a highly efficient screening instrument that takes only about three minutes to
administer in a primary care setting. It consists of a three-item word recall test to assess short-term
memory and a clock-drawing test to evaluate executive function and visuospatial skills. A score of 0-2 out
of 5 generally indicates a higher likelihood of clinically significant cognitive impairment. This tool is less
, affected by education level or language barriers than the Mini-Mental State Examination (MMSE). It
serves as an excellent initial step in a comprehensive geriatric assessment to determine the need for
further diagnostic testing.
6. Which of the following describes the condition ‘Presbycusis’ in the geriatric population?
A. Conductive hearing loss due to cerumen impaction
B. Age-related high-frequency sensorineural hearing loss
C. Low-frequency hearing loss caused by middle ear infection
D. Tinnitus caused by aspirin toxicity
Correct Answer: B
Rationale: Presbycusis is the most common type of sensorineural hearing loss found in the aging
population. It typically manifests as a progressive, bilateral, and symmetrical loss of high-frequency
hearing. Patients often complain that they can hear people speaking but cannot understand the specific
words, especially in noisy environments. This condition results from the degeneration of cochlear hair
cells and changes in the auditory nerve. Early identification through screening is vital as untreated
hearing loss is linked to social isolation, depression, and cognitive decline.
7. What is the primary reason for a decrease in the Glomerular Filtration Rate (GFR) in older adults even
when serum creatinine remains within normal limits?
A. Increased protein intake in the elderly
B. Improved renal blood flow with age
C. Hypertrophy of the nephrons
D. Loss of muscle mass (sarcopenia)
Correct Answer: D
University Updated and Latest Questions and Correct
Answers with Rationale
1. Which of the following is considered an Instrumental Activity of Daily Living (IADL) rather than a basic
Activity of Daily Living (ADL)?
A. Managing finances and bills
B. Bathing and showering
C. Feeding oneself
D. Transferring from bed to chair
Correct Answer: A
Rationale: Instrumental Activities of Daily Living (IADLs) involve more complex cognitive and
organizational skills needed to live independently. While ADLs focus on basic physical self-care like
bathing or feeding, IADLs include tasks such as managing money, shopping, and using a telephone.
Assessing IADLs helps a provider determine if an older adult requires support within their home
environment. Functional decline in IADLs often occurs before basic ADL impairment in the early stages of
cognitive decline. Therefore, documenting these abilities is a critical component of the comprehensive
geriatric assessment.
2. An 80-year-old patient presents with a new onset of confusion and agitation. What is the most common
atypical presentation of an infection in this age group?
A. Acute change in mental status (delirium)
B. Productive cough and chest pain
C. High-grade fever and chills
,D. Elevated white blood cell count
Correct Answer: A
Rationale: Older adults frequently exhibit atypical symptoms when dealing with acute infections such as
urinary tract infections or pneumonia. Instead of a fever, they may present with a sudden change in
mental status, commonly referred to as delirium. This occurs because the aging brain is more susceptible
to metabolic disturbances and systemic inflammation. Clinicians should always rule out infection when
an elderly patient experiences rapid cognitive or behavioral changes. Failure to recognize this atypical
presentation can lead to delayed treatment and increased morbidity in the geriatric population.
3. According to the Beer’s Criteria, which medication class should be avoided in older adults due to high risk
of falls and fractures?
A. Benzodiazepines
B. ACE inhibitors
C. Statin therapy
D. Proton pump inhibitors
Correct Answer: A
Rationale: Benzodiazepines are listed on the Beer’s Criteria as potentially inappropriate medications for
the elderly due to their side effect profile. They significantly increase the risk of cognitive impairment,
delirium, falls, and subsequent hip fractures in older patients. The aging body metabolizes these drugs
more slowly, leading to prolonged sedation and ataxia. Providers are encouraged to seek non-
pharmacological interventions for insomnia or anxiety before prescribing these agents. If they must be
used, they should be prescribed at the lowest possible dose for the shortest duration.
,4. Which physiological change of the respiratory system is commonly associated with normal aging?
A. Increased elastic recoil of the lungs
B. Increased chest wall compliance
C. Decreased surface area for gas exchange
D. Decreased residual volume
Correct Answer: C
Rationale: Normal aging leads to a reduction in the total surface area of the alveoli, which decreases the
efficiency of gas exchange. The lungs lose their elastic recoil, causing the airways to close prematurely
and increasing the residual volume. Additionally, the chest wall becomes stiffer and less compliant due to
calcification of the costal cartilages. These changes result in a decreased forced expiratory volume (FEV1)
and a lower partial pressure of arterial oxygen. Understanding these baseline changes is essential when
evaluating an older patient for respiratory distress or chronic lung disease.
5. The ‘Mini-Cog’ is a rapid screening tool for dementia. What are the two components of this assessment?
A. Orientation to time and place
B. Reading a sentence and copying a design
C. Serial 7s and naming objects
D. 3-item word recall and clock drawing
Correct Answer: D
Rationale: The Mini-Cog is a highly efficient screening instrument that takes only about three minutes to
administer in a primary care setting. It consists of a three-item word recall test to assess short-term
memory and a clock-drawing test to evaluate executive function and visuospatial skills. A score of 0-2 out
of 5 generally indicates a higher likelihood of clinically significant cognitive impairment. This tool is less
, affected by education level or language barriers than the Mini-Mental State Examination (MMSE). It
serves as an excellent initial step in a comprehensive geriatric assessment to determine the need for
further diagnostic testing.
6. Which of the following describes the condition ‘Presbycusis’ in the geriatric population?
A. Conductive hearing loss due to cerumen impaction
B. Age-related high-frequency sensorineural hearing loss
C. Low-frequency hearing loss caused by middle ear infection
D. Tinnitus caused by aspirin toxicity
Correct Answer: B
Rationale: Presbycusis is the most common type of sensorineural hearing loss found in the aging
population. It typically manifests as a progressive, bilateral, and symmetrical loss of high-frequency
hearing. Patients often complain that they can hear people speaking but cannot understand the specific
words, especially in noisy environments. This condition results from the degeneration of cochlear hair
cells and changes in the auditory nerve. Early identification through screening is vital as untreated
hearing loss is linked to social isolation, depression, and cognitive decline.
7. What is the primary reason for a decrease in the Glomerular Filtration Rate (GFR) in older adults even
when serum creatinine remains within normal limits?
A. Increased protein intake in the elderly
B. Improved renal blood flow with age
C. Hypertrophy of the nephrons
D. Loss of muscle mass (sarcopenia)
Correct Answer: D
