NR 601 Exam 3: Primary Care Aging - Chamberlain
University Updated and Latest Questions and Correct
Answers with Rationale
1. An 82-year-old patient presents with acute confusion, inattention, and fluctuating consciousness after a
recent hip surgery. Which tool is most appropriate for diagnosing this condition?
A. PHQ-9
B. Mini-Mental State Exam (MMSE)
C. Confusion Assessment Method (CAM)
D. Geriatric Depression Scale (GDS)
Correct Answer: C
Rationale: The Confusion Assessment Method (CAM) is the gold standard for identifying delirium in the
clinical setting. It focuses on acute onset, inattention, and either disorganized thinking or altered
consciousness levels. Early identification of delirium is crucial because the condition is often reversible if
the underlying cause is addressed. Nurse practitioners must distinguish these acute changes from the
gradual cognitive decline seen in dementia. Proper diagnosis allows for immediate intervention and
reduces the risk of long-term cognitive impairment.
2. A patient with moderate Alzheimer’s disease is prescribed Donepezil (Aricept). Which common side effect
should the provider counsel the family about?
A. Gastrointestinal upset and diarrhea
B. Hypertension and palpitations
C. Urinary retention and constipation
D. Increased appetite and weight gain
,Correct Answer: A
Rationale: Cholinesterase inhibitors like Donepezil commonly cause gastrointestinal side effects such as
nausea, vomiting, and diarrhea. These symptoms are related to increased cholinergic activity in the gut
and are dose-dependent. Education on taking the medication with food can sometimes help mitigate
these uncomfortable effects. Providers should monitor for weight loss and hydration status during the
initial titration phase. Ensuring caregiver understanding of side effects improves medication adherence
and patient comfort.
3. Which type of dementia is most likely associated with vivid visual hallucinations, parkinsonism, and
fluctuating cognition?
A. Vascular Dementia
B. Lewy Body Dementia
C. Frontotemporal Dementia
D. Alzheimer’s Disease
Correct Answer: B
Rationale: Lewy Body Dementia (LBD) is characterized by the presence of visual hallucinations and
motor features of Parkinson’s disease. Patients often experience significant fluctuations in alertness and
cognitive performance throughout the day. Distinguishing LBD from Alzheimer’s is important because
LBD patients may have severe sensitivities to neuroleptic medications. Management requires a
multidisciplinary approach focusing on both cognitive and motor symptoms. Accurate diagnosis guides
the selection of appropriate pharmacological treatments to avoid adverse drug reactions.
4. A 75-year-old male with a history of stroke and hypertension shows a ‘step-wise’ decline in cognitive
function. What is the most likely diagnosis?
A. Alzheimer’s Disease
,B. Normal Pressure Hydrocephalus
C. Vascular Dementia
D. Wernicke-Korsakoff Syndrome
Correct Answer: C
Rationale: Vascular dementia typically presents with a step-wise decline following discrete
cerebrovascular events like strokes or TIAs. This pattern differs from the smooth, progressive decline
usually seen in Alzheimer’s disease. Controlling cardiovascular risk factors such as blood pressure and
cholesterol is essential to slow progression. Providers should perform neuroimaging to confirm the
presence of vascular changes in the brain. Comprehensive care involves addressing both the physical and
cognitive sequelae of vascular disease.
5. During a fall risk assessment, a patient performs the Timed Up and Go (TUG) test in 15 seconds. How
should the provider interpret this result?
A. Normal mobility with low fall risk
B. Superior athletic performance
C. The test was performed incorrectly
D. Increased risk of falls requiring intervention
Correct Answer: D
Rationale: A TUG test score of 12 seconds or more is generally considered indicative of an increased risk
for falls. This screening tool measures the time it takes for a patient to stand, walk three meters, turn, and
sit back down. Patients exceeding the threshold should undergo a more thorough evaluation of their gait
and balance. Interventions may include physical therapy, strength training, or the use of assistive devices.
Reducing fall risk is a primary goal in geriatric care to prevent fractures and loss of independence.
, 6. A provider is screening an older adult for depression using the Geriatric Depression Scale (GDS) short
form. Which score is generally considered positive for depression?
A. 0 to 2
B. 5 or more
C. Only a 15
D. The GDS is not used for depression
Correct Answer: B
Rationale: A score of 5 or higher on the 15-item Geriatric Depression Scale suggests the presence of
clinical depression. The GDS is specifically designed for older adults and minimizes the focus on somatic
symptoms which can overlap with aging. High scores should prompt a follow-up diagnostic interview to
confirm the diagnosis and assess severity. Effective screening allows for timely initiation of therapy or
SSRIs to improve quality of life. Regular monitoring of the GDS score can track the patient’s response to
treatment over time.
7. According to the Beers Criteria, which medication class should be avoided in older adults due to high risks
of falls and delirium?
A. SSRIs
B. ACE Inhibitors
C. Benzodiazepines
D. Statins
Correct Answer: C
Rationale: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate for older adults
due to risks of falls, fractures, and delirium. Aging changes the metabolism of these drugs, leading to
University Updated and Latest Questions and Correct
Answers with Rationale
1. An 82-year-old patient presents with acute confusion, inattention, and fluctuating consciousness after a
recent hip surgery. Which tool is most appropriate for diagnosing this condition?
A. PHQ-9
B. Mini-Mental State Exam (MMSE)
C. Confusion Assessment Method (CAM)
D. Geriatric Depression Scale (GDS)
Correct Answer: C
Rationale: The Confusion Assessment Method (CAM) is the gold standard for identifying delirium in the
clinical setting. It focuses on acute onset, inattention, and either disorganized thinking or altered
consciousness levels. Early identification of delirium is crucial because the condition is often reversible if
the underlying cause is addressed. Nurse practitioners must distinguish these acute changes from the
gradual cognitive decline seen in dementia. Proper diagnosis allows for immediate intervention and
reduces the risk of long-term cognitive impairment.
2. A patient with moderate Alzheimer’s disease is prescribed Donepezil (Aricept). Which common side effect
should the provider counsel the family about?
A. Gastrointestinal upset and diarrhea
B. Hypertension and palpitations
C. Urinary retention and constipation
D. Increased appetite and weight gain
,Correct Answer: A
Rationale: Cholinesterase inhibitors like Donepezil commonly cause gastrointestinal side effects such as
nausea, vomiting, and diarrhea. These symptoms are related to increased cholinergic activity in the gut
and are dose-dependent. Education on taking the medication with food can sometimes help mitigate
these uncomfortable effects. Providers should monitor for weight loss and hydration status during the
initial titration phase. Ensuring caregiver understanding of side effects improves medication adherence
and patient comfort.
3. Which type of dementia is most likely associated with vivid visual hallucinations, parkinsonism, and
fluctuating cognition?
A. Vascular Dementia
B. Lewy Body Dementia
C. Frontotemporal Dementia
D. Alzheimer’s Disease
Correct Answer: B
Rationale: Lewy Body Dementia (LBD) is characterized by the presence of visual hallucinations and
motor features of Parkinson’s disease. Patients often experience significant fluctuations in alertness and
cognitive performance throughout the day. Distinguishing LBD from Alzheimer’s is important because
LBD patients may have severe sensitivities to neuroleptic medications. Management requires a
multidisciplinary approach focusing on both cognitive and motor symptoms. Accurate diagnosis guides
the selection of appropriate pharmacological treatments to avoid adverse drug reactions.
4. A 75-year-old male with a history of stroke and hypertension shows a ‘step-wise’ decline in cognitive
function. What is the most likely diagnosis?
A. Alzheimer’s Disease
,B. Normal Pressure Hydrocephalus
C. Vascular Dementia
D. Wernicke-Korsakoff Syndrome
Correct Answer: C
Rationale: Vascular dementia typically presents with a step-wise decline following discrete
cerebrovascular events like strokes or TIAs. This pattern differs from the smooth, progressive decline
usually seen in Alzheimer’s disease. Controlling cardiovascular risk factors such as blood pressure and
cholesterol is essential to slow progression. Providers should perform neuroimaging to confirm the
presence of vascular changes in the brain. Comprehensive care involves addressing both the physical and
cognitive sequelae of vascular disease.
5. During a fall risk assessment, a patient performs the Timed Up and Go (TUG) test in 15 seconds. How
should the provider interpret this result?
A. Normal mobility with low fall risk
B. Superior athletic performance
C. The test was performed incorrectly
D. Increased risk of falls requiring intervention
Correct Answer: D
Rationale: A TUG test score of 12 seconds or more is generally considered indicative of an increased risk
for falls. This screening tool measures the time it takes for a patient to stand, walk three meters, turn, and
sit back down. Patients exceeding the threshold should undergo a more thorough evaluation of their gait
and balance. Interventions may include physical therapy, strength training, or the use of assistive devices.
Reducing fall risk is a primary goal in geriatric care to prevent fractures and loss of independence.
, 6. A provider is screening an older adult for depression using the Geriatric Depression Scale (GDS) short
form. Which score is generally considered positive for depression?
A. 0 to 2
B. 5 or more
C. Only a 15
D. The GDS is not used for depression
Correct Answer: B
Rationale: A score of 5 or higher on the 15-item Geriatric Depression Scale suggests the presence of
clinical depression. The GDS is specifically designed for older adults and minimizes the focus on somatic
symptoms which can overlap with aging. High scores should prompt a follow-up diagnostic interview to
confirm the diagnosis and assess severity. Effective screening allows for timely initiation of therapy or
SSRIs to improve quality of life. Regular monitoring of the GDS score can track the patient’s response to
treatment over time.
7. According to the Beers Criteria, which medication class should be avoided in older adults due to high risks
of falls and delirium?
A. SSRIs
B. ACE Inhibitors
C. Benzodiazepines
D. Statins
Correct Answer: C
Rationale: Benzodiazepines are listed in the Beers Criteria as potentially inappropriate for older adults
due to risks of falls, fractures, and delirium. Aging changes the metabolism of these drugs, leading to
