CHAMBERLAIN UNIVERSITY
NR601 Midterm Exam Study Guide
Primary Care of the Maturing & Aged Family
Official Practice Exam - 2026/2027 Edition
Weeks 1-4 Content | Verified Questions and Answers | A+ Graded
Questions: 75 | Minutes: 90 | Passing Score: 80% | Midterm Exam
TABLE OF CONTENTS
Section 1: Health Promotion & Disease Prevention in Older Adults ........ Q1 - Q15
Section 2: Geriatric Assessment & Screening .............................. Q16 - Q30
Section 3: Common Geriatric Syndromes ................................... Q31 - Q45
Section 4: Chronic Disease Management in Aging ........................... Q46 - Q60
Instructions Section 5: Pharmacology & Polypharmacy in Older Adults ................... Q61 - Q75
This practice exam contains 75 multiple-choice questions covering Weeks 1 through 4 of NR601. Each question
presents a clinical scenario followed by four answer options. Select the single best answer. A correct answer and
rationale follow each question. A complete answer key appears on the final page. You have 90 minutes to
complete this exam. A score of 80% or higher (60 of 75 questions correct) is required to pass. This study guide is
designed to reinforce high-yield concepts and clinical decision-making for the midterm examination.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 1 of TOTAL
, Section: Health Promotion & Disease Prevention in Older Adults - 2026/2027
Q1 Question 1 of 75
A 72-year-old woman presents for her annual wellness visit. She lives independently,
walks 30 minutes daily, and has no chronic conditions. The nurse practitioner reviews the
recommended immunizations for her age group. Which vaccination schedule is most
appropriate for this patient?
A. Influenza annually, Tdap once then Td every 10 years, pneumococcal PCV20, and
shingles recombinant
B. Influenza annually, Tdap every 5 years, pneumococcal PPSV23 only, and shingles live vaccine
C. Influenza every 2 years, Td every 10 years, pneumococcal PCV13, and shingles recombinant
D. Influenza annually, Tdap once then Td every 10 years, pneumococcal PPSV23 only, and no
shingles vaccine needed
Correct Answer: A
Rationale:
The current CDC recommendation for adults 65 and older includes annual influenza, a single Tdap followed by
Td boosters every 10 years, pneumococcal PCV20 (which replaces the older PCV15/PPSV23 sequence for
most patients), and the recombinant shingles vaccine (Shingrix). Option B is incorrect because Tdap is not
repeated every 5 years and the live shingles vaccine is no longer recommended.
Q2 Question 2 of 75
A 68-year-old man with well-controlled hypertension asks about starting an exercise
program. He currently leads a sedentary lifestyle and expresses concern about cardiac risk
with physical activity. What is the most appropriate recommendation?
A. Refer him for a stress echocardiogram before initiating any exercise program
B. Recommend 150 minutes per week of moderate-intensity aerobic activity with a gradual
ramp-up period
C. Advise him to limit exercise to light stretching and avoid aerobic activity given his hypertension
D. Prescribe a beta-blocker before he begins any moderate-intensity exercise regimen
Correct Answer: B
Rationale:
Current guidelines recommend at least 150 minutes of moderate-intensity aerobic exercise weekly for older
adults, even those with controlled hypertension, as it lowers cardiovascular risk. A gradual ramp-up reduces
injury risk. Routine stress testing before exercise is not indicated for asymptomatic patients beginning
moderate-intensity programs. Option A represents unnecessary testing, and option C would deprive the patient
of established cardiovascular benefits.
, Q3 Question 3 of 75
An 80-year-old female patient is found to have a BMI of 19.2 kg/m2 during a routine visit.
She reports unintentional weight loss of 8 pounds over the past 6 months. She lives alone
and admits to skipping meals. What is the most appropriate first-step nutritional
intervention?
A. Prescribe oral corticosteroids to stimulate appetite and promote weight gain
B. Recommend a strict 2000-calorie daily meal plan with full dietary compliance tracking
C. Perform a comprehensive nutritional assessment and initiate oral nutritional
supplements between meals
D. Place a percutaneous endoscopic gastrostomy tube to ensure adequate caloric intake
Correct Answer: C
Rationale:
Unintentional weight loss in an older adult warrants a comprehensive nutritional assessment before any
intervention. Oral nutritional supplements between meals are a first-line evidence-based approach for
community-dwelling older adults with weight loss. Corticosteroids carry significant risks in older adults. PEG tube
placement is invasive and not indicated as a first step for a patient who can still swallow and take oral intake.
Q4 Question 4 of 75
A 75-year-old patient with type 2 diabetes mellitus has an A1C of 7.8%. He also has stage
3 chronic kidney disease and mild heart failure. The nurse practitioner is reviewing his
glycemic targets. What A1C goal is most appropriate for this patient?
A. A1C below 6.5% to minimize microvascular complications
B. A1C below 7.0% as recommended for all older adults regardless of comorbidities
C. A1C below 6.0% to reverse early kidney damage
D. A1C below 8.0% given his comorbidities and limited life expectancy considerations
Correct Answer: D
Rationale:
The American Diabetes Association and AGS Beers Criteria recommend less stringent glycemic targets (A1C
below 7.5-8.5%) for older adults with multiple comorbidities, limited life expectancy, or high hypoglycemia risk.
An A1C below 6.5% or 7.0% increases hypoglycemia risk in patients with CKD and heart failure. Individualizing
targets is essential in geriatric diabetes management.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 3 of 99
, Q5 Question 5 of 75
A 70-year-old man presents for a Medicare Annual Wellness Visit. He has never had a
colorectal cancer screening. He has no family history of colorectal cancer and no
gastrointestinal symptoms. What is the most appropriate screening recommendation?
A. Offer a colonoscopy every 10 years or a fecal immunochemical test annually as
screening options
B. Recommend a barium enema every 5 years as the preferred screening modality
C. Advise that screening is no longer recommended after age 70
D. Order a CT colonography annually beginning at age 70
Correct Answer: A
Rationale:
USPSTF guidelines recommend colorectal cancer screening for adults aged 45-75, with individualized decisions
for those 76-85. Colonoscopy every 10 years and FIT annually are both acceptable first-tier screening options.
Option C is incorrect because age 70 is still within the recommended screening window. Barium enema is no
longer a preferred modality.
Q6 Question 6 of 75
A 77-year-old woman with osteopenia asks about fall prevention strategies. She has fallen
once in the past year but did not sustain a fracture. She lives in a two-story home and
takes hydrochlorothiazide for hypertension. What is the most important first step in fall
prevention for this patient?
A. Discontinue hydrochlorothiazide immediately to eliminate orthostatic hypotension risk
B. Conduct a multifactorial fall risk assessment including medication review, home safety
evaluation, and gait testing
C. Recommend she move to a single-story residence to eliminate stair-related fall risk
D. Prescribe a bisphosphonate to reduce fracture risk if she falls again
Correct Answer: B
Rationale:
A multifactorial fall risk assessment is the gold standard for older adults who have fallen. This includes reviewing
medications (not necessarily discontinuing them), evaluating home safety, assessing gait and balance, and
checking vision. Simply stopping hydrochlorothiazide without assessment could worsen blood pressure control.
Moving homes is not a first-line recommendation. Bisphosphonates address fracture risk, not fall risk.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 4 of 99
NR601 Midterm Exam Study Guide
Primary Care of the Maturing & Aged Family
Official Practice Exam - 2026/2027 Edition
Weeks 1-4 Content | Verified Questions and Answers | A+ Graded
Questions: 75 | Minutes: 90 | Passing Score: 80% | Midterm Exam
TABLE OF CONTENTS
Section 1: Health Promotion & Disease Prevention in Older Adults ........ Q1 - Q15
Section 2: Geriatric Assessment & Screening .............................. Q16 - Q30
Section 3: Common Geriatric Syndromes ................................... Q31 - Q45
Section 4: Chronic Disease Management in Aging ........................... Q46 - Q60
Instructions Section 5: Pharmacology & Polypharmacy in Older Adults ................... Q61 - Q75
This practice exam contains 75 multiple-choice questions covering Weeks 1 through 4 of NR601. Each question
presents a clinical scenario followed by four answer options. Select the single best answer. A correct answer and
rationale follow each question. A complete answer key appears on the final page. You have 90 minutes to
complete this exam. A score of 80% or higher (60 of 75 questions correct) is required to pass. This study guide is
designed to reinforce high-yield concepts and clinical decision-making for the midterm examination.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 1 of TOTAL
, Section: Health Promotion & Disease Prevention in Older Adults - 2026/2027
Q1 Question 1 of 75
A 72-year-old woman presents for her annual wellness visit. She lives independently,
walks 30 minutes daily, and has no chronic conditions. The nurse practitioner reviews the
recommended immunizations for her age group. Which vaccination schedule is most
appropriate for this patient?
A. Influenza annually, Tdap once then Td every 10 years, pneumococcal PCV20, and
shingles recombinant
B. Influenza annually, Tdap every 5 years, pneumococcal PPSV23 only, and shingles live vaccine
C. Influenza every 2 years, Td every 10 years, pneumococcal PCV13, and shingles recombinant
D. Influenza annually, Tdap once then Td every 10 years, pneumococcal PPSV23 only, and no
shingles vaccine needed
Correct Answer: A
Rationale:
The current CDC recommendation for adults 65 and older includes annual influenza, a single Tdap followed by
Td boosters every 10 years, pneumococcal PCV20 (which replaces the older PCV15/PPSV23 sequence for
most patients), and the recombinant shingles vaccine (Shingrix). Option B is incorrect because Tdap is not
repeated every 5 years and the live shingles vaccine is no longer recommended.
Q2 Question 2 of 75
A 68-year-old man with well-controlled hypertension asks about starting an exercise
program. He currently leads a sedentary lifestyle and expresses concern about cardiac risk
with physical activity. What is the most appropriate recommendation?
A. Refer him for a stress echocardiogram before initiating any exercise program
B. Recommend 150 minutes per week of moderate-intensity aerobic activity with a gradual
ramp-up period
C. Advise him to limit exercise to light stretching and avoid aerobic activity given his hypertension
D. Prescribe a beta-blocker before he begins any moderate-intensity exercise regimen
Correct Answer: B
Rationale:
Current guidelines recommend at least 150 minutes of moderate-intensity aerobic exercise weekly for older
adults, even those with controlled hypertension, as it lowers cardiovascular risk. A gradual ramp-up reduces
injury risk. Routine stress testing before exercise is not indicated for asymptomatic patients beginning
moderate-intensity programs. Option A represents unnecessary testing, and option C would deprive the patient
of established cardiovascular benefits.
, Q3 Question 3 of 75
An 80-year-old female patient is found to have a BMI of 19.2 kg/m2 during a routine visit.
She reports unintentional weight loss of 8 pounds over the past 6 months. She lives alone
and admits to skipping meals. What is the most appropriate first-step nutritional
intervention?
A. Prescribe oral corticosteroids to stimulate appetite and promote weight gain
B. Recommend a strict 2000-calorie daily meal plan with full dietary compliance tracking
C. Perform a comprehensive nutritional assessment and initiate oral nutritional
supplements between meals
D. Place a percutaneous endoscopic gastrostomy tube to ensure adequate caloric intake
Correct Answer: C
Rationale:
Unintentional weight loss in an older adult warrants a comprehensive nutritional assessment before any
intervention. Oral nutritional supplements between meals are a first-line evidence-based approach for
community-dwelling older adults with weight loss. Corticosteroids carry significant risks in older adults. PEG tube
placement is invasive and not indicated as a first step for a patient who can still swallow and take oral intake.
Q4 Question 4 of 75
A 75-year-old patient with type 2 diabetes mellitus has an A1C of 7.8%. He also has stage
3 chronic kidney disease and mild heart failure. The nurse practitioner is reviewing his
glycemic targets. What A1C goal is most appropriate for this patient?
A. A1C below 6.5% to minimize microvascular complications
B. A1C below 7.0% as recommended for all older adults regardless of comorbidities
C. A1C below 6.0% to reverse early kidney damage
D. A1C below 8.0% given his comorbidities and limited life expectancy considerations
Correct Answer: D
Rationale:
The American Diabetes Association and AGS Beers Criteria recommend less stringent glycemic targets (A1C
below 7.5-8.5%) for older adults with multiple comorbidities, limited life expectancy, or high hypoglycemia risk.
An A1C below 6.5% or 7.0% increases hypoglycemia risk in patients with CKD and heart failure. Individualizing
targets is essential in geriatric diabetes management.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 3 of 99
, Q5 Question 5 of 75
A 70-year-old man presents for a Medicare Annual Wellness Visit. He has never had a
colorectal cancer screening. He has no family history of colorectal cancer and no
gastrointestinal symptoms. What is the most appropriate screening recommendation?
A. Offer a colonoscopy every 10 years or a fecal immunochemical test annually as
screening options
B. Recommend a barium enema every 5 years as the preferred screening modality
C. Advise that screening is no longer recommended after age 70
D. Order a CT colonography annually beginning at age 70
Correct Answer: A
Rationale:
USPSTF guidelines recommend colorectal cancer screening for adults aged 45-75, with individualized decisions
for those 76-85. Colonoscopy every 10 years and FIT annually are both acceptable first-tier screening options.
Option C is incorrect because age 70 is still within the recommended screening window. Barium enema is no
longer a preferred modality.
Q6 Question 6 of 75
A 77-year-old woman with osteopenia asks about fall prevention strategies. She has fallen
once in the past year but did not sustain a fracture. She lives in a two-story home and
takes hydrochlorothiazide for hypertension. What is the most important first step in fall
prevention for this patient?
A. Discontinue hydrochlorothiazide immediately to eliminate orthostatic hypotension risk
B. Conduct a multifactorial fall risk assessment including medication review, home safety
evaluation, and gait testing
C. Recommend she move to a single-story residence to eliminate stair-related fall risk
D. Prescribe a bisphosphonate to reduce fracture risk if she falls again
Correct Answer: B
Rationale:
A multifactorial fall risk assessment is the gold standard for older adults who have fallen. This includes reviewing
medications (not necessarily discontinuing them), evaluating home safety, assessing gait and balance, and
checking vision. Simply stopping hydrochlorothiazide without assessment could worsen blood pressure control.
Moving homes is not a first-line recommendation. Bisphosphonates address fracture risk, not fall risk.
NR601 Midterm Study Guide - 2026/2027 | Passing Score: 80% | Page 4 of 99
