1|Page
NR 601 MIDTERM EXAM 1 –QUESTION AND ANSWERS LATEST 2025,
EXAMS OF NURSING
A 60-year-old male patient presents with severe comorbidities that include history of MI,
hypertension, type 2 diabetes, and obesity. He reports feeling like his heart is skipping beats. He
is also experiencing dyspnea at rest and on exertion that is associated with fatigue. He also
reports two falls over the last month period on exam the NP notes and irregular rhythm. Which
of the following conditions should be included as a differential diagnosis?
Atrial fibrillation
A 69 year old male presents to the primary care clinic for follow up for the treatment of afib. As
the NP plans to prescribe an anticoagulant at today's visit she is aware that the patient has a
history of moderate mitral valve stenosis. Which anticoagulant is recommended for this
patient?
Warfarin (Coumadin)
Which of the following is not true regarding the low rates of successful treatment for
hypertension in older adults?
Among persons greater than or equal to 60 years of age, at least 70% will have their blood
pressure under control
As people age, what abnormal parameter is the best predictor of heart disease?
widening pulse pressure
According to ACC/AHRA guidelines for maintaining hypertension when should treatment be
initiated for adults greater than or equal to 65 years of age?
When the average SBP is greater than 130 mmHg
A 62-year-old male patient is diagnosed with uncomplicated hypertension. According to JNC-8
guidelines what classifications are recommended for first line treatment in this age group?
Calcium channel blocker and diuretic
A 70-year-old female with atrial fibrillation has an associated rapid ventricular response (AF
RVR). The NP recognizes that the long-term management of heart rate can prevent morbidity
from afib RVR. What medication should the NP prescribe for a long-term management of heart
rate in afib RVR?
Diltiazem
,2|Page
The NP is performing a cardiac exam on an 80-year-old patient with heart failure and here's an
S4 gallop. The MP recognizes that this heart sound may be common in older adults with heart
failure due to:
stiffness of the left ventricle
The NP identifies an elevated NT-proBNP and a 78-year-old female patient. Before making a
diagnosis of heart failure what important factors should be considered as a reason for the
elevated value?
The value may be elevated in older patients who have renal disease
After a trial of lifestyle modification, a 72 year old male has a blood pressure of 150/ 90. What
do you do next?
Prescribe the patient an antihypertensive drug in addition to lifestyle modifications
A 65-year-old male is a new patient that presents to the primary care office with increasing
dyspnea and a productive cough that started four days ago. The cough has been on and off for
the last six months. He reports smoking one pack of cigarettes per day since age of 25, but
recently cut back to 1/2 pack per day. One assessment the MP observes the patients increased
effort to breathe. On exam and P notes the presence of wheezing and rock eye. Due to the
patient's increased breathing effort smoking history and chronic cough the emphasis effect
COPD. To confirm the diagnosis what should the NP order first?
Spirometry to classify airway obstruction
Which of the following spirometry classifications indicate a moderate airflow obstruction
according to the GC guidelines?
50% _< FEVI < 80% predicted
The treatment of COPD is based on the patient's clinical symptoms and the number of recent
exacerbations that may or may not lead to hospitalization. According to the gold guidelines, the
recommended treatment for a patient who has had zero or one moderate exacerbations
requiring no hospitalization and an MRC 0-1, CAT <10 is?
A bronchodilator
The FeV1/FVC ratio for a patient with a restrictive lung disorder indicates:
Asthma
A 60-year-old male presents with dyspnea, nonproductive cough, inspiratory rails and clubbing
interstitial lung disease. Which of the following diagnostic findings would support a diagnosis?
,3|Page
High resolution CT scan shows honeycombing
The benefit of the six-minute walk test is that it can help the NP determine:
The patient's supplemental oxygen needs on exertion
There are well described racial and socioeconomic disparities in diagnosing lung cancer,
treatment of the following populations has the higher incidence and lower survival rates of lung
cancer?
Black and Hispanic older adults in general
For older adults with early-stage non-small cell lung cancer what is the appropriate treatment
for those who are strong candidates?
Lung resection
The NP has determined that a 72-year-old female patient that she has been following for the
last four years for anemia evaluation. Which clinical data below guided the NP's decision?
A 1 g/dL decrease in Hgb in less than 5 years
The NP has diagnosed iron deficiency anemia in her 66-year-old male patient. To establish the
ideology of the ID a comma what is the next action by the NP?
Order fecal guaiac tests and endoscopy
The NP is challenged to determine if her 70 year old patients anemia is due to iron deficiency
anemia or anemia of chronic inflammation. Because the patient has advanced cancer and a
ferritin level of less than 30 to 50 ng it is reasonable for the NP to:
Treat the patient for iron deficiency anemia
The NP identifies thrombocytopenia, neutropenia, and abnormal peripheral blood smear that is
unexplained. What is the NP's next action?
Refer the patient to a hematologist/oncologist for bone marrow examination
Chemotherapy related toxicity may occur in older adults. Nearly all antineoplastics cause:
Anemia and fatigue
Which of the following patients will benefit most from a geriatric assessment as part of
determining the best treatment of cancer?
A 72 year old female with lung cancer
, 4|Page
When performing an assessment, the NP recognizes that the metacarpophalangeal Joints are
frequently involved with?
Rheumatoid arthritis (RA)
The NP is examining a 64-year-old patient who is complaining of pain in her hips and knees. She
has a history of osteoarthritis. On exam the joints are painful to movement and are warm to
touch. The best immediate therapy for this patient is?
Physical therapy for range of motion of affected areas
There are well described racial and socioeconomic disparities in diagnosis, the following
populations have the higher incidence and lower survival
black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory loss and apathy. Which
intervention can best improve the brain's functional reserve?
decrease overstimulating the patient to avoid agitation
The NP is providing chronic management for a 74-year-old male with longstanding COPD. He
presents to the primary care office with increased shortness of breath to the point that he is
unable to walk to the mailbox or send a flight of stairs in his home. He reports that he still
smokes 1/4 pack of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's physical function is
due to:
disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to 50 years of age that
indicate the new reading glasses are due to
reduced lens elasticity
-year-old male reports to the primary care office with a complaint of feeling down since the
death of his spouse eight months ago. He has suppressed his depression through the use of
alcohol. His medical history includes gerd, atrial fibrillation, and chronic back pain. His
medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams daily, pantoprazole 40
milligrams daily, lisinopril 10 milligrams daily, Flomax 0.4 milligrams daily, multivitamin daily,
vitamin C 500 milligrams daily, and vitamin D 1000 IU daily. The MP decides to perform the cage
assessment to determine the patient's extent of alcohol dependency and obtains a score of
NR 601 MIDTERM EXAM 1 –QUESTION AND ANSWERS LATEST 2025,
EXAMS OF NURSING
A 60-year-old male patient presents with severe comorbidities that include history of MI,
hypertension, type 2 diabetes, and obesity. He reports feeling like his heart is skipping beats. He
is also experiencing dyspnea at rest and on exertion that is associated with fatigue. He also
reports two falls over the last month period on exam the NP notes and irregular rhythm. Which
of the following conditions should be included as a differential diagnosis?
Atrial fibrillation
A 69 year old male presents to the primary care clinic for follow up for the treatment of afib. As
the NP plans to prescribe an anticoagulant at today's visit she is aware that the patient has a
history of moderate mitral valve stenosis. Which anticoagulant is recommended for this
patient?
Warfarin (Coumadin)
Which of the following is not true regarding the low rates of successful treatment for
hypertension in older adults?
Among persons greater than or equal to 60 years of age, at least 70% will have their blood
pressure under control
As people age, what abnormal parameter is the best predictor of heart disease?
widening pulse pressure
According to ACC/AHRA guidelines for maintaining hypertension when should treatment be
initiated for adults greater than or equal to 65 years of age?
When the average SBP is greater than 130 mmHg
A 62-year-old male patient is diagnosed with uncomplicated hypertension. According to JNC-8
guidelines what classifications are recommended for first line treatment in this age group?
Calcium channel blocker and diuretic
A 70-year-old female with atrial fibrillation has an associated rapid ventricular response (AF
RVR). The NP recognizes that the long-term management of heart rate can prevent morbidity
from afib RVR. What medication should the NP prescribe for a long-term management of heart
rate in afib RVR?
Diltiazem
,2|Page
The NP is performing a cardiac exam on an 80-year-old patient with heart failure and here's an
S4 gallop. The MP recognizes that this heart sound may be common in older adults with heart
failure due to:
stiffness of the left ventricle
The NP identifies an elevated NT-proBNP and a 78-year-old female patient. Before making a
diagnosis of heart failure what important factors should be considered as a reason for the
elevated value?
The value may be elevated in older patients who have renal disease
After a trial of lifestyle modification, a 72 year old male has a blood pressure of 150/ 90. What
do you do next?
Prescribe the patient an antihypertensive drug in addition to lifestyle modifications
A 65-year-old male is a new patient that presents to the primary care office with increasing
dyspnea and a productive cough that started four days ago. The cough has been on and off for
the last six months. He reports smoking one pack of cigarettes per day since age of 25, but
recently cut back to 1/2 pack per day. One assessment the MP observes the patients increased
effort to breathe. On exam and P notes the presence of wheezing and rock eye. Due to the
patient's increased breathing effort smoking history and chronic cough the emphasis effect
COPD. To confirm the diagnosis what should the NP order first?
Spirometry to classify airway obstruction
Which of the following spirometry classifications indicate a moderate airflow obstruction
according to the GC guidelines?
50% _< FEVI < 80% predicted
The treatment of COPD is based on the patient's clinical symptoms and the number of recent
exacerbations that may or may not lead to hospitalization. According to the gold guidelines, the
recommended treatment for a patient who has had zero or one moderate exacerbations
requiring no hospitalization and an MRC 0-1, CAT <10 is?
A bronchodilator
The FeV1/FVC ratio for a patient with a restrictive lung disorder indicates:
Asthma
A 60-year-old male presents with dyspnea, nonproductive cough, inspiratory rails and clubbing
interstitial lung disease. Which of the following diagnostic findings would support a diagnosis?
,3|Page
High resolution CT scan shows honeycombing
The benefit of the six-minute walk test is that it can help the NP determine:
The patient's supplemental oxygen needs on exertion
There are well described racial and socioeconomic disparities in diagnosing lung cancer,
treatment of the following populations has the higher incidence and lower survival rates of lung
cancer?
Black and Hispanic older adults in general
For older adults with early-stage non-small cell lung cancer what is the appropriate treatment
for those who are strong candidates?
Lung resection
The NP has determined that a 72-year-old female patient that she has been following for the
last four years for anemia evaluation. Which clinical data below guided the NP's decision?
A 1 g/dL decrease in Hgb in less than 5 years
The NP has diagnosed iron deficiency anemia in her 66-year-old male patient. To establish the
ideology of the ID a comma what is the next action by the NP?
Order fecal guaiac tests and endoscopy
The NP is challenged to determine if her 70 year old patients anemia is due to iron deficiency
anemia or anemia of chronic inflammation. Because the patient has advanced cancer and a
ferritin level of less than 30 to 50 ng it is reasonable for the NP to:
Treat the patient for iron deficiency anemia
The NP identifies thrombocytopenia, neutropenia, and abnormal peripheral blood smear that is
unexplained. What is the NP's next action?
Refer the patient to a hematologist/oncologist for bone marrow examination
Chemotherapy related toxicity may occur in older adults. Nearly all antineoplastics cause:
Anemia and fatigue
Which of the following patients will benefit most from a geriatric assessment as part of
determining the best treatment of cancer?
A 72 year old female with lung cancer
, 4|Page
When performing an assessment, the NP recognizes that the metacarpophalangeal Joints are
frequently involved with?
Rheumatoid arthritis (RA)
The NP is examining a 64-year-old patient who is complaining of pain in her hips and knees. She
has a history of osteoarthritis. On exam the joints are painful to movement and are warm to
touch. The best immediate therapy for this patient is?
Physical therapy for range of motion of affected areas
There are well described racial and socioeconomic disparities in diagnosis, the following
populations have the higher incidence and lower survival
black and hispanic older adults in general
A 72 yo female has residual effects from a stroke that includes memory loss and apathy. Which
intervention can best improve the brain's functional reserve?
decrease overstimulating the patient to avoid agitation
The NP is providing chronic management for a 74-year-old male with longstanding COPD. He
presents to the primary care office with increased shortness of breath to the point that he is
unable to walk to the mailbox or send a flight of stairs in his home. He reports that he still
smokes 1/4 pack of cigarettes per day. He tells the NP I guess I'm just getting too old to do
normal things anymore. The NP recognizes that the decline in the patient's physical function is
due to:
disease-related disability
The physiologic eye changes that occur in adults between the ages of 42 to 50 years of age that
indicate the new reading glasses are due to
reduced lens elasticity
-year-old male reports to the primary care office with a complaint of feeling down since the
death of his spouse eight months ago. He has suppressed his depression through the use of
alcohol. His medical history includes gerd, atrial fibrillation, and chronic back pain. His
medications include:
Cyclobenzaprine 10 milligrams as needed for pain, warfarin 5 milligrams daily, pantoprazole 40
milligrams daily, lisinopril 10 milligrams daily, Flomax 0.4 milligrams daily, multivitamin daily,
vitamin C 500 milligrams daily, and vitamin D 1000 IU daily. The MP decides to perform the cage
assessment to determine the patient's extent of alcohol dependency and obtains a score of
