NR 601 FINAL EXAM NEWEST 2025
NR 601 FINAL EXAM NEWEST 2025 LATEST UPDATE ACTUAL EXAM
WITH QUESTIONS AND VERIFIED ANSWERS ALREADY GRADED A+
A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A
localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph
nodes for metastatic sampling. The patient wants to know if he should have chemotherapy.
Should he? - ANSWER-No because he can be followed with serial carcinoembryonic antigens
and CT scans.
An 80-year-old woman has no weight loss, no pain, and no distention but over 2 years
increasingly complains of constipation despite adequate medical treatment. A colonoscopy is
negative. An abdominal CT is performed. It reveals well-circumscribed pelvic masses, the largest
adherent to the ovarian ligament. The best first step is: - ANSWER-Invite her to return with a
family member and have a long talk about the diagnostic and therapeutic options.
An 85-year-old man with chronic obstructive pulmonary disease presents to your office with his
daughter with the complaint of new onset chest pain, shortness of breath, and cough. He is
clearly tachypneic and has tactile fremitus and egophany and crackles heard at the right lung
base. His daughter just wants you to give him an antibiotic pill so that she can take him home.
You are concerned that he might need to be hospitalized and require IV antibiotics. What
statement is true? - ANSWER-Treatment decisions for pneumonia are based on its severity, the
presence of comorbid illnesses, and a prior history of MRSA or Pseudomonas respiratory
infection.
An 80-year-old woman that you follow in a nursing home has an acute decline in her mental
status. She has a fever >100° F, but no other focal complaints or findings on physical
examination except for a chronic indwelling urinary catheter. What statement is true? -
ANSWER-Fever in an older adult with an indwelling urinary catheter is an appropriate indication
to start empiric antibiotic therapy.
An 82-year-old woman receives oral amoxicillin-clavulate for a skin abscess on her leg. She
develops new onset of frequent watery stool that persists for several days after the antibiotic is
stopped. You obtain a stool for Clostridium difficile antigen, toxin, and polymerase chain
, NR 601 FINAL EXAM NEWEST 2025
reaction (PCR). The antigen and PCR are both positive. She has never had C. difficile infection
before. What one statement is the best answer regarding her management? - ANSWER-Either
vancomycin or fidaxomicin are recommended for the first episode of C. difficile infection.
A 75-year-old man presents with the chief concern, "I may have a bladder infection." Further
questioning reveals for several months he has been needing to void every couple of hours (can't
sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it
off and had urinary leakage), and is getting up two to three times at night to void. He denies
delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of
the following best describes the category or type of his lower urinary tract symptoms? -
ANSWER-Storage (irritative)
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with benign
prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle
modifications. He is interested in medication to reduce his urinary symptoms but is concerned
about possible side effects. He notes that he is recently married and sexual activity is very
important to him. Which of the following medications would be most appropriate for this
patient? - ANSWER-Alfusozin
A 66-year-old man complains of nocturia (three to four times a night), hesitancy, and
incomplete emptying of the bladder. Physical examination reveals an enlarged, nontender
prostate, about 40 g in size without discrete nodules. Urinalysis reveals hematuria without
leukocyte esterase. Upon further evaluation, the hematuria is attributed to his BPH. The patient
declines surgical options at this time. Which of the following medications would be most
appropriate? - ANSWER-Finasteride
Mr. Quince is a 68-year-old patient who describes several months of urinary frequency and a
sensation of incomplete emptying with no associated dysuria, hematuria, or fever. Physical
examination reveals a slightly enlarged but nontender prostate, a postvoid residual urine
volume of 20 mL, and a urinalysis with 15 white blood cells (WBCs) and 5 red blood cells (RBCs).
Urine culture reveals 30,000 colony-forming units of Escherichia coli. You see a report from last
year that shows urinalysis with 10 WBCs and 4 RBCs that was obtained as part of a routine
, NR 601 FINAL EXAM NEWEST 2025
evaluation. What is the most appropriate next step in the management of Mr. Quince's
symptoms? - ANSWER-Start a 4-week course of ciprofloxacin.
Mr. Roberts, a 72-year-old patient who has sought medical care on an intermittent basis in the
past, complains of aching discomfort in his perineal area, urinary urgency, and frequency for the
past few years. He also complains of insomnia and intermittent anxiety that he attributes to
loneliness after his wife's death about a year ago. Digital rectal examination (DRE) reveals a
slightly enlarged, nontender prostate with no palpable nodules. Perineal examination is normal.
Bladder scan is unremarkable and postvoid residual urine volume is 50 mL. Urinalysis shows no
WBCs or RBCs. Urine culture is negative. Previous treatment has included dietary modification
and alpha-blocker medication. What is the most appropriate next step? - ANSWER-Screen for
depression.
Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency that have increased
over the past several months. There is no dysuria, hematuria, or sensation of incomplete
voiding. He drinks 2 cups of coffee daily and diet cola multiple times a day. His International
Prostate Symptom Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms
with low impact on his quality of life. His medical history includes hypertension, coronary artery
disease, and benign prostatic hyperplasia. Current medications are aspirin, metoprolol, and
hydrochlorothiazide. Physical examination reveals normal sized prostate. Which of the following
is the best next step? - ANSWER-Lifestyle modifications
Two years later Mr. Hunter reports progression of his urinary symptoms and desires "a pill to
make this better." His current IPSS is 17, with a bother score of 3 indicating moderate voiding
symptoms with moderate impact on his quality of life. On review of systems he notes that his
vision has worsened, especially in his left eye. His ophthalmologist has recommended cataract
surgery. For which of the following medications would initiation of therapy be delayed until
after cataract surgery? - ANSWER-Tamsulosin
Several years later, Mr. Hunter, who is now 75 years old, seeks additional intervention for his
urinary symptoms that have progressed further. He now experiences slow urinary stream,
hesitancy, straining, and a feeling of incomplete emptying in addition to the previous urinary
urgency and frequency. At times, he has noted blood in his urine. He has had five urinary tract
infections (UTIs) in the past 2 years. His current IPSS is 24, with a bother score of 5 indicating
, NR 601 FINAL EXAM NEWEST 2025
severe voiding symptoms with high impact on his quality of life. Mr. Hunter's updated medical
history includes hypertension, coronary artery disease, benign prostatic hyperplasia, cataract
surgery 4 years ago, and two falls within the past year while rushing to the bathroom during the
night. Current medications are aspirin, metoprolol, finasteride, and tamsulosin. Physical
examination reveals an enlarged, nontender prostate, about 50 g in size without d - ANSWER-
Perform surgical resection of prostate.
The US Advisory Committee on Immunization Practices and the Centers for Disease Control
currently recommend which one of the following? - ANSWER-a. All older adults be immunized
against influenza annually and that they receive at least one pneumococcal vaccination. b. All
high-risk older adults should receive an additional pneumococcal vaccination 5 years or more
after their first immunization. c. Older adults should receive a one-time revaccination for
pneumonia if they were initially vaccinated more than 5 years previously and were less than 65
years of age at the time of the initial vaccination. d. All of these are recommended.
Healthcare providers should recommend that older adults engage in which one of the
following? - ANSWER-150 minutes of moderate intensity physical activity weekly
Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of
the following? - ANSWER-Individuals whose risk is high enough for the benefits to outweigh the
risks
Even though older adults are less likely to get counseled for smoking cessation, they have which
one of the following? - ANSWER-The same quit rates as younger individuals
A 67-year-old female with a history of congestive heart failure and myocardial infarction is
admitted to the hospital because of increasing altered mental status and decreased arousal over
the last week. Physical examination reveals a confused woman with right lower lobe crackles
and a pulse oximetry of 86% on room air. While you are interviewing the patient, she is irritable,
paranoid, and inattentive, which her family tells you is out of character. You notice waxing and
waning in her alertness and impaired short-term memory during your examination. Which one
of the following features present in this patient best distinguishes delirium from depression or
dementia? - ANSWER-Inattentiveness
NR 601 FINAL EXAM NEWEST 2025 LATEST UPDATE ACTUAL EXAM
WITH QUESTIONS AND VERIFIED ANSWERS ALREADY GRADED A+
A 78-year-old man has an emergency partial colectomy for lower gastrointestinal bleeding. A
localized colonic adenocarcinoma is completely resected. The surgeon did not dissect lymph
nodes for metastatic sampling. The patient wants to know if he should have chemotherapy.
Should he? - ANSWER-No because he can be followed with serial carcinoembryonic antigens
and CT scans.
An 80-year-old woman has no weight loss, no pain, and no distention but over 2 years
increasingly complains of constipation despite adequate medical treatment. A colonoscopy is
negative. An abdominal CT is performed. It reveals well-circumscribed pelvic masses, the largest
adherent to the ovarian ligament. The best first step is: - ANSWER-Invite her to return with a
family member and have a long talk about the diagnostic and therapeutic options.
An 85-year-old man with chronic obstructive pulmonary disease presents to your office with his
daughter with the complaint of new onset chest pain, shortness of breath, and cough. He is
clearly tachypneic and has tactile fremitus and egophany and crackles heard at the right lung
base. His daughter just wants you to give him an antibiotic pill so that she can take him home.
You are concerned that he might need to be hospitalized and require IV antibiotics. What
statement is true? - ANSWER-Treatment decisions for pneumonia are based on its severity, the
presence of comorbid illnesses, and a prior history of MRSA or Pseudomonas respiratory
infection.
An 80-year-old woman that you follow in a nursing home has an acute decline in her mental
status. She has a fever >100° F, but no other focal complaints or findings on physical
examination except for a chronic indwelling urinary catheter. What statement is true? -
ANSWER-Fever in an older adult with an indwelling urinary catheter is an appropriate indication
to start empiric antibiotic therapy.
An 82-year-old woman receives oral amoxicillin-clavulate for a skin abscess on her leg. She
develops new onset of frequent watery stool that persists for several days after the antibiotic is
stopped. You obtain a stool for Clostridium difficile antigen, toxin, and polymerase chain
, NR 601 FINAL EXAM NEWEST 2025
reaction (PCR). The antigen and PCR are both positive. She has never had C. difficile infection
before. What one statement is the best answer regarding her management? - ANSWER-Either
vancomycin or fidaxomicin are recommended for the first episode of C. difficile infection.
A 75-year-old man presents with the chief concern, "I may have a bladder infection." Further
questioning reveals for several months he has been needing to void every couple of hours (can't
sit through a whole ball game), feels he must go as soon as he feels the urge (he tried putting it
off and had urinary leakage), and is getting up two to three times at night to void. He denies
delay in voiding or straining to initiate voiding, slow stream, feeling of incomplete emptying, or
dribbling after completion of urination. He also denies dysuria and abdominal pain. Which of
the following best describes the category or type of his lower urinary tract symptoms? -
ANSWER-Storage (irritative)
A 70-year-old man has bothersome lower urinary tract syndrome (LUTS) associated with benign
prostatic hyperplasia (BPH). His symptoms are no longer well managed with lifestyle
modifications. He is interested in medication to reduce his urinary symptoms but is concerned
about possible side effects. He notes that he is recently married and sexual activity is very
important to him. Which of the following medications would be most appropriate for this
patient? - ANSWER-Alfusozin
A 66-year-old man complains of nocturia (three to four times a night), hesitancy, and
incomplete emptying of the bladder. Physical examination reveals an enlarged, nontender
prostate, about 40 g in size without discrete nodules. Urinalysis reveals hematuria without
leukocyte esterase. Upon further evaluation, the hematuria is attributed to his BPH. The patient
declines surgical options at this time. Which of the following medications would be most
appropriate? - ANSWER-Finasteride
Mr. Quince is a 68-year-old patient who describes several months of urinary frequency and a
sensation of incomplete emptying with no associated dysuria, hematuria, or fever. Physical
examination reveals a slightly enlarged but nontender prostate, a postvoid residual urine
volume of 20 mL, and a urinalysis with 15 white blood cells (WBCs) and 5 red blood cells (RBCs).
Urine culture reveals 30,000 colony-forming units of Escherichia coli. You see a report from last
year that shows urinalysis with 10 WBCs and 4 RBCs that was obtained as part of a routine
, NR 601 FINAL EXAM NEWEST 2025
evaluation. What is the most appropriate next step in the management of Mr. Quince's
symptoms? - ANSWER-Start a 4-week course of ciprofloxacin.
Mr. Roberts, a 72-year-old patient who has sought medical care on an intermittent basis in the
past, complains of aching discomfort in his perineal area, urinary urgency, and frequency for the
past few years. He also complains of insomnia and intermittent anxiety that he attributes to
loneliness after his wife's death about a year ago. Digital rectal examination (DRE) reveals a
slightly enlarged, nontender prostate with no palpable nodules. Perineal examination is normal.
Bladder scan is unremarkable and postvoid residual urine volume is 50 mL. Urinalysis shows no
WBCs or RBCs. Urine culture is negative. Previous treatment has included dietary modification
and alpha-blocker medication. What is the most appropriate next step? - ANSWER-Screen for
depression.
Mr. Hunter, a 69-year-old man, complains of urinary frequency and urgency that have increased
over the past several months. There is no dysuria, hematuria, or sensation of incomplete
voiding. He drinks 2 cups of coffee daily and diet cola multiple times a day. His International
Prostate Symptom Score (IPSS) is 6, with a bother score of 1 indicating mild voiding symptoms
with low impact on his quality of life. His medical history includes hypertension, coronary artery
disease, and benign prostatic hyperplasia. Current medications are aspirin, metoprolol, and
hydrochlorothiazide. Physical examination reveals normal sized prostate. Which of the following
is the best next step? - ANSWER-Lifestyle modifications
Two years later Mr. Hunter reports progression of his urinary symptoms and desires "a pill to
make this better." His current IPSS is 17, with a bother score of 3 indicating moderate voiding
symptoms with moderate impact on his quality of life. On review of systems he notes that his
vision has worsened, especially in his left eye. His ophthalmologist has recommended cataract
surgery. For which of the following medications would initiation of therapy be delayed until
after cataract surgery? - ANSWER-Tamsulosin
Several years later, Mr. Hunter, who is now 75 years old, seeks additional intervention for his
urinary symptoms that have progressed further. He now experiences slow urinary stream,
hesitancy, straining, and a feeling of incomplete emptying in addition to the previous urinary
urgency and frequency. At times, he has noted blood in his urine. He has had five urinary tract
infections (UTIs) in the past 2 years. His current IPSS is 24, with a bother score of 5 indicating
, NR 601 FINAL EXAM NEWEST 2025
severe voiding symptoms with high impact on his quality of life. Mr. Hunter's updated medical
history includes hypertension, coronary artery disease, benign prostatic hyperplasia, cataract
surgery 4 years ago, and two falls within the past year while rushing to the bathroom during the
night. Current medications are aspirin, metoprolol, finasteride, and tamsulosin. Physical
examination reveals an enlarged, nontender prostate, about 50 g in size without d - ANSWER-
Perform surgical resection of prostate.
The US Advisory Committee on Immunization Practices and the Centers for Disease Control
currently recommend which one of the following? - ANSWER-a. All older adults be immunized
against influenza annually and that they receive at least one pneumococcal vaccination. b. All
high-risk older adults should receive an additional pneumococcal vaccination 5 years or more
after their first immunization. c. Older adults should receive a one-time revaccination for
pneumonia if they were initially vaccinated more than 5 years previously and were less than 65
years of age at the time of the initial vaccination. d. All of these are recommended.
Healthcare providers should recommend that older adults engage in which one of the
following? - ANSWER-150 minutes of moderate intensity physical activity weekly
Guidelines for the primary prevention of stroke recommend that aspirin be used in which one of
the following? - ANSWER-Individuals whose risk is high enough for the benefits to outweigh the
risks
Even though older adults are less likely to get counseled for smoking cessation, they have which
one of the following? - ANSWER-The same quit rates as younger individuals
A 67-year-old female with a history of congestive heart failure and myocardial infarction is
admitted to the hospital because of increasing altered mental status and decreased arousal over
the last week. Physical examination reveals a confused woman with right lower lobe crackles
and a pulse oximetry of 86% on room air. While you are interviewing the patient, she is irritable,
paranoid, and inattentive, which her family tells you is out of character. You notice waxing and
waning in her alertness and impaired short-term memory during your examination. Which one
of the following features present in this patient best distinguishes delirium from depression or
dementia? - ANSWER-Inattentiveness
