NR601 Primary Care of the Maturing and Aged
Family Midterm Exam (2025/2026 Update) –
Chamberlain College of Nursing | Prep Questions
with Verified Answers
This midterm exam for NR601 Primary Care of the Maturing and Aged Family is updated for the
2025/2026 academic year. It focuses on geriatric primary care, chronic disease management,
health promotion, and family-centered care for aging populations. Questions are aligned with
AGS and USPSTF guidelines, with 50 verified multiple-choice questions. Each question
includes the prompt, correct answer in RED, and a detailed rationale with evidence-based
reasoning, clinical implications, and exam tips.
Question 1: A 72-year-old woman with a history of hypertension and type 2 diabetes
presents for her annual physical. She is asymptomatic but has not had a screening
colonoscopy since age 65. What is the most appropriate recommendation based on USPSTF
guidelines?
No further colonoscopy screening is necessary as she is over age 65 and previously up-to-
date
Rationale: USPSTF recommends stopping routine colorectal cancer screening at age 75 for
average-risk individuals with prior normal screens; discuss if family history or symptoms.
Clinical implication: Shared decision-making; exam tip: Guidelines change - know cutoffs.
Question 2: During a routine visit, a 68-year-old man reports new onset of fatigue and
weight loss. His physical exam shows pallor and a new systolic murmur. What is the
priority diagnostic test?
Complete blood count to evaluate for anemia
Rationale: Fatigue and weight loss in older adults signal anemia (common from GI bleed,
malignancy); CBC identifies type (microcytic iron deficiency). Murmur suggests aortic stenosis.
Clinical: Colonoscopy if positive; tip: "New murmur + anemia" = GI workup.
Question 3: What is the first-line pharmacologic treatment for hypertension in a 75-year-
old woman with isolated systolic hypertension and no compelling indications?
Thiazide diuretic like chlorthalidone
Rationale: JNC 8/ACC guidelines recommend thiazides for isolated systolic HTN in elderly;
, target <150/90 mmHg. Monitor electrolytes; clinical: Lifestyle first. Tip: Elderly HTN -
thiazides, avoid beta-blockers first.
Question 4: A 82-year-old man with dementia is brought by family for evaluation. He has
fallen twice in the past month and takes multiple sedatives. What is the priority
intervention?
Conduct a comprehensive medication review and deprescribe high-risk sedatives
Rationale: Beers Criteria flags sedatives as high fall risk; STOPP/START aids deprescribing.
Clinical: Fall assessment (timed get-up-go); tip: Dementia + falls = polypharmacy review.
Question 5: What is the recommended screening interval for low-dose CT lung cancer
screening in a 70-year-old former smoker with 40 pack-year history?
Annually
Rationale: USPSTF recommends annual LDCT for ages 50-80 with ≥20 pack-years, quit <15
years; shared decision. Clinical: Discuss risks/benefits; tip: USPSTF 2021 expanded to 50-80.
Question 6: In managing chronic pain in a 78-year-old with osteoarthritis, what is the first-
line non-pharmacologic intervention?
Physical therapy and weight loss if BMI >25
Rationale: ACR guidelines prioritize non-drug for OA; PT strengthens joints, weight reduces
load. Clinical: Acetaminophen first drug; tip: OA - PT before meds.
Question 7: A 65-year-old woman with osteoporosis is prescribed alendronate. What is the
key administration instruction?
Take weekly upon arising with full glass of water, remain upright 30 minutes
Rationale: Prevents esophageal irritation; no calcium within 2 hours. Clinical: DEXA follow-up;
tip: Bisphosphonates - upright, fasting.
Question 8: What is the target blood pressure for a 76-year-old with diabetes and CKD?
<130/80 mmHg
Rationale: ADA/ACC guidelines for DM/CKD; tighter control preserves kidneys. Clinical:
ACEI first-line; tip: Elderly - <150/90 if frail, but <130/80 if comorbidities.
Family Midterm Exam (2025/2026 Update) –
Chamberlain College of Nursing | Prep Questions
with Verified Answers
This midterm exam for NR601 Primary Care of the Maturing and Aged Family is updated for the
2025/2026 academic year. It focuses on geriatric primary care, chronic disease management,
health promotion, and family-centered care for aging populations. Questions are aligned with
AGS and USPSTF guidelines, with 50 verified multiple-choice questions. Each question
includes the prompt, correct answer in RED, and a detailed rationale with evidence-based
reasoning, clinical implications, and exam tips.
Question 1: A 72-year-old woman with a history of hypertension and type 2 diabetes
presents for her annual physical. She is asymptomatic but has not had a screening
colonoscopy since age 65. What is the most appropriate recommendation based on USPSTF
guidelines?
No further colonoscopy screening is necessary as she is over age 65 and previously up-to-
date
Rationale: USPSTF recommends stopping routine colorectal cancer screening at age 75 for
average-risk individuals with prior normal screens; discuss if family history or symptoms.
Clinical implication: Shared decision-making; exam tip: Guidelines change - know cutoffs.
Question 2: During a routine visit, a 68-year-old man reports new onset of fatigue and
weight loss. His physical exam shows pallor and a new systolic murmur. What is the
priority diagnostic test?
Complete blood count to evaluate for anemia
Rationale: Fatigue and weight loss in older adults signal anemia (common from GI bleed,
malignancy); CBC identifies type (microcytic iron deficiency). Murmur suggests aortic stenosis.
Clinical: Colonoscopy if positive; tip: "New murmur + anemia" = GI workup.
Question 3: What is the first-line pharmacologic treatment for hypertension in a 75-year-
old woman with isolated systolic hypertension and no compelling indications?
Thiazide diuretic like chlorthalidone
Rationale: JNC 8/ACC guidelines recommend thiazides for isolated systolic HTN in elderly;
, target <150/90 mmHg. Monitor electrolytes; clinical: Lifestyle first. Tip: Elderly HTN -
thiazides, avoid beta-blockers first.
Question 4: A 82-year-old man with dementia is brought by family for evaluation. He has
fallen twice in the past month and takes multiple sedatives. What is the priority
intervention?
Conduct a comprehensive medication review and deprescribe high-risk sedatives
Rationale: Beers Criteria flags sedatives as high fall risk; STOPP/START aids deprescribing.
Clinical: Fall assessment (timed get-up-go); tip: Dementia + falls = polypharmacy review.
Question 5: What is the recommended screening interval for low-dose CT lung cancer
screening in a 70-year-old former smoker with 40 pack-year history?
Annually
Rationale: USPSTF recommends annual LDCT for ages 50-80 with ≥20 pack-years, quit <15
years; shared decision. Clinical: Discuss risks/benefits; tip: USPSTF 2021 expanded to 50-80.
Question 6: In managing chronic pain in a 78-year-old with osteoarthritis, what is the first-
line non-pharmacologic intervention?
Physical therapy and weight loss if BMI >25
Rationale: ACR guidelines prioritize non-drug for OA; PT strengthens joints, weight reduces
load. Clinical: Acetaminophen first drug; tip: OA - PT before meds.
Question 7: A 65-year-old woman with osteoporosis is prescribed alendronate. What is the
key administration instruction?
Take weekly upon arising with full glass of water, remain upright 30 minutes
Rationale: Prevents esophageal irritation; no calcium within 2 hours. Clinical: DEXA follow-up;
tip: Bisphosphonates - upright, fasting.
Question 8: What is the target blood pressure for a 76-year-old with diabetes and CKD?
<130/80 mmHg
Rationale: ADA/ACC guidelines for DM/CKD; tighter control preserves kidneys. Clinical:
ACEI first-line; tip: Elderly - <150/90 if frail, but <130/80 if comorbidities.
