NR 601 MIDTERM EXAM 1 2025 QUESTIONS WITH COMPLETE
SOLUTIONS 100% CORRECT
Question 1
In a spirometry test, the percentage of the forced vital capacity (FVC) that is expired in the first
second is known as the:
A) Forced vital capacity (FVC)
B) Forced expiratory volume in one second (FEV1)
C) FEV1/FVC ratio
D) Total lung capacity (TLC)
E) Residual volume (RV)
Correct Answer: C) FEV1/FVC ratio
Rationale: The FEV1/FVC ratio is a calculated value from pulmonary function testing that
represents the proportion of a person's vital capacity that they are able to expire in the first
second of forced expiration. It is a critical value used to distinguish between obstructive
and restrictive lung diseases.
Question 2
What normal physiological change occurs in the heart as a part of the aging process?
A) The myocardium becomes thinner and weaker.
B) The heart valves thicken and become more rigid due to fibrosis and sclerosis.
C) The resting heart rate significantly increases.
D) The heart becomes smaller in overall size.
E) The electrical conduction system becomes faster.
Correct Answer: B) The heart valve thickens and becomes rigid, secondary to fibrosis and
sclerosis
Rationale: With age, there is a progressive thickening and stiffening of the heart valves due
to collagen deposition (fibrosis) and calcification (sclerosis). This can lead to the
development of heart murmurs and valvular diseases like aortic stenosis.
Question 3
A 55-year-old Caucasian male, recently started on a new blood pressure medication, complains
of a persistent, dry cough and occasional difficulty breathing. Which of the following
medications was he most likely prescribed?
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A) Hydrochlorothiazide
B) Amlodipine
C) Metoprolol
D) Lisinopril
E) Losartan
Correct Answer: D) Lisinopril
Rationale: A persistent, non-productive cough is a well-known and common side effect of
ACE inhibitors, such as lisinopril. It is thought to be caused by the accumulation of
bradykinin in the respiratory tract.
Question 4
A patient has a history of a previous myocardial infarction (structural damage) and is now
presenting with shortness of breath and lower extremity edema (current symptoms of heart
failure). According to the ACC/AHA staging system, this patient is in:
A) Stage A
B) Stage B
C) Stage C
D) Stage D
E) Class III
Correct Answer: C) Stage C
Rationale: Stage C of the ACC/AHA heart failure classification includes patients who have
known, structural heart disease and who have developed current or have a history of prior
signs and symptoms of heart failure.
Question 5
A 65-year-old female is diagnosed with moderate mitral valve stenosis after an echocardiogram
but has no symptoms of heart failure. According to the ACC/AHA staging system, what is her
stage of heart failure?
A) Stage A
B) Stage B
C) Stage C
,[Type here]
D) Stage D
E) Class I
Correct Answer: B) Stage B
Rationale: Stage B includes patients who have structural heart disease (like mitral stenosis)
but have not yet developed any signs or symptoms of heart failure. This is considered the
"pre-heart failure" stage.
Question 6
What is the best non-invasive diagnostic test to confirm the presence of structural heart disease
or dysfunction, such as valvular disease or ventricular hypertrophy?
A) A 12-lead electrocardiogram (ECG)
B) A chest x-ray
C) A cardiac stress test
D) An echocardiogram
E) A cardiac MRI
Correct Answer: D) An echocardiogram
Rationale: An echocardiogram uses ultrasound to create real-time images of the heart's
structure and function. It is the gold standard for non-invasively assessing valve function,
measuring chamber sizes, evaluating wall motion, and calculating the ejection fraction.
Question 7
Chronic pain can have a profound negative impact on a patient's overall quality of life and is
often linked to which of the following comorbid conditions?
A) Hypertension and diabetes.
B) Depression, sleep disturbances, and decreased socialization.
C) Osteoporosis and arthritis.
D) Chronic kidney disease.
E) Asthma and COPD.
Correct Answer: B) Depression, sleep disturbances, and decreased socialization
Rationale: The relationship between chronic pain and these conditions is bidirectional. Pain
, [Type here]
can lead to depression and social isolation, and it frequently disrupts sleep. In turn,
depression and poor sleep can lower the pain threshold, creating a vicious cycle.
Question 8
The Beers Criteria is a widely used clinical tool designed to guide the safe use of medications in
which patient population?
A) Pregnant women
B) Children under the age of 12
C) Patients with chronic kidney disease
D) Patients 65 years of age and older
E) Patients with liver failure
Correct Answer: D) >65 y/o
Rationale: The Beers Criteria is an explicit list of potentially inappropriate medications for
older adults. It identifies drugs that have a high risk of causing adverse events in this
population due to age-related physiological changes.
Question 9
Which of the following statements about laboratory values in older adults is FALSE?
A) The reference ranges for some lab values may differ from those of younger adults.
B) An abnormal finding is a reliable indicator of an acute illness.
C) Abnormal laboratory findings are often due to the normal physiological changes of aging.
D) A normal lab value does not always rule out the presence of a disease.
E) Baseline lab values can be helpful for comparison during an acute illness.
Correct Answer: C) Abnormal findings are often due to physiological aging
Rationale: This statement is false. While some lab values may change slightly with age (e.g.,
a slight increase in creatinine), a significantly abnormal lab finding should not be dismissed
as a normal part of aging. It should be investigated as a potential sign of an underlying
disease process.
Question 10
According to the 2017 ACC/AHA hypertension guidelines, what is the recommended blood
pressure goal for a 65-year-old African American woman with a history of both hypertension and
SOLUTIONS 100% CORRECT
Question 1
In a spirometry test, the percentage of the forced vital capacity (FVC) that is expired in the first
second is known as the:
A) Forced vital capacity (FVC)
B) Forced expiratory volume in one second (FEV1)
C) FEV1/FVC ratio
D) Total lung capacity (TLC)
E) Residual volume (RV)
Correct Answer: C) FEV1/FVC ratio
Rationale: The FEV1/FVC ratio is a calculated value from pulmonary function testing that
represents the proportion of a person's vital capacity that they are able to expire in the first
second of forced expiration. It is a critical value used to distinguish between obstructive
and restrictive lung diseases.
Question 2
What normal physiological change occurs in the heart as a part of the aging process?
A) The myocardium becomes thinner and weaker.
B) The heart valves thicken and become more rigid due to fibrosis and sclerosis.
C) The resting heart rate significantly increases.
D) The heart becomes smaller in overall size.
E) The electrical conduction system becomes faster.
Correct Answer: B) The heart valve thickens and becomes rigid, secondary to fibrosis and
sclerosis
Rationale: With age, there is a progressive thickening and stiffening of the heart valves due
to collagen deposition (fibrosis) and calcification (sclerosis). This can lead to the
development of heart murmurs and valvular diseases like aortic stenosis.
Question 3
A 55-year-old Caucasian male, recently started on a new blood pressure medication, complains
of a persistent, dry cough and occasional difficulty breathing. Which of the following
medications was he most likely prescribed?
,[Type here]
A) Hydrochlorothiazide
B) Amlodipine
C) Metoprolol
D) Lisinopril
E) Losartan
Correct Answer: D) Lisinopril
Rationale: A persistent, non-productive cough is a well-known and common side effect of
ACE inhibitors, such as lisinopril. It is thought to be caused by the accumulation of
bradykinin in the respiratory tract.
Question 4
A patient has a history of a previous myocardial infarction (structural damage) and is now
presenting with shortness of breath and lower extremity edema (current symptoms of heart
failure). According to the ACC/AHA staging system, this patient is in:
A) Stage A
B) Stage B
C) Stage C
D) Stage D
E) Class III
Correct Answer: C) Stage C
Rationale: Stage C of the ACC/AHA heart failure classification includes patients who have
known, structural heart disease and who have developed current or have a history of prior
signs and symptoms of heart failure.
Question 5
A 65-year-old female is diagnosed with moderate mitral valve stenosis after an echocardiogram
but has no symptoms of heart failure. According to the ACC/AHA staging system, what is her
stage of heart failure?
A) Stage A
B) Stage B
C) Stage C
,[Type here]
D) Stage D
E) Class I
Correct Answer: B) Stage B
Rationale: Stage B includes patients who have structural heart disease (like mitral stenosis)
but have not yet developed any signs or symptoms of heart failure. This is considered the
"pre-heart failure" stage.
Question 6
What is the best non-invasive diagnostic test to confirm the presence of structural heart disease
or dysfunction, such as valvular disease or ventricular hypertrophy?
A) A 12-lead electrocardiogram (ECG)
B) A chest x-ray
C) A cardiac stress test
D) An echocardiogram
E) A cardiac MRI
Correct Answer: D) An echocardiogram
Rationale: An echocardiogram uses ultrasound to create real-time images of the heart's
structure and function. It is the gold standard for non-invasively assessing valve function,
measuring chamber sizes, evaluating wall motion, and calculating the ejection fraction.
Question 7
Chronic pain can have a profound negative impact on a patient's overall quality of life and is
often linked to which of the following comorbid conditions?
A) Hypertension and diabetes.
B) Depression, sleep disturbances, and decreased socialization.
C) Osteoporosis and arthritis.
D) Chronic kidney disease.
E) Asthma and COPD.
Correct Answer: B) Depression, sleep disturbances, and decreased socialization
Rationale: The relationship between chronic pain and these conditions is bidirectional. Pain
, [Type here]
can lead to depression and social isolation, and it frequently disrupts sleep. In turn,
depression and poor sleep can lower the pain threshold, creating a vicious cycle.
Question 8
The Beers Criteria is a widely used clinical tool designed to guide the safe use of medications in
which patient population?
A) Pregnant women
B) Children under the age of 12
C) Patients with chronic kidney disease
D) Patients 65 years of age and older
E) Patients with liver failure
Correct Answer: D) >65 y/o
Rationale: The Beers Criteria is an explicit list of potentially inappropriate medications for
older adults. It identifies drugs that have a high risk of causing adverse events in this
population due to age-related physiological changes.
Question 9
Which of the following statements about laboratory values in older adults is FALSE?
A) The reference ranges for some lab values may differ from those of younger adults.
B) An abnormal finding is a reliable indicator of an acute illness.
C) Abnormal laboratory findings are often due to the normal physiological changes of aging.
D) A normal lab value does not always rule out the presence of a disease.
E) Baseline lab values can be helpful for comparison during an acute illness.
Correct Answer: C) Abnormal findings are often due to physiological aging
Rationale: This statement is false. While some lab values may change slightly with age (e.g.,
a slight increase in creatinine), a significantly abnormal lab finding should not be dismissed
as a normal part of aging. It should be investigated as a potential sign of an underlying
disease process.
Question 10
According to the 2017 ACC/AHA hypertension guidelines, what is the recommended blood
pressure goal for a 65-year-old African American woman with a history of both hypertension and
