NR601 Midterm Exam Primary Care of the Maturing and Aged
Family Question Bank (Latest 2026/2027 Edition) – 50
Questions, Answers & Detailed Rationales |Grade A –
Chamberlain
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SECTION 1: GERIATRIC HEALTH ASSESSMENT & SCREENING
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Question 1
A 72-year-old patient presents for an annual wellness visit. The nurse practitioner is
conducting a comprehensive geriatric assessment. Which screening tool is most
appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Correct Answer:
B — Timed Up and Go (TUG) test
Rationale:
The TUG test assesses mobility, balance, and fall risk, which are key predictors of
functional decline in older adults. While the MMSE (A) evaluates cognition and the GDS
(C) screens for depression, the TUG directly measures physical function and
independence in activities of daily living.
Question 2
,A 68-year-old male patient reports that he has fallen twice in the past 6 months but did
not seek medical attention. Which assessment finding would most increase his risk for
future falls?
A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
Correct Answer:
B — Use of three or more chronic medications including a diuretic
Rationale:
Polypharmacy (≥5 medications) and specific drug classes including diuretics, sedatives,
and antihypertensives significantly increase fall risk through orthostatic hypotension,
sedation, or electrolyte disturbances. Normal gait speed (D) and tandem stance ability
(C) are protective factors, not risks.
Question 3
A nurse practitioner is performing a hearing assessment on an 80-year-old patient. The
patient has difficulty hearing high-frequency sounds and understanding speech in noisy
environments. Which type of hearing loss is most consistent with these findings?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Correct Answer:
B — Sensorineural hearing loss
Rationale:
,Presbycusis (age-related hearing loss) is a sensorineural loss characterized by
high-frequency hearing loss and difficulty with speech discrimination, particularly in
background noise. It results from degeneration of cochlear hair cells and neural
pathways. Conductive loss (A) involves the outer or middle ear.
Question 4
During a geriatric assessment, a patient scores 24 on the Mini-Mental State
Examination (MMSE). Which interpretation is most accurate?
A. Normal cognitive function
B. Mild cognitive impairment
C. Moderate cognitive impairment
D. Severe cognitive impairment
Correct Answer:
B — Mild cognitive impairment
Rationale:
MMSE scores of 24-30 suggest mild cognitive impairment or normal function
depending on education level; however, in the context of geriatric assessment, a score
of 24 typically falls at the lower threshold of normal or indicates mild impairment
warranting further evaluation. Scores below 24 are more definitively abnormal.
Question 5
A 75-year-old patient is being screened for malnutrition. Which finding is most specific
for protein-energy malnutrition in older adults?
A. Body mass index of 28 kg/m²
B. Serum albumin level of 2.8 g/dL
C. Total cholesterol of 220 mg/dL
D. Hemoglobin of 13.5 g/dL
, Correct Answer:
B — Serum albumin level of 2.8 g/dL
Rationale:
Hypoalbuminemia (<3.5 g/dL) is a sensitive marker of protein-energy malnutrition and is
associated with increased morbidity and mortality in older adults. While BMI (A) may be
normal or elevated in malnourished elderly due to edema or sarcopenic obesity, albumin
reflects visceral protein status.
Question 6
A nurse practitioner is conducting a driving safety assessment for an 82-year-old
patient. Which finding would most strongly suggest the need for formal driving
evaluation?
A. Corrected visual acuity of 20/30 in both eyes
B. History of two minor traffic violations in the past 10 years
C. Parkinson disease with medication-controlled tremor
D. Recent episode of syncope of undetermined cause
Correct Answer:
D — Recent episode of syncope of undetermined cause
Rationale:
Unexplained syncope poses an immediate and serious risk for sudden loss of
consciousness while driving, potentially causing catastrophic accidents. Formal
evaluation and diagnosis are required before driving can be considered safe. Controlled
Parkinson disease (C) requires monitoring but does not automatically preclude driving.
Question 7
Family Question Bank (Latest 2026/2027 Edition) – 50
Questions, Answers & Detailed Rationales |Grade A –
Chamberlain
──────────────────────────────
SECTION 1: GERIATRIC HEALTH ASSESSMENT & SCREENING
──────────────────────────────
Question 1
A 72-year-old patient presents for an annual wellness visit. The nurse practitioner is
conducting a comprehensive geriatric assessment. Which screening tool is most
appropriate to evaluate the patient's risk for functional decline?
A. Mini-Mental State Examination (MMSE)
B. Timed Up and Go (TUG) test
C. Geriatric Depression Scale (GDS)
D. Mini Nutritional Assessment (MNA)
Correct Answer:
B — Timed Up and Go (TUG) test
Rationale:
The TUG test assesses mobility, balance, and fall risk, which are key predictors of
functional decline in older adults. While the MMSE (A) evaluates cognition and the GDS
(C) screens for depression, the TUG directly measures physical function and
independence in activities of daily living.
Question 2
,A 68-year-old male patient reports that he has fallen twice in the past 6 months but did
not seek medical attention. Which assessment finding would most increase his risk for
future falls?
A. Blood pressure of 138/82 mmHg while seated
B. Use of three or more chronic medications including a diuretic
C. Ability to perform a tandem stance for 10 seconds
D. Normal gait speed on a 10-meter walk test
Correct Answer:
B — Use of three or more chronic medications including a diuretic
Rationale:
Polypharmacy (≥5 medications) and specific drug classes including diuretics, sedatives,
and antihypertensives significantly increase fall risk through orthostatic hypotension,
sedation, or electrolyte disturbances. Normal gait speed (D) and tandem stance ability
(C) are protective factors, not risks.
Question 3
A nurse practitioner is performing a hearing assessment on an 80-year-old patient. The
patient has difficulty hearing high-frequency sounds and understanding speech in noisy
environments. Which type of hearing loss is most consistent with these findings?
A. Conductive hearing loss
B. Sensorineural hearing loss
C. Mixed hearing loss
D. Central auditory processing disorder
Correct Answer:
B — Sensorineural hearing loss
Rationale:
,Presbycusis (age-related hearing loss) is a sensorineural loss characterized by
high-frequency hearing loss and difficulty with speech discrimination, particularly in
background noise. It results from degeneration of cochlear hair cells and neural
pathways. Conductive loss (A) involves the outer or middle ear.
Question 4
During a geriatric assessment, a patient scores 24 on the Mini-Mental State
Examination (MMSE). Which interpretation is most accurate?
A. Normal cognitive function
B. Mild cognitive impairment
C. Moderate cognitive impairment
D. Severe cognitive impairment
Correct Answer:
B — Mild cognitive impairment
Rationale:
MMSE scores of 24-30 suggest mild cognitive impairment or normal function
depending on education level; however, in the context of geriatric assessment, a score
of 24 typically falls at the lower threshold of normal or indicates mild impairment
warranting further evaluation. Scores below 24 are more definitively abnormal.
Question 5
A 75-year-old patient is being screened for malnutrition. Which finding is most specific
for protein-energy malnutrition in older adults?
A. Body mass index of 28 kg/m²
B. Serum albumin level of 2.8 g/dL
C. Total cholesterol of 220 mg/dL
D. Hemoglobin of 13.5 g/dL
, Correct Answer:
B — Serum albumin level of 2.8 g/dL
Rationale:
Hypoalbuminemia (<3.5 g/dL) is a sensitive marker of protein-energy malnutrition and is
associated with increased morbidity and mortality in older adults. While BMI (A) may be
normal or elevated in malnourished elderly due to edema or sarcopenic obesity, albumin
reflects visceral protein status.
Question 6
A nurse practitioner is conducting a driving safety assessment for an 82-year-old
patient. Which finding would most strongly suggest the need for formal driving
evaluation?
A. Corrected visual acuity of 20/30 in both eyes
B. History of two minor traffic violations in the past 10 years
C. Parkinson disease with medication-controlled tremor
D. Recent episode of syncope of undetermined cause
Correct Answer:
D — Recent episode of syncope of undetermined cause
Rationale:
Unexplained syncope poses an immediate and serious risk for sudden loss of
consciousness while driving, potentially causing catastrophic accidents. Formal
evaluation and diagnosis are required before driving can be considered safe. Controlled
Parkinson disease (C) requires monitoring but does not automatically preclude driving.
Question 7
