NR 601 Primary Care of the Maturing & Aged Family Midterm Exam: (Latest
2025/2026 Update) Comprehensive Q&A | Grade A | 100% Correct (Verified
Answers)
Subject: Primary Care of the Maturing & Aged Family (NR 601) – Midterm Exam: PFTs, Heart Failure,
Hypertension, Lipid Management, Arthritis, Geriatric Syndromes, Polypharmacy, Immunizations,
Depression/Delirium/Dementia
Source: Midterm Blueprint – GOLD Criteria, HF Staging, Beers Criteria, ASCVD Guidelines,
OA/RA/Gout, Polymyalgia Rheumatica, Fall Prevention, Thyroid Disorders
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: The percentage of the FVC expired in one second is?
Correct Answer: FEV1/FVC ratio (normal >0.70); ratio <0.70 indicates obstructive lung disease.
1. FEV1 is forced expiratory volume in first second; FVC is forced vital capacity.
2. Obstructive: FEV1/FVC <0.70; Restrictive: FEV1/FVC normalized or high.
3. Spirometry is gold standard for COPD diagnosis.
2: The aging process causes what normal physiological changes in the heart?
Correct Answer: Heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis.
1. Aortic sclerosis is common (50% over age 80).
2. LV wall thickness increases; early diastolic filling decreases.
3. Increased risk of valvular stenosis and regurgitation.
3: Thoracic aortic dissection presents typically as?
Correct Answer: Severe retrosternal chest pain that radiates to the back and both arms (tearing
quality).
1. Anterior chest pain → ascending aorta; interscapular pain → descending aorta.
2. Risk factors: hypertension, connective tissue disorders, bicuspid aortic valve.
3. Requires immediate CT angiography and surgical or medical management.
4: MJ presents with h/o structural damage with current signs/symptoms of HF. Treatment will be
based on his stage of HF which is?
Correct Answer: Stage C (structural heart disease with prior or current symptoms of HF).
1. Stage A: high risk but no structural disease.
2. Stage B: structural disease without symptoms.
3. Stage D: refractory HF requiring specialized interventions.
, 5: 65-year-old Caucasian presents with mitral valve stenosis, physical exam unremarkable. Her
stage of HF is?
Correct Answer: Stage B (structural heart disease without signs/symptoms of HF).
1. Stage B includes previous MI, LV remodeling, valvular disease.
2. Treatment: ACEi/ARB, beta-blockers as appropriate.
3. Goal: prevent HF symptoms and further remodeling.
6: The pathophysiology of heart failure is due to?
Correct Answer: Inadequate cardiac output to meet the metabolic and O2 demands of the body.
1. HFrEF: reduced ejection fraction, impaired systolic function.
2. HFpEF: preserved EF, diastolic dysfunction.
3. Neurohormonal activation (RAAS, sympathetic) worsens progression.
7: According to the 2017 ACC HTN guidelines, normal BP is?
Correct Answer: <120/80 mm Hg
1. Elevated BP: 120-129/<80.
2. Stage 1 HTN: 130-139 or 80-89.
3. Stage 2 HTN: ≥140 or ≥90.
8: The best way to diagnose structural heart disease/dysfunction noninvasively is?
Correct Answer: Echocardiogram (transthoracic echocardiography – TTE).
1. Assess chamber size, wall thickness, valve function, ejection fraction.
2. Stress echo for ischemia evaluation.
3. Transesophageal echocardiography (TEE) for better visualization when needed.
9: A 55-year-old postmenopausal woman with h/o HTN c/o jaw pain on heavy exertion. No CP. EKG
normal. Plan may include?
Correct Answer: Exercise stress test (jaw pain may be angina equivalent in women).
1. Angina equivalents: dyspnea, jaw pain, shoulder pain, epigastric discomfort.
2. Women more likely to have atypical presentations.
3. Stress testing indicated for intermediate-risk patients.
10: Which patient is most likely to have osteoporosis?
Correct Answer: 80-year-old underweight male who smokes and has been on steroids for psoriasis
(multiple risk factors).
1. Major risk factors: advanced age, low BMI, smoking, corticosteroid use, family history, low
calcium.
2. DEXA screening for all women ≥65 and men ≥70 with risk factors.
3. T-score ≤ -2.5 = osteoporosis.
2025/2026 Update) Comprehensive Q&A | Grade A | 100% Correct (Verified
Answers)
Subject: Primary Care of the Maturing & Aged Family (NR 601) – Midterm Exam: PFTs, Heart Failure,
Hypertension, Lipid Management, Arthritis, Geriatric Syndromes, Polypharmacy, Immunizations,
Depression/Delirium/Dementia
Source: Midterm Blueprint – GOLD Criteria, HF Staging, Beers Criteria, ASCVD Guidelines,
OA/RA/Gout, Polymyalgia Rheumatica, Fall Prevention, Thyroid Disorders
Format: Q&A Guide with Rationale – 100% Verified Answers
Verified: Latest 2025/2026 Update | Grade A Guaranteed
1: The percentage of the FVC expired in one second is?
Correct Answer: FEV1/FVC ratio (normal >0.70); ratio <0.70 indicates obstructive lung disease.
1. FEV1 is forced expiratory volume in first second; FVC is forced vital capacity.
2. Obstructive: FEV1/FVC <0.70; Restrictive: FEV1/FVC normalized or high.
3. Spirometry is gold standard for COPD diagnosis.
2: The aging process causes what normal physiological changes in the heart?
Correct Answer: Heart valve thickens and becomes rigid, secondary to fibrosis and sclerosis.
1. Aortic sclerosis is common (50% over age 80).
2. LV wall thickness increases; early diastolic filling decreases.
3. Increased risk of valvular stenosis and regurgitation.
3: Thoracic aortic dissection presents typically as?
Correct Answer: Severe retrosternal chest pain that radiates to the back and both arms (tearing
quality).
1. Anterior chest pain → ascending aorta; interscapular pain → descending aorta.
2. Risk factors: hypertension, connective tissue disorders, bicuspid aortic valve.
3. Requires immediate CT angiography and surgical or medical management.
4: MJ presents with h/o structural damage with current signs/symptoms of HF. Treatment will be
based on his stage of HF which is?
Correct Answer: Stage C (structural heart disease with prior or current symptoms of HF).
1. Stage A: high risk but no structural disease.
2. Stage B: structural disease without symptoms.
3. Stage D: refractory HF requiring specialized interventions.
, 5: 65-year-old Caucasian presents with mitral valve stenosis, physical exam unremarkable. Her
stage of HF is?
Correct Answer: Stage B (structural heart disease without signs/symptoms of HF).
1. Stage B includes previous MI, LV remodeling, valvular disease.
2. Treatment: ACEi/ARB, beta-blockers as appropriate.
3. Goal: prevent HF symptoms and further remodeling.
6: The pathophysiology of heart failure is due to?
Correct Answer: Inadequate cardiac output to meet the metabolic and O2 demands of the body.
1. HFrEF: reduced ejection fraction, impaired systolic function.
2. HFpEF: preserved EF, diastolic dysfunction.
3. Neurohormonal activation (RAAS, sympathetic) worsens progression.
7: According to the 2017 ACC HTN guidelines, normal BP is?
Correct Answer: <120/80 mm Hg
1. Elevated BP: 120-129/<80.
2. Stage 1 HTN: 130-139 or 80-89.
3. Stage 2 HTN: ≥140 or ≥90.
8: The best way to diagnose structural heart disease/dysfunction noninvasively is?
Correct Answer: Echocardiogram (transthoracic echocardiography – TTE).
1. Assess chamber size, wall thickness, valve function, ejection fraction.
2. Stress echo for ischemia evaluation.
3. Transesophageal echocardiography (TEE) for better visualization when needed.
9: A 55-year-old postmenopausal woman with h/o HTN c/o jaw pain on heavy exertion. No CP. EKG
normal. Plan may include?
Correct Answer: Exercise stress test (jaw pain may be angina equivalent in women).
1. Angina equivalents: dyspnea, jaw pain, shoulder pain, epigastric discomfort.
2. Women more likely to have atypical presentations.
3. Stress testing indicated for intermediate-risk patients.
10: Which patient is most likely to have osteoporosis?
Correct Answer: 80-year-old underweight male who smokes and has been on steroids for psoriasis
(multiple risk factors).
1. Major risk factors: advanced age, low BMI, smoking, corticosteroid use, family history, low
calcium.
2. DEXA screening for all women ≥65 and men ≥70 with risk factors.
3. T-score ≤ -2.5 = osteoporosis.
