NR 601 Week 4 Midterm Exam 2025| Chamberlain
University| Actual Exam Questions and Correct
Answers and Explanations
Question 1: A 60-year-old woman with uncomfortable breathing on exertion, minimally
productive cough, and worsening dyspnea when lying down. The most likely cause is:
A) Chronic obstructive pulmonary disease (COPD)
B) Congestive heart failure (CHF)
C) Pneumonia
D) Asthma
Correct Answer: B) Congestive heart failure (CHF)
Explanation: Dyspnea on exertion and orthopnea (worsening when lying down) are classic for
CHF, reflecting fluid overload and pulmonary congestion. COPD and asthma are less likely
without significant respiratory history, and pneumonia typically includes fever or acute
symptoms.
Question 2: A 68-year-old male with episodic lightheadedness, sweating, tachycardia, and hand
trembling. Which question helps confirm the diagnosis?
A) “Do you feel chest pain during episodes?”
B) “Do episodes occur after meals or fasting?”
C) “Do you have a history of seizures?”
D) “Are episodes triggered by loud noises?”
Correct Answer: B) “Do episodes occur after meals or fasting?”
Explanation: Symptoms suggest hypoglycemia or pheochromocytoma. Asking about meal or
fasting association helps identify hypoglycemia (postprandial or fasting). Other questions are less
specific to the likely diagnosis.
Question 3: A 68-year-old male with episodic dizziness when rolling over in bed or turning head
rapidly, lasting ~3 minutes. The most likely diagnosis is:
A) Vestibular neuritis
,B) Benign paroxysmal positional vertigo (BPPV)
C) Meniere’s disease
D) Orthostatic hypotension
Correct Answer: B) Benign paroxysmal positional vertigo (BPPV)
Explanation: Brief dizziness triggered by head position changes is characteristic of BPPV,
caused by canalith displacement. Other conditions involve different patterns or additional
symptoms.
Question 4: A 75-year-old with end-stage dementia, 10-pound weight loss in 2 months, difficulty
feeding, and drooling. What is the initial action of the nurse practitioner?
A) Order a feeding tube placement
B) Assess swallowing function
C) Increase caloric supplements
D) Consult hospice care
Correct Answer: B) Assess swallowing function
Explanation: Difficulty feeding and drooling suggest dysphagia, common in end-stage
dementia. Swallowing assessment is the initial step to guide nutritional management safely.
Question 5: A 77-year-old client with glaucoma asks what causes it. The nurse practitioner’s
response is based on:
A) Increased aqueous humor production or outflow obstruction
B) Corneal thickening
C) Lens opacity
D) Retinal detachment
Correct Answer: A) Increased aqueous humor production or outflow obstruction
Explanation: Glaucoma results from increased intraocular pressure due to excessive aqueous
humor production or blocked outflow, damaging the optic nerve.
Question 6: A 78-year-old man whose daughter reports forgetfulness draws a distorted clock
with numbers on one side. The nurse practitioner concludes:
A) Normal cognitive aging
, B) Mild cognitive impairment
C) Probable dementia
D) Delirium
Correct Answer: C) Probable dementia
Explanation: A distorted clock drawing test suggests significant cognitive impairment,
consistent with dementia (e.g., Alzheimer’s), not normal aging or delirium (acute onset).
Question 7: The abrupt onset of stress or urge incontinence is most often due to:
A) Pelvic floor weakness
B) Urinary tract infection
C) Bladder cancer
D) Neurological disease
Correct Answer: B) Urinary tract infection
Explanation: UTI is the most common cause of abrupt stress or urge incontinence due to bladder
irritation, especially in older adults.
Question 8: After managing pain in a client with gout, treatment focuses on:
A) Preventing urate crystal formation
B) Increasing joint mobility
C) Antibiotic therapy
D) Surgical intervention
Correct Answer: A) Preventing urate crystal formation
Explanation: After pain control, gout treatment focuses on lowering uric acid levels (e.g.,
allopurinol) to prevent urate crystal formation and recurrent attacks.
Question 9: Based on current demographic data, which statement identifies a predictive trend
regarding health care needs?
A) Decreased need for geriatric care
B) Increased demand for chronic disease management
C) Reduced mental health services
University| Actual Exam Questions and Correct
Answers and Explanations
Question 1: A 60-year-old woman with uncomfortable breathing on exertion, minimally
productive cough, and worsening dyspnea when lying down. The most likely cause is:
A) Chronic obstructive pulmonary disease (COPD)
B) Congestive heart failure (CHF)
C) Pneumonia
D) Asthma
Correct Answer: B) Congestive heart failure (CHF)
Explanation: Dyspnea on exertion and orthopnea (worsening when lying down) are classic for
CHF, reflecting fluid overload and pulmonary congestion. COPD and asthma are less likely
without significant respiratory history, and pneumonia typically includes fever or acute
symptoms.
Question 2: A 68-year-old male with episodic lightheadedness, sweating, tachycardia, and hand
trembling. Which question helps confirm the diagnosis?
A) “Do you feel chest pain during episodes?”
B) “Do episodes occur after meals or fasting?”
C) “Do you have a history of seizures?”
D) “Are episodes triggered by loud noises?”
Correct Answer: B) “Do episodes occur after meals or fasting?”
Explanation: Symptoms suggest hypoglycemia or pheochromocytoma. Asking about meal or
fasting association helps identify hypoglycemia (postprandial or fasting). Other questions are less
specific to the likely diagnosis.
Question 3: A 68-year-old male with episodic dizziness when rolling over in bed or turning head
rapidly, lasting ~3 minutes. The most likely diagnosis is:
A) Vestibular neuritis
,B) Benign paroxysmal positional vertigo (BPPV)
C) Meniere’s disease
D) Orthostatic hypotension
Correct Answer: B) Benign paroxysmal positional vertigo (BPPV)
Explanation: Brief dizziness triggered by head position changes is characteristic of BPPV,
caused by canalith displacement. Other conditions involve different patterns or additional
symptoms.
Question 4: A 75-year-old with end-stage dementia, 10-pound weight loss in 2 months, difficulty
feeding, and drooling. What is the initial action of the nurse practitioner?
A) Order a feeding tube placement
B) Assess swallowing function
C) Increase caloric supplements
D) Consult hospice care
Correct Answer: B) Assess swallowing function
Explanation: Difficulty feeding and drooling suggest dysphagia, common in end-stage
dementia. Swallowing assessment is the initial step to guide nutritional management safely.
Question 5: A 77-year-old client with glaucoma asks what causes it. The nurse practitioner’s
response is based on:
A) Increased aqueous humor production or outflow obstruction
B) Corneal thickening
C) Lens opacity
D) Retinal detachment
Correct Answer: A) Increased aqueous humor production or outflow obstruction
Explanation: Glaucoma results from increased intraocular pressure due to excessive aqueous
humor production or blocked outflow, damaging the optic nerve.
Question 6: A 78-year-old man whose daughter reports forgetfulness draws a distorted clock
with numbers on one side. The nurse practitioner concludes:
A) Normal cognitive aging
, B) Mild cognitive impairment
C) Probable dementia
D) Delirium
Correct Answer: C) Probable dementia
Explanation: A distorted clock drawing test suggests significant cognitive impairment,
consistent with dementia (e.g., Alzheimer’s), not normal aging or delirium (acute onset).
Question 7: The abrupt onset of stress or urge incontinence is most often due to:
A) Pelvic floor weakness
B) Urinary tract infection
C) Bladder cancer
D) Neurological disease
Correct Answer: B) Urinary tract infection
Explanation: UTI is the most common cause of abrupt stress or urge incontinence due to bladder
irritation, especially in older adults.
Question 8: After managing pain in a client with gout, treatment focuses on:
A) Preventing urate crystal formation
B) Increasing joint mobility
C) Antibiotic therapy
D) Surgical intervention
Correct Answer: A) Preventing urate crystal formation
Explanation: After pain control, gout treatment focuses on lowering uric acid levels (e.g.,
allopurinol) to prevent urate crystal formation and recurrent attacks.
Question 9: Based on current demographic data, which statement identifies a predictive trend
regarding health care needs?
A) Decreased need for geriatric care
B) Increased demand for chronic disease management
C) Reduced mental health services
