NR 601 Final Exam
NR 601 Final Exam Study Questions and
Answers with Complete Solutions 2024
Healthcare providers should recommend that older adults engage in which one of the
following?
a. 150 minutes of moderate intensity physical activity weekly
b. 20 minutes of moderate intensity physical activity 3 days per week
c. 10 minutes of vigorous physical activity most days of the week
d. 30 minutes of vigorous physical activity 3 days per week
a. 150 minutes of moderate intensity physical activity weekly
A 69-year-old female presents to your office for routine primary care. Her elder sister
was recently diagnosed with Alzheimer disease, and she wonders what steps she can
take to reduce her own risk of developing dementia. Which of the following statements
about the prevention of dementia is true?
a. There is moderate quality evidence to support daily use of vitamin B12 and fish oil to
prevent risk of cognitive decline.
b. Risk of dementia is modulated by nonmodifiable risk factors, such as genetics, family
history, and educational attainment, and there are no behavioral interventions that can
be taken to reduce risk of developing dementia.
c. There is moderate quality evidence to suggest control of cardiovascular and metabolic
risk factors, such as blood pressure, weight, and blood sugar, may reduce risk of
dementia.
d. There is moderate to low quality evidence supporting cannabinoids maementia.y
reduce rates of pro
c. There is moderate quality evidence to suggest control of cardiovascular and metabolic
risk factors, such as blood pressure, weight, and blood sugar, may reduce risk of
dementia.
An 86-year-old female comes to your office for a wellness visit. Her blood pressure is
125/70 mmHg, pulse 69 beats per min, and respiratory rate 18 breaths per min. She is
well appearing and reports she is up to date on her routine vaccinations. She introduces
her partner of 35 years whom she would like to make medical decisions for her in case
she becomes unable to make decisions for herself. She reports that she and her partner
NR 601 Final Exam
,NR 601 Final Exam
are not married. She asks if she needs any further documentation to ensure her goals of
care are followed.
Which one of the following would be the most appropriate recommendation for this
patient and her partner?
a. Advise them to complete a POLST.
b. Advise them that they have adequate documentation to be recognized legally.
c. Advise them to file an advanced directive.
d. Respond that although they lack documentation, her partner will be recognized de
facto.
c. Advise them to file an advanced directive.
A 78-year-old male was recently diagnosed with Alzheimer disease. He scored 23/30 on
his Montreal Cognitive Assessment (MoCA) and his clinical presentation is consistent
with mild disease. He returns to clinic with his family to discuss possible initiation of
pharmacotherapy. You consider beginning donepezil 5 mg daily for 4 weeks, with a plan
to increase to 10 mg daily if he tolerates the lower dose. Which of the following is not a
common side effect of donepezil?
a. Thrombocytopenia
b. Bradycardia
c. Vivid dreams
d. Gastrointestinal distress
a. Thrombocytopenia
An 84-year-old male with history of stroke without residual deficit, systolic heart failure,
and type 2 diabetes presents to clinic for follow-up. He is independently living in a
retirement community and still works part time on a golf course. He currently takes
aspirin 81 mg, metoprolol tartrate 25 mg BID (twice a day), furosemide 20 mg BID, and
lisinopril 10 mg daily. He reports his last colonoscopy was 8 years ago, with no
abnormality. He reports he is sexually active with men and women, engaging in
receptive oral, receptive anal, and penetrative sex. He states he has had over three
sexual partners in the last year with intermittent condom use.
What sexually transmitted infection testing should be offered?
NR 601 Final Exam
,NR 601 Final Exam
a. Urine testing
b. Urine testing, blood testing
c. Urine testing, blood testing, anal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
d. Urine testing, blood testing, anal swab, and oropharyngeal swab
2. An 81-year-old transgender female with history of depression and hyperlipidemia
presents to your clinic for routine care. She endorses a history of smoking, currently
smoking 1 pack per day, and occasionally drinks a glass of wine, although she denies
illicit drug use. She reports she takes atorvastatin 20 mg and subcutaneous estrogen
therapy.
Which of the following is the most important next step in this patient’s primary care?
a. Counseling on starting aspirin
b. Counseling on alcohol cessation
c. Counseling on smoking cessation
d. Counseling on mammogram
c. Counseling on smoking cessation
Which of the following is true about tolterodine?
a. It should be avoided in men with prostatic hypertrophy.
b. It increases the risk of constipation compared with oral oxybutynin.
c. It acts by ablating detrusor spasms.
d. It has greater risk of adverse effects with its twice-daily formulation.
d. It has greater risk of adverse effects with its twice-daily formulation.
An 82-year-old man, Mr. A, complains of worsening nocturia, occurring four times per
night. His other lower urinary tract symptoms are slow stream, occasional urgency, and
urgency-related leakage once weekly. Medical problems include poorly controlled
hypertension, diastolic heart failure, hyperlipidemia, osteoarthritis, and prediabetes. His
medications include lisinopril 20 mg daily, metoprolol succinate 75 mg daily, atorvastatin
10 mg daily, metformin 500 mg twice daily, hydrocodone-acetaminophen as needed, and
aspirin 81 mg daily. Amlodipine 5 mg daily was recently added by his cardiologist. On
NR 601 Final Exam
, NR 601 Final Exam
review of systems, Mr. A complains that nocturia is causing daytime fatigue, and he is
more constipated. Physical examination is notable for blood pressure 162/83 mmHg,
heart rate 60 beats per minute, clear lungs, soft abdomen, enlarged prostate, and 21
pretibial edema. Your next step in management should be:
a. Stop hydroc
b. Stop amlodipine and increase lisinopril.
The daughter of a 79-year-old woman notes that her mother, who has dementia and
lives with her, is wetting herself when she attends her new day program. Program staff
have requested that “something be done” as she is requiring a clothes change nearly
every time she is there. She cannot describe the circumstances of leakage, saying “it just
comes.” Leakage is uncommon at home. Her medications include donepezil and
acetaminophen. Physical examination is normal. Initial treatment approach will require
intervention by which of the following?
a. Mrs. A’s physician
b. Mrs. A’s daughter
c. Day program staff
d. Physical therapist through a home care agency
c. Day program staff
Ms. J, who is 82 years old, complains of urine leakage while playing golf. This has gotten
worse over the past year, and she rarely makes it through nine holes without feeling like
she needs to “run into the bushes and go.” Leakage is usually small volume, but causes
her extreme embarrassment because she is afraid she will smell of urine. She has tried
limiting caffeine in the morning before she golfs and avoiding drinking water while
playing, to no effect. She also tried “those Kegler” exercises in the past without success.
Which of the following is the most appropriate recommendation for Ms. J?
a. Bladder training
b. Referral for biofeedback training in pelvic muscle exercise
c. Trial of solifenacin
d. Trial of topical estrogen
a. Bladder training
What is the most common cause of erectile dysfunction in older men?
NR 601 Final Exam
