1
TEST BANK FOR ADVANCED PRACTICE NURSING IN THE CARE OF OLDER
ADULTS, 2ND EDITION BY KENNEDY-MALONE | 150 NGN-STYLE PRACTICE
QUESTIONS WITH DETAILED RATIONALES & PARTIAL CREDIT SCORING |
GERONTOLOGICAL ASSESSMENT, CHRONIC DISEASE MANAGEMENT,
POLYPHARMACY, PALLIATIVE CARE | RN & NP COMPREHENSIVE REVIEW
TABLE OF CONTENTS
NGN Partial Credit Cheat Sheet (Below)
Case Study 1: Changes With Aging and Physiological Adaptation - Questions 1-15
Case Study 2: Health Promotion and Exercise - Questions 16-25
Case Study 3: Comprehensive Geriatric Assessment - Questions 26-40
Case Study 4: Symptoms, Syndromes, and Skin Disorders - Questions 41-55
Case Study 5: Chest and Peripheral Vascular Disorders - Questions 56-70
Case Study 6: Abdominal, Urological, and Gynecological Disorders - Questions 71-80
Case Study 7: Musculoskeletal and Neurological Disorders - Questions 81-95
Case Study 8: Endocrine, Hematological, and Immune Disorders - Questions 96-110
Case Study 9: Psychosocial Disorders - Questions 111-120
Case Study 10: Polypharmacy and Pharmacokinetic Changes - Questions 121-135
Case Study 11: Chronic Illness, Palliative Care, and End-of-Life Care - Questions 136-150
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CASE STUDY 1: CHANGES WITH AGING AND PHYSIOLOGICAL ADAPTATION
QUESTION 1: SATA - PHYSIOLOGICAL CHANGES WITH AGING
• Question: The nurse practitioner is educating a group of new graduate nurses about
physiological changes that occur with aging. Which changes are considered normal age-
related physiological alterations? Select all that apply.
• Options:
A. Decreased arterial elasticity (arteriosclerosis)
B. Reduced glomerular filtration rate (GFR)
C. Complete loss of melanocytes leading to hair whitening
D. Decreased total body water
E. Impaired immunological response
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, B, D, E
o Pathophysiology Summary: Normal aging involves decreased arterial elasticity,
reduced GFR, decreased total body water, and impaired immunological response.
The loss of melanocytes leading to complete hair whitening is not universal or
considered a "normal" change in all individuals. Aging affects multiple systems,
leading to reduced physiological reserve and diminished homeostatic
mechanisms.
o Distractor Pitfalls: Option C is incorrect; while hair graying/whitening occurs,
complete loss of melanocytes is not a universal age-related change.
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QUESTION 2: PHARMACOKINETIC CHANGES WITH AGING
• Question: An 80-year-old patient is prescribed a highly protein-bound medication. The
nurse practitioner recognizes that which pharmacokinetic change in the older adult may
increase the risk of adverse drug reactions?
• Options:
A. Increased gastric acidity leading to faster absorption
B. Decreased serum albumin leading to increased free drug levels
C. Increased total body water leading to dilution
D. Faster hepatic metabolism leading to rapid elimination
• **Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Older adults often have decreased serum albumin
levels, which leads to reduced protein binding of medications. This results in
higher concentrations of free (unbound) drug, increasing the potential for adverse
drug reactions, particularly with highly protein-bound medications like warfarin
and phenytoin. Drug distribution is affected by age-related changes in body
composition, including increased fat and decreased lean body mass and total body
water.
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o Distractor Pitfalls: Option A is incorrect; gastric acidity often decreases with
age, not increases. Option C is incorrect; total body water decreases, not
increases. Option D is incorrect; hepatic metabolism often slows with age.
QUESTION 3: THE MAJOR IMPACT OF AGING
• Question: The nurse practitioner understands that the major impact of the physiological
changes that occur with aging is:
• Options:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
• Zero-Flip Premium Rationale Box:
o Correct Answer: D
o Pathophysiology Summary: The major impact of aging includes reduced
physiological reserve, reduced homeostatic mechanisms, and impaired
immunological response. These changes collectively contribute to the increased
vulnerability of older adults to illness and disease. All body systems interact, and
this interaction can increase the older person's vulnerability to illness/disease.
o Distractor Pitfalls: Options A, B, and C are all correct components; D represents
the comprehensive answer.
TEST BANK FOR ADVANCED PRACTICE NURSING IN THE CARE OF OLDER
ADULTS, 2ND EDITION BY KENNEDY-MALONE | 150 NGN-STYLE PRACTICE
QUESTIONS WITH DETAILED RATIONALES & PARTIAL CREDIT SCORING |
GERONTOLOGICAL ASSESSMENT, CHRONIC DISEASE MANAGEMENT,
POLYPHARMACY, PALLIATIVE CARE | RN & NP COMPREHENSIVE REVIEW
TABLE OF CONTENTS
NGN Partial Credit Cheat Sheet (Below)
Case Study 1: Changes With Aging and Physiological Adaptation - Questions 1-15
Case Study 2: Health Promotion and Exercise - Questions 16-25
Case Study 3: Comprehensive Geriatric Assessment - Questions 26-40
Case Study 4: Symptoms, Syndromes, and Skin Disorders - Questions 41-55
Case Study 5: Chest and Peripheral Vascular Disorders - Questions 56-70
Case Study 6: Abdominal, Urological, and Gynecological Disorders - Questions 71-80
Case Study 7: Musculoskeletal and Neurological Disorders - Questions 81-95
Case Study 8: Endocrine, Hematological, and Immune Disorders - Questions 96-110
Case Study 9: Psychosocial Disorders - Questions 111-120
Case Study 10: Polypharmacy and Pharmacokinetic Changes - Questions 121-135
Case Study 11: Chronic Illness, Palliative Care, and End-of-Life Care - Questions 136-150
, 2
CASE STUDY 1: CHANGES WITH AGING AND PHYSIOLOGICAL ADAPTATION
QUESTION 1: SATA - PHYSIOLOGICAL CHANGES WITH AGING
• Question: The nurse practitioner is educating a group of new graduate nurses about
physiological changes that occur with aging. Which changes are considered normal age-
related physiological alterations? Select all that apply.
• Options:
A. Decreased arterial elasticity (arteriosclerosis)
B. Reduced glomerular filtration rate (GFR)
C. Complete loss of melanocytes leading to hair whitening
D. Decreased total body water
E. Impaired immunological response
• Zero-Flip Premium Rationale Box:
o Correct Answers: A, B, D, E
o Pathophysiology Summary: Normal aging involves decreased arterial elasticity,
reduced GFR, decreased total body water, and impaired immunological response.
The loss of melanocytes leading to complete hair whitening is not universal or
considered a "normal" change in all individuals. Aging affects multiple systems,
leading to reduced physiological reserve and diminished homeostatic
mechanisms.
o Distractor Pitfalls: Option C is incorrect; while hair graying/whitening occurs,
complete loss of melanocytes is not a universal age-related change.
, 3
QUESTION 2: PHARMACOKINETIC CHANGES WITH AGING
• Question: An 80-year-old patient is prescribed a highly protein-bound medication. The
nurse practitioner recognizes that which pharmacokinetic change in the older adult may
increase the risk of adverse drug reactions?
• Options:
A. Increased gastric acidity leading to faster absorption
B. Decreased serum albumin leading to increased free drug levels
C. Increased total body water leading to dilution
D. Faster hepatic metabolism leading to rapid elimination
• **Zero-Flip Premium Rationale Box:
o Correct Answer: B
o Pathophysiology Summary: Older adults often have decreased serum albumin
levels, which leads to reduced protein binding of medications. This results in
higher concentrations of free (unbound) drug, increasing the potential for adverse
drug reactions, particularly with highly protein-bound medications like warfarin
and phenytoin. Drug distribution is affected by age-related changes in body
composition, including increased fat and decreased lean body mass and total body
water.
, 4
o Distractor Pitfalls: Option A is incorrect; gastric acidity often decreases with
age, not increases. Option C is incorrect; total body water decreases, not
increases. Option D is incorrect; hepatic metabolism often slows with age.
QUESTION 3: THE MAJOR IMPACT OF AGING
• Question: The nurse practitioner understands that the major impact of the physiological
changes that occur with aging is:
• Options:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
• Zero-Flip Premium Rationale Box:
o Correct Answer: D
o Pathophysiology Summary: The major impact of aging includes reduced
physiological reserve, reduced homeostatic mechanisms, and impaired
immunological response. These changes collectively contribute to the increased
vulnerability of older adults to illness and disease. All body systems interact, and
this interaction can increase the older person's vulnerability to illness/disease.
o Distractor Pitfalls: Options A, B, and C are all correct components; D represents
the comprehensive answer.
