NUR 257 Concepts of Aging and Chronic Illness in
Nursing Exam 4 | Galen College of Nursing |
Gerontology & Palliative Care Test Bank |
2026/2027 | Q&A with Answers & Rationales |
Physiological Changes, Chronic Illness,
Psychosocial, End-of-Life
1. Which age-related change most increases an older adult's risk for
dehydration?
A. Increased thirst sensation
B. Decreased glomerular filtration rate and diminished thirst
C. Increased body water percentage
D. Increased renin secretion
Answer: B
Rationale: Aging reduces GFR and blunts thirst, decreasing ability to concentrate
urine and recognize fluid needs. A and C are opposite of true aging changes; D is
not a normal aging change.
2. An older adult's temperature is 97.8°F (36.6°C) with a urinary tract infection.
What should the nurse recognize?
A. This is a normal finding requiring no concern
B. Older adults may not mount a febrile response
C. The infection is likely viral
D. The thermometer is malfunctioning
Answer: B
Rationale: Basal temperature and febrile response decrease with age; infection
may present without fever, often with confusion.
3. Which change contributes most to falls in older adults?
A. Increased muscle mass
B. Decreased proprioception and balance
C. Increased bone density
D. Faster reaction time
Answer: B
,Rationale: Decreased proprioception, vestibular changes, and slowed reflexes
increase fall risk. A, C, D are not aging changes.
4. The nurse should monitor which lab most closely when an older adult starts a
new renally-cleared drug?
A. Hemoglobin
B. Serum creatinine and estimated GFR
C. Platelet count
D. Serum calcium
Answer: B
Rationale: Reduced renal clearance increases drug accumulation risk; creatinine
may be misleading due to decreased muscle mass, so eGFR is preferred.
5. Which sensory change most affects medication safety?
A. Presbycusis
B. Presbyopia and decreased near vision
C. Decreased taste
D. Decreased smell
Answer: B
Rationale: Difficulty reading labels contributes directly to medication errors.
Presbycusis affects instructions but not label reading.
6. An older adult reports decreased appetite. Which normal aging change
explains this?
A. Increased gastric acid
B. Decreased taste and smell acuity
C. Faster gastric emptying
D. Increased saliva
Answer: B
Rationale: Taste/smell decline reduces food enjoyment and intake. Gastric acid
and saliva decrease; gastric emptying slows.
7. Which skin change places older adults at highest risk for pressure injury?
A. Increased subcutaneous fat
B. Thinning epidermis and decreased dermal blood flow
C. Increased collagen
D. Increased sweat gland activity
, Answer: B
Rationale: Thinning skin, reduced perfusion, and decreased elasticity increase
breakdown risk.
8. Which cardiovascular change is a normal part of aging?
A. Increased resting heart rate
B. Decreased cardiac output and arterial stiffening
C. Increased baroreceptor sensitivity
D. Decreased systolic blood pressure
Answer: B
Rationale: Arterial stiffening and reduced compliance decrease cardiac output;
baroreceptor sensitivity declines, increasing orthostasis risk.
9. Orthostatic hypotension in older adults is primarily due to:
A. Increased blood volume
B. Decreased baroreceptor responsiveness
C. Increased cardiac contractility
D. Decreased venous pooling
Answer: B
Rationale: Blunted baroreceptor reflexes prevent compensatory vasoconstriction
on standing.
10. Which respiratory change increases pneumonia risk?
A. Increased cough reflex
B. Decreased ciliary function and cough strength
C. Increased vital capacity
D. Increased chest wall compliance
Answer: B
Rationale: Weakened cough and ciliary clearance allow secretions to pool.
11. Which finding is a normal aging change rather than pathology?
A. New-onset confusion
B. Urinary incontinence
C. Decreased bladder capacity with nocturia
D. Hematuria
Answer: C
Nursing Exam 4 | Galen College of Nursing |
Gerontology & Palliative Care Test Bank |
2026/2027 | Q&A with Answers & Rationales |
Physiological Changes, Chronic Illness,
Psychosocial, End-of-Life
1. Which age-related change most increases an older adult's risk for
dehydration?
A. Increased thirst sensation
B. Decreased glomerular filtration rate and diminished thirst
C. Increased body water percentage
D. Increased renin secretion
Answer: B
Rationale: Aging reduces GFR and blunts thirst, decreasing ability to concentrate
urine and recognize fluid needs. A and C are opposite of true aging changes; D is
not a normal aging change.
2. An older adult's temperature is 97.8°F (36.6°C) with a urinary tract infection.
What should the nurse recognize?
A. This is a normal finding requiring no concern
B. Older adults may not mount a febrile response
C. The infection is likely viral
D. The thermometer is malfunctioning
Answer: B
Rationale: Basal temperature and febrile response decrease with age; infection
may present without fever, often with confusion.
3. Which change contributes most to falls in older adults?
A. Increased muscle mass
B. Decreased proprioception and balance
C. Increased bone density
D. Faster reaction time
Answer: B
,Rationale: Decreased proprioception, vestibular changes, and slowed reflexes
increase fall risk. A, C, D are not aging changes.
4. The nurse should monitor which lab most closely when an older adult starts a
new renally-cleared drug?
A. Hemoglobin
B. Serum creatinine and estimated GFR
C. Platelet count
D. Serum calcium
Answer: B
Rationale: Reduced renal clearance increases drug accumulation risk; creatinine
may be misleading due to decreased muscle mass, so eGFR is preferred.
5. Which sensory change most affects medication safety?
A. Presbycusis
B. Presbyopia and decreased near vision
C. Decreased taste
D. Decreased smell
Answer: B
Rationale: Difficulty reading labels contributes directly to medication errors.
Presbycusis affects instructions but not label reading.
6. An older adult reports decreased appetite. Which normal aging change
explains this?
A. Increased gastric acid
B. Decreased taste and smell acuity
C. Faster gastric emptying
D. Increased saliva
Answer: B
Rationale: Taste/smell decline reduces food enjoyment and intake. Gastric acid
and saliva decrease; gastric emptying slows.
7. Which skin change places older adults at highest risk for pressure injury?
A. Increased subcutaneous fat
B. Thinning epidermis and decreased dermal blood flow
C. Increased collagen
D. Increased sweat gland activity
, Answer: B
Rationale: Thinning skin, reduced perfusion, and decreased elasticity increase
breakdown risk.
8. Which cardiovascular change is a normal part of aging?
A. Increased resting heart rate
B. Decreased cardiac output and arterial stiffening
C. Increased baroreceptor sensitivity
D. Decreased systolic blood pressure
Answer: B
Rationale: Arterial stiffening and reduced compliance decrease cardiac output;
baroreceptor sensitivity declines, increasing orthostasis risk.
9. Orthostatic hypotension in older adults is primarily due to:
A. Increased blood volume
B. Decreased baroreceptor responsiveness
C. Increased cardiac contractility
D. Decreased venous pooling
Answer: B
Rationale: Blunted baroreceptor reflexes prevent compensatory vasoconstriction
on standing.
10. Which respiratory change increases pneumonia risk?
A. Increased cough reflex
B. Decreased ciliary function and cough strength
C. Increased vital capacity
D. Increased chest wall compliance
Answer: B
Rationale: Weakened cough and ciliary clearance allow secretions to pool.
11. Which finding is a normal aging change rather than pathology?
A. New-onset confusion
B. Urinary incontinence
C. Decreased bladder capacity with nocturia
D. Hematuria
Answer: C
