NR601 Final Exam – Practice Questions & Answer
Review
Section 1: Geriatric Assessment & Physiologic Changes
(Questions 1–10)
Question 1: Which of the following is a normal physiologic change of aging that affects
pharmacokinetics?
A) Increased gastric pH
B) Increased renal blood flow
C) Decreased body fat
D) Increased hepatic blood flow
Correct Answer: A
Rationale: Gastric pH increases (becomes more alkaline) with age due to decreased
gastric acid production, affecting medication absorption. Renal blood flow, hepatic
blood flow, and lean body mass all decrease with age .
Question 2: An 80-year-old patient has a new prescription for digoxin. Which age-
related change should the nurse practitioner consider?
A) Increased glomerular filtration rate
B) Decreased lean body mass
C) Increased hepatic metabolism
D) Decreased gastric pH
Correct Answer: B
Rationale: Decreased lean body mass alters the volume of distribution for digoxin,
which distributes primarily to lean tissue, leading to higher serum concentrations and
increased toxicity risk .
,Question 3: Which pulmonary change increases infection risk in older adults?
A) Increased alveolar surface area
B) Decreased cough reflex
C) Increased mucociliary clearance
D) Increased chest wall compliance
Correct Answer: B
Rationale: The cough reflex diminishes with age, making older adults more susceptible
to aspiration and respiratory infections. Mucociliary clearance also decreases .
Question 4: An older adult reports feeling dizzy when standing up quickly. What is the
most appropriate initial recommendation?
A) Prescribe fludrocortisone
B) Instruct the patient to rise slowly from sitting or lying positions
C) Order a tilt-table test
D) Increase dietary sodium intake
Correct Answer: B
Rationale: Orthostatic hypotension is common due to decreased baroreceptor
sensitivity. Initial management is non-pharmacologic: rising slowly, adequate hydration,
avoiding sudden postural changes .
Question 5: According to the rule of fourths in geriatric care, which statement is most
accurate?
A) One-fourth of geriatric problems are iatrogenic
B) One-fourth of older adults live in nursing homes
C) One-fourth of geriatric patients have dementia
D) One-fourth of older adults are depressed
, Correct Answer: A
Rationale: The "rule of fourths" states approximately one-fourth of problems in older
adults are iatrogenic (caused by medical interventions), highlighting the importance of
careful medication management .
Question 6: Which of the following is most true about aging changes?
A) Stage 3 and 4 sleep increases
B) Renal perfusion is not reduced, but renal function is reduced
C) Hearing acuity declines beginning in middle age
D) All of the above
Correct Answer: C
Rationale: Presbycusis (hearing decline) typically begins in middle age, affecting high-
frequency sounds. Stage 3 and 4 sleep decreases with age, and both renal perfusion and
function decrease .
Question 7: What is the preferred amount of exercise recommended for older adults?
A) 15 minutes/day, 3 days/week
B) 30 minutes/day, 5 days/week
C) 60 minutes/day, 7 days/week
D) 45 minutes/day, 3 days/week
Correct Answer: B
Rationale: Guidelines recommend at least 150 minutes of moderate-intensity aerobic
activity per week (30 minutes/day, 5 days/week) plus muscle-strengthening activities 2+
days/week .
Review
Section 1: Geriatric Assessment & Physiologic Changes
(Questions 1–10)
Question 1: Which of the following is a normal physiologic change of aging that affects
pharmacokinetics?
A) Increased gastric pH
B) Increased renal blood flow
C) Decreased body fat
D) Increased hepatic blood flow
Correct Answer: A
Rationale: Gastric pH increases (becomes more alkaline) with age due to decreased
gastric acid production, affecting medication absorption. Renal blood flow, hepatic
blood flow, and lean body mass all decrease with age .
Question 2: An 80-year-old patient has a new prescription for digoxin. Which age-
related change should the nurse practitioner consider?
A) Increased glomerular filtration rate
B) Decreased lean body mass
C) Increased hepatic metabolism
D) Decreased gastric pH
Correct Answer: B
Rationale: Decreased lean body mass alters the volume of distribution for digoxin,
which distributes primarily to lean tissue, leading to higher serum concentrations and
increased toxicity risk .
,Question 3: Which pulmonary change increases infection risk in older adults?
A) Increased alveolar surface area
B) Decreased cough reflex
C) Increased mucociliary clearance
D) Increased chest wall compliance
Correct Answer: B
Rationale: The cough reflex diminishes with age, making older adults more susceptible
to aspiration and respiratory infections. Mucociliary clearance also decreases .
Question 4: An older adult reports feeling dizzy when standing up quickly. What is the
most appropriate initial recommendation?
A) Prescribe fludrocortisone
B) Instruct the patient to rise slowly from sitting or lying positions
C) Order a tilt-table test
D) Increase dietary sodium intake
Correct Answer: B
Rationale: Orthostatic hypotension is common due to decreased baroreceptor
sensitivity. Initial management is non-pharmacologic: rising slowly, adequate hydration,
avoiding sudden postural changes .
Question 5: According to the rule of fourths in geriatric care, which statement is most
accurate?
A) One-fourth of geriatric problems are iatrogenic
B) One-fourth of older adults live in nursing homes
C) One-fourth of geriatric patients have dementia
D) One-fourth of older adults are depressed
, Correct Answer: A
Rationale: The "rule of fourths" states approximately one-fourth of problems in older
adults are iatrogenic (caused by medical interventions), highlighting the importance of
careful medication management .
Question 6: Which of the following is most true about aging changes?
A) Stage 3 and 4 sleep increases
B) Renal perfusion is not reduced, but renal function is reduced
C) Hearing acuity declines beginning in middle age
D) All of the above
Correct Answer: C
Rationale: Presbycusis (hearing decline) typically begins in middle age, affecting high-
frequency sounds. Stage 3 and 4 sleep decreases with age, and both renal perfusion and
function decrease .
Question 7: What is the preferred amount of exercise recommended for older adults?
A) 15 minutes/day, 3 days/week
B) 30 minutes/day, 5 days/week
C) 60 minutes/day, 7 days/week
D) 45 minutes/day, 3 days/week
Correct Answer: B
Rationale: Guidelines recommend at least 150 minutes of moderate-intensity aerobic
activity per week (30 minutes/day, 5 days/week) plus muscle-strengthening activities 2+
days/week .
