NURS 5461 ADULT GERONTOLOGY FINAL EXAM 2026/2027 & STUDY
GUIDE COMPLETE ACCURATE EXAM ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES
1. An 82-year-old patient tells the nurse that aging has caused slower
movement, decreased skin elasticity, and a need for brighter lighting when
reading, but the patient remains independent in managing finances,
medications, and household activities. Which interpretation of these
findings is most appropriate?
A. The patient is demonstrating pathological aging because independence is
inconsistent with normal aging
B. The patient is demonstrating normal physiologic aging changes that do
not necessarily indicate disease
C. The patient is demonstrating early dementia because sensory changes
occur with aging
D. The patient is experiencing accelerated aging caused by inevitable
chronic disease
Answer: B
2. An older adult reports difficulty remembering a person's name but later
recalls it without assistance and continues to manage medications,
finances, transportation, and personal care independently. Which finding is
most consistent with normal aging?
A. Progressive inability to perform instrumental activities of daily living
B. Loss of the ability to recognize familiar family members
C. Occasional difficulty retrieving information with preserved overall
functioning
D. Repeatedly becoming lost in familiar surroundings
Answer: C
3. During an assessment of an 80-year-old patient, the nurse notices that the
skin is thinner, less elastic, and more prone to bruising than it was earlier in
life. Which physiologic change primarily contributes to these findings?
A. Increased collagen production and increased subcutaneous fat
pg. 1
, B. Increased epidermal thickness and increased sebaceous gland activity
C. Reduced collagen, elastin, and subcutaneous tissue associated with aging
D. Increased peripheral circulation and increased skin hydration
Answer: C
4. An older adult is hospitalized with dehydration and receives several
medications that are primarily eliminated through the kidneys. Why should
the nurse anticipate a greater risk of medication accumulation in this
patient?
A. Aging may reduce renal blood flow, glomerular filtration, and renal
clearance
B. Older adults always have increased renal filtration compared with
younger adults
C. Aging causes the kidneys to metabolize medications more rapidly
D. Dehydration consistently increases renal elimination of medications
Answer: A
5. A 79-year-old patient reports becoming short of breath while climbing stairs
but denies chest pain or cough. Which age-related respiratory change can
contribute to decreased exercise tolerance in an otherwise healthy older
adult?
A. Increased alveolar surface area
B. Increased chest wall compliance
C. Increased pulmonary elastic recoil
D. Reduced elastic recoil and decreased pulmonary reserve
Answer: D
6. An older adult has a resting heart rate within the expected adult range but
develops fatigue during strenuous activity more quickly than when younger.
Which cardiovascular change associated with aging can contribute to this
response?
A. Increased maximal cardiac output
B. Reduced cardiovascular reserve during exertion
C. Complete loss of myocardial contractility
pg. 2
, D. Persistent severe resting tachycardia
Answer: B
7. An older patient reports constipation after becoming less physically active
and changing dietary habits. Which age-associated gastrointestinal change
may contribute to this problem?
A. Increased intestinal motility
B. Increased gastric emptying
C. Reduced gastrointestinal motility
D. Increased digestive enzyme secretion
Answer: C
8. A nurse is evaluating the nutritional status of an 86-year-old patient who
has unintentionally lost 8 kg over six months. Which finding should receive
the greatest attention because it may indicate a significant geriatric health
problem?
A. Mild preference for softer foods
B. Unintentional weight loss and reduced nutritional intake
C. Preference for eating breakfast rather than dinner
D. Increased interest in drinking water
Answer: B
9. An older adult reports waking several times during the night and sleeping
less deeply than when younger. Which explanation is most appropriate?
A. Older adults normally require no sleep
B. Aging can alter sleep architecture and increase nighttime awakenings
C. Sleep disruption always indicates dementia
D. Frequent awakening is diagnostic of major depression
Answer: B
10. An 88-year-old patient reports difficulty hearing conversations when several
people are speaking simultaneously. Which age-related sensory change is
most consistent with this complaint?
A. Presbycusis
B. Glaucoma
pg. 3
, C. Presbyopia
D. Cataract formation
Answer: A
11. An older adult has increasing difficulty seeing objects close to the face and
requires reading glasses. Which normal age-related visual change is most
likely responsible?
A. Retinal detachment
B. Presbyopia
C. Macular degeneration
D. Acute glaucoma
Answer: B
12. During a home assessment, the nurse finds that an older patient takes 12
prescription medications, three over-the-counter products, and several
herbal supplements. Which concern should the nurse prioritize?
A. Polypharmacy and increased potential for drug interactions and adverse
effects
B. Excessive hydration caused by multiple medications
C. Normal medication use that requires no further assessment
D. Increased medication adherence because more medications are
prescribed
Answer: A
13. An 84-year-old patient becomes dizzy after standing from a chair. Blood
pressure decreases substantially when moving from sitting to standing.
Which condition should the nurse recognize?
A. Orthostatic hypotension
B. Essential hypertension
C. Increased intracranial pressure
D. Hypervolemia
Answer: A
14. An older adult taking several antihypertensive and sedating medications has
fallen twice in the past month. Which intervention is most appropriate for
pg. 4
GUIDE COMPLETE ACCURATE EXAM ACTUAL QUESTIONS AND CORRECT
ANSWERS WITH DETAILED RATIONALES
1. An 82-year-old patient tells the nurse that aging has caused slower
movement, decreased skin elasticity, and a need for brighter lighting when
reading, but the patient remains independent in managing finances,
medications, and household activities. Which interpretation of these
findings is most appropriate?
A. The patient is demonstrating pathological aging because independence is
inconsistent with normal aging
B. The patient is demonstrating normal physiologic aging changes that do
not necessarily indicate disease
C. The patient is demonstrating early dementia because sensory changes
occur with aging
D. The patient is experiencing accelerated aging caused by inevitable
chronic disease
Answer: B
2. An older adult reports difficulty remembering a person's name but later
recalls it without assistance and continues to manage medications,
finances, transportation, and personal care independently. Which finding is
most consistent with normal aging?
A. Progressive inability to perform instrumental activities of daily living
B. Loss of the ability to recognize familiar family members
C. Occasional difficulty retrieving information with preserved overall
functioning
D. Repeatedly becoming lost in familiar surroundings
Answer: C
3. During an assessment of an 80-year-old patient, the nurse notices that the
skin is thinner, less elastic, and more prone to bruising than it was earlier in
life. Which physiologic change primarily contributes to these findings?
A. Increased collagen production and increased subcutaneous fat
pg. 1
, B. Increased epidermal thickness and increased sebaceous gland activity
C. Reduced collagen, elastin, and subcutaneous tissue associated with aging
D. Increased peripheral circulation and increased skin hydration
Answer: C
4. An older adult is hospitalized with dehydration and receives several
medications that are primarily eliminated through the kidneys. Why should
the nurse anticipate a greater risk of medication accumulation in this
patient?
A. Aging may reduce renal blood flow, glomerular filtration, and renal
clearance
B. Older adults always have increased renal filtration compared with
younger adults
C. Aging causes the kidneys to metabolize medications more rapidly
D. Dehydration consistently increases renal elimination of medications
Answer: A
5. A 79-year-old patient reports becoming short of breath while climbing stairs
but denies chest pain or cough. Which age-related respiratory change can
contribute to decreased exercise tolerance in an otherwise healthy older
adult?
A. Increased alveolar surface area
B. Increased chest wall compliance
C. Increased pulmonary elastic recoil
D. Reduced elastic recoil and decreased pulmonary reserve
Answer: D
6. An older adult has a resting heart rate within the expected adult range but
develops fatigue during strenuous activity more quickly than when younger.
Which cardiovascular change associated with aging can contribute to this
response?
A. Increased maximal cardiac output
B. Reduced cardiovascular reserve during exertion
C. Complete loss of myocardial contractility
pg. 2
, D. Persistent severe resting tachycardia
Answer: B
7. An older patient reports constipation after becoming less physically active
and changing dietary habits. Which age-associated gastrointestinal change
may contribute to this problem?
A. Increased intestinal motility
B. Increased gastric emptying
C. Reduced gastrointestinal motility
D. Increased digestive enzyme secretion
Answer: C
8. A nurse is evaluating the nutritional status of an 86-year-old patient who
has unintentionally lost 8 kg over six months. Which finding should receive
the greatest attention because it may indicate a significant geriatric health
problem?
A. Mild preference for softer foods
B. Unintentional weight loss and reduced nutritional intake
C. Preference for eating breakfast rather than dinner
D. Increased interest in drinking water
Answer: B
9. An older adult reports waking several times during the night and sleeping
less deeply than when younger. Which explanation is most appropriate?
A. Older adults normally require no sleep
B. Aging can alter sleep architecture and increase nighttime awakenings
C. Sleep disruption always indicates dementia
D. Frequent awakening is diagnostic of major depression
Answer: B
10. An 88-year-old patient reports difficulty hearing conversations when several
people are speaking simultaneously. Which age-related sensory change is
most consistent with this complaint?
A. Presbycusis
B. Glaucoma
pg. 3
, C. Presbyopia
D. Cataract formation
Answer: A
11. An older adult has increasing difficulty seeing objects close to the face and
requires reading glasses. Which normal age-related visual change is most
likely responsible?
A. Retinal detachment
B. Presbyopia
C. Macular degeneration
D. Acute glaucoma
Answer: B
12. During a home assessment, the nurse finds that an older patient takes 12
prescription medications, three over-the-counter products, and several
herbal supplements. Which concern should the nurse prioritize?
A. Polypharmacy and increased potential for drug interactions and adverse
effects
B. Excessive hydration caused by multiple medications
C. Normal medication use that requires no further assessment
D. Increased medication adherence because more medications are
prescribed
Answer: A
13. An 84-year-old patient becomes dizzy after standing from a chair. Blood
pressure decreases substantially when moving from sitting to standing.
Which condition should the nurse recognize?
A. Orthostatic hypotension
B. Essential hypertension
C. Increased intracranial pressure
D. Hypervolemia
Answer: A
14. An older adult taking several antihypertensive and sedating medications has
fallen twice in the past month. Which intervention is most appropriate for
pg. 4
