Practice Questions — Advanced Practice
Nursing in the Care of Older Adults
(original)
Chapter 1 — Principles of Aging (Questions 1–10)
1. Normal age-related change in cardiovascular function includes:
A. Increased maximal heart rate
B. Increased arterial stiffness
C. Increased cardiac output at rest
D. Large increase in stroke volume
Answer: B
Rationale: Aging causes arterial stiffening and higher systolic BP.
2. Which best describes "homeostenosis"?
A. Increased physiologic reserve with age
B. Narrowing of ability to maintain homeostasis
C. New onset chronic disease process
D. Increased immune response in older adults
Answer: B
Rationale: Homeostenosis = reduced reserve, vulnerability to stressors.
3. Normal sensory change with age:
A. Improved visual acuity in low light
B. Presbycusis—high-frequency hearing loss
C. Complete loss of taste buds
D. Sudden, severe olfactory loss
Answer: B
Rationale: Presbycusis commonly affects high frequencies gradually.
4. The most important factor influencing variability of aging is:
A. Chronologic age alone
B. Genetics only
C. Lifecourse exposures and behaviors
D. Race exclusively
Answer: C
, Rationale: Lifecourse exposures and behaviors drive heterogeneity in aging.
5. Sarcopenia is best defined as:
A. Replacement of muscle with fat only
B. Progressive loss of skeletal muscle mass and strength
C. Acute muscle wasting from infection
D. Condition exclusive to bedridden patients
Answer: B
Rationale: Sarcopenia involves chronic muscle mass and strength decline.
6. Which statement about aging immune function is true?
A. Older adults have enhanced vaccine responses
B. Innate immunity becomes hyperactive and flawless
C. Immunosenescence leads to reduced response to new antigens
D. T-cell function is unchanged with age
Answer: C
Rationale: Immunosenescence reduces adaptive responses to novel antigens.
7. Which is a common renal change with age?
A. Increased GFR after age 65
B. Decreased renal blood flow and GFR
C. Total elimination of drug clearance capacity
D. Improved ability to concentrate urine
Answer: B
Rationale: Renal blood flow and GFR commonly decline with age.
8. Frailty is best characterized by:
A. Single chronic disease only
B. Increased resiliency and strength
C. Decreased physiologic reserve and increased vulnerability
D. Always reversible with bed rest
Answer: C
Rationale: Frailty = low reserve, high vulnerability to stressors.
9. Most validated frailty screening includes which component?
A. Young chronological age
B. Weight loss, exhaustion, low activity, slowness, weakness
C. Isolated lab value abnormality
D. Presence of polypharmacy only
Answer: B
Rationale: Fried phenotype uses weight loss, exhaustion, low activity, slowness,
weakness.
, 10.Lifespan ≠ healthspan. Healthspan is:
A. Years lived with disease burden only
B. Years lived in good health and function
C. Chronologic age at death
D. Time spent hospitalized
Answer: B
Rationale: Healthspan = years lived with preserved health and function.
Chapter 2 — Comprehensive Geriatric Assessment
(Questions 11–20)
11.The core domains of CGA do NOT include:
A. Functional status
B. Social support
C. Genetic sequencing panels
D. Cognition
Answer: C
Rationale: CGA focuses on function, cognition, mood, meds, social supports—not
genetics.
12.Best tool to screen for basic ADLs independence:
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence in ADLs
C. PHQ-9
D. Timed Up and Go only
Answer: B
Rationale: Katz Index assesses independence in ADLs.
13.Which assessment identifies fall risk by gait and balance?
A. 6-minute walk test
B. Timed Up and Go (TUG)
C. Serum albumin level
D. Beck Depression Inventory
Answer: B
Rationale: TUG measures mobility, gait, and balance fall risk.
14.When performing medication review, the clinician should:
A. Only list current prescriptions without reconciliation
B. Reconcile all meds including OTCs and supplements
C. Stop all medications older adults take
, D. Ignore PRN medications
Answer: B
Rationale: Complete reconciliation includes prescription, OTC, supplements, PRNs.
15.A key social domain in CGA includes:
A. DNA ancestry testing
B. Availability of caregivers and living situation
C. Blood glucose values
D. Hearing test only
Answer: B
Rationale: Social assessment includes caregivers, living, financial, safety.
16.Cognitive screening with high sensitivity for dementia:
A. Clock Drawing Test combined with recall
B. Random blood pressure check
C. Measuring height and weight
D. Urinalysis only
Answer: A
Rationale: Clock drawing plus recall is quick sensitive cognitive screen.
17.The best approach to address malnutrition risk in CGA:
A. Ignore weight change if mild
B. Use Mini Nutritional Assessment and intervene early
C. Wait for BMI <18 before acting
D. Encourage unlimited high-sugar snacks
Answer: B
Rationale: MNA identifies malnutrition risk for early intervention.
18.Depression in older adults often presents as:
A. Only sadness and tearfulness
B. Apathy, somatic complaints, decreased energy
C. Increased appetite and hyperactivity only
D. New onset delusions always
Answer: B
Rationale: Older adults may show apathy, somatic complaints, sleep/appetite changes.
19.Advance care planning in CGA should:
A. Be avoided until terminal illness
B. Be initiated proactively and revisited regularly
C. Only include monetary wills
D. Be documented only verbally
Answer: B
Rationale: ACP should be proactive, documented, and revisited.
Nursing in the Care of Older Adults
(original)
Chapter 1 — Principles of Aging (Questions 1–10)
1. Normal age-related change in cardiovascular function includes:
A. Increased maximal heart rate
B. Increased arterial stiffness
C. Increased cardiac output at rest
D. Large increase in stroke volume
Answer: B
Rationale: Aging causes arterial stiffening and higher systolic BP.
2. Which best describes "homeostenosis"?
A. Increased physiologic reserve with age
B. Narrowing of ability to maintain homeostasis
C. New onset chronic disease process
D. Increased immune response in older adults
Answer: B
Rationale: Homeostenosis = reduced reserve, vulnerability to stressors.
3. Normal sensory change with age:
A. Improved visual acuity in low light
B. Presbycusis—high-frequency hearing loss
C. Complete loss of taste buds
D. Sudden, severe olfactory loss
Answer: B
Rationale: Presbycusis commonly affects high frequencies gradually.
4. The most important factor influencing variability of aging is:
A. Chronologic age alone
B. Genetics only
C. Lifecourse exposures and behaviors
D. Race exclusively
Answer: C
, Rationale: Lifecourse exposures and behaviors drive heterogeneity in aging.
5. Sarcopenia is best defined as:
A. Replacement of muscle with fat only
B. Progressive loss of skeletal muscle mass and strength
C. Acute muscle wasting from infection
D. Condition exclusive to bedridden patients
Answer: B
Rationale: Sarcopenia involves chronic muscle mass and strength decline.
6. Which statement about aging immune function is true?
A. Older adults have enhanced vaccine responses
B. Innate immunity becomes hyperactive and flawless
C. Immunosenescence leads to reduced response to new antigens
D. T-cell function is unchanged with age
Answer: C
Rationale: Immunosenescence reduces adaptive responses to novel antigens.
7. Which is a common renal change with age?
A. Increased GFR after age 65
B. Decreased renal blood flow and GFR
C. Total elimination of drug clearance capacity
D. Improved ability to concentrate urine
Answer: B
Rationale: Renal blood flow and GFR commonly decline with age.
8. Frailty is best characterized by:
A. Single chronic disease only
B. Increased resiliency and strength
C. Decreased physiologic reserve and increased vulnerability
D. Always reversible with bed rest
Answer: C
Rationale: Frailty = low reserve, high vulnerability to stressors.
9. Most validated frailty screening includes which component?
A. Young chronological age
B. Weight loss, exhaustion, low activity, slowness, weakness
C. Isolated lab value abnormality
D. Presence of polypharmacy only
Answer: B
Rationale: Fried phenotype uses weight loss, exhaustion, low activity, slowness,
weakness.
, 10.Lifespan ≠ healthspan. Healthspan is:
A. Years lived with disease burden only
B. Years lived in good health and function
C. Chronologic age at death
D. Time spent hospitalized
Answer: B
Rationale: Healthspan = years lived with preserved health and function.
Chapter 2 — Comprehensive Geriatric Assessment
(Questions 11–20)
11.The core domains of CGA do NOT include:
A. Functional status
B. Social support
C. Genetic sequencing panels
D. Cognition
Answer: C
Rationale: CGA focuses on function, cognition, mood, meds, social supports—not
genetics.
12.Best tool to screen for basic ADLs independence:
A. Mini-Mental State Exam (MMSE)
B. Katz Index of Independence in ADLs
C. PHQ-9
D. Timed Up and Go only
Answer: B
Rationale: Katz Index assesses independence in ADLs.
13.Which assessment identifies fall risk by gait and balance?
A. 6-minute walk test
B. Timed Up and Go (TUG)
C. Serum albumin level
D. Beck Depression Inventory
Answer: B
Rationale: TUG measures mobility, gait, and balance fall risk.
14.When performing medication review, the clinician should:
A. Only list current prescriptions without reconciliation
B. Reconcile all meds including OTCs and supplements
C. Stop all medications older adults take
, D. Ignore PRN medications
Answer: B
Rationale: Complete reconciliation includes prescription, OTC, supplements, PRNs.
15.A key social domain in CGA includes:
A. DNA ancestry testing
B. Availability of caregivers and living situation
C. Blood glucose values
D. Hearing test only
Answer: B
Rationale: Social assessment includes caregivers, living, financial, safety.
16.Cognitive screening with high sensitivity for dementia:
A. Clock Drawing Test combined with recall
B. Random blood pressure check
C. Measuring height and weight
D. Urinalysis only
Answer: A
Rationale: Clock drawing plus recall is quick sensitive cognitive screen.
17.The best approach to address malnutrition risk in CGA:
A. Ignore weight change if mild
B. Use Mini Nutritional Assessment and intervene early
C. Wait for BMI <18 before acting
D. Encourage unlimited high-sugar snacks
Answer: B
Rationale: MNA identifies malnutrition risk for early intervention.
18.Depression in older adults often presents as:
A. Only sadness and tearfulness
B. Apathy, somatic complaints, decreased energy
C. Increased appetite and hyperactivity only
D. New onset delusions always
Answer: B
Rationale: Older adults may show apathy, somatic complaints, sleep/appetite changes.
19.Advance care planning in CGA should:
A. Be avoided until terminal illness
B. Be initiated proactively and revisited regularly
C. Only include monetary wills
D. Be documented only verbally
Answer: B
Rationale: ACP should be proactive, documented, and revisited.
