Page 1 of 82
ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS, 3RD
EDITION QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED
QUESTIONS & ANSWERS
ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS, 3RD EDITION
By Laurie Kennedy-Malone & Evelyn Groenke Duffy
COMPREHENSIVE PRACTICE QUESTIONS WITH ANSWERS AND RATIONALES
SECTION 1: FOUNDATIONS OF GERONTOLOGICAL NURSING (Chapters 1–5)
Questions 1–40
1. The major impact of the physiological changes that occur with aging is:
A) Reduced physiological reserve
B) Reduced homeostatic mechanisms
C) Impaired immunological response
D) All of the above
Answer: D) All of the above
Rationale: Aging results in reduced physiological reserve (decreased ability to respond
to stress), reduced homeostatic mechanisms (impaired ability to maintain internal
balance), and impaired immunological response (increased susceptibility to infection).
These changes collectively increase vulnerability to illness and decreased ability to
recover from stressors.
2. The strongest evidence regarding normal physiological aging is available
through:
A) Randomized controlled clinical trials
B) Cross-sectional studies
C) Longitudinal studies
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D) Case control studies
Answer: C) Longitudinal studies
Rationale: Longitudinal studies follow the same individuals over time, providing the
strongest evidence for understanding normal physiological aging by distinguishing age-
related changes from cohort effects.
3. Biochemical individuality is best described as:
A) Each individual's variation is often much greater than that of a larger group
B) The unique biochemical profile of a selected population
C) The truly "normal" individual—falling within average range
D) Each individual's variation is often much smaller than that of a larger group
Answer: A) Each individual's variation is often much greater than that of a larger
group
Rationale: Biochemical individuality recognizes that each person's biochemical profile
is unique and that individual variation is often greater than group variation. This concept
is essential when interpreting laboratory values in older adults.
4. Polypharmacy is best described as taking:
A) More than nine medications per day
B) More than five medications per day
C) Even a single medication if there is not a clear indication for its use
D) When a drug is given to treat the side effect of another drug
Answer: C) Even a single medication if there is not a clear indication for its use
Rationale: Polypharmacy is defined as the use of multiple medications, but more
importantly, it includes the use of medications without a clear indication. This definition
emphasizes the clinical significance of inappropriate prescribing rather than just the
number of medications.
5. Pharmacokinetic changes with aging reflect:
A) What the drug does to the body
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B) What the body does to the drug
C) The effect at the site of action and the time and intensity of the drug
D) The side effects commonly associated with the drug
Answer: B) What the body does to the drug
Rationale: Pharmacokinetics refers to what the body does to the drug—absorption,
distribution, metabolism, and excretion. Pharmacodynamics refers to what the drug
does to the body.
6. All of the following statements are true about drug absorption in older adults
EXCEPT:
A) Antacids increase the bioavailability of digitalis
B) Gastric acidity decreases with age
C) Anticholinergics increase colonic motility
D) Underlying chronic disease has little impact on drug absorption
Answer: C) Anticholinergics increase colonic motility
Rationale: Anticholinergics actually decrease colonic motility, leading to constipation,
not increased motility. This is a common side effect in older adults. The other
statements are true regarding drug absorption in the elderly.
7. All of the following statements are true about drug distribution in older adults
EXCEPT:
A) Drugs distributed in water have lower concentration
B) Drugs distributed in fat have less intense, more prolonged effect
C) Drugs highly protein bound have greater potential to cause an adverse drug reaction
D) The fastest way to deliver a drug to the action site is by inhalation
Answer: A) Drugs distributed in water have lower concentration
Rationale: In older adults, total body water decreases, so drugs distributed in water
actually have higher concentration (not lower) due to smaller volume of distribution.
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8. Men have faster and more efficient biotransformation of drugs, thought to be due
to:
A) Less obesity rates than women
B) Prostate enlargement
C) Testosterone
D) Less estrogen than women
Answer: C) Testosterone
Rationale: Testosterone is thought to contribute to faster and more efficient drug
biotransformation in men compared to women, affecting drug metabolism and
clearance.
9. The cytochrome P450 system involves enzymes that are generally:
A) Inhibited by drugs
B) Induced by drugs
C) Inhibited or induced by drugs
D) Associated with decreased liver perfusion
Answer: C) Inhibited or induced by drugs
Rationale: The cytochrome P450 enzyme system can be either inhibited or induced by
various drugs, leading to clinically significant drug interactions. Inhibition decreases
metabolism, while induction increases metabolism of other drugs.
10. A statement NOT shown to be true about pharmacodynamic changes with aging
is:
A) Decreased sensitivity to oral anticoagulants
B) Enhanced sensitivity to central nervous system drugs
C) Drug responsiveness can be influenced by patient activity level
D) There is a decreased sensitivity to beta blockers
Answer: A) Decreased sensitivity to oral anticoagulants
ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS, 3RD
EDITION QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED
QUESTIONS & ANSWERS
ADVANCED PRACTICE NURSING IN THE CARE OF OLDER ADULTS, 3RD EDITION
By Laurie Kennedy-Malone & Evelyn Groenke Duffy
COMPREHENSIVE PRACTICE QUESTIONS WITH ANSWERS AND RATIONALES
SECTION 1: FOUNDATIONS OF GERONTOLOGICAL NURSING (Chapters 1–5)
Questions 1–40
1. The major impact of the physiological changes that occur with aging is:
A) Reduced physiological reserve
B) Reduced homeostatic mechanisms
C) Impaired immunological response
D) All of the above
Answer: D) All of the above
Rationale: Aging results in reduced physiological reserve (decreased ability to respond
to stress), reduced homeostatic mechanisms (impaired ability to maintain internal
balance), and impaired immunological response (increased susceptibility to infection).
These changes collectively increase vulnerability to illness and decreased ability to
recover from stressors.
2. The strongest evidence regarding normal physiological aging is available
through:
A) Randomized controlled clinical trials
B) Cross-sectional studies
C) Longitudinal studies
, Page 2 of 82
D) Case control studies
Answer: C) Longitudinal studies
Rationale: Longitudinal studies follow the same individuals over time, providing the
strongest evidence for understanding normal physiological aging by distinguishing age-
related changes from cohort effects.
3. Biochemical individuality is best described as:
A) Each individual's variation is often much greater than that of a larger group
B) The unique biochemical profile of a selected population
C) The truly "normal" individual—falling within average range
D) Each individual's variation is often much smaller than that of a larger group
Answer: A) Each individual's variation is often much greater than that of a larger
group
Rationale: Biochemical individuality recognizes that each person's biochemical profile
is unique and that individual variation is often greater than group variation. This concept
is essential when interpreting laboratory values in older adults.
4. Polypharmacy is best described as taking:
A) More than nine medications per day
B) More than five medications per day
C) Even a single medication if there is not a clear indication for its use
D) When a drug is given to treat the side effect of another drug
Answer: C) Even a single medication if there is not a clear indication for its use
Rationale: Polypharmacy is defined as the use of multiple medications, but more
importantly, it includes the use of medications without a clear indication. This definition
emphasizes the clinical significance of inappropriate prescribing rather than just the
number of medications.
5. Pharmacokinetic changes with aging reflect:
A) What the drug does to the body
, Page 3 of 82
B) What the body does to the drug
C) The effect at the site of action and the time and intensity of the drug
D) The side effects commonly associated with the drug
Answer: B) What the body does to the drug
Rationale: Pharmacokinetics refers to what the body does to the drug—absorption,
distribution, metabolism, and excretion. Pharmacodynamics refers to what the drug
does to the body.
6. All of the following statements are true about drug absorption in older adults
EXCEPT:
A) Antacids increase the bioavailability of digitalis
B) Gastric acidity decreases with age
C) Anticholinergics increase colonic motility
D) Underlying chronic disease has little impact on drug absorption
Answer: C) Anticholinergics increase colonic motility
Rationale: Anticholinergics actually decrease colonic motility, leading to constipation,
not increased motility. This is a common side effect in older adults. The other
statements are true regarding drug absorption in the elderly.
7. All of the following statements are true about drug distribution in older adults
EXCEPT:
A) Drugs distributed in water have lower concentration
B) Drugs distributed in fat have less intense, more prolonged effect
C) Drugs highly protein bound have greater potential to cause an adverse drug reaction
D) The fastest way to deliver a drug to the action site is by inhalation
Answer: A) Drugs distributed in water have lower concentration
Rationale: In older adults, total body water decreases, so drugs distributed in water
actually have higher concentration (not lower) due to smaller volume of distribution.
, Page 4 of 82
8. Men have faster and more efficient biotransformation of drugs, thought to be due
to:
A) Less obesity rates than women
B) Prostate enlargement
C) Testosterone
D) Less estrogen than women
Answer: C) Testosterone
Rationale: Testosterone is thought to contribute to faster and more efficient drug
biotransformation in men compared to women, affecting drug metabolism and
clearance.
9. The cytochrome P450 system involves enzymes that are generally:
A) Inhibited by drugs
B) Induced by drugs
C) Inhibited or induced by drugs
D) Associated with decreased liver perfusion
Answer: C) Inhibited or induced by drugs
Rationale: The cytochrome P450 enzyme system can be either inhibited or induced by
various drugs, leading to clinically significant drug interactions. Inhibition decreases
metabolism, while induction increases metabolism of other drugs.
10. A statement NOT shown to be true about pharmacodynamic changes with aging
is:
A) Decreased sensitivity to oral anticoagulants
B) Enhanced sensitivity to central nervous system drugs
C) Drug responsiveness can be influenced by patient activity level
D) There is a decreased sensitivity to beta blockers
Answer: A) Decreased sensitivity to oral anticoagulants
