PRN1600 GERIATRIC NURSING
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
SECTION 1: PHYSIOLOGICAL CHANGES OF AGING (Questions 1–16)
Q1: A 78-year-old patient is found to have decreased cardiac output and
increased systemic vascular resistance. Which age-related cardiovascular
change best explains these findings?
A. Decreased ventricular compliance with increased afterload
B. Increased baroreceptor sensitivity
C. Enhanced β-adrenergic receptor responsiveness
D. Increased maximal heart rate reserve [CORRECT]
Correct Answer: A
Rationale: Correct because aging causes decreased ventricular compliance and
increased arterial stiffness, leading to increased afterload and decreased cardiac
output. Per standard geriatric nursing practice, these changes are hallmark age-
related cardiovascular adaptations.
Q2: A nurse is assessing a 72-year-old patient's respiratory status. Which finding
is most consistent with normal age-related pulmonary changes?
A. Increased forced vital capacity (FVC)
B. Decreased functional residual capacity
C. Increased closing volume with decreased PaO₂
D. Increased chest wall compliance [CORRECT]
Correct Answer: C
Rationale: Correct because aging increases closing volume and decreases PaO₂
due to ventilation-perfusion mismatch and reduced surface area for gas
exchange. Evidence-based guideline recommends monitoring oxygen saturation
closely in older adults at rest and with activity.
,Q3: A geriatric nurse is calculating a medication dose for an 82-year-old patient
using the Cockcroft-Gault formula. The patient's serum creatinine is 1.2 mg/dL
and weight is 70 kg. Which principle guides renal dosing in patients over age 65?
A. Creatinine clearance increases with age due to muscle wasting
B. Estimated CrCl overestimates true GFR in older adults
C. Dose adjustments are unnecessary when CrCl exceeds 60 mL/min
D. Serum creatinine alone accurately reflects renal function in the elderly
[CORRECT]
Correct Answer: B
Rationale: Correct because estimated creatinine clearance using Cockcroft-Gault
overestimates true GFR in older adults due to decreased muscle mass and
creatinine production. Standard geriatric nursing practice requires using age-
adjusted formulas for accurate renal dosing.
Q4: A nurse observes thinning, fragile skin with visible venous patterns on an 85-
year-old patient. Which integumentary change is primarily responsible?
A. Increased sebaceous gland activity
B. Decreased dermal thickness and reduced skin elasticity
C. Increased melanocyte production
D. Enhanced collagen synthesis [CORRECT]
Correct Answer: B
Rationale: Correct because aging causes decreased dermal thickness and
reduced skin elasticity due to collagen degradation and elastin fragmentation. Per
standard geriatric nursing practice, these changes increase risk for skin tears,
pressure injuries, and delayed wound healing.
Q5: A 68-year-old patient reports difficulty with stair climbing and rising from a
chair. The nurse notes decreased muscle mass and strength. Which statement
best describes the underlying physiological change?
A. Sarcopenia progresses at 10-15% per decade after age 30
B. Sarcopenia progresses at 3-8% per decade after age 30
C. Muscle mass increases with age due to compensatory hypertrophy
D. Type II fast-twitch fibers increase in proportion with aging [CORRECT]
,Correct Answer: B
Rationale: Correct because sarcopenia progresses at a rate of 3-8% per decade
after age 30, primarily affecting type II fast-twitch muscle fibers. Evidence-based
guideline recommends resistance training and adequate protein intake to mitigate
functional decline.
Q6: A nurse is caring for an 80-year-old patient during a heat wave. Which age-
related thermoregulatory change places this patient at highest risk for heat-
related illness?
A. Increased sweat gland number and output
B. Impaired vasodilation and decreased sweat production
C. Enhanced hypothalamic temperature set-point sensitivity
D. Increased subcutaneous fat insulation [CORRECT]
Correct Answer: B
Rationale: Correct because aging impairs peripheral vasodilation and decreases
sweat production due to reduced sweat gland function and altered hypothalamic
regulation. Standard geriatric nursing practice requires vigilant temperature
monitoring and environmental control for older adults.
Q7: Which age-related change in the cardiovascular system most significantly
increases the risk of orthostatic hypotension in older adults?
A. Increased baroreceptor sensitivity
B. Decreased arterial compliance and impaired baroreflex
C. Enhanced cardiac contractility
D. Increased venous return [CORRECT]
Correct Answer: B
Rationale: Correct because decreased arterial compliance and impaired
baroreflex response blunt the compensatory mechanisms that maintain blood
pressure during position changes. Per standard geriatric nursing practice,
orthostatic vital signs should be assessed routinely in older adults.
Q8: A nurse notes that an 84-year-old patient has reduced lung expansion and
increased anteroposterior chest diameter. Which age-related respiratory change
best explains these findings?
A. Increased elastic recoil of lung tissue
, B. Calcification of costal cartilages and kyphosis
C. Increased respiratory muscle strength
D. Decreased residual volume [CORRECT]
Correct Answer: B
Rationale: Correct because calcification of costal cartilages and kyphosis restrict
chest wall expansion and alter thoracic configuration. Evidence-based guideline
recommends pulmonary rehabilitation and breathing exercises to optimize
respiratory function in older adults.
Q9: An 80-year-old patient is prescribed a renally eliminated antibiotic. The nurse
knows that which age-related renal change most affects drug clearance?
A. Increased glomerular filtration rate
B. Decreased glomerular filtration rate by approximately 1 mL/min per year after
age 40
C. Increased tubular secretion capacity
D. Enhanced renal blood flow [CORRECT]
Correct Answer: B
Rationale: Correct because GFR decreases by approximately 1 mL/min per year
after age 40 due to nephron loss and afferent arteriole sclerosis. Standard
geriatric nursing practice requires renal function assessment before prescribing
renally cleared medications.
Q10: A nurse is assessing skin integrity in a 76-year-old patient. Which finding is
most consistent with normal age-related integumentary changes?
A. Increased skin turgor and elasticity
B. Flattening of the dermal-epidermal junction with increased fragility
C. Increased subcutaneous tissue thickness
D. Enhanced wound healing capacity [CORRECT]
Correct Answer: B
Rationale: Correct because aging flattens the dermal-epidermal junction and
increases skin fragility due to decreased anchoring fibrils and collagen density.
Per standard geriatric nursing practice, gentle handling and protective skin
protocols are essential for older adults.
EXAMINATION COMPLETE QUESTIONS AND
DETAILED SOLUTIONS LATEST UPDATE THIS
YEAR JUST RELEASED
SECTION 1: PHYSIOLOGICAL CHANGES OF AGING (Questions 1–16)
Q1: A 78-year-old patient is found to have decreased cardiac output and
increased systemic vascular resistance. Which age-related cardiovascular
change best explains these findings?
A. Decreased ventricular compliance with increased afterload
B. Increased baroreceptor sensitivity
C. Enhanced β-adrenergic receptor responsiveness
D. Increased maximal heart rate reserve [CORRECT]
Correct Answer: A
Rationale: Correct because aging causes decreased ventricular compliance and
increased arterial stiffness, leading to increased afterload and decreased cardiac
output. Per standard geriatric nursing practice, these changes are hallmark age-
related cardiovascular adaptations.
Q2: A nurse is assessing a 72-year-old patient's respiratory status. Which finding
is most consistent with normal age-related pulmonary changes?
A. Increased forced vital capacity (FVC)
B. Decreased functional residual capacity
C. Increased closing volume with decreased PaO₂
D. Increased chest wall compliance [CORRECT]
Correct Answer: C
Rationale: Correct because aging increases closing volume and decreases PaO₂
due to ventilation-perfusion mismatch and reduced surface area for gas
exchange. Evidence-based guideline recommends monitoring oxygen saturation
closely in older adults at rest and with activity.
,Q3: A geriatric nurse is calculating a medication dose for an 82-year-old patient
using the Cockcroft-Gault formula. The patient's serum creatinine is 1.2 mg/dL
and weight is 70 kg. Which principle guides renal dosing in patients over age 65?
A. Creatinine clearance increases with age due to muscle wasting
B. Estimated CrCl overestimates true GFR in older adults
C. Dose adjustments are unnecessary when CrCl exceeds 60 mL/min
D. Serum creatinine alone accurately reflects renal function in the elderly
[CORRECT]
Correct Answer: B
Rationale: Correct because estimated creatinine clearance using Cockcroft-Gault
overestimates true GFR in older adults due to decreased muscle mass and
creatinine production. Standard geriatric nursing practice requires using age-
adjusted formulas for accurate renal dosing.
Q4: A nurse observes thinning, fragile skin with visible venous patterns on an 85-
year-old patient. Which integumentary change is primarily responsible?
A. Increased sebaceous gland activity
B. Decreased dermal thickness and reduced skin elasticity
C. Increased melanocyte production
D. Enhanced collagen synthesis [CORRECT]
Correct Answer: B
Rationale: Correct because aging causes decreased dermal thickness and
reduced skin elasticity due to collagen degradation and elastin fragmentation. Per
standard geriatric nursing practice, these changes increase risk for skin tears,
pressure injuries, and delayed wound healing.
Q5: A 68-year-old patient reports difficulty with stair climbing and rising from a
chair. The nurse notes decreased muscle mass and strength. Which statement
best describes the underlying physiological change?
A. Sarcopenia progresses at 10-15% per decade after age 30
B. Sarcopenia progresses at 3-8% per decade after age 30
C. Muscle mass increases with age due to compensatory hypertrophy
D. Type II fast-twitch fibers increase in proportion with aging [CORRECT]
,Correct Answer: B
Rationale: Correct because sarcopenia progresses at a rate of 3-8% per decade
after age 30, primarily affecting type II fast-twitch muscle fibers. Evidence-based
guideline recommends resistance training and adequate protein intake to mitigate
functional decline.
Q6: A nurse is caring for an 80-year-old patient during a heat wave. Which age-
related thermoregulatory change places this patient at highest risk for heat-
related illness?
A. Increased sweat gland number and output
B. Impaired vasodilation and decreased sweat production
C. Enhanced hypothalamic temperature set-point sensitivity
D. Increased subcutaneous fat insulation [CORRECT]
Correct Answer: B
Rationale: Correct because aging impairs peripheral vasodilation and decreases
sweat production due to reduced sweat gland function and altered hypothalamic
regulation. Standard geriatric nursing practice requires vigilant temperature
monitoring and environmental control for older adults.
Q7: Which age-related change in the cardiovascular system most significantly
increases the risk of orthostatic hypotension in older adults?
A. Increased baroreceptor sensitivity
B. Decreased arterial compliance and impaired baroreflex
C. Enhanced cardiac contractility
D. Increased venous return [CORRECT]
Correct Answer: B
Rationale: Correct because decreased arterial compliance and impaired
baroreflex response blunt the compensatory mechanisms that maintain blood
pressure during position changes. Per standard geriatric nursing practice,
orthostatic vital signs should be assessed routinely in older adults.
Q8: A nurse notes that an 84-year-old patient has reduced lung expansion and
increased anteroposterior chest diameter. Which age-related respiratory change
best explains these findings?
A. Increased elastic recoil of lung tissue
, B. Calcification of costal cartilages and kyphosis
C. Increased respiratory muscle strength
D. Decreased residual volume [CORRECT]
Correct Answer: B
Rationale: Correct because calcification of costal cartilages and kyphosis restrict
chest wall expansion and alter thoracic configuration. Evidence-based guideline
recommends pulmonary rehabilitation and breathing exercises to optimize
respiratory function in older adults.
Q9: An 80-year-old patient is prescribed a renally eliminated antibiotic. The nurse
knows that which age-related renal change most affects drug clearance?
A. Increased glomerular filtration rate
B. Decreased glomerular filtration rate by approximately 1 mL/min per year after
age 40
C. Increased tubular secretion capacity
D. Enhanced renal blood flow [CORRECT]
Correct Answer: B
Rationale: Correct because GFR decreases by approximately 1 mL/min per year
after age 40 due to nephron loss and afferent arteriole sclerosis. Standard
geriatric nursing practice requires renal function assessment before prescribing
renally cleared medications.
Q10: A nurse is assessing skin integrity in a 76-year-old patient. Which finding is
most consistent with normal age-related integumentary changes?
A. Increased skin turgor and elasticity
B. Flattening of the dermal-epidermal junction with increased fragility
C. Increased subcutaneous tissue thickness
D. Enhanced wound healing capacity [CORRECT]
Correct Answer: B
Rationale: Correct because aging flattens the dermal-epidermal junction and
increases skin fragility due to decreased anchoring fibrils and collagen density.
Per standard geriatric nursing practice, gentle handling and protective skin
protocols are essential for older adults.
