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NURS 6540 / NURS 6540 Exam
Study Guide (Latest 2025/2026)
Advanced Practice Care of Frail
Elders – Walden University
Comprehensive 150-Question
Multiple-Choice Exam Bank
SECTION 1: PHYSIOLOGY OF AGING & FRAILTY (Questions 1–20)
1. A 78-year-old patient reports feeling weak, has unintentional weight loss of 8%
over the past 6 months, reports exhaustion most days, walks slowly, and has low
physical activity. This presentation is most consistent with:
A) Normal aging
B) Sarcopenia
C) Frailty syndrome
D) Depression
- detailed 100% correctanswer :- C
Rationale: This patient meets three or more of the Fried frailty criteria: unintentional
weight loss (>5% in 6 months), exhaustion, weakness, slow walking speed, and low
physical activity. Frailty is a distinct clinical syndrome associated with increased
vulnerability to stressors and adverse outcomes.
, 2
2. Which physiological change of aging increases the risk of hypothermia in older
adults?
A) Increased metabolic rate
B) Decreased subcutaneous fat and impaired thermoregulation
C) Increased sweat gland activity
D) Enhanced peripheral vasodilation
- detailed 100% correctanswer :- B
Rationale: Aging is associated with decreased subcutaneous fat (reduced insulation),
impaired vasoconstriction response, and decreased shivering response, all contributing
to increased risk of hypothermia in older adults.
3. A 72-year-old patient has a serum creatinine of 1.4 mg/dL. The nurse
practitioner understands that:
A) This indicates normal renal function for age
B) Creatinine may overestimate GFR due to decreased muscle mass
C) Creatinine is the most accurate measure of renal function in older adults
D) This value indicates acute kidney injury
- detailed 100% correctanswer :- B
Rationale: Age-related loss of muscle mass (sarcopenia) reduces creatinine production. A
normal or mildly elevated serum creatinine may actually reflect significantly reduced
GFR in older adults.
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4. Which of the following is TRUE regarding cortical neuronal loss in normal
aging?
A) Cortical neuronal loss is a normal part of the aging process
B) Cortical neuronal loss does not occur in normal aging
C) Cortical neuronal loss occurs only in Alzheimer's disease
D) Cortical neuronal loss is reversible with cognitive training
- detailed 100% correctanswer :- B
Rationale: Cortical neuronal loss is NOT part of normal aging. Neuronal loss in normal
aging occurs in areas such as the thalamus, striatum, and basal forebrain, but not in the
cerebral cortex.
5. Which of the following best defines frailty in the older adult population?
A) A normal consequence of aging that requires no intervention
B) Decreased ability to cope with acute stressors due to age-related physiological and
functional decline
C) A psychological condition characterized by depression and social withdrawal
D) The inevitable loss of all activities of daily living
- detailed 100% correctanswer :- B
Rationale: Frailty is defined as a decreased ability to cope with acute stressors due to
age-related physiological and functional decline. It is a distinct clinical syndrome, not an
inevitable part of aging.
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6. Sarcopenia in older adults is characterized by:
A) Increased muscle mass and strength
B) Age-related loss of skeletal muscle mass and function
C) Excessive fat deposition in muscle tissue
D) Reversible muscle wasting with high-protein diet alone
- detailed 100% correctanswer :- B
Rationale: Sarcopenia is the age-related loss of skeletal muscle mass and function. It
contributes to weakness, frailty, and increased risk of falls and disability in older adults.
7. Immunosenescence refers to:
A) Enhanced immune response in older adults
B) The age-related decline in immune system function
C) The process of immunization in elderly populations
D) Increased production of antibodies with aging
- detailed 100% correctanswer :- B
Rationale: Immunosenescence is the age-related decline in immune system function,
making older adults more susceptible to infections and less responsive to vaccinations.
8. A frail older adult is at increased risk for which of the following adverse
outcomes? (Select the BEST answer)
NURS 6540 / NURS 6540 Exam
Study Guide (Latest 2025/2026)
Advanced Practice Care of Frail
Elders – Walden University
Comprehensive 150-Question
Multiple-Choice Exam Bank
SECTION 1: PHYSIOLOGY OF AGING & FRAILTY (Questions 1–20)
1. A 78-year-old patient reports feeling weak, has unintentional weight loss of 8%
over the past 6 months, reports exhaustion most days, walks slowly, and has low
physical activity. This presentation is most consistent with:
A) Normal aging
B) Sarcopenia
C) Frailty syndrome
D) Depression
- detailed 100% correctanswer :- C
Rationale: This patient meets three or more of the Fried frailty criteria: unintentional
weight loss (>5% in 6 months), exhaustion, weakness, slow walking speed, and low
physical activity. Frailty is a distinct clinical syndrome associated with increased
vulnerability to stressors and adverse outcomes.
, 2
2. Which physiological change of aging increases the risk of hypothermia in older
adults?
A) Increased metabolic rate
B) Decreased subcutaneous fat and impaired thermoregulation
C) Increased sweat gland activity
D) Enhanced peripheral vasodilation
- detailed 100% correctanswer :- B
Rationale: Aging is associated with decreased subcutaneous fat (reduced insulation),
impaired vasoconstriction response, and decreased shivering response, all contributing
to increased risk of hypothermia in older adults.
3. A 72-year-old patient has a serum creatinine of 1.4 mg/dL. The nurse
practitioner understands that:
A) This indicates normal renal function for age
B) Creatinine may overestimate GFR due to decreased muscle mass
C) Creatinine is the most accurate measure of renal function in older adults
D) This value indicates acute kidney injury
- detailed 100% correctanswer :- B
Rationale: Age-related loss of muscle mass (sarcopenia) reduces creatinine production. A
normal or mildly elevated serum creatinine may actually reflect significantly reduced
GFR in older adults.
, 3
4. Which of the following is TRUE regarding cortical neuronal loss in normal
aging?
A) Cortical neuronal loss is a normal part of the aging process
B) Cortical neuronal loss does not occur in normal aging
C) Cortical neuronal loss occurs only in Alzheimer's disease
D) Cortical neuronal loss is reversible with cognitive training
- detailed 100% correctanswer :- B
Rationale: Cortical neuronal loss is NOT part of normal aging. Neuronal loss in normal
aging occurs in areas such as the thalamus, striatum, and basal forebrain, but not in the
cerebral cortex.
5. Which of the following best defines frailty in the older adult population?
A) A normal consequence of aging that requires no intervention
B) Decreased ability to cope with acute stressors due to age-related physiological and
functional decline
C) A psychological condition characterized by depression and social withdrawal
D) The inevitable loss of all activities of daily living
- detailed 100% correctanswer :- B
Rationale: Frailty is defined as a decreased ability to cope with acute stressors due to
age-related physiological and functional decline. It is a distinct clinical syndrome, not an
inevitable part of aging.
, 4
6. Sarcopenia in older adults is characterized by:
A) Increased muscle mass and strength
B) Age-related loss of skeletal muscle mass and function
C) Excessive fat deposition in muscle tissue
D) Reversible muscle wasting with high-protein diet alone
- detailed 100% correctanswer :- B
Rationale: Sarcopenia is the age-related loss of skeletal muscle mass and function. It
contributes to weakness, frailty, and increased risk of falls and disability in older adults.
7. Immunosenescence refers to:
A) Enhanced immune response in older adults
B) The age-related decline in immune system function
C) The process of immunization in elderly populations
D) Increased production of antibodies with aging
- detailed 100% correctanswer :- B
Rationale: Immunosenescence is the age-related decline in immune system function,
making older adults more susceptible to infections and less responsive to vaccinations.
8. A frail older adult is at increased risk for which of the following adverse
outcomes? (Select the BEST answer)
