Page 1 of 120
Nightingale College BSN 425-02 Gerontological Nursing EXAM
QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
Nightingale College BSN 425-02 Gerontological Nursing
10-Line Exam Coverage in Points Form
1. Theories of Aging (8%) – Stochastic theories (Wear-and-Tear, Free Radical, Somatic
Mutation, Cross-linkage); Non-stochastic theories (Programmed Longevity,
Endocrine/Immunological); Psychosocial theories (Disengagement, Activity, Continuity,
Erikson's Integrity vs. Despair)
2. Age-Related Physiological Changes (20%) – Integumentary (skin thinning, atrophy);
Cardiovascular (increased peripheral resistance, decreased baroreceptor sensitivity);
Respiratory (decreased compliance, increased residual volume); Musculoskeletal
(sarcopenia, kyphosis); Neurological (slower processing); Sensory (presbyopia,
presbycusis, arcus senilis); Genitourinary (decreased GFR, stress incontinence)
3. Assessment & Functional Ability (12%) – ADLs vs. IADLs; SPICES tool; Braden Scale;
Mini-Mental State Exam (MMSE); Geriatric Depression Scale (GDS); Confusion
Assessment Method (CAM); Functional decline assessment
4. Geriatric Syndromes (12%) – Delirium (acute, fluctuating, reversible); Dementia
(Alzheimer's, vascular, Lewy body); Depression (atypical presentation); Falls (leading
cause of injury); Incontinence (stress, urge, overflow, functional); Polypharmacy and
adverse drug reactions
5. Pharmacology & Medication Safety (12%) – Beers Criteria (potentially inappropriate
medications); Pharmacokinetic changes (decreased GFR, reduced hepatic metabolism,
altered distribution); Polypharmacy risks; "Start low, go slow" principle; Drug
interactions
6. Psychosocial & Ethical Aspects (10%) – Ageism and stereotypes; Erikson's Integrity vs.
Despair; Advance Directives; Durable Power of Attorney for Healthcare; Patient Self-
Determination Act (PSDA); Elder abuse and mandatory reporting
7. Nutrition & Hydration (8%) – Age-related changes (decreased thirst, reduced
absorption); Malnutrition risk; Protein requirements to prevent sarcopenia; Dysphagia
management; Vitamin B12, D deficiencies; Dehydration prevention
8. Health Promotion & Disease Prevention (8%) – Primary, secondary, tertiary prevention;
Immunizations (flu, pneumococcal, shingles); Screening recommendations (colonoscopy,
mammography, bone density); Fall prevention strategies
, Page 2 of 120
9. Pain Management & Palliative Care (5%) – Atypical pain presentation; Gold standard:
self-report; Non-pharmacological interventions; Opioid use and side effect management;
Palliative vs. hospice care
10. Healthcare Systems & Long-Term Care (5%) – Medicare (Parts A, B, C, D); PACE program;
Skilled Nursing vs. Rehabilitation; MDS assessment; Nursing home placement criteria;
Care transitions
COMPREHENSIVE PRACTICE QUESTIONS
Section 1: Theories of Aging & Demographics
1. Which segment of the older adult population is currently the fastest-growing in the United
States?
A) 65 to 74 years old
B) 75 to 84 years old
C) 85 years and older
D) 60 to 64 years old
Answer: C
Rationale: The 'old-old' population, those 85 years and older, is the fastest-growing
demographic due to advancements in healthcare and living conditions. This demographic shift
has significant implications for healthcare delivery and long-term care planning. The 65-74 age
group (A) is growing but not the fastest. The 60-64 group (D) is approaching older adult status
but does not represent the fastest-growing segment .
2. A nurse is explaining the 'Wear and Tear' theory of aging to a client. Which statement best
describes this stochastic theory?
, Page 3 of 120
A) Repeated use and injury to body parts over time leads to functional loss
B) Aging is a preprogrammed genetic event controlled by a biological clock
C) Free radicals damage DNA and proteins, causing cellular mutations
D) The immune system loses its ability to distinguish self from non-self
Answer: A
Rationale: The Wear and Tear theory suggests that the body is like a machine that eventually
wears out due to repeated use and stress. This is a stochastic theory, meaning aging results
from random environmental damage over time. Programmed Longevity Theory (B) is a non-
stochastic theory suggesting a biological timetable. Free Radical Theory (C) involves oxidative
damage. Immunological Theory (D) suggests immune system decline .
3. Which stochastic theory of aging suggests that internal and external stressors cause
damage to the DNA over time?
A) Programmed Theory
B) Endocrine Theory
C) Immunological Theory
D) Somatic Mutation Theory
Answer: D
Rationale: Somatic Mutation Theory is a stochastic theory suggesting that aging results from the
accumulation of mutations in somatic cells due to internal and external stressors. Programmed
, Page 4 of 120
Theory (A) and Endocrine Theory (B) are non-stochastic theories. Immunological Theory (C)
relates to immune system decline .
4. According to the Programmed Longevity Theory of aging, which factor primarily determines
the aging process?
A) Cumulative environmental damage
B) The body's genetic clock
C) The rate of free radical production
D) Cross-linking of collagen fibers
Answer: B
Rationale: Programmed Longevity Theory proposes that aging follows a biological timetable,
regulated by genes that determine the lifespan of an organism. Genetic inheritance plays a
central role. Environmental damage (A) is a stochastic theory concept. Free radicals (C) relate to
Free Radical Theory. Cross-linking (D) is another stochastic theory .
5. According to Erikson's developmental stages, which task should an older adult be working
through?
A) Identity vs. Role Confusion
B) Generativity vs. Stagnation
C) Integrity vs. Despair
D) Trust vs. Mistrust
Answer: C
Nightingale College BSN 425-02 Gerontological Nursing EXAM
QUESTIONS AND CORRECT VERIFIED SOLUTIONS LATEST
UPDATE THIS YEAR – JUST RELEASED
Nightingale College BSN 425-02 Gerontological Nursing
10-Line Exam Coverage in Points Form
1. Theories of Aging (8%) – Stochastic theories (Wear-and-Tear, Free Radical, Somatic
Mutation, Cross-linkage); Non-stochastic theories (Programmed Longevity,
Endocrine/Immunological); Psychosocial theories (Disengagement, Activity, Continuity,
Erikson's Integrity vs. Despair)
2. Age-Related Physiological Changes (20%) – Integumentary (skin thinning, atrophy);
Cardiovascular (increased peripheral resistance, decreased baroreceptor sensitivity);
Respiratory (decreased compliance, increased residual volume); Musculoskeletal
(sarcopenia, kyphosis); Neurological (slower processing); Sensory (presbyopia,
presbycusis, arcus senilis); Genitourinary (decreased GFR, stress incontinence)
3. Assessment & Functional Ability (12%) – ADLs vs. IADLs; SPICES tool; Braden Scale;
Mini-Mental State Exam (MMSE); Geriatric Depression Scale (GDS); Confusion
Assessment Method (CAM); Functional decline assessment
4. Geriatric Syndromes (12%) – Delirium (acute, fluctuating, reversible); Dementia
(Alzheimer's, vascular, Lewy body); Depression (atypical presentation); Falls (leading
cause of injury); Incontinence (stress, urge, overflow, functional); Polypharmacy and
adverse drug reactions
5. Pharmacology & Medication Safety (12%) – Beers Criteria (potentially inappropriate
medications); Pharmacokinetic changes (decreased GFR, reduced hepatic metabolism,
altered distribution); Polypharmacy risks; "Start low, go slow" principle; Drug
interactions
6. Psychosocial & Ethical Aspects (10%) – Ageism and stereotypes; Erikson's Integrity vs.
Despair; Advance Directives; Durable Power of Attorney for Healthcare; Patient Self-
Determination Act (PSDA); Elder abuse and mandatory reporting
7. Nutrition & Hydration (8%) – Age-related changes (decreased thirst, reduced
absorption); Malnutrition risk; Protein requirements to prevent sarcopenia; Dysphagia
management; Vitamin B12, D deficiencies; Dehydration prevention
8. Health Promotion & Disease Prevention (8%) – Primary, secondary, tertiary prevention;
Immunizations (flu, pneumococcal, shingles); Screening recommendations (colonoscopy,
mammography, bone density); Fall prevention strategies
, Page 2 of 120
9. Pain Management & Palliative Care (5%) – Atypical pain presentation; Gold standard:
self-report; Non-pharmacological interventions; Opioid use and side effect management;
Palliative vs. hospice care
10. Healthcare Systems & Long-Term Care (5%) – Medicare (Parts A, B, C, D); PACE program;
Skilled Nursing vs. Rehabilitation; MDS assessment; Nursing home placement criteria;
Care transitions
COMPREHENSIVE PRACTICE QUESTIONS
Section 1: Theories of Aging & Demographics
1. Which segment of the older adult population is currently the fastest-growing in the United
States?
A) 65 to 74 years old
B) 75 to 84 years old
C) 85 years and older
D) 60 to 64 years old
Answer: C
Rationale: The 'old-old' population, those 85 years and older, is the fastest-growing
demographic due to advancements in healthcare and living conditions. This demographic shift
has significant implications for healthcare delivery and long-term care planning. The 65-74 age
group (A) is growing but not the fastest. The 60-64 group (D) is approaching older adult status
but does not represent the fastest-growing segment .
2. A nurse is explaining the 'Wear and Tear' theory of aging to a client. Which statement best
describes this stochastic theory?
, Page 3 of 120
A) Repeated use and injury to body parts over time leads to functional loss
B) Aging is a preprogrammed genetic event controlled by a biological clock
C) Free radicals damage DNA and proteins, causing cellular mutations
D) The immune system loses its ability to distinguish self from non-self
Answer: A
Rationale: The Wear and Tear theory suggests that the body is like a machine that eventually
wears out due to repeated use and stress. This is a stochastic theory, meaning aging results
from random environmental damage over time. Programmed Longevity Theory (B) is a non-
stochastic theory suggesting a biological timetable. Free Radical Theory (C) involves oxidative
damage. Immunological Theory (D) suggests immune system decline .
3. Which stochastic theory of aging suggests that internal and external stressors cause
damage to the DNA over time?
A) Programmed Theory
B) Endocrine Theory
C) Immunological Theory
D) Somatic Mutation Theory
Answer: D
Rationale: Somatic Mutation Theory is a stochastic theory suggesting that aging results from the
accumulation of mutations in somatic cells due to internal and external stressors. Programmed
, Page 4 of 120
Theory (A) and Endocrine Theory (B) are non-stochastic theories. Immunological Theory (C)
relates to immune system decline .
4. According to the Programmed Longevity Theory of aging, which factor primarily determines
the aging process?
A) Cumulative environmental damage
B) The body's genetic clock
C) The rate of free radical production
D) Cross-linking of collagen fibers
Answer: B
Rationale: Programmed Longevity Theory proposes that aging follows a biological timetable,
regulated by genes that determine the lifespan of an organism. Genetic inheritance plays a
central role. Environmental damage (A) is a stochastic theory concept. Free radicals (C) relate to
Free Radical Theory. Cross-linking (D) is another stochastic theory .
5. According to Erikson's developmental stages, which task should an older adult be working
through?
A) Identity vs. Role Confusion
B) Generativity vs. Stagnation
C) Integrity vs. Despair
D) Trust vs. Mistrust
Answer: C
