NUR 198 EXAM 1 KEY CONCEPTS: CHRONIC ILLNESS
& PERIOPERATIVE CARE | 2026 UPDATED | WITH
COMPLETE SOLUTIONS - JOYCE UNIVERSITY.
Question 1
A 78-year-old patient reports feeling cold even when the room temperature is
comfortable. Which age-related physiological change best explains this symptom?
A) Increased thyroid hormone production
B) Enhanced peripheral circulation
C) Decreased metabolic rate and reduced subcutaneous fat
D) Increased muscle mass
Answer: C
Rationale: Older adults experience a decreased metabolic rate and reduced
subcutaneous fat, which impairs thermoregulation and makes them more
sensitive to cold temperatures.
Question 2
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the musculoskeletal system?
A) Increased muscle mass
B) Enhanced joint flexibility
C) Decreased bone density
D) Improved tendon strength
Answer: C
Rationale: Age-related musculoskeletal changes include decreased bone density
(bone decalcification), decreased height, decreased muscle strength and tone, and
joint degeneration. Bone density decreases with age, increasing fracture risk.
,Question 3
Which physiological change in older adults increases the risk of falls?
A) Increased muscle strength
B) Improved proprioception
C) Slowed reaction time and decreased muscle mass
D) Enhanced vestibular function
Answer: C
Rationale: Age-related decreases in muscle mass (sarcopenia), slowed reaction
time, and reduced proprioception all contribute to an increased risk of falls in
older adults.
Question 4
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the renal system?
A) Increased glomerular filtration rate (GFR)
B) Enhanced ability to concentrate urine
C) Decreased renal blood flow
D) Improved electrolyte balance
Answer: C
Rationale: Age-related renal changes include decreased renal blood flow,
decreased GFR, and decreased ability to concentrate urine. These changes
increase the risk of dehydration, electrolyte imbalances, and drug toxicity.
Question 5
What age-related gastrointestinal change is expected in an older adult?
A) Increased gastric acid secretion
B) Decreased esophageal motility
,C) Enhanced liver function
D) Increased intestinal absorption
Answer: B
Rationale: Older adults experience decreased esophageal motility and delayed
gastric emptying, which can lead to gastroesophageal reflux, dysphagia, and
constipation.
Question 6
Which cardiovascular change is expected in a healthy older adult?
A) Increased cardiac output
B) Decreased peripheral vascular resistance
C) Increased systolic blood pressure
D) Decreased left ventricular wall thickness
Answer: C
Rationale: Age-related cardiovascular changes include increased systolic blood
pressure, decreased cardiac output, arterial stiffness, and orthostatic hypotension.
The heart muscle may thicken rather than thin.
Question 7
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the pulmonary system?
A) Increased lung elasticity
B) Enhanced alveolar surface area
C) Decreased chest wall compliance
D) Improved cough reflex
Answer: C
Rationale: Age-related pulmonary changes include decreased lung elasticity,
decreased chest wall compliance, reduced alveolar surface area, and a diminished
, cough reflex. These changes increase the risk of pneumonia and other respiratory
infections.
Question 8
Which integumentary system change is expected with aging?
A) Increased skin thickness
B) Increased elasticity
C) Decreased subcutaneous fat
D) Increased sebaceous gland activity
Answer: C
Rationale: Age-related skin changes include thinning of the epidermis, decreased
subcutaneous fat, decreased elasticity, and decreased sebaceous gland activity.
These changes increase vulnerability to pressure injuries and skin breakdown.
Question 9
Which endocrine change is expected in older adults?
A) Increased T3 production
B) Lowered T3 production
C) Increased sensitivity to insulin
D) Enhanced glucose tolerance
Answer: B
Rationale: Age-related endocrine changes include lowered T3 production and
decreased sensitivity to insulin. These changes can affect metabolism and glucose
regulation, contributing to increased risk of hypothyroidism and type 2 diabetes.
Question 10
Which immune system change is expected in an older adult?
& PERIOPERATIVE CARE | 2026 UPDATED | WITH
COMPLETE SOLUTIONS - JOYCE UNIVERSITY.
Question 1
A 78-year-old patient reports feeling cold even when the room temperature is
comfortable. Which age-related physiological change best explains this symptom?
A) Increased thyroid hormone production
B) Enhanced peripheral circulation
C) Decreased metabolic rate and reduced subcutaneous fat
D) Increased muscle mass
Answer: C
Rationale: Older adults experience a decreased metabolic rate and reduced
subcutaneous fat, which impairs thermoregulation and makes them more
sensitive to cold temperatures.
Question 2
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the musculoskeletal system?
A) Increased muscle mass
B) Enhanced joint flexibility
C) Decreased bone density
D) Improved tendon strength
Answer: C
Rationale: Age-related musculoskeletal changes include decreased bone density
(bone decalcification), decreased height, decreased muscle strength and tone, and
joint degeneration. Bone density decreases with age, increasing fracture risk.
,Question 3
Which physiological change in older adults increases the risk of falls?
A) Increased muscle strength
B) Improved proprioception
C) Slowed reaction time and decreased muscle mass
D) Enhanced vestibular function
Answer: C
Rationale: Age-related decreases in muscle mass (sarcopenia), slowed reaction
time, and reduced proprioception all contribute to an increased risk of falls in
older adults.
Question 4
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the renal system?
A) Increased glomerular filtration rate (GFR)
B) Enhanced ability to concentrate urine
C) Decreased renal blood flow
D) Improved electrolyte balance
Answer: C
Rationale: Age-related renal changes include decreased renal blood flow,
decreased GFR, and decreased ability to concentrate urine. These changes
increase the risk of dehydration, electrolyte imbalances, and drug toxicity.
Question 5
What age-related gastrointestinal change is expected in an older adult?
A) Increased gastric acid secretion
B) Decreased esophageal motility
,C) Enhanced liver function
D) Increased intestinal absorption
Answer: B
Rationale: Older adults experience decreased esophageal motility and delayed
gastric emptying, which can lead to gastroesophageal reflux, dysphagia, and
constipation.
Question 6
Which cardiovascular change is expected in a healthy older adult?
A) Increased cardiac output
B) Decreased peripheral vascular resistance
C) Increased systolic blood pressure
D) Decreased left ventricular wall thickness
Answer: C
Rationale: Age-related cardiovascular changes include increased systolic blood
pressure, decreased cardiac output, arterial stiffness, and orthostatic hypotension.
The heart muscle may thicken rather than thin.
Question 7
A nurse is caring for an older adult client. Which of the following is an expected
age-related physiological change in the pulmonary system?
A) Increased lung elasticity
B) Enhanced alveolar surface area
C) Decreased chest wall compliance
D) Improved cough reflex
Answer: C
Rationale: Age-related pulmonary changes include decreased lung elasticity,
decreased chest wall compliance, reduced alveolar surface area, and a diminished
, cough reflex. These changes increase the risk of pneumonia and other respiratory
infections.
Question 8
Which integumentary system change is expected with aging?
A) Increased skin thickness
B) Increased elasticity
C) Decreased subcutaneous fat
D) Increased sebaceous gland activity
Answer: C
Rationale: Age-related skin changes include thinning of the epidermis, decreased
subcutaneous fat, decreased elasticity, and decreased sebaceous gland activity.
These changes increase vulnerability to pressure injuries and skin breakdown.
Question 9
Which endocrine change is expected in older adults?
A) Increased T3 production
B) Lowered T3 production
C) Increased sensitivity to insulin
D) Enhanced glucose tolerance
Answer: B
Rationale: Age-related endocrine changes include lowered T3 production and
decreased sensitivity to insulin. These changes can affect metabolism and glucose
regulation, contributing to increased risk of hypothyroidism and type 2 diabetes.
Question 10
Which immune system change is expected in an older adult?
