NUR 257 CONCEPTS OF AGING & CHRONIC ILLNESS
EXAM 4 – PRACTICE QUESTIONS
Section 1: Theories of Aging & Normal Physiological Changes (Questions 1-
50)
1. Which physiological change is considered a normal part of aging?
A. Markedly increased cardiac output
B. Decreased residual lung volume
C. Reduced glomerular filtration rate
D. Enhanced hepatic blood flow
Answer: C
Rationale: GFR declines with age due to nephrosclerosis. Cardiac output at
rest is preserved, residual lung volume increases, and hepatic blood flow
decreases.
2. An 82-year-old reports feeling fulfilled despite arthritis. This best reflects
which theory of aging?
A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Wear-and-tear theory
,Answer: C
Rationale: Continuity theory states older adults maintain successful patterns
from earlier life. Disengagement is withdrawal, activity theory emphasizes
staying busy, wear-and-tear is biological.
3. The nurse expects which change in an older adult's integumentary system?
A. Increased sweat gland function
B. Increased melanocyte activity
C. Decreased subcutaneous fat
D. Thickened dermis
Answer: C
Rationale: Subcutaneous fat decreases, causing wrinkles and
thermoregulation issues. Sweat glands decrease, melanocytes decrease (gray
hair), dermis thins.
4. A normal age-related change in the cardiovascular system is:
A. Increased arterial stiffness
B. Decreased systolic blood pressure
C. Increased left ventricular ejection fraction
D. Decreased peripheral vascular resistance
Answer: A
Rationale: Arterial stiffness increases with age due to loss of elastin and
collagen changes in vessel walls.
5. Which statement about sleep in older adults is true?
,A. Total sleep time increases significantly
B. Stage N3 (deep sleep) decreases
C. REM sleep is completely absent
D. Nighttime awakenings are pathological
Answer: B
Rationale: Deep sleep decreases; total sleep time may slightly decrease. REM
persists. Nighttime awakenings are common due to nocturia and pain.
6. The nurse understands that immunosenescence increases risk for:
A. Autoimmune diseases only
B. Infection and poor vaccine response
C. Allergic reactions
D. Anaphylaxis
Answer: B
Rationale: Aging immune system has reduced T-cell function and lower
antibody response to vaccines. Increased infection risk and poorer vaccine
efficacy.
7. Which musculoskeletal change is expected with aging?
A. Increased bone density
B. Increased muscle mass
C. Decreased joint flexibility
D. Increased cartilage thickness
, Answer: C
Rationale: Collagen changes and cartilage thinning reduce flexibility. Bone
density decreases (osteoporosis risk), muscle mass decreases (sarcopenia).
8. An older adult's gag reflex is intact but swallowing is slower. The nurse
should:
A. Recommend a pureed diet
B. Allow extra time for meals
C. Decrease fluid intake
D. Place on NPO status
Answer: B
Rationale: Slower swallow is normal; allow time. No indication for modified
texture without dysphagia assessment.
9. Which renal change increases medication toxicity risk in older adults?
A. Increased creatinine clearance
B. Decreased drug-binding proteins
C. Increased urine concentrating ability
D. Decreased tubular secretion
Answer: D
Rationale: Tubular secretion declines, prolonging drug half-life. Creatinine
clearance decreases, concentrating ability decreases.
10. A normal age-related endocrine change is:
EXAM 4 – PRACTICE QUESTIONS
Section 1: Theories of Aging & Normal Physiological Changes (Questions 1-
50)
1. Which physiological change is considered a normal part of aging?
A. Markedly increased cardiac output
B. Decreased residual lung volume
C. Reduced glomerular filtration rate
D. Enhanced hepatic blood flow
Answer: C
Rationale: GFR declines with age due to nephrosclerosis. Cardiac output at
rest is preserved, residual lung volume increases, and hepatic blood flow
decreases.
2. An 82-year-old reports feeling fulfilled despite arthritis. This best reflects
which theory of aging?
A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Wear-and-tear theory
,Answer: C
Rationale: Continuity theory states older adults maintain successful patterns
from earlier life. Disengagement is withdrawal, activity theory emphasizes
staying busy, wear-and-tear is biological.
3. The nurse expects which change in an older adult's integumentary system?
A. Increased sweat gland function
B. Increased melanocyte activity
C. Decreased subcutaneous fat
D. Thickened dermis
Answer: C
Rationale: Subcutaneous fat decreases, causing wrinkles and
thermoregulation issues. Sweat glands decrease, melanocytes decrease (gray
hair), dermis thins.
4. A normal age-related change in the cardiovascular system is:
A. Increased arterial stiffness
B. Decreased systolic blood pressure
C. Increased left ventricular ejection fraction
D. Decreased peripheral vascular resistance
Answer: A
Rationale: Arterial stiffness increases with age due to loss of elastin and
collagen changes in vessel walls.
5. Which statement about sleep in older adults is true?
,A. Total sleep time increases significantly
B. Stage N3 (deep sleep) decreases
C. REM sleep is completely absent
D. Nighttime awakenings are pathological
Answer: B
Rationale: Deep sleep decreases; total sleep time may slightly decrease. REM
persists. Nighttime awakenings are common due to nocturia and pain.
6. The nurse understands that immunosenescence increases risk for:
A. Autoimmune diseases only
B. Infection and poor vaccine response
C. Allergic reactions
D. Anaphylaxis
Answer: B
Rationale: Aging immune system has reduced T-cell function and lower
antibody response to vaccines. Increased infection risk and poorer vaccine
efficacy.
7. Which musculoskeletal change is expected with aging?
A. Increased bone density
B. Increased muscle mass
C. Decreased joint flexibility
D. Increased cartilage thickness
, Answer: C
Rationale: Collagen changes and cartilage thinning reduce flexibility. Bone
density decreases (osteoporosis risk), muscle mass decreases (sarcopenia).
8. An older adult's gag reflex is intact but swallowing is slower. The nurse
should:
A. Recommend a pureed diet
B. Allow extra time for meals
C. Decrease fluid intake
D. Place on NPO status
Answer: B
Rationale: Slower swallow is normal; allow time. No indication for modified
texture without dysphagia assessment.
9. Which renal change increases medication toxicity risk in older adults?
A. Increased creatinine clearance
B. Decreased drug-binding proteins
C. Increased urine concentrating ability
D. Decreased tubular secretion
Answer: D
Rationale: Tubular secretion declines, prolonging drug half-life. Creatinine
clearance decreases, concentrating ability decreases.
10. A normal age-related endocrine change is:
