• NURS 5461 Exam 09/13/2026
NURS 5461 Quiz 4 UPDATED ACTUAL Exam
| Actual Q&A with Rationale (NURS6521 Exam 1) |
Walden University
1. What is the primary cause of the mild forgetfulness and slowed processing seen in normal neurological aging?
A) Demyelination of peripheral nerves from vitamin B12 depletion
B) Accumulation of amyloid plaques causing progressive neuronal death
C) Autoimmune destruction of cortical neurons
D) Decreased size/number of neurons from reduced cerebral blood flow –
Correct Answer :D) Decreased size/number of neurons from reduced cerebral blood flow
2. How should a nurse distinguish normal age-related cognitive slowing from delirium, dementia, or depression?
P 1
, • NURS 5461 Exam 09/13/2026
A) Normal aging causes hallucinations, while dementia never does
B) Normal aging only affects short-term memory, while delirium only affects long-term memory
C) Normal aging causes mild, stable slowing in processing/memory — not the sudden onset, progressive decline,
or mood-driven pattern seen in those conditions
D) Normal aging and dementia are clinically indistinguishable until autopsy confirms it –
Correct Answer :C) Normal aging causes mild, stable slowing in processing/memory — not the sudden onset,
progressive decline, or mood-driven pattern seen in those conditions
3. What aging-related change explains more fragmented sleep and increased nighttime waking in older adults?
A) Decreased melatonin receptor density in the pineal gland alone
B) Loss of circadian rhythm entirely, with no sleep-wake pattern remaining
C) Increased total sleep time requirement with age
D) Changes in NREM/REM sleep architecture –
Correct Answer :D) Changes in NREM/REM sleep architecture
4. Endocrine changes: insulin/glucagon with aging — what is the mechanism and outcome?
A) Increased insulin production + increased tissue sensitivity → hypoglycemia risk
B) Decreased glucagon secretion alone, with insulin production unaffected by aging
C) Reduced insulin production + decreased tissue sensitivity to insulin → increased hyperglycemia/type 2
diabetes risk
D) Increased pancreatic beta-cell proliferation compensating for peripheral insulin resistance
- Correct Answer :C) Reduced insulin production + decreased tissue sensitivity to insulin → increased
hyperglycemia/type 2 diabetes risk
P 2
, • NURS 5461 Exam 09/13/2026
5. Endocrine changes: PTH with aging — what is the mechanism and outcome?
A) Decreased parathyroid hormone secretion → increased muscle spasms and tetany
B) Increased hormone production → higher bone density → decreased fracture risk
C) Excessive calcium absorption → hypercalcemia → kidney stone formation
D) Poor calcium intake/reabsorption → decreased bone density → osteopenia/osteoporosis risk –
Correct Answer :D) Poor calcium intake/reabsorption → decreased bone density → osteopenia/osteoporosis
risk
6. Endocrine changes: ADH with aging — what is the mechanism and outcome?
A) Increased ADH secretion → fluid retention → risk of hyponatremia
B) Increased renal sensitivity to ADH → concentrated urine → risk of fluid overload
C) Decreased ADH secretion only, with renal responsiveness unaffected
D) Decreased responsiveness to ADH → excess fluid excretion → increased dehydration risk –
Correct Answer :D) Decreased responsiveness to ADH → excess fluid excretion → increased dehydration risk
7. Endocrine changes: thyroid with aging — what is the mechanism and outcome?
A) Thyroid gland atrophy with compensatory TSH suppression, causing hyperthyroid symptoms
B) Increased thyroid hormone production → hypermetabolic state and weight loss
C) Reduced thyroid hormone production → lower metabolic rate
D) No significant change in thyroid function occurs with normal aging –
Correct Answer :C) Reduced thyroid hormone production → lower metabolic rate
8. How does normal aging affect immune function (T-cells, neutrophils) and what is the clinical consequence?
P 3
, • NURS 5461 Exam 09/13/2026
A) ↑ T-cell function compensates for neutrophil decline, keeping infection risk unchanged
B) B-cell antibody production increases with age, raising autoimmune disease risk but lowering infection risk
C) ↓ T-cell function and ↓ neutrophils → weakened immune response, decreased vaccine response, and a
blunted/atypical febrile response to infection
D) Immune function is preserved with aging; only wound healing slows –
Correct Answer :C) ↓ T-cell function and ↓ neutrophils → weakened immune response, decreased vaccine
response, and a blunted/atypical febrile response to infection
9. Cardiovascular: arteriosclerosis effect — what is the mechanism and downstream result?
A) Loss of vessel elasticity → increased afterload/LV workload → increased systolic pressure, widened pulse
pressure, ventricular hypertrophy
B) Loss of vessel elasticity primarily affects venous return, causing peripheral edema without BP changes
C) Increased vessel elasticity → decreased afterload → reduced systolic pressure over time
D) Thickening of the venous walls → decreased preload → compensatory tachycardia
- Correct Answer :A) Loss of vessel elasticity → increased afterload/LV workload → increased systolic pressure,
widened pulse pressure, ventricular hypertrophy
10. Why does maximum achievable heart rate decrease with age?
A) Decreased catecholamine receptor sensitivity in the ventricles only
B) Increased vagal tone overriding sympathetic stimulation during exertion
C) Loss of SA node pacemaker cells
D) Progressive fibrosis of the AV node reducing conduction speed –
Correct Answer :C) Loss of SA node pacemaker cells
P 4
NURS 5461 Quiz 4 UPDATED ACTUAL Exam
| Actual Q&A with Rationale (NURS6521 Exam 1) |
Walden University
1. What is the primary cause of the mild forgetfulness and slowed processing seen in normal neurological aging?
A) Demyelination of peripheral nerves from vitamin B12 depletion
B) Accumulation of amyloid plaques causing progressive neuronal death
C) Autoimmune destruction of cortical neurons
D) Decreased size/number of neurons from reduced cerebral blood flow –
Correct Answer :D) Decreased size/number of neurons from reduced cerebral blood flow
2. How should a nurse distinguish normal age-related cognitive slowing from delirium, dementia, or depression?
P 1
, • NURS 5461 Exam 09/13/2026
A) Normal aging causes hallucinations, while dementia never does
B) Normal aging only affects short-term memory, while delirium only affects long-term memory
C) Normal aging causes mild, stable slowing in processing/memory — not the sudden onset, progressive decline,
or mood-driven pattern seen in those conditions
D) Normal aging and dementia are clinically indistinguishable until autopsy confirms it –
Correct Answer :C) Normal aging causes mild, stable slowing in processing/memory — not the sudden onset,
progressive decline, or mood-driven pattern seen in those conditions
3. What aging-related change explains more fragmented sleep and increased nighttime waking in older adults?
A) Decreased melatonin receptor density in the pineal gland alone
B) Loss of circadian rhythm entirely, with no sleep-wake pattern remaining
C) Increased total sleep time requirement with age
D) Changes in NREM/REM sleep architecture –
Correct Answer :D) Changes in NREM/REM sleep architecture
4. Endocrine changes: insulin/glucagon with aging — what is the mechanism and outcome?
A) Increased insulin production + increased tissue sensitivity → hypoglycemia risk
B) Decreased glucagon secretion alone, with insulin production unaffected by aging
C) Reduced insulin production + decreased tissue sensitivity to insulin → increased hyperglycemia/type 2
diabetes risk
D) Increased pancreatic beta-cell proliferation compensating for peripheral insulin resistance
- Correct Answer :C) Reduced insulin production + decreased tissue sensitivity to insulin → increased
hyperglycemia/type 2 diabetes risk
P 2
, • NURS 5461 Exam 09/13/2026
5. Endocrine changes: PTH with aging — what is the mechanism and outcome?
A) Decreased parathyroid hormone secretion → increased muscle spasms and tetany
B) Increased hormone production → higher bone density → decreased fracture risk
C) Excessive calcium absorption → hypercalcemia → kidney stone formation
D) Poor calcium intake/reabsorption → decreased bone density → osteopenia/osteoporosis risk –
Correct Answer :D) Poor calcium intake/reabsorption → decreased bone density → osteopenia/osteoporosis
risk
6. Endocrine changes: ADH with aging — what is the mechanism and outcome?
A) Increased ADH secretion → fluid retention → risk of hyponatremia
B) Increased renal sensitivity to ADH → concentrated urine → risk of fluid overload
C) Decreased ADH secretion only, with renal responsiveness unaffected
D) Decreased responsiveness to ADH → excess fluid excretion → increased dehydration risk –
Correct Answer :D) Decreased responsiveness to ADH → excess fluid excretion → increased dehydration risk
7. Endocrine changes: thyroid with aging — what is the mechanism and outcome?
A) Thyroid gland atrophy with compensatory TSH suppression, causing hyperthyroid symptoms
B) Increased thyroid hormone production → hypermetabolic state and weight loss
C) Reduced thyroid hormone production → lower metabolic rate
D) No significant change in thyroid function occurs with normal aging –
Correct Answer :C) Reduced thyroid hormone production → lower metabolic rate
8. How does normal aging affect immune function (T-cells, neutrophils) and what is the clinical consequence?
P 3
, • NURS 5461 Exam 09/13/2026
A) ↑ T-cell function compensates for neutrophil decline, keeping infection risk unchanged
B) B-cell antibody production increases with age, raising autoimmune disease risk but lowering infection risk
C) ↓ T-cell function and ↓ neutrophils → weakened immune response, decreased vaccine response, and a
blunted/atypical febrile response to infection
D) Immune function is preserved with aging; only wound healing slows –
Correct Answer :C) ↓ T-cell function and ↓ neutrophils → weakened immune response, decreased vaccine
response, and a blunted/atypical febrile response to infection
9. Cardiovascular: arteriosclerosis effect — what is the mechanism and downstream result?
A) Loss of vessel elasticity → increased afterload/LV workload → increased systolic pressure, widened pulse
pressure, ventricular hypertrophy
B) Loss of vessel elasticity primarily affects venous return, causing peripheral edema without BP changes
C) Increased vessel elasticity → decreased afterload → reduced systolic pressure over time
D) Thickening of the venous walls → decreased preload → compensatory tachycardia
- Correct Answer :A) Loss of vessel elasticity → increased afterload/LV workload → increased systolic pressure,
widened pulse pressure, ventricular hypertrophy
10. Why does maximum achievable heart rate decrease with age?
A) Decreased catecholamine receptor sensitivity in the ventricles only
B) Increased vagal tone overriding sympathetic stimulation during exertion
C) Loss of SA node pacemaker cells
D) Progressive fibrosis of the AV node reducing conduction speed –
Correct Answer :C) Loss of SA node pacemaker cells
P 4
