NURS 5461 / NURS5461 (Latest Update 2026/2027) Adult Gerontology
Management Across the Continuum of Care
Practice Questions & Answers | Grade A | 100% Correct – UTA
Section 1: Foundational Gerontological Principles & Health Promotion
(Questions 1–25)
1. An 80-year-old patient reports that they no longer enjoy eating steak
because it "takes too much effort to chew." Which age-related physiological
change is MOST likely responsible?
A) Xerostomia from anticholinergic medications
B) Decreased muscle mass and strength of the masseter muscles, combined
with potential periodontal disease
C) Early Parkinson's disease
D) Esophageal stricture
Answer B: — Decreased muscle mass and strength of the masseter muscles,
combined with potential periodontal disease
,Rationale: Age-related sarcopenia affects all skeletal muscles, including the
masticatory muscles (masseter, temporalis). Combined with periodontal
disease (prevalence increases with age) and potential tooth loss, chewing
tough foods becomes difficult. This is a normal age-related change, not
pathology. ---
2. A 76-year-old patient has a resting heart rate of 58 bpm. They are
asymptomatic, exercise regularly, and have no history of cardiac disease.
Which age-related cardiovascular change BEST explains this finding?
A) Sick sinus syndrome requiring pacemaker evaluation
B) Decreased intrinsic heart rate due to sinoatrial node fibrosis and increased
vagal tone
C) Beta-blocker toxicity
D) Hypothyroidism
Answer B: — Decreased intrinsic heart rate due to sinoatrial node fibrosis
and increased vagal tone
Rationale: Normal aging causes sinoatrial node fibrosis and loss of pacemaker
cells (up to 75% by age 75), resulting in a decreased intrinsic heart rate
(typically 60–100 in younger adults, may be 50–60 in healthy older adults).
Athletic older adults may have even lower resting rates due to increased vagal
tone. This is asymptomatic bradycardia — no intervention needed. ---
,3. Which of the following is a component of the Fried Frailty Phenotype?
A) Body mass index >30 kg/m²
B) Slow gait speed <0.8 m/s over 4.6 meters
C) Polypharmacy >5 medications
D) Chronic kidney disease stage 3
Answer B: — Slow gait speed <0.8 m/s over 4.6 meters
Rationale: The Fried Frailty Phenotype (2001) includes 5 criteria: (1)
unintentional weight loss (>10 lbs in past year); (2) exhaustion (self-reported);
(3) weakness (decreased grip strength); (4) slow gait speed (<0.8 m/s over
4.6m or 15 feet); and (5) low physical activity. 3+ criteria = frail; 1–2 = pre-frail;
0 = robust. BMI >30 is not a criterion. ---
4. According to the Beers Criteria, which class of medications should be
avoided in older adults with a history of falls or fractures?
A) ACE inhibitors
B) Statins
C) Benzodiazepines
D) Proton pump inhibitors
Answer C: — Benzodiazepines
, Rationale: Benzodiazepines increase the risk of ataxia, impaired psychomotor
function, and syncope, which significantly elevates the risk of falls and
fractures in the elderly. ---
5. The Katz Index is used to assess which of the following in an older
patient?
A) Instrumental Activities of Daily Living (IADLs)
B) Cognitive impairment
C) Gait and balance
D) Basic Activities of Daily Living (ADLs)
Answer D: — Basic Activities of Daily Living (ADLs)
Rationale: The Katz Index of Independence in Activities of Daily Living (ADLs)
assesses basic self-care tasks such as bathing, dressing, toileting, transferring,
continence, and feeding. ---
6. What is the hallmark clinical feature that distinguishes delirium from
dementia?
A) Memory loss
B) Gradual onset
C) Acute onset with fluctuating course
D) Aphasia
Management Across the Continuum of Care
Practice Questions & Answers | Grade A | 100% Correct – UTA
Section 1: Foundational Gerontological Principles & Health Promotion
(Questions 1–25)
1. An 80-year-old patient reports that they no longer enjoy eating steak
because it "takes too much effort to chew." Which age-related physiological
change is MOST likely responsible?
A) Xerostomia from anticholinergic medications
B) Decreased muscle mass and strength of the masseter muscles, combined
with potential periodontal disease
C) Early Parkinson's disease
D) Esophageal stricture
Answer B: — Decreased muscle mass and strength of the masseter muscles,
combined with potential periodontal disease
,Rationale: Age-related sarcopenia affects all skeletal muscles, including the
masticatory muscles (masseter, temporalis). Combined with periodontal
disease (prevalence increases with age) and potential tooth loss, chewing
tough foods becomes difficult. This is a normal age-related change, not
pathology. ---
2. A 76-year-old patient has a resting heart rate of 58 bpm. They are
asymptomatic, exercise regularly, and have no history of cardiac disease.
Which age-related cardiovascular change BEST explains this finding?
A) Sick sinus syndrome requiring pacemaker evaluation
B) Decreased intrinsic heart rate due to sinoatrial node fibrosis and increased
vagal tone
C) Beta-blocker toxicity
D) Hypothyroidism
Answer B: — Decreased intrinsic heart rate due to sinoatrial node fibrosis
and increased vagal tone
Rationale: Normal aging causes sinoatrial node fibrosis and loss of pacemaker
cells (up to 75% by age 75), resulting in a decreased intrinsic heart rate
(typically 60–100 in younger adults, may be 50–60 in healthy older adults).
Athletic older adults may have even lower resting rates due to increased vagal
tone. This is asymptomatic bradycardia — no intervention needed. ---
,3. Which of the following is a component of the Fried Frailty Phenotype?
A) Body mass index >30 kg/m²
B) Slow gait speed <0.8 m/s over 4.6 meters
C) Polypharmacy >5 medications
D) Chronic kidney disease stage 3
Answer B: — Slow gait speed <0.8 m/s over 4.6 meters
Rationale: The Fried Frailty Phenotype (2001) includes 5 criteria: (1)
unintentional weight loss (>10 lbs in past year); (2) exhaustion (self-reported);
(3) weakness (decreased grip strength); (4) slow gait speed (<0.8 m/s over
4.6m or 15 feet); and (5) low physical activity. 3+ criteria = frail; 1–2 = pre-frail;
0 = robust. BMI >30 is not a criterion. ---
4. According to the Beers Criteria, which class of medications should be
avoided in older adults with a history of falls or fractures?
A) ACE inhibitors
B) Statins
C) Benzodiazepines
D) Proton pump inhibitors
Answer C: — Benzodiazepines
, Rationale: Benzodiazepines increase the risk of ataxia, impaired psychomotor
function, and syncope, which significantly elevates the risk of falls and
fractures in the elderly. ---
5. The Katz Index is used to assess which of the following in an older
patient?
A) Instrumental Activities of Daily Living (IADLs)
B) Cognitive impairment
C) Gait and balance
D) Basic Activities of Daily Living (ADLs)
Answer D: — Basic Activities of Daily Living (ADLs)
Rationale: The Katz Index of Independence in Activities of Daily Living (ADLs)
assesses basic self-care tasks such as bathing, dressing, toileting, transferring,
continence, and feeding. ---
6. What is the hallmark clinical feature that distinguishes delirium from
dementia?
A) Memory loss
B) Gradual onset
C) Acute onset with fluctuating course
D) Aphasia
