Advanced Practice Nursing in the Care of Older
Adults 3rd Edition (Kennedy-Malone) 2026/2027
BELOW ARE QUESTIONS AND ANSWERS WITH RATIONALES
Chapter 1: Changes with Aging
1. The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
Answer: D
Rationale: Aging results in reduced physiologic reserve, diminished homeostatic regulation, and
impaired immune function. Together, these changes decrease the older adult's ability to respond
to stressors such as illness, trauma, and environmental changes.
2. The strongest evidence regarding normal physiological aging is available through:
A. Randomized controlled clinical trials
B. Cross-sectional studies
C. Longitudinal studies
D. Case control studies
Answer: C
,Rationale: Longitudinal studies follow the same individuals over time, allowing researchers to
distinguish normal aging changes from disease-related processes, making them the gold standard
for aging research.
3. All of the following statements are true about laboratory values in older adults except:
A. Reference ranges are preferable
B. Abnormal findings are often due to physiological aging
C. Normal ranges may not be applicable for older adults
D. Reference values are not necessarily acceptable values
Answer: B
Rationale: Abnormal laboratory findings should not automatically be attributed to aging. Most
significant lab abnormalities reflect pathology rather than normal aging processes.
4. Biochemical individuality is best described as:
A. Each individual's variation is often much greater than that of a larger group
B. The unique biochemical profile of a selected population
C. The truly "normal" individual—falling within average range
D. Each individual's variation is often much smaller than that of a larger group
Answer: D
Rationale: Biochemical individuality recognizes that each person maintains a narrow personal
homeostatic range, which may differ from population norms but remains stable for that
individual.
5. Polypharmacy is best described as taking:
A. More than nine medications per day
,B. More than five medications per day
C. Even a single medication if there is not a clear indication for its use
D. When a drug is given to treat the side effect of another drug
Answer: C
Rationale: Polypharmacy is not strictly defined by number alone; inappropriate prescribing—
even of a single unnecessary medication—meets the definition because it increases risk for
adverse effects.
6. Pharmacokinetic changes with aging is reflective of:
A. What the drug does to the body
B. What the body does to the drug
C. The effect at the site of action and the time and intensity of the drug
D. The side effects commonly associated with the drug
Answer: B
Rationale: Pharmacokinetics includes absorption, distribution, metabolism, and excretion. These
processes are commonly altered in older adults.
7. All the following statements are false about drug absorption except:
A. Antacids increase the bioavailability of digitalis
B. Gastric acidity decreases with age
C. Anticholinergics increase colonic motility
D. Underlying chronic disease has little impact on drug absorption
Answer: D
, Rationale: Although aging alters gastric pH and motility, clinically significant absorption
changes are uncommon unless chronic disease interferes with gastrointestinal function.
8. All of the following statements are true about drug distribution in the elderly except:
A. Drugs distributed in water have lower concentration
B. Drugs distributed in fat have less intense, more prolonged effect
C. Drugs highly protein bound have greater potential to cause an adverse drug reaction
D. The fastest way to deliver a drug to the action site is by inhalation
Answer: A
Rationale: Older adults have decreased total body water, which increases serum concentration of
water-soluble drugs, not lowers it.
9. Men have faster and more efficient biotransformation of drugs and this is thought to be due to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
D. Less estrogen than women
Answer: C
Rationale: Testosterone enhances hepatic enzyme activity, contributing to faster drug
metabolism compared with women.
10. An 80-year-old patient expresses frustration that complicated treatment regimens "don't seem
to help much." Which principle of gerontological nursing best guides your response?
A. Patient-centered care
B. Evidence-based practice
Adults 3rd Edition (Kennedy-Malone) 2026/2027
BELOW ARE QUESTIONS AND ANSWERS WITH RATIONALES
Chapter 1: Changes with Aging
1. The major impact of the physiological changes that occur with aging is:
A. Reduced physiological reserve
B. Reduced homeostatic mechanisms
C. Impaired immunological response
D. All of the above
Answer: D
Rationale: Aging results in reduced physiologic reserve, diminished homeostatic regulation, and
impaired immune function. Together, these changes decrease the older adult's ability to respond
to stressors such as illness, trauma, and environmental changes.
2. The strongest evidence regarding normal physiological aging is available through:
A. Randomized controlled clinical trials
B. Cross-sectional studies
C. Longitudinal studies
D. Case control studies
Answer: C
,Rationale: Longitudinal studies follow the same individuals over time, allowing researchers to
distinguish normal aging changes from disease-related processes, making them the gold standard
for aging research.
3. All of the following statements are true about laboratory values in older adults except:
A. Reference ranges are preferable
B. Abnormal findings are often due to physiological aging
C. Normal ranges may not be applicable for older adults
D. Reference values are not necessarily acceptable values
Answer: B
Rationale: Abnormal laboratory findings should not automatically be attributed to aging. Most
significant lab abnormalities reflect pathology rather than normal aging processes.
4. Biochemical individuality is best described as:
A. Each individual's variation is often much greater than that of a larger group
B. The unique biochemical profile of a selected population
C. The truly "normal" individual—falling within average range
D. Each individual's variation is often much smaller than that of a larger group
Answer: D
Rationale: Biochemical individuality recognizes that each person maintains a narrow personal
homeostatic range, which may differ from population norms but remains stable for that
individual.
5. Polypharmacy is best described as taking:
A. More than nine medications per day
,B. More than five medications per day
C. Even a single medication if there is not a clear indication for its use
D. When a drug is given to treat the side effect of another drug
Answer: C
Rationale: Polypharmacy is not strictly defined by number alone; inappropriate prescribing—
even of a single unnecessary medication—meets the definition because it increases risk for
adverse effects.
6. Pharmacokinetic changes with aging is reflective of:
A. What the drug does to the body
B. What the body does to the drug
C. The effect at the site of action and the time and intensity of the drug
D. The side effects commonly associated with the drug
Answer: B
Rationale: Pharmacokinetics includes absorption, distribution, metabolism, and excretion. These
processes are commonly altered in older adults.
7. All the following statements are false about drug absorption except:
A. Antacids increase the bioavailability of digitalis
B. Gastric acidity decreases with age
C. Anticholinergics increase colonic motility
D. Underlying chronic disease has little impact on drug absorption
Answer: D
, Rationale: Although aging alters gastric pH and motility, clinically significant absorption
changes are uncommon unless chronic disease interferes with gastrointestinal function.
8. All of the following statements are true about drug distribution in the elderly except:
A. Drugs distributed in water have lower concentration
B. Drugs distributed in fat have less intense, more prolonged effect
C. Drugs highly protein bound have greater potential to cause an adverse drug reaction
D. The fastest way to deliver a drug to the action site is by inhalation
Answer: A
Rationale: Older adults have decreased total body water, which increases serum concentration of
water-soluble drugs, not lowers it.
9. Men have faster and more efficient biotransformation of drugs and this is thought to be due to:
A. Less obesity rates than women
B. Prostate enlargement
C. Testosterone
D. Less estrogen than women
Answer: C
Rationale: Testosterone enhances hepatic enzyme activity, contributing to faster drug
metabolism compared with women.
10. An 80-year-old patient expresses frustration that complicated treatment regimens "don't seem
to help much." Which principle of gerontological nursing best guides your response?
A. Patient-centered care
B. Evidence-based practice
