NURS 611 Advanced Pathophysiology: Aging & Lifespan Physiological
Changes 2026 |Maryville
1. Which physiological change contributes most significantly to the increased
systolic blood pressure often observed in the elderly?
A. Decrease in total peripheral resistance
B. Decreased production of angiotensin II
C. Increased arterial stiffness and reduced compliance
D. Increased venous return and stroke volume
Answer: C
Rationale: Aging is associated with structural changes in the large arteries, including
collagen deposition and elastin fragmentation, leading to arterial stiffness. This increases
pulse wave velocity and systolic pressure.
2. In the aging respiratory system, what is the primary cause of the increase in
residual volume?
A. Increased alveolar surface area
B. Hypertrophy of the diaphragm
C. Increased chest wall compliance
D. Loss of elastic recoil in lung tissue
Answer: D
Rationale: The loss of pulmonary elastic recoil reduces the force available to expel air
during expiration, leading to air trapping and an increase in residual volume (RV).
,3. A 75-year-old patient has a ‘normal’ serum creatinine level. Why might this
be a misleading indicator of renal function?
A. Creatinine production increases with age
B. Kidneys secrete more creatinine into the urine in old age
C. Decreased muscle mass leads to lower creatinine production
D. Serum creatinine is not filtered by the glomerulus
Answer: C
Rationale: Creatinine is a byproduct of muscle metabolism. Because muscle mass
(sarcopenia) decreases with age, creatinine production also decreases, which can mask a
significant decline in Glomerular Filtration Rate (GFR).
4. What occurs to the thymus gland during the process of immunosenescence?
A. It undergoes hypertrophy to compensate for infection
B. It increases the production of B cells
C. It undergoes involution, reducing the output of naive T cells
D. It migrates to the bone marrow
Answer: C
Rationale: Thymic involution begins after puberty and continues with age, resulting in a
significantly reduced capacity to produce new, naive T cells, thereby impairing the adaptive
immune response to new antigens.
5. Which statement best describes the changes in cardiac output during
maximal exercise in an aging adult?
A. Maximum cardiac output increases to compensate for lower stroke volume
B. Maximum cardiac output decreases due to a lower maximum heart rate
C. Maximum cardiac output remains constant due to Frank-Starling mechanism
D. Maximum cardiac output decreases solely due to decreased blood volume
Answer: B
, Rationale: While resting cardiac output is often maintained, maximum cardiac output
during exercise decreases primarily due to a decline in maximum heart rate and reduced
beta-adrenergic sensitivity.
6. How does aging affect the pharmacokinetics of lipophilic drugs?
A. Increased total body water decreases the volume of distribution
B. Decreased body fat leads to faster clearance
C. Increased body fat increases the volume of distribution and half-life
D. Increased serum albumin increases drug binding
Answer: C
Rationale: Aging is associated with an increase in body fat percentage. Lipophilic drugs
(like diazepam) have an increased volume of distribution in elderly patients, leading to a
prolonged half-life.
7. Which neurological change is considered a hallmark of normal aging, rather
than pathology?
A. Mild brain atrophy, particularly in the prefrontal cortex
B. Widespread neurofibrillary tangles in the neocortex
C. Complete loss of dopaminergic neurons in the substantia nigra
D. Formation of large amyloid-beta plaques in all brain regions
Answer: A
Rationale: Normal aging is associated with modest brain volume loss and cortical thinning,
especially in the prefrontal cortex and hippocampus, whereas dense plaques and tangles
are hallmarks of Alzheimer’s disease.
Changes 2026 |Maryville
1. Which physiological change contributes most significantly to the increased
systolic blood pressure often observed in the elderly?
A. Decrease in total peripheral resistance
B. Decreased production of angiotensin II
C. Increased arterial stiffness and reduced compliance
D. Increased venous return and stroke volume
Answer: C
Rationale: Aging is associated with structural changes in the large arteries, including
collagen deposition and elastin fragmentation, leading to arterial stiffness. This increases
pulse wave velocity and systolic pressure.
2. In the aging respiratory system, what is the primary cause of the increase in
residual volume?
A. Increased alveolar surface area
B. Hypertrophy of the diaphragm
C. Increased chest wall compliance
D. Loss of elastic recoil in lung tissue
Answer: D
Rationale: The loss of pulmonary elastic recoil reduces the force available to expel air
during expiration, leading to air trapping and an increase in residual volume (RV).
,3. A 75-year-old patient has a ‘normal’ serum creatinine level. Why might this
be a misleading indicator of renal function?
A. Creatinine production increases with age
B. Kidneys secrete more creatinine into the urine in old age
C. Decreased muscle mass leads to lower creatinine production
D. Serum creatinine is not filtered by the glomerulus
Answer: C
Rationale: Creatinine is a byproduct of muscle metabolism. Because muscle mass
(sarcopenia) decreases with age, creatinine production also decreases, which can mask a
significant decline in Glomerular Filtration Rate (GFR).
4. What occurs to the thymus gland during the process of immunosenescence?
A. It undergoes hypertrophy to compensate for infection
B. It increases the production of B cells
C. It undergoes involution, reducing the output of naive T cells
D. It migrates to the bone marrow
Answer: C
Rationale: Thymic involution begins after puberty and continues with age, resulting in a
significantly reduced capacity to produce new, naive T cells, thereby impairing the adaptive
immune response to new antigens.
5. Which statement best describes the changes in cardiac output during
maximal exercise in an aging adult?
A. Maximum cardiac output increases to compensate for lower stroke volume
B. Maximum cardiac output decreases due to a lower maximum heart rate
C. Maximum cardiac output remains constant due to Frank-Starling mechanism
D. Maximum cardiac output decreases solely due to decreased blood volume
Answer: B
, Rationale: While resting cardiac output is often maintained, maximum cardiac output
during exercise decreases primarily due to a decline in maximum heart rate and reduced
beta-adrenergic sensitivity.
6. How does aging affect the pharmacokinetics of lipophilic drugs?
A. Increased total body water decreases the volume of distribution
B. Decreased body fat leads to faster clearance
C. Increased body fat increases the volume of distribution and half-life
D. Increased serum albumin increases drug binding
Answer: C
Rationale: Aging is associated with an increase in body fat percentage. Lipophilic drugs
(like diazepam) have an increased volume of distribution in elderly patients, leading to a
prolonged half-life.
7. Which neurological change is considered a hallmark of normal aging, rather
than pathology?
A. Mild brain atrophy, particularly in the prefrontal cortex
B. Widespread neurofibrillary tangles in the neocortex
C. Complete loss of dopaminergic neurons in the substantia nigra
D. Formation of large amyloid-beta plaques in all brain regions
Answer: A
Rationale: Normal aging is associated with modest brain volume loss and cortical thinning,
especially in the prefrontal cortex and hippocampus, whereas dense plaques and tangles
are hallmarks of Alzheimer’s disease.
