NUR257 EXAM 3 AGING AND CHRONIC ILLNESS IN
NURSING 2026/2027 | Galen College Updated | Questions
& Answers | Pass Guaranteed - A+ Graded
Section 1: Theories of Aging & Physiological Changes - Q1-20
Q1. A nursing student is explaining the programmed theory of aging to a classmate.
Which statement best describes this theory?
A. Aging is caused by accumulated damage to DNA and proteins over time from free
radicals and oxidative stress.
B. Aging follows a genetically predetermined biological clock regulated by telomere
shortening and apoptosis.
C. Aging results from gradual wear and tear on body systems similar to mechanical
breakdown.
D. Aging is primarily caused by cross-linking of collagen proteins leading to tissue
stiffening.
Correct Answer: B
Rationale: The programmed theory (biological clock theory) proposes that aging is
genetically predetermined through mechanisms like telomere shortening and
programmed cell death (apoptosis). A describes the free radical/error theory, C
describes the wear-and-tear theory, and D describes the cross-linkage theory.
Q2. A 78-year-old patient asks the nurse why their heart rate does not increase as
much with exercise as it did when they were younger. The nurse's best response is
based on which physiological change?
A. Decreased sensitivity of baroreceptors to blood pressure changes
B. Reduced responsiveness of the sinoatrial (SA) node to sympathetic stimulation
,C. Increased left ventricular wall thickness causing diastolic dysfunction
D. Decreased venous return due to venous valve incompetence
Correct Answer: B
Rationale: With aging, the SA node loses pacemaker cells and becomes less
responsive to sympathetic stimulation (beta-adrenergic receptor downregulation),
resulting in a blunted maximal heart rate response to exercise. While A, C, and D are
age-related cardiovascular changes, B directly explains the reduced chronotropic
response.
Q3. Which age-related respiratory change places older adults at highest risk for
aspiration pneumonia?
A. Decreased vital capacity and increased residual volume
B. Reduced sensitivity of cough and gag reflexes
C. Calcification of costal cartilage limiting chest expansion
D. Decreased number of functional alveoli
Correct Answer: B
Rationale: The diminished cough and gag reflexes in older adults impair airway
protection, significantly increasing aspiration risk. While A, C, and D are normal age-
related changes affecting respiratory efficiency, they do not directly increase
aspiration risk as much as impaired protective reflexes.
Q4. A nurse is caring for an 82-year-old patient with newly diagnosed heart failure.
The nurse understands that which age-related renal change most significantly
impacts medication dosing?
A. Decreased glomerular filtration rate (GFR)
B. Reduced ability to concentrate urine
C. Decreased renin and aldosterone secretion
D. Loss of nephron units
,Correct Answer: A
Rationale: GFR declines by approximately 1 mL/min/year after age 40, significantly
affecting drug elimination and increasing risk of toxicity. While B, C, and D are age-
related renal changes, the decreased GFR is the primary factor requiring dose
adjustments for renally cleared medications like digoxin and metformin.
Q5. Which neurological change is considered a normal part of aging and NOT
pathological?
A. Formation of neurofibrillary tangles and amyloid plaques
B. Mild slowing of nerve conduction velocity
C. Progressive loss of dopaminergic neurons in the substantia nigra
D. Significant cortical atrophy with ventricular enlargement
Correct Answer: B
Rationale: Mild slowing of nerve conduction velocity (approximately 5-10%
decrease) is a normal age-related change due to decreased myelin integrity and
axonal diameter. A describes Alzheimer's pathology, C describes Parkinson's disease,
and D describes significant atrophy beyond normal aging.
Q6. A nurse is assessing skin integrity in an 82-year-old patient. Which finding is
expected as a normal age-related change?
A. Deep, irregular skin folds with weeping
B. Thinning of the dermis and decreased subcutaneous fat
C. Purple striae on the abdomen and extremities
D. Thick, leathery skin with increased turgor
Correct Answer: B
Rationale: Normal aging causes thinning of the dermis, loss of elastin and collagen,
and decreased subcutaneous fat, making skin more fragile and susceptible to injury.
A suggests fungal infection, C suggests Cushing's syndrome or steroid use, and D
contradicts normal aging changes.
, Q7. Which theory of aging best explains why caloric restriction has been shown to
extend lifespan in animal models?
A. Immunological theory
B. Free radical theory
C. Neuroendocrine theory
D. Gene theory
Correct Answer: B
Rationale: The free radical theory proposes that metabolic processes generate
reactive oxygen species that damage cellular components; caloric restriction reduces
metabolic rate and oxidative stress, thereby slowing cellular damage. While other
theories contribute to aging understanding, caloric restriction's mechanism aligns
most directly with reduced oxidative damage.
Q8. An 80-year-old patient has a temperature of 99.1°F (37.3°C) during a
postoperative assessment. The nurse recognizes this as significant because:
A. Older adults normally have higher baseline temperatures than younger adults.
B. The blunted febrile response in aging means infection may present with minimal
or no fever.
C. Postoperative patients always develop low-grade fevers that are not concerning.
D. Older adults have hyperactive immune responses that mask true infection.
Correct Answer: B
Rationale: Older adults have a blunted febrile response due to decreased
hypothalamic sensitivity and reduced cytokine production; a temperature of 99.1°F
may represent a significant infection in an older adult whose baseline is lower. A is
incorrect (baseline is often lower), C is dangerous generalization, and D is
physiologically incorrect.
NURSING 2026/2027 | Galen College Updated | Questions
& Answers | Pass Guaranteed - A+ Graded
Section 1: Theories of Aging & Physiological Changes - Q1-20
Q1. A nursing student is explaining the programmed theory of aging to a classmate.
Which statement best describes this theory?
A. Aging is caused by accumulated damage to DNA and proteins over time from free
radicals and oxidative stress.
B. Aging follows a genetically predetermined biological clock regulated by telomere
shortening and apoptosis.
C. Aging results from gradual wear and tear on body systems similar to mechanical
breakdown.
D. Aging is primarily caused by cross-linking of collagen proteins leading to tissue
stiffening.
Correct Answer: B
Rationale: The programmed theory (biological clock theory) proposes that aging is
genetically predetermined through mechanisms like telomere shortening and
programmed cell death (apoptosis). A describes the free radical/error theory, C
describes the wear-and-tear theory, and D describes the cross-linkage theory.
Q2. A 78-year-old patient asks the nurse why their heart rate does not increase as
much with exercise as it did when they were younger. The nurse's best response is
based on which physiological change?
A. Decreased sensitivity of baroreceptors to blood pressure changes
B. Reduced responsiveness of the sinoatrial (SA) node to sympathetic stimulation
,C. Increased left ventricular wall thickness causing diastolic dysfunction
D. Decreased venous return due to venous valve incompetence
Correct Answer: B
Rationale: With aging, the SA node loses pacemaker cells and becomes less
responsive to sympathetic stimulation (beta-adrenergic receptor downregulation),
resulting in a blunted maximal heart rate response to exercise. While A, C, and D are
age-related cardiovascular changes, B directly explains the reduced chronotropic
response.
Q3. Which age-related respiratory change places older adults at highest risk for
aspiration pneumonia?
A. Decreased vital capacity and increased residual volume
B. Reduced sensitivity of cough and gag reflexes
C. Calcification of costal cartilage limiting chest expansion
D. Decreased number of functional alveoli
Correct Answer: B
Rationale: The diminished cough and gag reflexes in older adults impair airway
protection, significantly increasing aspiration risk. While A, C, and D are normal age-
related changes affecting respiratory efficiency, they do not directly increase
aspiration risk as much as impaired protective reflexes.
Q4. A nurse is caring for an 82-year-old patient with newly diagnosed heart failure.
The nurse understands that which age-related renal change most significantly
impacts medication dosing?
A. Decreased glomerular filtration rate (GFR)
B. Reduced ability to concentrate urine
C. Decreased renin and aldosterone secretion
D. Loss of nephron units
,Correct Answer: A
Rationale: GFR declines by approximately 1 mL/min/year after age 40, significantly
affecting drug elimination and increasing risk of toxicity. While B, C, and D are age-
related renal changes, the decreased GFR is the primary factor requiring dose
adjustments for renally cleared medications like digoxin and metformin.
Q5. Which neurological change is considered a normal part of aging and NOT
pathological?
A. Formation of neurofibrillary tangles and amyloid plaques
B. Mild slowing of nerve conduction velocity
C. Progressive loss of dopaminergic neurons in the substantia nigra
D. Significant cortical atrophy with ventricular enlargement
Correct Answer: B
Rationale: Mild slowing of nerve conduction velocity (approximately 5-10%
decrease) is a normal age-related change due to decreased myelin integrity and
axonal diameter. A describes Alzheimer's pathology, C describes Parkinson's disease,
and D describes significant atrophy beyond normal aging.
Q6. A nurse is assessing skin integrity in an 82-year-old patient. Which finding is
expected as a normal age-related change?
A. Deep, irregular skin folds with weeping
B. Thinning of the dermis and decreased subcutaneous fat
C. Purple striae on the abdomen and extremities
D. Thick, leathery skin with increased turgor
Correct Answer: B
Rationale: Normal aging causes thinning of the dermis, loss of elastin and collagen,
and decreased subcutaneous fat, making skin more fragile and susceptible to injury.
A suggests fungal infection, C suggests Cushing's syndrome or steroid use, and D
contradicts normal aging changes.
, Q7. Which theory of aging best explains why caloric restriction has been shown to
extend lifespan in animal models?
A. Immunological theory
B. Free radical theory
C. Neuroendocrine theory
D. Gene theory
Correct Answer: B
Rationale: The free radical theory proposes that metabolic processes generate
reactive oxygen species that damage cellular components; caloric restriction reduces
metabolic rate and oxidative stress, thereby slowing cellular damage. While other
theories contribute to aging understanding, caloric restriction's mechanism aligns
most directly with reduced oxidative damage.
Q8. An 80-year-old patient has a temperature of 99.1°F (37.3°C) during a
postoperative assessment. The nurse recognizes this as significant because:
A. Older adults normally have higher baseline temperatures than younger adults.
B. The blunted febrile response in aging means infection may present with minimal
or no fever.
C. Postoperative patients always develop low-grade fevers that are not concerning.
D. Older adults have hyperactive immune responses that mask true infection.
Correct Answer: B
Rationale: Older adults have a blunted febrile response due to decreased
hypothalamic sensitivity and reduced cytokine production; a temperature of 99.1°F
may represent a significant infection in an older adult whose baseline is lower. A is
incorrect (baseline is often lower), C is dangerous generalization, and D is
physiologically incorrect.
