NUR 257 GERONTOLOGICAL NURSING EXAM 1
2026/2027 | 100% Correct Answers | Latest Update | Pass
Guaranteed - A+ Graded
[Section 1: Theories of Aging & Physiologic Changes (Q1-12)]
Q1. A nurse is caring for an 82-year-old patient who states, "I've lived a good life and
have no regrets. I enjoy sharing my stories with my grandchildren." According to
Erikson's psychosocial theory of development, which developmental task is this
patient successfully resolving?
A. Generativity vs. Stagnation
B. Integrity vs. Despair
C. Ego Differentiation vs. Work-Role Preoccupation
D. Identity vs. Role Confusion
B. Integrity vs. Despair [CORRECT]
Rationale: Erikson's final stage (age 65+) involves achieving ego integrity through
acceptance of one's life course, or falling into despair over unmet goals. This
patient's life review and contentment indicate successful resolution. Generativity (A)
occurs in middle adulthood; Ego Differentiation (C) is Peck's theory; Identity (D) is
adolescence. Correct Answer: B
Q2. A nursing student is studying the biological theories of aging. Which theory
proposes that unstable molecules damage cellular DNA, proteins, and lipids over
time, contributing to cellular senescence?
A. Cross-linkage theory
B. Immunologic theory
,C. Free radical theory
D. Programmed cell death theory
C. Free radical theory [CORRECT]
Rationale: The free radical theory (Harman) proposes that reactive oxygen species
(ROS) cause oxidative damage to cellular components. Antioxidant defenses decline
with age, accelerating damage. Cross-linkage theory (A) involves glucose binding to
proteins; Immunologic theory (B) involves immune system dysfunction; Programmed
theory (D) suggests genetic programming. Correct Answer: C
Q3. A 78-year-old patient has stiff joints and decreased flexibility. The nurse
understands this is related to cross-linkage of collagen fibers. Which biological
theory of aging explains this finding?
A. Free radical theory
B. Cross-linkage theory
C. Immunologic theory
D. Neuroendocrine theory
B. Cross-linkage theory [CORRECT]
Rationale: The cross-linkage theory proposes that glucose and other aldehydes bind
to proteins (glycation), forming advanced glycation end-products (AGEs) that cross-
link collagen and elastin. This causes tissue stiffening (arteries, joints, skin), reduced
elasticity, and impaired function. Correct Answer: B
Q4. A nurse observes that an 85-year-old patient has reduced skin turgor, thinning
dermis, and increased bruising. Which age-related integumentary change is the
nurse recognizing?
A. Increased subcutaneous fat deposition
B. Decreased collagen and elastin, reduced sweat gland function, and thinning of
dermal-epidermal junction
,C. Increased melanocyte activity and hyperpigmentation
D. Enhanced wound healing capacity
B. Decreased collagen and elastin, reduced sweat gland function, and thinning of
dermal-epidermal junction [CORRECT]
Rationale: Normal aging causes dermal thinning (20-80% decrease in thickness),
reduced collagen/elastin synthesis, flattening of rete ridges, decreased
sweat/sebaceous glands, and reduced thermoregulation. These changes increase
bruising risk, impair wound healing, and reduce barrier function. Correct Answer: B
Q5. A nurse is assessing an 80-year-old patient's cardiovascular system. Which
finding represents a normal age-related change rather than pathology?
A. Systolic murmur grade III/VI with radiation to the carotids
B. Decreased arterial compliance with isolated systolic hypertension (systolic ↑,
diastolic normal or ↓)
C. Acute ST-elevation myocardial infarction
D. New-onset atrial fibrillation with rapid ventricular response
B. Decreased arterial compliance with isolated systolic hypertension (systolic ↑,
diastolic normal or ↓) [CORRECT]
Rationale: Normal aging causes arterial stiffening from collagen cross-linking, elastin
fragmentation, and endothelial dysfunction. This increases pulse wave velocity and
systolic pressure while diastolic pressure may fall, widening pulse pressure. Options
A, C, and D represent pathological conditions requiring intervention. Correct
Answer: B
Q6. A nurse notes that a 76-year-old patient has reduced vital capacity and increased
residual volume. Which age-related respiratory change explains these pulmonary
function test findings?
, A. Acute bacterial pneumonia
B. Decreased chest wall compliance, alveolar duct dilation, loss of elastic recoil, and
reduced respiratory muscle strength
C. Pulmonary embolism
D. Acute respiratory distress syndrome
B. Decreased chest wall compliance, alveolar duct dilation, loss of elastic recoil,
and reduced respiratory muscle strength [CORRECT]
Rationale: Normal respiratory aging includes: kyphosis/rib calcification reducing
compliance, alveolar duct dilation (senile emphysema), loss of elastic recoil,
decreased surfactant, and respiratory muscle atrophy. This causes ↓VC, ↑RV, ↑FRC,
and impaired gas exchange. Options A, C, and D are acute pathologies. Correct
Answer: B
Q7. A nurse is reviewing medication dosages for an 80-year-old patient. The provider
reduces the dose of a renally cleared antibiotic. Which age-related renal change
supports this decision?
A. Increased glomerular filtration rate from compensatory hyperfiltration
B. Decreased GFR (1% per year after age 40), reduced renal blood flow, and
decreased tubular secretion
C. Increased creatinine production from enhanced muscle mass
D. Enhanced tubular reabsorption of all medications
B. Decreased GFR (1% per year after age 40), reduced renal blood flow, and
decreased tubular secretion [CORRECT]
Rationale: Normal renal aging includes nephron loss, GFR decline (~1%/year after
40), reduced RBF, decreased tubular function, and impaired concentrating ability.
Creatinine may appear normal despite reduced GFR due to decreased muscle mass.
Dose reduction of renally cleared drugs prevents toxicity. Correct Answer: B
2026/2027 | 100% Correct Answers | Latest Update | Pass
Guaranteed - A+ Graded
[Section 1: Theories of Aging & Physiologic Changes (Q1-12)]
Q1. A nurse is caring for an 82-year-old patient who states, "I've lived a good life and
have no regrets. I enjoy sharing my stories with my grandchildren." According to
Erikson's psychosocial theory of development, which developmental task is this
patient successfully resolving?
A. Generativity vs. Stagnation
B. Integrity vs. Despair
C. Ego Differentiation vs. Work-Role Preoccupation
D. Identity vs. Role Confusion
B. Integrity vs. Despair [CORRECT]
Rationale: Erikson's final stage (age 65+) involves achieving ego integrity through
acceptance of one's life course, or falling into despair over unmet goals. This
patient's life review and contentment indicate successful resolution. Generativity (A)
occurs in middle adulthood; Ego Differentiation (C) is Peck's theory; Identity (D) is
adolescence. Correct Answer: B
Q2. A nursing student is studying the biological theories of aging. Which theory
proposes that unstable molecules damage cellular DNA, proteins, and lipids over
time, contributing to cellular senescence?
A. Cross-linkage theory
B. Immunologic theory
,C. Free radical theory
D. Programmed cell death theory
C. Free radical theory [CORRECT]
Rationale: The free radical theory (Harman) proposes that reactive oxygen species
(ROS) cause oxidative damage to cellular components. Antioxidant defenses decline
with age, accelerating damage. Cross-linkage theory (A) involves glucose binding to
proteins; Immunologic theory (B) involves immune system dysfunction; Programmed
theory (D) suggests genetic programming. Correct Answer: C
Q3. A 78-year-old patient has stiff joints and decreased flexibility. The nurse
understands this is related to cross-linkage of collagen fibers. Which biological
theory of aging explains this finding?
A. Free radical theory
B. Cross-linkage theory
C. Immunologic theory
D. Neuroendocrine theory
B. Cross-linkage theory [CORRECT]
Rationale: The cross-linkage theory proposes that glucose and other aldehydes bind
to proteins (glycation), forming advanced glycation end-products (AGEs) that cross-
link collagen and elastin. This causes tissue stiffening (arteries, joints, skin), reduced
elasticity, and impaired function. Correct Answer: B
Q4. A nurse observes that an 85-year-old patient has reduced skin turgor, thinning
dermis, and increased bruising. Which age-related integumentary change is the
nurse recognizing?
A. Increased subcutaneous fat deposition
B. Decreased collagen and elastin, reduced sweat gland function, and thinning of
dermal-epidermal junction
,C. Increased melanocyte activity and hyperpigmentation
D. Enhanced wound healing capacity
B. Decreased collagen and elastin, reduced sweat gland function, and thinning of
dermal-epidermal junction [CORRECT]
Rationale: Normal aging causes dermal thinning (20-80% decrease in thickness),
reduced collagen/elastin synthesis, flattening of rete ridges, decreased
sweat/sebaceous glands, and reduced thermoregulation. These changes increase
bruising risk, impair wound healing, and reduce barrier function. Correct Answer: B
Q5. A nurse is assessing an 80-year-old patient's cardiovascular system. Which
finding represents a normal age-related change rather than pathology?
A. Systolic murmur grade III/VI with radiation to the carotids
B. Decreased arterial compliance with isolated systolic hypertension (systolic ↑,
diastolic normal or ↓)
C. Acute ST-elevation myocardial infarction
D. New-onset atrial fibrillation with rapid ventricular response
B. Decreased arterial compliance with isolated systolic hypertension (systolic ↑,
diastolic normal or ↓) [CORRECT]
Rationale: Normal aging causes arterial stiffening from collagen cross-linking, elastin
fragmentation, and endothelial dysfunction. This increases pulse wave velocity and
systolic pressure while diastolic pressure may fall, widening pulse pressure. Options
A, C, and D represent pathological conditions requiring intervention. Correct
Answer: B
Q6. A nurse notes that a 76-year-old patient has reduced vital capacity and increased
residual volume. Which age-related respiratory change explains these pulmonary
function test findings?
, A. Acute bacterial pneumonia
B. Decreased chest wall compliance, alveolar duct dilation, loss of elastic recoil, and
reduced respiratory muscle strength
C. Pulmonary embolism
D. Acute respiratory distress syndrome
B. Decreased chest wall compliance, alveolar duct dilation, loss of elastic recoil,
and reduced respiratory muscle strength [CORRECT]
Rationale: Normal respiratory aging includes: kyphosis/rib calcification reducing
compliance, alveolar duct dilation (senile emphysema), loss of elastic recoil,
decreased surfactant, and respiratory muscle atrophy. This causes ↓VC, ↑RV, ↑FRC,
and impaired gas exchange. Options A, C, and D are acute pathologies. Correct
Answer: B
Q7. A nurse is reviewing medication dosages for an 80-year-old patient. The provider
reduces the dose of a renally cleared antibiotic. Which age-related renal change
supports this decision?
A. Increased glomerular filtration rate from compensatory hyperfiltration
B. Decreased GFR (1% per year after age 40), reduced renal blood flow, and
decreased tubular secretion
C. Increased creatinine production from enhanced muscle mass
D. Enhanced tubular reabsorption of all medications
B. Decreased GFR (1% per year after age 40), reduced renal blood flow, and
decreased tubular secretion [CORRECT]
Rationale: Normal renal aging includes nephron loss, GFR decline (~1%/year after
40), reduced RBF, decreased tubular function, and impaired concentrating ability.
Creatinine may appear normal despite reduced GFR due to decreased muscle mass.
Dose reduction of renally cleared drugs prevents toxicity. Correct Answer: B
