NUR 2214 / NUR2214: Nursing Care of the Older
Adult Quiz 2 Review – Rasmussen Actual Exam
2026/2027
Section 1: Physiological Changes of Aging (Questions 1–30)
1. Which cardiovascular change is considered a normal part of aging?
A. Increased resting heart rate
B. Thickening and stiffening of heart valves
C. Decreased systolic blood pressure
D. Increased cardiac output
Answer: B
Rationale: Age-related fibrosis and calcification cause valve thickening/stiffness (e.g., aortic
sclerosis). Resting HR usually unchanged; systolic BP rises; cardiac output declines.
2. An older adult’s respiratory assessment shows decreased cough reflex. This
increases risk for:
A. Hyperventilation
B. Aspiration pneumonia
C. Pulmonary embolism
D. Asthma exacerbation
Answer: B
Rationale: Reduced cough/gag reflex allows aspiration of oropharyngeal contents, leading to
pneumonia.
3. Which age-related renal change affects drug dosing?
A. Increased renal blood flow
B. Increased glomerular filtration rate (GFR)
C. Decreased number of nephrons
D. Increased creatinine clearance
Answer: C
Rationale: Number of nephrons decreases by 30–40% by age 80, reducing GFR and drug
excretion. Creatinine clearance declines despite stable serum creatinine due to muscle loss.
4. An older adult reports feeling full quickly and has unintentional weight loss. Most
likely cause:
A. Hyperthyroidism
B. Delayed gastric emptying
C. Increased appetite
, D. Malabsorption syndrome
Answer: B
Rationale: Aging slows gastric emptying, causing early satiety. Weight loss is common;
hyperthyroidism less common and increases appetite.
5. Which neurological change is typical in normal aging?
A. Loss of all deep tendon reflexes
B. Slowed reaction time
C. New-onset aphasia
D. Tremor at rest
Answer: B
Rationale: Slowed nerve conduction velocity and central processing slow reaction time. Loss
of all reflexes, aphasia, or resting tremor suggests pathology.
6. A nurse expects which change in an older adult’s skin?
A. Increased sweat gland activity
B. Increased melanocyte function
C. Thinning of epidermis
D. Increased subcutaneous fat
Answer: C
Rationale: Epidermis thins, sweat glands decrease, melanocytes decrease (graying hair,
lentigines), subcutaneous fat decreases.
7. Age-related visual change most likely to affect driving safety:
A. Increased near vision (presbyopia)
B. Decreased peripheral vision
C. Increased tear production
D. Improved night vision
Answer: B
Rationale: Peripheral vision narrows (loss of rods), increasing risk for not seeing cars in
adjacent lanes. Night vision declines.
8. Which statement about aging and the immune system is accurate?
A. Antibody response to vaccines improves
B. T-cell function declines
C. Autoimmune diseases become less common
D. Wound healing accelerates
,Answer: B
Rationale: Thymic involution reduces naïve T-cells, impairing response to new antigens (e.g.,
influenza vaccine less effective).
9. Older adults are more susceptible to hypothermia because:
A. Increased metabolic rate
B. Decreased vasoconstriction response
C. Increased shivering ability
D. Thickened subcutaneous fat
Answer: B
Rationale: Impaired vasoconstriction and reduced shivering capacity increase heat loss.
10. Which musculoskeletal change is considered normal aging?
A. Osteoporosis (significant bone loss)
B. Loss of height from vertebral compression
C. Muscle hypertrophy
D. Increased joint flexibility
Answer: B
Rationale: Disc dehydration and vertebral thinning cause modest height loss (1–3 inches).
Osteoporosis is pathologic; sarcopenia (muscle loss) occurs, not hypertrophy.
11. An older adult’s gastric pH becomes less acidic. This increases risk for:
A. Peptic ulcer disease
B. Bacterial overgrowth in GI tract
C. Increased iron absorption
D. Faster drug absorption
Answer: B
Rationale: Hypochlorhydria allows bacterial colonization in stomach/small bowel, leading to
malabsorption and diarrhea.
12. Which change in the endocrine system is age-related?
A. Increased insulin sensitivity
B. Decreased ADH response to osmolarity
C. Increased thyroid hormone production
D. Increased cortisol degradation
Answer: B
Rationale: Blunted ADH release increases risk for dehydration and hypernatremia. Insulin
resistance increases; thyroid function slightly declines.
, 13. A nurse assessing an 80-year-old notes a systolic ejection murmur at right sternal
border. Most likely:
A. Mitral regurgitation
B. Aortic sclerosis (benign)
C. Hypertrophic cardiomyopathy
D. Atrial septal defect
Answer: B
Rationale: Aortic sclerosis from calcific changes is common, usually benign without stenosis.
Murmur is systolic, ejection-type.
14. The primary reason older adults have increased risk for urinary tract infections
(UTIs):
A. Increased bladder capacity
B. Incomplete bladder emptying
C. Acidic urine pH
D. Increased estrogen
Answer: B
Rationale: Detrusor muscle weakness and prostate enlargement cause residual urine, a
medium for bacterial growth.
15. Which sleep pattern change is normal in older adults?
A. Increased slow-wave (deep) sleep
B. More time in REM sleep
C. Decreased total sleep time with more awakenings
D. No change in circadian rhythm
Answer: C
Rationale: Older adults have less deep sleep, more awakenings, advanced sleep phase, but
total time may be preserved with naps.
16. A patient’s liver function tests are normal, but drug metabolism is slowed. Why?
A. Decreased liver blood flow
B. Increased microsomal enzyme activity
C. Increased liver mass
D. Increased albumin
Answer: A
Rationale: Hepatic blood flow decreases by 40–50%, reducing first-pass metabolism. Liver
mass decreases.
Adult Quiz 2 Review – Rasmussen Actual Exam
2026/2027
Section 1: Physiological Changes of Aging (Questions 1–30)
1. Which cardiovascular change is considered a normal part of aging?
A. Increased resting heart rate
B. Thickening and stiffening of heart valves
C. Decreased systolic blood pressure
D. Increased cardiac output
Answer: B
Rationale: Age-related fibrosis and calcification cause valve thickening/stiffness (e.g., aortic
sclerosis). Resting HR usually unchanged; systolic BP rises; cardiac output declines.
2. An older adult’s respiratory assessment shows decreased cough reflex. This
increases risk for:
A. Hyperventilation
B. Aspiration pneumonia
C. Pulmonary embolism
D. Asthma exacerbation
Answer: B
Rationale: Reduced cough/gag reflex allows aspiration of oropharyngeal contents, leading to
pneumonia.
3. Which age-related renal change affects drug dosing?
A. Increased renal blood flow
B. Increased glomerular filtration rate (GFR)
C. Decreased number of nephrons
D. Increased creatinine clearance
Answer: C
Rationale: Number of nephrons decreases by 30–40% by age 80, reducing GFR and drug
excretion. Creatinine clearance declines despite stable serum creatinine due to muscle loss.
4. An older adult reports feeling full quickly and has unintentional weight loss. Most
likely cause:
A. Hyperthyroidism
B. Delayed gastric emptying
C. Increased appetite
, D. Malabsorption syndrome
Answer: B
Rationale: Aging slows gastric emptying, causing early satiety. Weight loss is common;
hyperthyroidism less common and increases appetite.
5. Which neurological change is typical in normal aging?
A. Loss of all deep tendon reflexes
B. Slowed reaction time
C. New-onset aphasia
D. Tremor at rest
Answer: B
Rationale: Slowed nerve conduction velocity and central processing slow reaction time. Loss
of all reflexes, aphasia, or resting tremor suggests pathology.
6. A nurse expects which change in an older adult’s skin?
A. Increased sweat gland activity
B. Increased melanocyte function
C. Thinning of epidermis
D. Increased subcutaneous fat
Answer: C
Rationale: Epidermis thins, sweat glands decrease, melanocytes decrease (graying hair,
lentigines), subcutaneous fat decreases.
7. Age-related visual change most likely to affect driving safety:
A. Increased near vision (presbyopia)
B. Decreased peripheral vision
C. Increased tear production
D. Improved night vision
Answer: B
Rationale: Peripheral vision narrows (loss of rods), increasing risk for not seeing cars in
adjacent lanes. Night vision declines.
8. Which statement about aging and the immune system is accurate?
A. Antibody response to vaccines improves
B. T-cell function declines
C. Autoimmune diseases become less common
D. Wound healing accelerates
,Answer: B
Rationale: Thymic involution reduces naïve T-cells, impairing response to new antigens (e.g.,
influenza vaccine less effective).
9. Older adults are more susceptible to hypothermia because:
A. Increased metabolic rate
B. Decreased vasoconstriction response
C. Increased shivering ability
D. Thickened subcutaneous fat
Answer: B
Rationale: Impaired vasoconstriction and reduced shivering capacity increase heat loss.
10. Which musculoskeletal change is considered normal aging?
A. Osteoporosis (significant bone loss)
B. Loss of height from vertebral compression
C. Muscle hypertrophy
D. Increased joint flexibility
Answer: B
Rationale: Disc dehydration and vertebral thinning cause modest height loss (1–3 inches).
Osteoporosis is pathologic; sarcopenia (muscle loss) occurs, not hypertrophy.
11. An older adult’s gastric pH becomes less acidic. This increases risk for:
A. Peptic ulcer disease
B. Bacterial overgrowth in GI tract
C. Increased iron absorption
D. Faster drug absorption
Answer: B
Rationale: Hypochlorhydria allows bacterial colonization in stomach/small bowel, leading to
malabsorption and diarrhea.
12. Which change in the endocrine system is age-related?
A. Increased insulin sensitivity
B. Decreased ADH response to osmolarity
C. Increased thyroid hormone production
D. Increased cortisol degradation
Answer: B
Rationale: Blunted ADH release increases risk for dehydration and hypernatremia. Insulin
resistance increases; thyroid function slightly declines.
, 13. A nurse assessing an 80-year-old notes a systolic ejection murmur at right sternal
border. Most likely:
A. Mitral regurgitation
B. Aortic sclerosis (benign)
C. Hypertrophic cardiomyopathy
D. Atrial septal defect
Answer: B
Rationale: Aortic sclerosis from calcific changes is common, usually benign without stenosis.
Murmur is systolic, ejection-type.
14. The primary reason older adults have increased risk for urinary tract infections
(UTIs):
A. Increased bladder capacity
B. Incomplete bladder emptying
C. Acidic urine pH
D. Increased estrogen
Answer: B
Rationale: Detrusor muscle weakness and prostate enlargement cause residual urine, a
medium for bacterial growth.
15. Which sleep pattern change is normal in older adults?
A. Increased slow-wave (deep) sleep
B. More time in REM sleep
C. Decreased total sleep time with more awakenings
D. No change in circadian rhythm
Answer: C
Rationale: Older adults have less deep sleep, more awakenings, advanced sleep phase, but
total time may be preserved with naps.
16. A patient’s liver function tests are normal, but drug metabolism is slowed. Why?
A. Decreased liver blood flow
B. Increased microsomal enzyme activity
C. Increased liver mass
D. Increased albumin
Answer: A
Rationale: Hepatic blood flow decreases by 40–50%, reducing first-pass metabolism. Liver
mass decreases.
