_NUR 257 EXAMS 1–4 – AGING & CHRONIC ILLNESS 150 Tested Questions & Answers with Rationales 2026_2027 Academic Year _ Gerontological Nursing.

NUR 257 EXAMS 1–4 – AGING & CHRONIC ILLNESS 150
Tested Questions & Answers with Rationales 2026/2027
Academic Year | Gerontological Nursing


EXAM 1 – FOUNDATIONS OF AGING & PHYSIOLOGIC CHANGES


Question 1
Which theory of aging proposes that accumulated damage from free radicals leads to cellular
dysfunction?
A) Telomere shortening theory
B) Free radical theory
C) Immunologic theory
D) Neuroendocrine theory
Correct answer: B
Rationale: Free radical theory (Harman) suggests reactive oxygen species cause cumulative
oxidative damage.

Question 2
A normal age-related change in the cardiovascular system is:
A) Decreased systolic blood pressure
B) Increased arterial stiffness and increased afterload
C) Increased cardiac output at rest
D) Decreased left ventricular wall thickness
Correct answer: B
Rationale: Arterial stiffness increases with age, raising systolic BP and afterload.

Question 3
Which finding in an older adult would be considered pathologic rather than age-related?
A) Decreased skin turgor
B) Forgetfulness with difficulty managing finances
C) Presbyopia (difficulty focusing on near objects)
D) Decreased maximal heart rate
Correct answer: B
Rationale: Forgetfulness affecting IADLs (finances) is not normal aging; suggests possible
cognitive impairment.

Question 4
Presbycusis refers to:

,A) Age-related farsightedness
B) Age-related hearing loss, especially high frequencies
C) Age-related balance disorder
D) Age-related taste loss
Correct answer: B
Rationale: Presbycusis is bilateral sensorineural hearing loss affecting high-pitched sounds.

Question 5
Which statement about polypharmacy in older adults is true?
A) Polypharmacy is defined as taking 3 or more medications
B) Polypharmacy decreases risk of adverse drug events
C) Beer's List identifies potentially inappropriate medications for older adults
D) Older adults metabolize medications faster than younger adults
Correct answer: C
Rationale: Beer's Criteria (AGS Beers List) identifies potentially inappropriate meds in older
adults.

Question 6
An older adult has a creatinine level of 1.0 mg/dL. The nurse recognizes that:
A) Kidney function is excellent for any age
B) Serum creatinine may be normal despite significantly reduced GFR due to decreased muscle
mass
C) This indicates kidney failure
D) No further renal assessment is needed
Correct answer: B
Rationale: Creatinine is produced from muscle; low muscle mass in aging can mask CKD.

Question 7
The most common type of dementia is:
A) Vascular dementia
B) Lewy body dementia
C) Alzheimer's disease
D) Frontotemporal dementia
Correct answer: C
Rationale: Alzheimer's disease accounts for 60-80% of dementia cases.

Question 8
A patient with Alzheimer's disease has difficulty finding words and exhibits apathy. These are:
A) Reversible symptoms
B) Early-stage symptoms
C) Middle-stage symptoms
D) Late-stage symptoms
Correct answer: B

,Rationale: Word-finding difficulty, apathy, and recent memory loss are early Alzheimer's
symptoms.

Question 9
Which medication is a cholinesterase inhibitor used for mild to moderate Alzheimer's disease?
A) Memantine
B) Donepezil (Aricept)
C) Levodopa
D) Rivastigmine patch only
Correct answer: B
Rationale: Donepezil, rivastigmine, and galantamine are cholinesterase inhibitors.

Question 10
The "Sundowning" phenomenon in dementia refers to:
A) Waking up early
B) Increased confusion and agitation in the late afternoon/evening
C) Sleeping all day
D) Refusing to eat breakfast
Correct answer: B
Rationale: Sundowning is increased behavioral symptoms as daylight fades.

Question 11
A patient with Parkinson's disease presents with a shuffling gait, resting tremor, and rigidity.
These are caused by:
A) Excess acetylcholine in the basal ganglia
B) Dopamine deficiency in the substantia nigra
C) Serotonin excess
D) Norepinephrine deficiency
Correct answer: B
Rationale: Parkinson's results from degeneration of dopamine-producing neurons in substantia
nigra.

Question 12
Levodopa-carbidopa (Sinemet) is used to treat Parkinson's disease. Carbidopa is added to:
A) Increase dopamine release
B) Prevent peripheral conversion of levodopa to dopamine, reducing side effects
C) Block acetylcholine
D) Increase GABA
Correct answer: B
Rationale: Carbidopa prevents peripheral decarboxylation of levodopa, allowing more to reach
the brain.

Question 13
An older adult reports dizziness when standing up. The nurse suspects:

, A) Orthostatic hypotension
B) Meniere's disease
C) Vestibular neuritis
D) Normal aging variant
Correct answer: A
Rationale: Orthostatic hypotension (drop in BP upon standing) is common in older adults due to
baroreceptor sensitivity decline and medications.

Question 14
The Get Up and Go test is used to assess:
A) Hearing
B) Vision
C) Mobility and fall risk
D) Cognition
Correct answer: C
Rationale: Timed Get Up and Go assesses functional mobility; >12 seconds indicates fall risk.

Question 15
A patient scores 24/30 on the Mini-Mental State Examination (MMSE). This suggests:
A) Normal cognition
B) Mild cognitive impairment or early dementia
C) Severe dementia
D) Delirium only
Correct answer: B
Rationale: MMSE <24 suggests cognitive impairment (scores 20-24 mild, 10-20 moderate, <10
severe).

Question 16
The most important intervention to prevent falls in older adults is:
A) Bed alarms
B) Physical restraints
C) Multifactorial interventions (exercise, medication review, home safety)
D) Low beds only
Correct answer: C
Rationale: Multifactorial fall prevention is most effective; restraints are harmful.

Question 17
Which laboratory finding is a normal age-related change?
A) Increased albumin
B) Decreased creatinine clearance
C) Increased hemoglobin
D) Decreased blood glucose
Correct answer: B
Rationale: Creatinine clearance declines with age (by ~1 mL/min/year after age 40).