Nursing / Advanced Practice Care of Older Adults:
Walden University NRNP 6540 – Advanced Practice
Care of Older Adults Final Exam – Spring-Summer
Quarter 2026
QUESTION 1
A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. The nurse practitioner needs to know which of the following laboratory values before
ordering medications?
A) CBC
B) Culture and sensitivity of the urine
C) Creatinine clearance
D) Uric acid levels
Answer: C
Rationale: The calculation of creatinine clearance provides an estimation of renal function. This
value allows the provider to adjust medication dosages appropriately for a patient with renal
disease to prevent toxicity. A CBC does not evaluate kidney function, a culture and sensitivity
test identifies infection, and uric acid levels are elevated in gout .
QUESTION 2
Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
A) The body undergoes physiological changes with aging.
B) A healthy body does not experience significant changes as one gets older.
C) Older patients do not feel any systemic symptoms, such as malaise and weight loss.
D) Even though the same joints are usually affected, age makes it feel different.
Answer: A
Rationale: Knowledge of the bimodality of age onset of certain disease conditions will aid the
advanced practice nurse in avoiding misdiagnosis or delay in diagnosis due to lack of
recognition. Symptoms of rheumatoid arthritis may be different depending on the age of the
patient .
QUESTION 3
For individuals over 65 years old, the most common morbidities are related to:
A) Heart disease, arthritis
,B) Respiratory problems, cancer
C) Diabetes, stroke
D) All of these are common morbidities.
Answer: D
Rationale: Heart disease, cancer, and diabetes combined are the most common morbidities in
older patients. Heart disease is one of the common morbidities; cancer is common in the
general population (however, specific types are more common in the older patient); diabetes is
common in patients over 40 years of age .
QUESTION 4
A gerontological patient is being examined for a report of pain in the shoulder. The nurse
practitioner completes a thorough systemic examination because:
A) Older patients with one morbidity often express difficulties in general.
B) Arthritis of the shoulder is accompanied by other neurological symptoms.
C) Older patients with arthritis often experience pain in lower extremities.
D) The patient may not report significant signs and symptoms.
Answer: A
Rationale: Older patients with late-onset rheumatoid arthritis experience joint involvement more
often in the larger joints, such as the shoulder, and they also experience systemic symptoms
such as fever, malaise, weight loss, and depression. Older patients may express symptoms in
any other physical systems .
QUESTION 5
A 70-year-old man is seeing a nurse practitioner because he is feeling weak and dizzy. The
nurse practitioner is discussing a care plan with him and makes which of the following
statements? Select all that apply.
A) I want to order a test for your heart to evaluate its function.
B) I will perform a thorough examination of your functional abilities.
C) I will order a blood sugar test to check for diabetes.
D) Many older people feel this way. It is to be expected.
E) I will assess you for the presence of other conditions.
Answer: A, B, C, E
Rationale: A complete assessment will help differentiate signs of aging from disease. All
systems interact and can affect an existing condition. Identifying underlying conditions will avoid
undertreatment. Attributing symptoms to aging can contribute to depression in an older person.
, There are changes in the sympathetic response which contribute to orthostasis and falls, as well
as lack of hypoglycemic response .
QUESTION 6
The nurse practitioner is leading a class of seniors over age 65 years and is teaching about
nutritional needs. One of the men asks why, even though he eats correctly according to the
standards presented, he still feels weaker than he did 10 years ago. He also wonders why he
gets more infections than he used to. Which of the following are helpful answers? Select all that
apply.
A) I suggest that you exercise a little more than you are currently doing.
B) Some people experience a decrease in reserve energy.
C) For some people, the immune system weakens.
D) More viruses are being spread throughout the community.
E) I suggest that you see your primary caregiver for extensive testing.
Answer: B, C, E
Rationale: Many factors can influence the health of elders, including lifestyle and medications.
Many factors can influence the health of elders, including changes in the immune system.
Biochemical individuality is important in detecting asymptomatic abnormalities in older adults .
QUESTION 7
Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination, including
urinalysis and complete blood count (CBC). The total assessment is necessary because:
A) All body systems interact, and symptoms could indicate a variety of diagnoses.
B) The symptoms are vague and may be signs of aging.
C) There may be other signs or symptoms more indicative of the condition.
D) Mrs. Smith may not be reporting all significant information.
Answer: A
Rationale: The clinician must be aware that all the systems interact and, in doing so, can
increase the older person's vulnerability to illness/disease. The nurse must not attribute
symptoms only to the aging process. There may be comorbidities accompanying this condition.
Assumptions of not reporting properly may not be true .
QUESTION 8
An elderly couple is discussing health concerns with the nurse practitioner. The couple is
concerned that each of their individual blood studies show different results. One set of test
results shows a significant decrease in blood sugar, but the test results of the partner does not
Walden University NRNP 6540 – Advanced Practice
Care of Older Adults Final Exam – Spring-Summer
Quarter 2026
QUESTION 1
A patient with renal disease has blood work drawn, and the results show an increase in serum
creatinine. The nurse practitioner needs to know which of the following laboratory values before
ordering medications?
A) CBC
B) Culture and sensitivity of the urine
C) Creatinine clearance
D) Uric acid levels
Answer: C
Rationale: The calculation of creatinine clearance provides an estimation of renal function. This
value allows the provider to adjust medication dosages appropriately for a patient with renal
disease to prevent toxicity. A CBC does not evaluate kidney function, a culture and sensitivity
test identifies infection, and uric acid levels are elevated in gout .
QUESTION 2
Janey, 25 years old, may experience arthritis differently than 65-year-old Mrs. Johnson because:
A) The body undergoes physiological changes with aging.
B) A healthy body does not experience significant changes as one gets older.
C) Older patients do not feel any systemic symptoms, such as malaise and weight loss.
D) Even though the same joints are usually affected, age makes it feel different.
Answer: A
Rationale: Knowledge of the bimodality of age onset of certain disease conditions will aid the
advanced practice nurse in avoiding misdiagnosis or delay in diagnosis due to lack of
recognition. Symptoms of rheumatoid arthritis may be different depending on the age of the
patient .
QUESTION 3
For individuals over 65 years old, the most common morbidities are related to:
A) Heart disease, arthritis
,B) Respiratory problems, cancer
C) Diabetes, stroke
D) All of these are common morbidities.
Answer: D
Rationale: Heart disease, cancer, and diabetes combined are the most common morbidities in
older patients. Heart disease is one of the common morbidities; cancer is common in the
general population (however, specific types are more common in the older patient); diabetes is
common in patients over 40 years of age .
QUESTION 4
A gerontological patient is being examined for a report of pain in the shoulder. The nurse
practitioner completes a thorough systemic examination because:
A) Older patients with one morbidity often express difficulties in general.
B) Arthritis of the shoulder is accompanied by other neurological symptoms.
C) Older patients with arthritis often experience pain in lower extremities.
D) The patient may not report significant signs and symptoms.
Answer: A
Rationale: Older patients with late-onset rheumatoid arthritis experience joint involvement more
often in the larger joints, such as the shoulder, and they also experience systemic symptoms
such as fever, malaise, weight loss, and depression. Older patients may express symptoms in
any other physical systems .
QUESTION 5
A 70-year-old man is seeing a nurse practitioner because he is feeling weak and dizzy. The
nurse practitioner is discussing a care plan with him and makes which of the following
statements? Select all that apply.
A) I want to order a test for your heart to evaluate its function.
B) I will perform a thorough examination of your functional abilities.
C) I will order a blood sugar test to check for diabetes.
D) Many older people feel this way. It is to be expected.
E) I will assess you for the presence of other conditions.
Answer: A, B, C, E
Rationale: A complete assessment will help differentiate signs of aging from disease. All
systems interact and can affect an existing condition. Identifying underlying conditions will avoid
undertreatment. Attributing symptoms to aging can contribute to depression in an older person.
, There are changes in the sympathetic response which contribute to orthostasis and falls, as well
as lack of hypoglycemic response .
QUESTION 6
The nurse practitioner is leading a class of seniors over age 65 years and is teaching about
nutritional needs. One of the men asks why, even though he eats correctly according to the
standards presented, he still feels weaker than he did 10 years ago. He also wonders why he
gets more infections than he used to. Which of the following are helpful answers? Select all that
apply.
A) I suggest that you exercise a little more than you are currently doing.
B) Some people experience a decrease in reserve energy.
C) For some people, the immune system weakens.
D) More viruses are being spread throughout the community.
E) I suggest that you see your primary caregiver for extensive testing.
Answer: B, C, E
Rationale: Many factors can influence the health of elders, including lifestyle and medications.
Many factors can influence the health of elders, including changes in the immune system.
Biochemical individuality is important in detecting asymptomatic abnormalities in older adults .
QUESTION 7
Mrs. Smith, 75 years old, reports that she is weak, has difficulty urinating, and is dehydrated.
Although she is afebrile, the nurse conducts a thorough physical examination, including
urinalysis and complete blood count (CBC). The total assessment is necessary because:
A) All body systems interact, and symptoms could indicate a variety of diagnoses.
B) The symptoms are vague and may be signs of aging.
C) There may be other signs or symptoms more indicative of the condition.
D) Mrs. Smith may not be reporting all significant information.
Answer: A
Rationale: The clinician must be aware that all the systems interact and, in doing so, can
increase the older person's vulnerability to illness/disease. The nurse must not attribute
symptoms only to the aging process. There may be comorbidities accompanying this condition.
Assumptions of not reporting properly may not be true .
QUESTION 8
An elderly couple is discussing health concerns with the nurse practitioner. The couple is
concerned that each of their individual blood studies show different results. One set of test
results shows a significant decrease in blood sugar, but the test results of the partner does not
