Adult-Gerontology Clinical Nurse Specialist (CNS) Practice Exam

In an 84-year-old female patient, which finding are you least likely to observe?

1. High-frequency hearing loss

2. Decrease in the GFR

3. Slower metabolism of drugs

4. Increase in peak expiratory flow

The correct answer is: Increase in peak expiratory flow

In an 84-year-old female patient, an increase in peak expiratory flow is least likely to be observed due to the physiological changes that occur with aging. As individuals age, there is a natural decline in lung capacity and respiratory function, which typically results in decreased peak expiratory flow rates, not an increase. This decline can be attributed to several factors, including a loss of elastic recoil in the lungs, weakening of respiratory muscles, and increased stiffness of the thoracic wall. These changes lead to more rigid airways and a reduced ability to exhale forcefully, resulting in lower peak expiratory flow measurements. In contrast, high-frequency hearing loss, decreased glomerular filtration rate (GFR), and slower metabolism of drugs are common findings in older adults. Age-related changes in the auditory system often result in a specific type of sensorineural hearing loss that primarily affects high-frequency sounds. The decline in GFR is a normal physiological consequence of aging, reflecting decreased kidney function. Additionally, the metabolism of drugs can slow as a result of changes in liver and kidney function, impacting the pharmacokinetics in elderly patients. These findings are typical in the aging population, making the increase in peak expiratory flow the least likely observation in