NUR 257 CONCEPTS OF AGING AND CHRONIC ILLNESS
EXAM 4 130 QUESTIONS AND ANSWERS UPDATED 2026
2027 REAL EXAM QUESTIONS VERIFIED AND APPROVED
GRADED A+
The nurse is assessing an older adult client. Which finding should cause the nurse to suspect the
client has Parkinson disease (PD)? (Select all that apply.)
A. The client has hand tremors at rest.
B. The client does not remember what he ate for breakfast.
C. The client's blood pressure increases when the client stands up.
D. The client has a slurred speech.
E. The client's facial expression shows no emotion. - CORRECT ANSWER - Answer: A,
B, D, E
Rationale: PD causes slowed movements, including slurred speech. Tremors at rest are very common
in PD and easy to identify. Tremors may occur in the hands, face, neck, lips, tongue, and jaw. PD
causes a frozen, mask-like expression (lack of affect). The client will not have an expression that is
consistent with the emotions the client is feeling. Memory loss occurs in Parkinson disease because of
the loss of neurons and other changes in the brain. The client may develop dementia. Postural
hypotension, not hypertension, is a common manifestation in clients with PD. This is caused by damage
to the autonomic nervous system.
Which is the main pathology of Parkinson disease that causes changes in muscular and sensory
function?
A. Reduction of acetylcholine in the brain
B. Reduction of dopamine in the brain
C. Genetic predisposition
D. Presence of Lewy bodies - CORRECT ANSWER - Answer: B
Rationale: The changes in muscular and sensory function in Parkinson disease (PD) are caused by a
decreased amount of dopamine in the brain, which in turn increases, not reduces, the amount of
,acetylcholine. The presence of Lewy bodies (abnormal aggregates of proteins) in the neurons is a
characteristic of PD, but it is unclear whether they are helpful or harmful. Although there is a genetic
link in approximately 15dash25% of cases, it is a risk factor rather than a cause of PD manifestations.
Which clinical manifestation would be required to confirm the diagnosis of Parkinson disease?
A. Tremors at rest and bradykinesia
B. Bradykinesia only
C. Rigidity only
D. Tremor at rest and flaccidity - CORRECT ANSWER - Answer: A
Rationale: A diagnosis of Parkinson disease requires the presence of two of the three cardinal
manifestations: tremor, rigidity, and bradykinesia. Tremors at rest and bradykinesia are two of the
cardinal signs. Bradykinesia alone would not be diagnostic. Tremors at rest are a cardinal sign, but
flaccidity is not. Rigidity is a cardinal sign, but rigidity alone is not diagnostic.
Which symptom for a client with Parkinson disease (PD) is due to the lack of automatic muscle
movement?
A. Diminished voice volume
B. Reduced ability to swallow
C. Alterations in sleep pattern
D. Diminished physical mobility - CORRECT ANSWER - Answer: C
Rationale: Alterations in sleep pattern may occur due to lack of automatic muscle movement in a
client with Parkinson disease. Reducing strenuous activities near bedtime, limiting intake of caffeine,
and providing a glass of milk before bedtime are all examples of interventions that directly address
issues with sleep pattern. Reduced ability to swallow, diminished voice volume, and diminished
physical mobility are all related to dysfunction of voluntary muscle movement.
A client newly diagnosed with Parkinson disease asks the nurse, "What does dopamine do in the
brain?" Which is the most appropriate response?
A. "Dopamine enhances the action of acetylcholine."
,B. "Dopamine causes spinal cord neurons to transmit impulses."
C. "Dopamine stimulates the neurons to transmit sensory and motor impulses."
D. "Dopamine helps maintain coordinated motor movement." - CORRECT ANSWER -
Answer:
Rationale: Dopamine is responsible for coordination. It balances the neurotransmitter acetylcholine,
which stimulates the neurons. Dopamine prevents this stimulation from becoming excessive.
Dopamine provides regulation rather than stimulation. Dopamine regulates motor neuron impulses
and balances acetylcholine. Dopamine only works on certain brain neurons located in the basal
ganglia, not the spinal cord. Dopamine minimizes and balances the effects of acetylcholine and does
not enhance it.
Which type of therapy is used to manage problems with eating and swallowing?
A. Physical
B. Occupational
C. Speech
D. Nutritional - CORRECT ANSWER - Answer: C
Rationale: Speech therapy is used to manage problems with eating and swallowing. Occupational
therapy is used to maintain self-care activities, not specifically eating and swallowing. Physical
therapy is used to improve coordination of balance and gait. There is no nutritional therapy needed
for a client with Parkinson disease.
An older adult client with Parkinson disease uses a walker, speaks in a slurred manner with poor
articulation, but tries to speak louder to accommodate for this impairment. The client states, "I catch
my daughter looking at me angrily sometimes, but she doesn't say anything." Which nursing diagnosis
is the priority?
A. Communication: Verbal, Impaired
B. Caregiver Role Strain
C. Falls, Risk for
, D. Nutrition, Imbalanced: Less than Body Requirements - CORRECT ANSWER - Answer:
B
Rationale: The client is making accommodations for preventing falls by using a walker. Being the
primary caregiver, the client's daughter assists the client in feeding so imbalanced nutrition is not a
risk. The client is also practicing speech by speaking louder. It is the caregiver's role strain that is the
major risk for this client.
The healthcare provider of an older adult client with advancing Parkinson disease suggested that the
client start an exercise regime. Which exercise should the nurse recommend?
A. T'ai chi
B. Running
C. Weight lifting
D. Football - CORRECT ANSWER - Answer:
Rationale: For a client with Parkinson disease, an exercise regime that promotes balance and walking
is the best. So, the nurse may recommend t'ai chi. Considering the client's age, football, running, and
weight lifting may be too strenuous.
An older adult client was diagnosed with Parkinson disease 3 months ago. Since the diagnosis, the
client has not gone out of the house. Which statement by the nurse is most appropriate?
A. "Tell your family to come and take you out of the house."
B. "Can I ask why you aren't going out of the house?"
C. "You need to start getting out."
D. "Getting out of the house will help you to feel less depressed." - CORRECT ANSWER
- Answer: B
Rationale: Asking an open-ended question and inquiring about the reason why the client is not going
out of the house will encourage the client to discuss and share information. Advising the client about
going out, telling the client that they will feel better by going out, or involving the family will not
encourage the client to discuss the reason behind staying at home.
EXAM 4 130 QUESTIONS AND ANSWERS UPDATED 2026
2027 REAL EXAM QUESTIONS VERIFIED AND APPROVED
GRADED A+
The nurse is assessing an older adult client. Which finding should cause the nurse to suspect the
client has Parkinson disease (PD)? (Select all that apply.)
A. The client has hand tremors at rest.
B. The client does not remember what he ate for breakfast.
C. The client's blood pressure increases when the client stands up.
D. The client has a slurred speech.
E. The client's facial expression shows no emotion. - CORRECT ANSWER - Answer: A,
B, D, E
Rationale: PD causes slowed movements, including slurred speech. Tremors at rest are very common
in PD and easy to identify. Tremors may occur in the hands, face, neck, lips, tongue, and jaw. PD
causes a frozen, mask-like expression (lack of affect). The client will not have an expression that is
consistent with the emotions the client is feeling. Memory loss occurs in Parkinson disease because of
the loss of neurons and other changes in the brain. The client may develop dementia. Postural
hypotension, not hypertension, is a common manifestation in clients with PD. This is caused by damage
to the autonomic nervous system.
Which is the main pathology of Parkinson disease that causes changes in muscular and sensory
function?
A. Reduction of acetylcholine in the brain
B. Reduction of dopamine in the brain
C. Genetic predisposition
D. Presence of Lewy bodies - CORRECT ANSWER - Answer: B
Rationale: The changes in muscular and sensory function in Parkinson disease (PD) are caused by a
decreased amount of dopamine in the brain, which in turn increases, not reduces, the amount of
,acetylcholine. The presence of Lewy bodies (abnormal aggregates of proteins) in the neurons is a
characteristic of PD, but it is unclear whether they are helpful or harmful. Although there is a genetic
link in approximately 15dash25% of cases, it is a risk factor rather than a cause of PD manifestations.
Which clinical manifestation would be required to confirm the diagnosis of Parkinson disease?
A. Tremors at rest and bradykinesia
B. Bradykinesia only
C. Rigidity only
D. Tremor at rest and flaccidity - CORRECT ANSWER - Answer: A
Rationale: A diagnosis of Parkinson disease requires the presence of two of the three cardinal
manifestations: tremor, rigidity, and bradykinesia. Tremors at rest and bradykinesia are two of the
cardinal signs. Bradykinesia alone would not be diagnostic. Tremors at rest are a cardinal sign, but
flaccidity is not. Rigidity is a cardinal sign, but rigidity alone is not diagnostic.
Which symptom for a client with Parkinson disease (PD) is due to the lack of automatic muscle
movement?
A. Diminished voice volume
B. Reduced ability to swallow
C. Alterations in sleep pattern
D. Diminished physical mobility - CORRECT ANSWER - Answer: C
Rationale: Alterations in sleep pattern may occur due to lack of automatic muscle movement in a
client with Parkinson disease. Reducing strenuous activities near bedtime, limiting intake of caffeine,
and providing a glass of milk before bedtime are all examples of interventions that directly address
issues with sleep pattern. Reduced ability to swallow, diminished voice volume, and diminished
physical mobility are all related to dysfunction of voluntary muscle movement.
A client newly diagnosed with Parkinson disease asks the nurse, "What does dopamine do in the
brain?" Which is the most appropriate response?
A. "Dopamine enhances the action of acetylcholine."
,B. "Dopamine causes spinal cord neurons to transmit impulses."
C. "Dopamine stimulates the neurons to transmit sensory and motor impulses."
D. "Dopamine helps maintain coordinated motor movement." - CORRECT ANSWER -
Answer:
Rationale: Dopamine is responsible for coordination. It balances the neurotransmitter acetylcholine,
which stimulates the neurons. Dopamine prevents this stimulation from becoming excessive.
Dopamine provides regulation rather than stimulation. Dopamine regulates motor neuron impulses
and balances acetylcholine. Dopamine only works on certain brain neurons located in the basal
ganglia, not the spinal cord. Dopamine minimizes and balances the effects of acetylcholine and does
not enhance it.
Which type of therapy is used to manage problems with eating and swallowing?
A. Physical
B. Occupational
C. Speech
D. Nutritional - CORRECT ANSWER - Answer: C
Rationale: Speech therapy is used to manage problems with eating and swallowing. Occupational
therapy is used to maintain self-care activities, not specifically eating and swallowing. Physical
therapy is used to improve coordination of balance and gait. There is no nutritional therapy needed
for a client with Parkinson disease.
An older adult client with Parkinson disease uses a walker, speaks in a slurred manner with poor
articulation, but tries to speak louder to accommodate for this impairment. The client states, "I catch
my daughter looking at me angrily sometimes, but she doesn't say anything." Which nursing diagnosis
is the priority?
A. Communication: Verbal, Impaired
B. Caregiver Role Strain
C. Falls, Risk for
, D. Nutrition, Imbalanced: Less than Body Requirements - CORRECT ANSWER - Answer:
B
Rationale: The client is making accommodations for preventing falls by using a walker. Being the
primary caregiver, the client's daughter assists the client in feeding so imbalanced nutrition is not a
risk. The client is also practicing speech by speaking louder. It is the caregiver's role strain that is the
major risk for this client.
The healthcare provider of an older adult client with advancing Parkinson disease suggested that the
client start an exercise regime. Which exercise should the nurse recommend?
A. T'ai chi
B. Running
C. Weight lifting
D. Football - CORRECT ANSWER - Answer:
Rationale: For a client with Parkinson disease, an exercise regime that promotes balance and walking
is the best. So, the nurse may recommend t'ai chi. Considering the client's age, football, running, and
weight lifting may be too strenuous.
An older adult client was diagnosed with Parkinson disease 3 months ago. Since the diagnosis, the
client has not gone out of the house. Which statement by the nurse is most appropriate?
A. "Tell your family to come and take you out of the house."
B. "Can I ask why you aren't going out of the house?"
C. "You need to start getting out."
D. "Getting out of the house will help you to feel less depressed." - CORRECT ANSWER
- Answer: B
Rationale: Asking an open-ended question and inquiring about the reason why the client is not going
out of the house will encourage the client to discuss and share information. Advising the client about
going out, telling the client that they will feel better by going out, or involving the family will not
encourage the client to discuss the reason behind staying at home.
