NUR 257 Exam 1 Aging and Chronic Illness 2026/2027 Test Bank Questions with Verified Answers and Rationales NGN Grade A

INSTANT PDF DOWNLOAD — This is the comprehensive Exam 1 preparation guide for NUR 257 - Aging and Chronic Illness (2026/2027), featuring practice questions with verified answers and detailed rationales. Designed for nursing students in gerontology and chronic illness courses, this resource consolidates the essential concepts of aging, chronic disease management, and Next Generation NCLEX (NGN) clinical judgment required to master the NUR 257 Exam 1 and excel in gerontological nursing practice. The guide is meticulously aligned with NGN testing blueprints, NCLEX-RN® test plan, and current evidence-based geriatric nursing standards. This verified resource provides comprehensive coverage of key NUR 257 Aging and Chronic Illness Exam 3 topics, including: Theories of Aging (biological theories—programmed theories (Hayflick limit (cells divide finite number of times), telomere shortening (repetitive DNA sequences at chromosome ends shorten with each division, telomerase activity decreases with age), programmed senescence (aging is genetically programmed, species-specific lifespan), endocrine theory (hormonal changes (decline in growth hormone, estrogen, testosterone, DHEA, melatonin), hypothalamic-pituitary-adrenal (HPA) axis dysregulation, increased cortisol), immunological theory (decline in immune function (immunosenescence), decreased T cell production (thymus involution), decreased B cell function, increased autoantibodies, increased susceptibility to infection, cancer, autoimmune disease, decreased vaccine response), stochastic theories (wear and tear (cumulative damage from environmental stressors, metabolic waste products, free radicals), free radical theory (oxidative stress, reactive oxygen species (ROS) damage cellular components (DNA, proteins, lipids, mitochondria), antioxidants (vitamin C, E, beta-carotene, selenium, glutathione, coenzyme Q10) may reduce damage, mixed evidence for lifespan extension in humans), cross-linking theory (accumulation of cross-linked proteins (collagen, elastin) in connective tissue, skin, blood vessels, leads to decreased elasticity, wrinkles, arteriosclerosis, stiff joints, cataracts, decreased organ function), error theory (errors in DNA replication, transcription, translation accumulate over time, leading to cellular dysfunction, apoptosis, senescence), mitochondrial theory (mitochondrial DNA (mtDNA) mutations accumulate with age, decreased ATP production, increased ROS, apoptosis, contributes to neurodegeneration, sarcopenia, hearing loss, metabolic syndrome, frailty), psychosocial theories—disengagement theory (aging involves mutual withdrawal between older adult and society, inevitable, universal, beneficial for both, allows transfer of power from old to young, criticized as ageist, not supported by research (many older adults remain engaged, satisfied with active roles)), activity theory (successful aging requires continued activity, social engagement, role replacement (substitute lost roles with new ones), positive correlation between activity and life satisfaction, but some prefer less activity, introverts, health limitations), continuity theory (personality, preferences, coping styles remain consistent across lifespan, older adults adapt by continuing familiar activities, relationships, roles, maintaining internal and external structures, most supported by research), socioemotional selectivity theory (as people age, they become more selective about social relationships, prioritize emotionally meaningful relationships (close family, friends) over new acquaintances, seek positive emotional experiences, avoid negative interactions, focus on present-oriented goals, emotional regulation improves with age), gerotranscendence theory (shift from materialistic, rational view of world to cosmic, transcendent, less focused on possessions, status, appearance, more reflective, accepting of mortality, wisdom, peace, reduced fear of death, may appear as disinterest to younger observers), selective optimization with compensation (SOC) model (successful aging involves selection (focus on most valued activities, goals), optimization (practice, training, technology to enhance performance), compensation (use alternative strategies when abilities decline (e.g., cane, walker, hearing aid, magnifying glass, pill organizer, medication reminder, assistive technology)), applies to physical, cognitive, social functioning), common aging changes (integumentary—skin (atrophy, thinning, loss of elasticity, wrinkling, sagging, dryness (xerosis), decreased sebaceous/sweat glands (impaired thermoregulation, dry skin, pruritus), decreased vitamin D synthesis (from sunlight), increased risk skin tears, bruising (senile purpura), pressure injuries, delayed wound healing, actinic keratosis (precancerous), seborrheic keratosis (benign), cherry angiomas, skin tags, lentigines (age spots, liver spots), hair (graying (decreased melanin), thinning (androgenetic alopecia), increased facial hair in women (hormonal changes), decreased body hair), nails (thickening, brittleness, ridging, slow growth, yellow discoloration, fungal infections (onychomycosis)), nursing interventions (skin (moisturize daily, avoid hot water, harsh soaps, use mild cleanser, humidifier, protective clothing, sunscreen (SPF 30+, broad spectrum), inspect skin daily for lesions, skin tears, pressure injuries, early detection of skin cancer (ABCDE: Asymmetry, Border irregularity, Color variation, Diameter 6mm, Evolution/changes), nutrition (adequate hydration, protein, vitamins A, C, E, zinc), pressure injury prevention (turn q2h, support surfaces, offload heels, manage moisture, optimize nutrition)), musculoskeletal—sarcopenia (age-related loss of muscle mass (3-8% per decade after 30, accelerates after 60), strength, function, causes (mitochondrial dysfunction, decreased protein synthesis, increased protein degradation (ubiquitin-proteasome pathway), satellite cell dysfunction, denervation, inflammation (IL-6, TNF-alpha), malnutrition, inactivity), prevention/treatment (resistance exercise (strength training 2-3 times per week, progressive overload), protein intake (1.2-1.5 g/kg/day, distribute evenly across meals, leucine-rich sources (whey, soy, meat, fish, eggs, dairy)), vitamin D (800-1000 IU/day), creatine supplementation (may improve strength, muscle mass), treatment of underlying chronic disease (heart failure, COPD, CKD, diabetes, cancer, inflammatory bowel disease, rheumatoid arthritis)), bone (decreased bone density (osteoporosis, osteopenia), increased fracture risk (hip, spine, wrist, humerus, pelvis, rib), kyphosis (dowager's hump) from vertebral compression fractures, height loss (1-3 inches over lifetime), joint (osteoarthritis (degenerative joint disease, most common arthritis, cartilage degradation, osteophytes (bone spurs), joint space narrowing, pain with activity, relieved by rest, morning stiffness 30 minutes, crepitus, Heberden nodes (DIP), Bouchard nodes (PIP)), risk factors (age, obesity, female sex, genetics, joint trauma, repetitive use, occupational kneeling, squatting, lifting, sports (soccer, football, wrestling, weightlifting, running)), treatment (non-pharmacologic (weight loss, exercise (low-impact: swimming, cycling, walking), physical therapy, occupational therapy (splints, braces, adaptive equipment, cane (contralateral hand), walker), heat/cold therapy, weight management), pharmacologic (acetaminophen (first-line, limit to 3 g/day in elderly, risk hepatotoxicity), NSAIDs (topical (diclofenac gel) first-line for knee/hand OA, oral (ibuprofen, naproxen, celecoxib) short-term lowest effective dose, risk GI bleeding, acute kidney injury, hypertension, heart failure exacerbation), tramadol (weak opioid, risk falls, sedation, constipation, serotonin syndrome (with SSRIs, SNRIs, MAOIs)), duloxetine (SNRI, for chronic pain, FDA-approved for OA, risk nausea, dry mouth, fatigue, falls), intra-articular corticosteroids (triamcinolone, methylprednisolone, betamethasone, dexamethasone) for flare (short-term relief, limited to 3-4 times per year, risk cartilage damage with frequent use), hyaluronic acid (viscosupplementation, efficacy modest, controversial)), surgery (total joint arthroplasty (hip, knee, shoulder), osteotomy, arthroscopy (debridement, lavage, not for OA unless mechanical symptoms (loose body, meniscal tear))), rheumatoid arthritis (autoimmune inflammatory arthritis, synovitis, pannus, joint erosion, deformity, systemic (fatigue, fever, weight loss, rheumatoid nodules, vasculitis, pericarditis, pleural effusion, Felty's syndrome (splenomegaly, neutropenia), Sjögren's syndrome (dry eyes, dry mouth)), symmetrical, small joints (MCP, PIP, wrists, MTP), morning stiffness 1 hour, improves with activity, RF, anti-CCP, elevated ESR, CRP, treatment (DMARDs: methotrexate (first-line, folic acid 1-2 mg/day), leflunomide, sulfasalazine, hydroxychloroquine; biologics (TNF inhibitors (etanercept, adalimumab, infliximab), IL-6 inhibitors (tocilizumab), JAK inhibitors (tofacitinib, baricitinib, upadacitinib)), NSAIDs, corticosteroids (lowest effective dose, shortest duration)), gout (monosodium urate crystals, acute flare (sudden severe pain, swelling, erythema, warmth, first MTP (podagra), midfoot, ankle, knee, wrist, finger, elbow), treat with NSAIDs, colchicine, corticosteroids, urate-lowering therapy (allopurinol, febuxostat, probenecid, pegloticase) for chronic gout, tophi), nursing interventions (fall prevention (fall risk assessment (Morse, Hendrich II, Hester Davis, STRATIFY), home safety evaluation (remove loose rugs, improve lighting, install grab bars, handrails, nonslip mats, raised toilet seat, shower chair, tub transfer bench, handheld showerhead, bed height, nightlights, clear pathways), medication review (deprescribe Beers