NUR 257 Final Exam V1 | NUR 257
Concepts of Aging & Chronic Illness | Q&A
with Rationale (NUR257 Final Exam) |
Galen College of Nursing
1. A nurse is assessing an 82-year-old patient with a history of Chronic Heart Failure (CHF).
Which finding is the most reliable indicator of a worsening condition requiring immediate
intervention?
A. A weight gain of 3 pounds in 24 hours
B. 3+ pitting edema in the lower extremities
C. Reported fatigue during activities of daily living
D. Occasional dry cough during the daytime
Answer: A
Rationale: Daily weight monitoring is the most sensitive and reliable indicator of fluid
volume status in patients with chronic heart failure. A sudden weight gain of 3 pounds in
one day or 5 pounds in a week suggests significant fluid retention before overt physical
symptoms appear. Rapid intervention at this stage can prevent acute decompensation and
hospitalization.
2. When evaluating an older adult for delirium versus dementia, which characteristic is
uniquely associated with delirium?
A. Slow, progressive loss of memory and cognitive function
,B. Irreversible changes in brain structure and function
C. Acute onset with a fluctuating level of consciousness
D. Difficulty finding words and performing complex tasks
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset and a fluctuating course of
symptoms throughout the day. Unlike dementia, which is a slow and progressive decline,
delirium often involves a disturbed level of consciousness and is frequently reversible.
Nurses must identify and treat the underlying cause, such as infection or medication
toxicity, to resolve the delirium.
3. An older adult is prescribed a new medication that appears on the Beers Criteria list. Which
action should the nurse take first?
A. Collaborate with the pharmacist to suggest a safer alternative
B. Research the drug’s mechanism of action for older adults
C. Administer the medication as prescribed by the healthcare provider
D. Wait until the patient shows side effects before notifying the doctor
Answer: A
Rationale: The Beers Criteria identifies medications that are potentially inappropriate for
older adults due to a high risk of adverse effects. When a prescribed medication is on this
list, the nurse should advocate for the patient by discussing safer alternatives with the
,healthcare team. Proactive collaboration helps prevent polypharmacy and improves
medication safety in the geriatric population.
4. Which statement by a patient diagnosed with Chronic Obstructive Pulmonary Disease
(COPD) indicates a correct understanding of ‘Pursed-Lip Breathing’?
A. I should inhale quickly through my mouth to get more air
B. This technique helps keep my airways open longer during exhalation
C. I will use this only when my oxygen saturation drops below 88%
D. I should puff out my cheeks while holding my breath
Answer: B
Rationale: Pursed-lip breathing is designed to create back-pressure in the airways, which
prevents them from collapsing during exhalation. This technique allows for more effective
CO2 elimination and reduces the work of breathing for patients with obstructive lung
disease. Consistent practice of this method helps manage dyspnea during physical exertion
or stress.
5. A nurse is caring for an older adult with Osteoarthritis. What is the primary goal of the
interprofessional care team for this patient?
A. Curing the underlying inflammatory process
B. Restoring the joint to its pre-disease state
C. Managing pain while maintaining functional mobility
, D. Restricting all weight-bearing activities to prevent joint wear
Answer: C
Rationale: Osteoarthritis is a chronic, degenerative joint disease for which there is
currently no cure. The focus of nursing care is on symptom management, specifically pain
control and the preservation of joint function and mobility. This approach helps the patient
maintain independence and a higher quality of life despite the progressive nature of the
condition.
6. An 88-year-old patient is admitted with a suspected Urinary Tract Infection (UTI). Which
clinical manifestation is the nurse most likely to observe in this patient?
A. High-grade fever and severe flank pain
B. Acute confusion or altered mental status
C. Burning sensation during urination and urgency
D. Hematuria and abdominal guarding
Answer: B
Rationale: Older adults often present with atypical symptoms when suffering from an
infection like a UTI. Instead of common symptoms like fever or dysuria, they frequently
exhibit cognitive changes, such as sudden confusion or agitation. Nurses must recognize
that any acute change in behavior or mental status in an elderly patient warrants an
assessment for underlying infection.
Concepts of Aging & Chronic Illness | Q&A
with Rationale (NUR257 Final Exam) |
Galen College of Nursing
1. A nurse is assessing an 82-year-old patient with a history of Chronic Heart Failure (CHF).
Which finding is the most reliable indicator of a worsening condition requiring immediate
intervention?
A. A weight gain of 3 pounds in 24 hours
B. 3+ pitting edema in the lower extremities
C. Reported fatigue during activities of daily living
D. Occasional dry cough during the daytime
Answer: A
Rationale: Daily weight monitoring is the most sensitive and reliable indicator of fluid
volume status in patients with chronic heart failure. A sudden weight gain of 3 pounds in
one day or 5 pounds in a week suggests significant fluid retention before overt physical
symptoms appear. Rapid intervention at this stage can prevent acute decompensation and
hospitalization.
2. When evaluating an older adult for delirium versus dementia, which characteristic is
uniquely associated with delirium?
A. Slow, progressive loss of memory and cognitive function
,B. Irreversible changes in brain structure and function
C. Acute onset with a fluctuating level of consciousness
D. Difficulty finding words and performing complex tasks
Answer: C
Rationale: Delirium is characterized by an acute, rapid onset and a fluctuating course of
symptoms throughout the day. Unlike dementia, which is a slow and progressive decline,
delirium often involves a disturbed level of consciousness and is frequently reversible.
Nurses must identify and treat the underlying cause, such as infection or medication
toxicity, to resolve the delirium.
3. An older adult is prescribed a new medication that appears on the Beers Criteria list. Which
action should the nurse take first?
A. Collaborate with the pharmacist to suggest a safer alternative
B. Research the drug’s mechanism of action for older adults
C. Administer the medication as prescribed by the healthcare provider
D. Wait until the patient shows side effects before notifying the doctor
Answer: A
Rationale: The Beers Criteria identifies medications that are potentially inappropriate for
older adults due to a high risk of adverse effects. When a prescribed medication is on this
list, the nurse should advocate for the patient by discussing safer alternatives with the
,healthcare team. Proactive collaboration helps prevent polypharmacy and improves
medication safety in the geriatric population.
4. Which statement by a patient diagnosed with Chronic Obstructive Pulmonary Disease
(COPD) indicates a correct understanding of ‘Pursed-Lip Breathing’?
A. I should inhale quickly through my mouth to get more air
B. This technique helps keep my airways open longer during exhalation
C. I will use this only when my oxygen saturation drops below 88%
D. I should puff out my cheeks while holding my breath
Answer: B
Rationale: Pursed-lip breathing is designed to create back-pressure in the airways, which
prevents them from collapsing during exhalation. This technique allows for more effective
CO2 elimination and reduces the work of breathing for patients with obstructive lung
disease. Consistent practice of this method helps manage dyspnea during physical exertion
or stress.
5. A nurse is caring for an older adult with Osteoarthritis. What is the primary goal of the
interprofessional care team for this patient?
A. Curing the underlying inflammatory process
B. Restoring the joint to its pre-disease state
C. Managing pain while maintaining functional mobility
, D. Restricting all weight-bearing activities to prevent joint wear
Answer: C
Rationale: Osteoarthritis is a chronic, degenerative joint disease for which there is
currently no cure. The focus of nursing care is on symptom management, specifically pain
control and the preservation of joint function and mobility. This approach helps the patient
maintain independence and a higher quality of life despite the progressive nature of the
condition.
6. An 88-year-old patient is admitted with a suspected Urinary Tract Infection (UTI). Which
clinical manifestation is the nurse most likely to observe in this patient?
A. High-grade fever and severe flank pain
B. Acute confusion or altered mental status
C. Burning sensation during urination and urgency
D. Hematuria and abdominal guarding
Answer: B
Rationale: Older adults often present with atypical symptoms when suffering from an
infection like a UTI. Instead of common symptoms like fever or dysuria, they frequently
exhibit cognitive changes, such as sudden confusion or agitation. Nurses must recognize
that any acute change in behavior or mental status in an elderly patient warrants an
assessment for underlying infection.
