NUR 257 Exam 4 V2 | NUR 257 Concepts
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is assessing an older adult client for signs of glaucoma. Which clinical manifestation
should the nurse prioritize as an early sign of primary open-angle glaucoma?
A. Sudden onset of severe eye pain
B. Gradual loss of peripheral vision
C. Visible cloudiness of the lens
D. Seeing floating spots or light flashes
Answer: B
Rationale: Primary open-angle glaucoma typically presents with a gradual, painless loss of
peripheral vision, often referred to as tunnel vision. This occurs due to increased
intraocular pressure causing damage to the optic nerve over time. Sudden pain is more
characteristic of angle-closure glaucoma, while lens cloudiness indicates cataracts.
2. An older adult patient is prescribed Levodopa-Carbidopa for the management of
Parkinson’s disease. Which dietary instruction is most important for the nurse to include?
A. Increase intake of dark green leafy vegetables
B. Take the medication with a high-protein meal
,C. Restrict fluid intake to 1000 mL per day
D. Avoid taking the medication with high-protein foods
Answer: D
Rationale: High-protein foods can compete with Levodopa for absorption in the small
intestine and transport across the blood-brain barrier. Patients should be advised to spread
their protein intake throughout the day rather than consuming it in one large meal. This
helps maintain consistent therapeutic levels of the drug and prevents ‘off’ periods.
3. A nurse is caring for a client with late-stage Alzheimer’s disease who is experiencing
sundowning. Which intervention is most appropriate to manage this behavior?
A. Provide a quiet, calm environment in the late afternoon
B. Limit physical activity during the daylight hours
C. Ensure the room is brightly lit during the evening
D. Administer a sedative at the first sign of agitation
Answer: A
Rationale: Sundowning involves increased confusion and agitation during the late
afternoon or evening hours. Providing a calm, quiet environment helps reduce sensory
overload, which often triggers these behaviors. Using bright lights or excessive sedation
can worsen confusion or lead to falls in elderly patients.
, 4. During the assessment of an actively dying patient, the nurse notes periods of apnea
followed by rapid, deep breathing. How should the nurse document this finding?
A. Cheyne-Stokes respirations
B. Bradypnea
C. Orthopnea
D. Kussmaul respirations
Answer: A
Rationale: Cheyne-Stokes respirations are a common pattern observed in the final stages
of life, characterized by rhythmic waxing and waning of breathing depth with periods of
apnea. This pattern indicates a decline in brainstem function and decreased sensitivity to
carbon dioxide levels. It is a significant indicator that death is approaching within hours or
days.
5. A client with Multiple Sclerosis (MS) reports severe fatigue that interferes with daily
activities. Which strategy should the nurse recommend?
A. Plan frequent rest periods and prioritize activities
B. Schedule demanding tasks for the end of the day
C. Take hot showers to relax muscles and boost energy
D. Engage in high-intensity exercise in the evening
Answer: A
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is assessing an older adult client for signs of glaucoma. Which clinical manifestation
should the nurse prioritize as an early sign of primary open-angle glaucoma?
A. Sudden onset of severe eye pain
B. Gradual loss of peripheral vision
C. Visible cloudiness of the lens
D. Seeing floating spots or light flashes
Answer: B
Rationale: Primary open-angle glaucoma typically presents with a gradual, painless loss of
peripheral vision, often referred to as tunnel vision. This occurs due to increased
intraocular pressure causing damage to the optic nerve over time. Sudden pain is more
characteristic of angle-closure glaucoma, while lens cloudiness indicates cataracts.
2. An older adult patient is prescribed Levodopa-Carbidopa for the management of
Parkinson’s disease. Which dietary instruction is most important for the nurse to include?
A. Increase intake of dark green leafy vegetables
B. Take the medication with a high-protein meal
,C. Restrict fluid intake to 1000 mL per day
D. Avoid taking the medication with high-protein foods
Answer: D
Rationale: High-protein foods can compete with Levodopa for absorption in the small
intestine and transport across the blood-brain barrier. Patients should be advised to spread
their protein intake throughout the day rather than consuming it in one large meal. This
helps maintain consistent therapeutic levels of the drug and prevents ‘off’ periods.
3. A nurse is caring for a client with late-stage Alzheimer’s disease who is experiencing
sundowning. Which intervention is most appropriate to manage this behavior?
A. Provide a quiet, calm environment in the late afternoon
B. Limit physical activity during the daylight hours
C. Ensure the room is brightly lit during the evening
D. Administer a sedative at the first sign of agitation
Answer: A
Rationale: Sundowning involves increased confusion and agitation during the late
afternoon or evening hours. Providing a calm, quiet environment helps reduce sensory
overload, which often triggers these behaviors. Using bright lights or excessive sedation
can worsen confusion or lead to falls in elderly patients.
, 4. During the assessment of an actively dying patient, the nurse notes periods of apnea
followed by rapid, deep breathing. How should the nurse document this finding?
A. Cheyne-Stokes respirations
B. Bradypnea
C. Orthopnea
D. Kussmaul respirations
Answer: A
Rationale: Cheyne-Stokes respirations are a common pattern observed in the final stages
of life, characterized by rhythmic waxing and waning of breathing depth with periods of
apnea. This pattern indicates a decline in brainstem function and decreased sensitivity to
carbon dioxide levels. It is a significant indicator that death is approaching within hours or
days.
5. A client with Multiple Sclerosis (MS) reports severe fatigue that interferes with daily
activities. Which strategy should the nurse recommend?
A. Plan frequent rest periods and prioritize activities
B. Schedule demanding tasks for the end of the day
C. Take hot showers to relax muscles and boost energy
D. Engage in high-intensity exercise in the evening
Answer: A
