NUR 258 Exam 4 V1 | NUR 258 Concepts
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 4) | Galen
1. A nurse is caring for an 82-year-old client with terminal cancer who is receiving palliative
care. The client’s respirations are shallow and labored, and they appear restless. Which
intervention is most appropriate?
A. Administering oxygen at 6L via simple mask
B. Suctioning the client vigorously to clear secretions
C. Increasing IV fluid rate to improve hydration
D. Administering prescribed morphine sulfate sublingually
Correct Answer: D
Explanation: AI Analysis: This exam focuses on the holistic management of aging and
chronic illness, emphasizing symptom control and ethical decision-making. The questions
integrate clinical judgment through NCLEX-style scenarios focusing on safety,
pathophysiology, and geriatric-specific care. Morphine is the gold standard in palliative
care to treat dyspnea and terminal restlessness by reducing the perception of air hunger
and providing sedation.
,2. An older adult client is admitted with acute confusion and a suspected urinary tract
infection. The nurse recognizes this as delirium rather than dementia based on which
characteristic?
A. The onset of symptoms was rapid and fluctuating
B. The client has difficulty finding words during the interview
C. The client’s memory loss is permanent and irreversible
D. The symptoms have been progressing slowly over several years
Correct Answer: A
Explanation: Delirium is characterized by an acute, rapid onset and a fluctuating course,
often triggered by an underlying medical condition like a UTI. Dementia is a chronic,
progressive, and irreversible decline in cognitive function.
3. Which clinical manifestation should the nurse expect to find in a client diagnosed with
open-angle glaucoma?
A. Sudden, severe eye pain and nausea
B. Loss of central vision with intact peripheral vision
C. Gradual loss of peripheral vision (tunnel vision)
D. Floating spots or ‘curtain’ falling over the field of vision
Correct Answer: C
, Explanation: Open-angle glaucoma typically presents with a gradual, painless loss of
peripheral vision. Sudden pain is associated with angle-closure glaucoma, central vision
loss with macular degeneration, and a ‘curtain’ effect with retinal detachment.
4. A nurse is teaching an older adult client about managing osteoarthritis of the knees. Which
statement by the client indicates a need for further teaching?
A. ‘I should stay in bed and avoid all movement when my joints are sore.’
B. ‘I will use a heating pad for 20 minutes to help with morning stiffness.’
C. ‘I should try to maintain a healthy weight to reduce stress on my joints.’
D. ‘I will perform low-impact exercises like swimming or walking.’
Correct Answer: A
Explanation: Bed rest is contraindicated in osteoarthritis as it leads to joint stiffness and
muscle atrophy. Balanced rest and activity, weight management, and low-impact exercise
are recommended.
5. The nurse is discussing the difference between hospice care and palliative care with a
family. Which statement is accurate?
A. Hospice care is only for clients with a prognosis of 2 years or more.
B. Palliative care can be provided at any stage of a serious illness.
C. Palliative care focuses solely on curing the underlying disease.
D. Hospice care is provided exclusively in a hospital setting.
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 4) | Galen
1. A nurse is caring for an 82-year-old client with terminal cancer who is receiving palliative
care. The client’s respirations are shallow and labored, and they appear restless. Which
intervention is most appropriate?
A. Administering oxygen at 6L via simple mask
B. Suctioning the client vigorously to clear secretions
C. Increasing IV fluid rate to improve hydration
D. Administering prescribed morphine sulfate sublingually
Correct Answer: D
Explanation: AI Analysis: This exam focuses on the holistic management of aging and
chronic illness, emphasizing symptom control and ethical decision-making. The questions
integrate clinical judgment through NCLEX-style scenarios focusing on safety,
pathophysiology, and geriatric-specific care. Morphine is the gold standard in palliative
care to treat dyspnea and terminal restlessness by reducing the perception of air hunger
and providing sedation.
,2. An older adult client is admitted with acute confusion and a suspected urinary tract
infection. The nurse recognizes this as delirium rather than dementia based on which
characteristic?
A. The onset of symptoms was rapid and fluctuating
B. The client has difficulty finding words during the interview
C. The client’s memory loss is permanent and irreversible
D. The symptoms have been progressing slowly over several years
Correct Answer: A
Explanation: Delirium is characterized by an acute, rapid onset and a fluctuating course,
often triggered by an underlying medical condition like a UTI. Dementia is a chronic,
progressive, and irreversible decline in cognitive function.
3. Which clinical manifestation should the nurse expect to find in a client diagnosed with
open-angle glaucoma?
A. Sudden, severe eye pain and nausea
B. Loss of central vision with intact peripheral vision
C. Gradual loss of peripheral vision (tunnel vision)
D. Floating spots or ‘curtain’ falling over the field of vision
Correct Answer: C
, Explanation: Open-angle glaucoma typically presents with a gradual, painless loss of
peripheral vision. Sudden pain is associated with angle-closure glaucoma, central vision
loss with macular degeneration, and a ‘curtain’ effect with retinal detachment.
4. A nurse is teaching an older adult client about managing osteoarthritis of the knees. Which
statement by the client indicates a need for further teaching?
A. ‘I should stay in bed and avoid all movement when my joints are sore.’
B. ‘I will use a heating pad for 20 minutes to help with morning stiffness.’
C. ‘I should try to maintain a healthy weight to reduce stress on my joints.’
D. ‘I will perform low-impact exercises like swimming or walking.’
Correct Answer: A
Explanation: Bed rest is contraindicated in osteoarthritis as it leads to joint stiffness and
muscle atrophy. Balanced rest and activity, weight management, and low-impact exercise
are recommended.
5. The nurse is discussing the difference between hospice care and palliative care with a
family. Which statement is accurate?
A. Hospice care is only for clients with a prognosis of 2 years or more.
B. Palliative care can be provided at any stage of a serious illness.
C. Palliative care focuses solely on curing the underlying disease.
D. Hospice care is provided exclusively in a hospital setting.
