NUR 258 Exam 1 V3 | NUR 258 Concepts
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 1) | Galen
2. An 82-year-old patient is admitted with a hip fracture. The nurse notes the patient is
suddenly confused and agitated. What is the priority nursing action?
A. Administer a PRN dose of haloperidol (Haldol).
B. Request a psychiatric consultation.
C. Apply soft wrist restraints to prevent falls.
D. Assess oxygen saturation and vital signs.
Correct Answer: D
Explanation: Acute confusion in an older adult is often a symptom of a physiological
problem such as hypoxia, infection (UTI), or electrolyte imbalance. Assessment is the first
step of the nursing process.
3. Which theory of aging suggests that the body has a ‘genetic clock’ that determines the
timing of cell death?
A. Programmed Theory
B. Free Radical Theory
C. Wear and Tear Theory
,D. Cross-Link Theory
Correct Answer: A
Explanation: The Programmed Theory (or Biological Clock Theory) proposes that aging is
follow a biological timetable, likely a continuation of childhood growth and development.
4. A nurse is teaching a group of older adults about skin health. Which statement by a
participant indicates a need for further teaching?
A. I should check my skin for changes in moles regularly.
B. I will apply moisturizer immediately after drying off.
C. I need to drink more water to keep my skin hydrated.
D. I should take a hot bath every day to keep my skin clean.
Correct Answer: D
Explanation: Older adults have thinner skin and decreased oil production. Frequent hot
baths can strip the skin of essential oils, leading to xerosis (dry skin) and pruritus.
5. The nurse is reviewing the medications of a 75-year-old patient. Which of the following
medications is listed on the Beers Criteria as potentially inappropriate for older adults?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Atorvastatin
, Correct Answer: B
Explanation: Diphenhydramine (Benadryl) has strong anticholinergic effects in older
adults, significantly increasing the risk of confusion, blurred vision, urinary retention, and
falls.
6. Select All That Apply (SATA): Which factors contribute to the high risk of polypharmacy in
the elderly population?
A. Seeing multiple different specialists for care.
B. The use of ‘pill sharing’ among peers.
C. Using a single pharmacy for all prescriptions.
D. Treatment of side effects with more medications (prescribing cascade).
Correct Answer: A, B, D
Explanation: Multiple specialists and the prescribing cascade directly lead to
polypharmacy. Sharing pills is a dangerous behavior that adds to the problem. Using a
single pharmacy is a preventive strategy, not a risk factor.
7. An older adult complains of ‘difficulty hearing’ in crowded rooms. The nurse recognizes this
as most likely being:
A. Presbycusis.
B. Candidiasis of the ear canal.
C. Otosclerosis.
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 1) | Galen
2. An 82-year-old patient is admitted with a hip fracture. The nurse notes the patient is
suddenly confused and agitated. What is the priority nursing action?
A. Administer a PRN dose of haloperidol (Haldol).
B. Request a psychiatric consultation.
C. Apply soft wrist restraints to prevent falls.
D. Assess oxygen saturation and vital signs.
Correct Answer: D
Explanation: Acute confusion in an older adult is often a symptom of a physiological
problem such as hypoxia, infection (UTI), or electrolyte imbalance. Assessment is the first
step of the nursing process.
3. Which theory of aging suggests that the body has a ‘genetic clock’ that determines the
timing of cell death?
A. Programmed Theory
B. Free Radical Theory
C. Wear and Tear Theory
,D. Cross-Link Theory
Correct Answer: A
Explanation: The Programmed Theory (or Biological Clock Theory) proposes that aging is
follow a biological timetable, likely a continuation of childhood growth and development.
4. A nurse is teaching a group of older adults about skin health. Which statement by a
participant indicates a need for further teaching?
A. I should check my skin for changes in moles regularly.
B. I will apply moisturizer immediately after drying off.
C. I need to drink more water to keep my skin hydrated.
D. I should take a hot bath every day to keep my skin clean.
Correct Answer: D
Explanation: Older adults have thinner skin and decreased oil production. Frequent hot
baths can strip the skin of essential oils, leading to xerosis (dry skin) and pruritus.
5. The nurse is reviewing the medications of a 75-year-old patient. Which of the following
medications is listed on the Beers Criteria as potentially inappropriate for older adults?
A. Lisinopril
B. Diphenhydramine
C. Metformin
D. Atorvastatin
, Correct Answer: B
Explanation: Diphenhydramine (Benadryl) has strong anticholinergic effects in older
adults, significantly increasing the risk of confusion, blurred vision, urinary retention, and
falls.
6. Select All That Apply (SATA): Which factors contribute to the high risk of polypharmacy in
the elderly population?
A. Seeing multiple different specialists for care.
B. The use of ‘pill sharing’ among peers.
C. Using a single pharmacy for all prescriptions.
D. Treatment of side effects with more medications (prescribing cascade).
Correct Answer: A, B, D
Explanation: Multiple specialists and the prescribing cascade directly lead to
polypharmacy. Sharing pills is a dangerous behavior that adds to the problem. Using a
single pharmacy is a preventive strategy, not a risk factor.
7. An older adult complains of ‘difficulty hearing’ in crowded rooms. The nurse recognizes this
as most likely being:
A. Presbycusis.
B. Candidiasis of the ear canal.
C. Otosclerosis.
