NUR 258 Exam 4 V3 | NUR 258 Concepts
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 4) | Galen
1. A nurse is caring for an older adult patient who has been diagnosed with terminal cancer.
The family asks about the primary difference between palliative care and hospice care. Which
response by the nurse is most accurate?
A. Hospice care focuses on the final six months of life, while palliative care can begin at any
stage of a serious illness.
B. Palliative care is strictly for patients who have decided to stop all curative treatments.
C. Hospice care is only for patients who have more than 12 months to live.
D. Palliative care is provided only in a hospital setting, whereas hospice is only at home.
Correct Answer: A
Explanation: This examination focuses on the complex physiological and psychosocial
needs of the aging population, specifically targeting chronic illness management and end-
of-life care. The clinical scenarios emphasize the nurse’s role in safety, advocacy, and
interdisciplinary collaboration to optimize outcomes for older adults. By integrating Next
Generation NCLEX (NGN) elements, the test evaluates clinical judgment and the ability to
prioritize care in high-stakes geriatric environments. Hospice care is a subset of palliative
care specifically for those with a prognosis of 6 months or less, while palliative care can be
concurrent with curative treatment.
,2. A client with Parkinson’s disease is experiencing frequent ‘freezing’ episodes while walking.
Which instruction should the nurse provide to help the client resume walking?
A. Try to push through the freeze by leaning forward.
B. Imagine stepping over an imaginary line on the floor.
C. Wait for someone to pick you up and move you.
D. Take a large step backward before moving forward.
Correct Answer: B
Explanation: Visual triggering or ‘rhythmic’ cues like imagining a line or stepping over a
laser line help overcome the neurological block associated with freezing of gait in
Parkinson’s.
3. The nurse is assessing an older adult client for signs of caregiver strain in the client’s
daughter. Which finding most strongly suggests caregiver burnout?
A. The daughter asks for a list of local support groups.
B. The daughter expresses frustration and has neglected her own health appointments.
C. The daughter reports she has gained 5 pounds in the last month.
D. The daughter hires a part-time home health aide for assistance.
Correct Answer: B
, Explanation: Caregiver burnout is characterized by emotional exhaustion, withdrawal, and
neglect of personal needs or health due to the demands of caring for a chronically ill
relative.
4. An 82-year-old client with moderate Alzheimer’s disease becomes increasingly agitated
and confused in the late afternoon. Which intervention should the nurse implement first?
A. Administer a PRN dose of lorazepam as ordered.
B. Ask the client why they are acting so upset.
C. Restrain the client in a chair to prevent wandering.
D. Turn on the lights and provide a quiet, familiar activity.
Correct Answer: D
Explanation: This client is experiencing sundowning. The first intervention should be non-
pharmacological, such as improving lighting to reduce shadows and providing a calm
environment.
5. Which of the following are risk factors for the development of osteoporosis in an older
adult? (Select all that apply)
A. Long-term use of corticosteroids
B. Regular weight-bearing exercise
C. History of cigarette smoking
D. High intake of Vitamin D and Calcium
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 4) | Galen
1. A nurse is caring for an older adult patient who has been diagnosed with terminal cancer.
The family asks about the primary difference between palliative care and hospice care. Which
response by the nurse is most accurate?
A. Hospice care focuses on the final six months of life, while palliative care can begin at any
stage of a serious illness.
B. Palliative care is strictly for patients who have decided to stop all curative treatments.
C. Hospice care is only for patients who have more than 12 months to live.
D. Palliative care is provided only in a hospital setting, whereas hospice is only at home.
Correct Answer: A
Explanation: This examination focuses on the complex physiological and psychosocial
needs of the aging population, specifically targeting chronic illness management and end-
of-life care. The clinical scenarios emphasize the nurse’s role in safety, advocacy, and
interdisciplinary collaboration to optimize outcomes for older adults. By integrating Next
Generation NCLEX (NGN) elements, the test evaluates clinical judgment and the ability to
prioritize care in high-stakes geriatric environments. Hospice care is a subset of palliative
care specifically for those with a prognosis of 6 months or less, while palliative care can be
concurrent with curative treatment.
,2. A client with Parkinson’s disease is experiencing frequent ‘freezing’ episodes while walking.
Which instruction should the nurse provide to help the client resume walking?
A. Try to push through the freeze by leaning forward.
B. Imagine stepping over an imaginary line on the floor.
C. Wait for someone to pick you up and move you.
D. Take a large step backward before moving forward.
Correct Answer: B
Explanation: Visual triggering or ‘rhythmic’ cues like imagining a line or stepping over a
laser line help overcome the neurological block associated with freezing of gait in
Parkinson’s.
3. The nurse is assessing an older adult client for signs of caregiver strain in the client’s
daughter. Which finding most strongly suggests caregiver burnout?
A. The daughter asks for a list of local support groups.
B. The daughter expresses frustration and has neglected her own health appointments.
C. The daughter reports she has gained 5 pounds in the last month.
D. The daughter hires a part-time home health aide for assistance.
Correct Answer: B
, Explanation: Caregiver burnout is characterized by emotional exhaustion, withdrawal, and
neglect of personal needs or health due to the demands of caring for a chronically ill
relative.
4. An 82-year-old client with moderate Alzheimer’s disease becomes increasingly agitated
and confused in the late afternoon. Which intervention should the nurse implement first?
A. Administer a PRN dose of lorazepam as ordered.
B. Ask the client why they are acting so upset.
C. Restrain the client in a chair to prevent wandering.
D. Turn on the lights and provide a quiet, familiar activity.
Correct Answer: D
Explanation: This client is experiencing sundowning. The first intervention should be non-
pharmacological, such as improving lighting to reduce shadows and providing a calm
environment.
5. Which of the following are risk factors for the development of osteoporosis in an older
adult? (Select all that apply)
A. Long-term use of corticosteroids
B. Regular weight-bearing exercise
C. History of cigarette smoking
D. High intake of Vitamin D and Calcium
