NUR 258 Final Exam V2 | NUR 258
Concepts of Aging & Chronic Illness |
Actual Q&A with Rationale (NUR258 Final
Exam) | Galen
1. An 82-year-old client is admitted with an acute onset of confusion and agitation. Which
assessment is most critical to differentiate delirium from dementia?
A. The client’s ability to perform activities of daily living (ADLs).
B. The presence of long-term memory loss and word-finding difficulty.
C. The timeline and suddenness of the mental status changes.
D. The client’s history of cardiovascular disease and hypertension.
Correct Answer: C
Explanation: Delirium is characterized by an acute, abrupt onset of confusion, whereas
dementia is a slow, progressive decline. Determining the timeline is the most critical
diagnostic indicator.
2. Which physiological change in the aging process significantly increases the risk of drug
toxicity in an older adult client?
A. Decreased glomerular filtration rate (GFR) and renal clearance.
B. Increased hepatic blood flow and enzyme activity.
C. Increased total body water and decreased body fat.
,D. Decreased gastric pH and faster stomach emptying.
Correct Answer: A
Explanation: Decreased renal function (GFR) in older adults leads to reduced excretion of
medications, causing drugs to stay in the system longer and increasing the risk of toxicity.
3. A nurse is teaching an older adult with Osteoarthritis (OA) about joint protection. Which
instruction should the nurse include?
A. Avoid using large joints to perform tasks whenever possible.
B. Push off with your fingers when rising from a seated position.
C. Use a walker or cane to reduce weight-bearing stress on hip and knee joints.
D. Engage in high-impact aerobic exercise to strengthen joint capsules.
Correct Answer: C
Explanation: Using assistive devices like canes or walkers reduces the load on weight-
bearing joints affected by OA, preventing further damage and pain.
4. An older adult client with Heart Failure reports a weight gain of 4 lbs in 48 hours. What is
the nurse’s priority action?
A. Auscultate the client’s lung sounds for crackles.
B. Instruct the client to restrict their fluid intake to 1 liter per day.
C. Review the client’s sodium intake for the past 24 hours.
D. Re-weigh the client using a different scale for accuracy.
, Correct Answer: A
Explanation: Weight gain is a sign of fluid retention. The nurse must prioritize assessment
of the respiratory system to check for pulmonary edema (crackles) associated with heart
failure exacerbation.
5. Which assessment finding in an older adult should the nurse report as a potential sign of
elder neglect?
A. A small bruise on the forearm caused by a bumping a table.
B. Presence of a Stage III pressure injury in the sacral area.
C. The client choosing to wear mismatched clothing.
D. A report of decreased appetite over the last week.
Correct Answer: B
Explanation: Advanced pressure injuries (Stage III or IV) in an older adult receiving home
care are often red flags for neglect regarding hygiene and repositioning.
6. A client with end-stage COPD is being transitioned to palliative care. What is the primary
goal of this type of care?
A. To cure the underlying disease using aggressive pharmacological therapy.
B. To provide comfort and improve the quality of life for the client and family.
C. To restrict all medical treatments and focus solely on spiritual counseling.
D. To prepare the client for a rapid discharge to a long-term care facility.
Concepts of Aging & Chronic Illness |
Actual Q&A with Rationale (NUR258 Final
Exam) | Galen
1. An 82-year-old client is admitted with an acute onset of confusion and agitation. Which
assessment is most critical to differentiate delirium from dementia?
A. The client’s ability to perform activities of daily living (ADLs).
B. The presence of long-term memory loss and word-finding difficulty.
C. The timeline and suddenness of the mental status changes.
D. The client’s history of cardiovascular disease and hypertension.
Correct Answer: C
Explanation: Delirium is characterized by an acute, abrupt onset of confusion, whereas
dementia is a slow, progressive decline. Determining the timeline is the most critical
diagnostic indicator.
2. Which physiological change in the aging process significantly increases the risk of drug
toxicity in an older adult client?
A. Decreased glomerular filtration rate (GFR) and renal clearance.
B. Increased hepatic blood flow and enzyme activity.
C. Increased total body water and decreased body fat.
,D. Decreased gastric pH and faster stomach emptying.
Correct Answer: A
Explanation: Decreased renal function (GFR) in older adults leads to reduced excretion of
medications, causing drugs to stay in the system longer and increasing the risk of toxicity.
3. A nurse is teaching an older adult with Osteoarthritis (OA) about joint protection. Which
instruction should the nurse include?
A. Avoid using large joints to perform tasks whenever possible.
B. Push off with your fingers when rising from a seated position.
C. Use a walker or cane to reduce weight-bearing stress on hip and knee joints.
D. Engage in high-impact aerobic exercise to strengthen joint capsules.
Correct Answer: C
Explanation: Using assistive devices like canes or walkers reduces the load on weight-
bearing joints affected by OA, preventing further damage and pain.
4. An older adult client with Heart Failure reports a weight gain of 4 lbs in 48 hours. What is
the nurse’s priority action?
A. Auscultate the client’s lung sounds for crackles.
B. Instruct the client to restrict their fluid intake to 1 liter per day.
C. Review the client’s sodium intake for the past 24 hours.
D. Re-weigh the client using a different scale for accuracy.
, Correct Answer: A
Explanation: Weight gain is a sign of fluid retention. The nurse must prioritize assessment
of the respiratory system to check for pulmonary edema (crackles) associated with heart
failure exacerbation.
5. Which assessment finding in an older adult should the nurse report as a potential sign of
elder neglect?
A. A small bruise on the forearm caused by a bumping a table.
B. Presence of a Stage III pressure injury in the sacral area.
C. The client choosing to wear mismatched clothing.
D. A report of decreased appetite over the last week.
Correct Answer: B
Explanation: Advanced pressure injuries (Stage III or IV) in an older adult receiving home
care are often red flags for neglect regarding hygiene and repositioning.
6. A client with end-stage COPD is being transitioned to palliative care. What is the primary
goal of this type of care?
A. To cure the underlying disease using aggressive pharmacological therapy.
B. To provide comfort and improve the quality of life for the client and family.
C. To restrict all medical treatments and focus solely on spiritual counseling.
D. To prepare the client for a rapid discharge to a long-term care facility.
