NUR 257 EXAM 3 – CONCEPTS OF AGING & CHRONIC ILLNESS IN
NURSING NEWEST 2026/2027 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+||BRAND NEW VERSION!!
GALEN COLLEGE OF NURSING
QUESTION 1
An older adult client with chronic obstructive pulmonary disease (COPD) is
experiencing shortness of breath. Which position is most appropriate to promote
airway clearance?
A) Supine position with head flat
B) High-Fowler's position with leaning forward on an overbed table
C) Trendelenburg position
D) Left lateral position
CORRECT ANSWER: B) High-Fowler's position with leaning forward on an overbed
table
RATIONALE: High-Fowler's position with forward leaning (tripod position) uses
gravity and mechanical advantage to improve lung expansion and ease breathing.
This position allows accessory muscles to assist with respiration and reduces work
of breathing.
WHY WRONG: A) Supine position worsens dyspnea by allowing abdominal
contents to push against the diaphragm; C) Trendelenburg increases intra-
abdominal pressure and worsens breathing; D) Lateral position is not optimal for
maximal lung expansion in COPD.
QUESTION 2
The nurse is assessing an older adult client with heart failure. Which finding
indicates worsening fluid overload?
A) Peripheral edema 1+ and mild dyspnea on exertion
1
,B) Jugular venous distention and crackles in lung bases
C) Weight loss of 2 pounds in 24 hours
D) Dry mucous membranes and poor skin turgor
CORRECT ANSWER: B) Jugular venous distention and crackles in lung bases
RATIONALE: Jugular venous distention (JVD) and crackles (rales) in lung bases
indicate worsening heart failure and fluid overload. JVD reflects elevated central
venous pressure, and crackles indicate pulmonary congestion.
WHY WRONG: A) 1+ edema and mild dyspnea are expected—not signs of
worsening; C) Weight loss indicates fluid loss, not overload; D) Dry mucous
membranes indicate dehydration, not fluid overload.
QUESTION 3
The nurse is teaching an older adult client with diabetes about foot care. Which
instruction is most important?
A) Soak feet in hot water daily to soften skin
B) Inspect feet daily for cuts, blisters, or redness
C) Walk barefoot to improve circulation
D) Apply heating pads to feet for warmth
CORRECT ANSWER: B) Inspect feet daily for cuts, blisters, or redness
RATIONALE: Daily foot inspection is critical for clients with diabetes to detect
injuries early. Due to neuropathy, clients may not feel injuries, leading to
infection, ulceration, and amputation.
WHY WRONG: A) Hot water can cause burns due to decreased sensation; C)
Barefoot walking increases injury risk; D) Heating pads can cause burns due to
neuropathy and decreased sensation.
QUESTION 4
2
,An older adult client with heart failure is prescribed furosemide (Lasix). Which
electrolyte imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
CORRECT ANSWER: B) Hypokalemia
RATIONALE: Furosemide is a loop diuretic that causes potassium excretion,
leading to hypokalemia. Monitor serum potassium levels and signs of
hypokalemia (muscle weakness, cardiac arrhythmias).
WHY WRONG: A) Hyperkalemia is associated with potassium-sparing diuretics,
not furosemide; C) Hypernatremia is not typically caused by loop diuretics; D)
Hypercalcemia is not associated with furosemide.
QUESTION 5
The nurse is assessing an older adult client with chronic kidney disease (CKD).
Which laboratory finding is consistent with this condition?
A) Elevated serum creatinine and decreased GFR
B) Decreased serum creatinine and elevated GFR
C) Elevated hemoglobin and hematocrit
D) Decreased blood urea nitrogen (BUN)
CORRECT ANSWER: A) Elevated serum creatinine and decreased GFR
RATIONALE: Chronic kidney disease is characterized by elevated serum creatinine
and blood urea nitrogen (BUN) with a decreased glomerular filtration rate (GFR).
These indicate reduced kidney function.
WHY WRONG: B) Creatinine would be elevated, not decreased; C) Hemoglobin
decreases in CKD due to decreased erythropoietin production; D) BUN increases,
not decreases.
3
, QUESTION 6
The nurse is caring for an older adult client receiving hemodialysis. Which
intervention is most important to prevent infection?
A) Use strict aseptic technique for vascular access care
B) Restrict all visitors to prevent infection
C) Administer prophylactic antibiotics before dialysis
D) Restrict fluid intake to 1 liter per day
CORRECT ANSWER: A) Use strict aseptic technique for vascular access care
RATIONALE: The vascular access site (fistula, graft, or catheter) is a direct portal
for infection. Strict aseptic technique during access care is the most important
intervention to prevent infection.
WHY WRONG: B) Restricting visitors does not prevent infection; C) Antibiotics are
not routinely given before dialysis; D) Fluid restriction is important but does not
prevent infection.
QUESTION 7
An older adult client with heart failure is prescribed digoxin. Which assessment
finding indicates digoxin toxicity?
A) Heart rate of 70 beats/min and normal sinus rhythm
B) Anorexia, nausea, and visual disturbances (yellow halos)
C) Weight gain and peripheral edema
D) Increased energy and appetite
CORRECT ANSWER: B) Anorexia, nausea, and visual disturbances (yellow halos)
RATIONALE: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea,
vomiting) and visual disturbances (yellow or green halos). Cardiac arrhythmias
(bradycardia, heart block) may also occur.
4
NURSING NEWEST 2026/2027 ACTUAL EXAM COMPLETE 200
QUESTIONS AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS)
ALREADY GRADED A+||BRAND NEW VERSION!!
GALEN COLLEGE OF NURSING
QUESTION 1
An older adult client with chronic obstructive pulmonary disease (COPD) is
experiencing shortness of breath. Which position is most appropriate to promote
airway clearance?
A) Supine position with head flat
B) High-Fowler's position with leaning forward on an overbed table
C) Trendelenburg position
D) Left lateral position
CORRECT ANSWER: B) High-Fowler's position with leaning forward on an overbed
table
RATIONALE: High-Fowler's position with forward leaning (tripod position) uses
gravity and mechanical advantage to improve lung expansion and ease breathing.
This position allows accessory muscles to assist with respiration and reduces work
of breathing.
WHY WRONG: A) Supine position worsens dyspnea by allowing abdominal
contents to push against the diaphragm; C) Trendelenburg increases intra-
abdominal pressure and worsens breathing; D) Lateral position is not optimal for
maximal lung expansion in COPD.
QUESTION 2
The nurse is assessing an older adult client with heart failure. Which finding
indicates worsening fluid overload?
A) Peripheral edema 1+ and mild dyspnea on exertion
1
,B) Jugular venous distention and crackles in lung bases
C) Weight loss of 2 pounds in 24 hours
D) Dry mucous membranes and poor skin turgor
CORRECT ANSWER: B) Jugular venous distention and crackles in lung bases
RATIONALE: Jugular venous distention (JVD) and crackles (rales) in lung bases
indicate worsening heart failure and fluid overload. JVD reflects elevated central
venous pressure, and crackles indicate pulmonary congestion.
WHY WRONG: A) 1+ edema and mild dyspnea are expected—not signs of
worsening; C) Weight loss indicates fluid loss, not overload; D) Dry mucous
membranes indicate dehydration, not fluid overload.
QUESTION 3
The nurse is teaching an older adult client with diabetes about foot care. Which
instruction is most important?
A) Soak feet in hot water daily to soften skin
B) Inspect feet daily for cuts, blisters, or redness
C) Walk barefoot to improve circulation
D) Apply heating pads to feet for warmth
CORRECT ANSWER: B) Inspect feet daily for cuts, blisters, or redness
RATIONALE: Daily foot inspection is critical for clients with diabetes to detect
injuries early. Due to neuropathy, clients may not feel injuries, leading to
infection, ulceration, and amputation.
WHY WRONG: A) Hot water can cause burns due to decreased sensation; C)
Barefoot walking increases injury risk; D) Heating pads can cause burns due to
neuropathy and decreased sensation.
QUESTION 4
2
,An older adult client with heart failure is prescribed furosemide (Lasix). Which
electrolyte imbalance should the nurse monitor for?
A) Hyperkalemia
B) Hypokalemia
C) Hypernatremia
D) Hypercalcemia
CORRECT ANSWER: B) Hypokalemia
RATIONALE: Furosemide is a loop diuretic that causes potassium excretion,
leading to hypokalemia. Monitor serum potassium levels and signs of
hypokalemia (muscle weakness, cardiac arrhythmias).
WHY WRONG: A) Hyperkalemia is associated with potassium-sparing diuretics,
not furosemide; C) Hypernatremia is not typically caused by loop diuretics; D)
Hypercalcemia is not associated with furosemide.
QUESTION 5
The nurse is assessing an older adult client with chronic kidney disease (CKD).
Which laboratory finding is consistent with this condition?
A) Elevated serum creatinine and decreased GFR
B) Decreased serum creatinine and elevated GFR
C) Elevated hemoglobin and hematocrit
D) Decreased blood urea nitrogen (BUN)
CORRECT ANSWER: A) Elevated serum creatinine and decreased GFR
RATIONALE: Chronic kidney disease is characterized by elevated serum creatinine
and blood urea nitrogen (BUN) with a decreased glomerular filtration rate (GFR).
These indicate reduced kidney function.
WHY WRONG: B) Creatinine would be elevated, not decreased; C) Hemoglobin
decreases in CKD due to decreased erythropoietin production; D) BUN increases,
not decreases.
3
, QUESTION 6
The nurse is caring for an older adult client receiving hemodialysis. Which
intervention is most important to prevent infection?
A) Use strict aseptic technique for vascular access care
B) Restrict all visitors to prevent infection
C) Administer prophylactic antibiotics before dialysis
D) Restrict fluid intake to 1 liter per day
CORRECT ANSWER: A) Use strict aseptic technique for vascular access care
RATIONALE: The vascular access site (fistula, graft, or catheter) is a direct portal
for infection. Strict aseptic technique during access care is the most important
intervention to prevent infection.
WHY WRONG: B) Restricting visitors does not prevent infection; C) Antibiotics are
not routinely given before dialysis; D) Fluid restriction is important but does not
prevent infection.
QUESTION 7
An older adult client with heart failure is prescribed digoxin. Which assessment
finding indicates digoxin toxicity?
A) Heart rate of 70 beats/min and normal sinus rhythm
B) Anorexia, nausea, and visual disturbances (yellow halos)
C) Weight gain and peripheral edema
D) Increased energy and appetite
CORRECT ANSWER: B) Anorexia, nausea, and visual disturbances (yellow halos)
RATIONALE: Early signs of digoxin toxicity include GI symptoms (anorexia, nausea,
vomiting) and visual disturbances (yellow or green halos). Cardiac arrhythmias
(bradycardia, heart block) may also occur.
4
