NUR 257 EXAM 4 – CONCEPTS OF AGING & CHRONIC ILLNESS IN
NURSING NEWEST 2026/2027 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+||BRAND NEW VERSION!!
GALEN COLLEGE OF NURSING
QUESTION 1
The nurse is assessing an older adult client who is experiencing grief after the
death of a spouse. Which statement by the nurse is most therapeutic?
A) "You should be over this by now, it's been 3 months"
B) "Tell me about your spouse and what you are feeling"
C) "Don't cry, your spouse wouldn't want you to be sad"
D) "You need to stay busy and keep your mind occupied"
CORRECT ANSWER: B) "Tell me about your spouse and what you are feeling"
RATIONALE: This response uses therapeutic communication by encouraging the
client to express feelings, validating grief, and promoting emotional expression. It
is open-ended and supportive.
WHY WRONG: A) This is judgmental and dismissive—grief has no timeline; C)
Discouraging tears is nontherapeutic and invalidates the client's feelings; D) This
minimizes the client's grief and avoids addressing emotions.
QUESTION 2
An older adult client is diagnosed with major depressive disorder. Which
assessment finding is most consistent with depression in this population?
A) Increased energy and hyperactivity
B) Sleep disturbances and loss of interest
C) Weight gain and increased appetite
D) Improved concentration and focus
CORRECT ANSWER: B) Sleep disturbances and loss of interest
1
,RATIONALE: Depression in older adults often presents with sleep disturbances,
anhedonia (loss of interest), depressed mood, fatigue, and cognitive changes.
Atypical symptoms are common.
WHY WRONG: A) Depression causes decreased energy, not hyperactivity; C)
Weight loss and decreased appetite are more common; D) Concentration typically
decreases, not improves.
QUESTION 3
The nurse is assessing an older adult client for signs of elder abuse. Which finding
is most concerning for physical abuse?
A) Bruises on the client's knees and shins
B) Bruises on the wrists and ankles in a bilateral pattern
C) Skin tears on the forearms
D) Age-related skin thinning
CORRECT ANSWER: B) Bruises on the wrists and ankles in a bilateral pattern
RATIONALE: Bilateral bruises on wrists and ankles suggest restraint or abuse.
These are not consistent with accidental injuries.
WHY WRONG: A) Bruises on knees/shins are common from minor falls; C) Skin
tears are common on forearms; D) Skin thinning is a normal age-related change—
these do not suggest abuse.
QUESTION 4
An older adult client is experiencing chronic pain from osteoarthritis. Which non-
pharmacologic intervention should the nurse recommend first?
A) Complete bed rest
B) Warm compresses and gentle range-of-motion exercises
C) High-impact aerobic exercise daily
D) Continuous cold compresses for 24 hours
2
,CORRECT ANSWER: B) Warm compresses and gentle range-of-motion exercises
RATIONALE: Warm compresses relax muscles and increase blood flow; gentle
ROM exercises maintain joint mobility and reduce stiffness. These are
nonpharmacologic first-line interventions.
WHY WRONG: A) Complete bed rest leads to stiffness and deconditioning; C)
High-impact exercise worsens joint pain; D) Continuous cold application can cause
tissue damage—20 minutes at a time is recommended.
QUESTION 5
The nurse is assessing an older adult client's nutritional status. Which laboratory
value indicates poor nutritional status?
A) Serum albumin of 4.0 g/dL
B) Prealbumin of 12 mg/dL
C) Hemoglobin of 14 g/dL
D) Serum cholesterol of 180 mg/dL
CORRECT ANSWER: B) Prealbumin of 12 mg/dL
RATIONALE: Prealbumin has a short half-life and is a sensitive marker of acute
malnutrition. Normal prealbumin is 15-36 mg/dL. Low levels indicate protein-
calorie malnutrition.
WHY WRONG: A) Albumin >4.0 is normal; C) Hemoglobin 14 is normal; D)
Cholesterol 180 is acceptable—these do not indicate malnutrition.
QUESTION 6
The nurse is providing end-of-life care to an older adult client. Which intervention
is most appropriate?
A) Continue all aggressive interventions regardless of comfort
B) Focus on pain management and comfort measures
C) Discourage family visits to maintain quiet
3
, D) Withhold all medications to hasten death
CORRECT ANSWER: B) Focus on pain management and comfort measures
RATIONALE: End-of-life care prioritizes comfort, dignity, pain relief, symptom
management, and psychosocial support.
WHY WRONG: A) Aggressive interventions may prolong suffering; C) Family visits
are encouraged for support; D) Withholding appropriate medications is not
palliative—pain management should continue.
QUESTION 7
An older adult client has a living will. What is the nurse's responsibility regarding
this document?
A) Ignore the living will until a crisis occurs
B) Honor the documented wishes of the client regarding end-of-life care
C) Encourage the family to override the client's wishes
D) Hide the document to avoid conflict
CORRECT ANSWER: B) Honor the documented wishes of the client regarding end-
of-life care
RATIONALE: A living will is a legal document expressing a client's wishes for end-
of-life care. The nurse must advocate for and honor these wishes.
WHY WRONG: A) The document should be reviewed with the healthcare team; C)
The family cannot legally override a valid living will; D) Hiding the document is
unethical and illegal.
QUESTION 8
The nurse is assessing an older adult client for signs of depression. Which
screening tool is most commonly used for this population?
A) Mini-Mental State Examination (MMSE)
4
NURSING NEWEST 2026/2027 ACTUAL EXAM COMPLETE QUESTIONS
AND CORRECT DETAILED ANSWERS (VERIFIED ANSWERS) |
ALREADY GRADED A+||BRAND NEW VERSION!!
GALEN COLLEGE OF NURSING
QUESTION 1
The nurse is assessing an older adult client who is experiencing grief after the
death of a spouse. Which statement by the nurse is most therapeutic?
A) "You should be over this by now, it's been 3 months"
B) "Tell me about your spouse and what you are feeling"
C) "Don't cry, your spouse wouldn't want you to be sad"
D) "You need to stay busy and keep your mind occupied"
CORRECT ANSWER: B) "Tell me about your spouse and what you are feeling"
RATIONALE: This response uses therapeutic communication by encouraging the
client to express feelings, validating grief, and promoting emotional expression. It
is open-ended and supportive.
WHY WRONG: A) This is judgmental and dismissive—grief has no timeline; C)
Discouraging tears is nontherapeutic and invalidates the client's feelings; D) This
minimizes the client's grief and avoids addressing emotions.
QUESTION 2
An older adult client is diagnosed with major depressive disorder. Which
assessment finding is most consistent with depression in this population?
A) Increased energy and hyperactivity
B) Sleep disturbances and loss of interest
C) Weight gain and increased appetite
D) Improved concentration and focus
CORRECT ANSWER: B) Sleep disturbances and loss of interest
1
,RATIONALE: Depression in older adults often presents with sleep disturbances,
anhedonia (loss of interest), depressed mood, fatigue, and cognitive changes.
Atypical symptoms are common.
WHY WRONG: A) Depression causes decreased energy, not hyperactivity; C)
Weight loss and decreased appetite are more common; D) Concentration typically
decreases, not improves.
QUESTION 3
The nurse is assessing an older adult client for signs of elder abuse. Which finding
is most concerning for physical abuse?
A) Bruises on the client's knees and shins
B) Bruises on the wrists and ankles in a bilateral pattern
C) Skin tears on the forearms
D) Age-related skin thinning
CORRECT ANSWER: B) Bruises on the wrists and ankles in a bilateral pattern
RATIONALE: Bilateral bruises on wrists and ankles suggest restraint or abuse.
These are not consistent with accidental injuries.
WHY WRONG: A) Bruises on knees/shins are common from minor falls; C) Skin
tears are common on forearms; D) Skin thinning is a normal age-related change—
these do not suggest abuse.
QUESTION 4
An older adult client is experiencing chronic pain from osteoarthritis. Which non-
pharmacologic intervention should the nurse recommend first?
A) Complete bed rest
B) Warm compresses and gentle range-of-motion exercises
C) High-impact aerobic exercise daily
D) Continuous cold compresses for 24 hours
2
,CORRECT ANSWER: B) Warm compresses and gentle range-of-motion exercises
RATIONALE: Warm compresses relax muscles and increase blood flow; gentle
ROM exercises maintain joint mobility and reduce stiffness. These are
nonpharmacologic first-line interventions.
WHY WRONG: A) Complete bed rest leads to stiffness and deconditioning; C)
High-impact exercise worsens joint pain; D) Continuous cold application can cause
tissue damage—20 minutes at a time is recommended.
QUESTION 5
The nurse is assessing an older adult client's nutritional status. Which laboratory
value indicates poor nutritional status?
A) Serum albumin of 4.0 g/dL
B) Prealbumin of 12 mg/dL
C) Hemoglobin of 14 g/dL
D) Serum cholesterol of 180 mg/dL
CORRECT ANSWER: B) Prealbumin of 12 mg/dL
RATIONALE: Prealbumin has a short half-life and is a sensitive marker of acute
malnutrition. Normal prealbumin is 15-36 mg/dL. Low levels indicate protein-
calorie malnutrition.
WHY WRONG: A) Albumin >4.0 is normal; C) Hemoglobin 14 is normal; D)
Cholesterol 180 is acceptable—these do not indicate malnutrition.
QUESTION 6
The nurse is providing end-of-life care to an older adult client. Which intervention
is most appropriate?
A) Continue all aggressive interventions regardless of comfort
B) Focus on pain management and comfort measures
C) Discourage family visits to maintain quiet
3
, D) Withhold all medications to hasten death
CORRECT ANSWER: B) Focus on pain management and comfort measures
RATIONALE: End-of-life care prioritizes comfort, dignity, pain relief, symptom
management, and psychosocial support.
WHY WRONG: A) Aggressive interventions may prolong suffering; C) Family visits
are encouraged for support; D) Withholding appropriate medications is not
palliative—pain management should continue.
QUESTION 7
An older adult client has a living will. What is the nurse's responsibility regarding
this document?
A) Ignore the living will until a crisis occurs
B) Honor the documented wishes of the client regarding end-of-life care
C) Encourage the family to override the client's wishes
D) Hide the document to avoid conflict
CORRECT ANSWER: B) Honor the documented wishes of the client regarding end-
of-life care
RATIONALE: A living will is a legal document expressing a client's wishes for end-
of-life care. The nurse must advocate for and honor these wishes.
WHY WRONG: A) The document should be reviewed with the healthcare team; C)
The family cannot legally override a valid living will; D) Hiding the document is
unethical and illegal.
QUESTION 8
The nurse is assessing an older adult client for signs of depression. Which
screening tool is most commonly used for this population?
A) Mini-Mental State Examination (MMSE)
4
