NUR 257 CONCEPTS OF AGING AND CHRONIC ILLNESS EXAM –
COMPLETE STUDY GUIDE | PRACTICE QUESTIONS AND
ANSWERS-RATIONALES | EXAM PREP | DOWNLOAD INSTANT
PDF |GUARANTEED PASS || LATEST EXAM 2026-2027
1. Which physiological age-related change in the cardiovascular system primarily
contributes to systolic hypertension in older adults?
A. Increased myocardial contractility
B. Decreased arterial compliance and arterial stiffening
C. Dilation of the ascending aorta
D. Enhanced baroreceptor sensitivity
As people age, collagen deposition and elastin degradation lead to arterial stiffening and
decreased compliance, widening pulse pressure and elevating systolic blood pressure.
2. A 78-year-old client with chronic heart failure is prescribed a new loop diuretic. Which
electrolyte imbalance should the nurse monitor for most closely during routine lab draws?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Loop diuretics inhibit sodium and chloride reabsorption in the ascending loop of Henle,
leading to significant renal excretion of potassium and subsequent hypokalemia.
3. When assessing an 82-year-old resident in a long-term care facility, which finding is
considered a normal, age-related change in the integumentary system rather than a
pathological lesion?
A. Purpura caused by minor trauma
B. Solar lentigines on sun-exposed skin
C. Development of new asymmetric pigmented macules
D. Diffuse scaling with intense pruritus
Solar lentigines, commonly known as liver spots or age spots, are benign hyperpigmented
macules resulting from cumulative sun exposure over time.
4. A nurse is evaluating an older adult for early signs of delirium versus dementia. Which
characteristic strongly points toward a diagnosis of delirium?
A. Insidious and slow onset over several years
B. Intact immediate memory with stable attention span
,C. Acute onset with fluctuating levels of consciousness
D. Permanent and irreversible cognitive decline
Delirium is characterized by an acute, abrupt onset and a fluctuating course with prominent
disturbances in attention and level of consciousness, unlike chronic dementia.
5. Which screening tool is widely recommended and validated for assessing geriatric
depression in primary care and acute care settings?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. Braden Scale for Predicting Pressure Sore Risk
D. Morse Fall Scale
The Geriatric Depression Scale is specifically designed and validated to screen for depressive
symptoms in older populations, minimizing somatic symptom overlap.
6. Which age-related pharmacokinetic change places the older adult at increased risk for
drug toxicity when administered fat-soluble medications such as diazepam?
A. Increased total body water
B. Decreased percentage of body fat
C. Increased ratio of adipose tissue to lean body mass
D. Enhanced hepatic phase I metabolism
Older adults experience an increase in body fat percentage and a decrease in total body water,
which expands the distribution volume for lipophilic drugs and prolongs their half-life.
7. An 85-year-old client with osteoarthritis reports chronic knee pain that worsens with
activity and improves with rest. Which pharmacological agent is typically recommended as
first-line therapy by clinical guidelines?
A. Oral ibuprofen
B. Topical diclofenac sodium
C. Systemic long-acting opioids
D. Intra-articular corticosteroids
Topical nonsteroidal anti-inflammatory drugs provide targeted pain relief for localized
osteoarthritis while minimizing systemic adverse effects common in older adults.
8. Which age-related alteration in pulmonary physiology is responsible for a progressive
decline in forced expiratory volume in one second (FEV1)?
A. Increased chest wall compliance
B. Loss of elastic recoil in lung parenchyma
C. Hypertrophy of diaphragmatic muscle fibers
, D. Increased alveolar surface area
The loss of elastic recoil in aging lung tissue leads to premature airway closure during
expiration and a reduction in maximal expiratory flow rates like FEV1.
9. A nurse is designing a fall prevention plan for a community-dwelling older adult with
peripheral neuropathy. Which intervention addresses the primary risk factor associated
with this condition?
A. Recommending high-heeled supportive footwear
B. Assessing home lighting and removing floor clutter
C. Encouraging strict bed rest during daylight hours
D. Restricting fluid intake to decrease nocturnal bathroom trips
Peripheral neuropathy impairs proprioception and tactile sensation in the lower extremities,
making environmental hazard removal essential for preventing trips and falls.
10. Which clinical manifestation is most characteristic of early-stage Parkinson disease in
an older adult?
A. Unilateral resting pill-rolling tremor
B. Symmetric proximal muscle weakness
C. Sudden catastrophic memory loss
D. Profuse generalized diaphoresis
Parkinson disease classically presents with asymmetric, insidious motor symptoms, most
commonly a resting tremor in one upper extremity, rather than symmetric weakness.
11. Which age-related renal change explains why serum creatinine alone can be a
misleading indicator of kidney function in older adults?
A. Increased glomerular filtration rate
B. Decreased muscle mass leading to lower baseline creatinine production
C. Hypertrophy of renal nephrons
D. Enhanced tubular secretion of creatinine
Because older adults often have reduced muscle mass, baseline creatinine production is lower;
thus, a normal serum creatinine can mask a significantly reduced glomerular filtration rate.
12. A home health nurse is reviewing the medication list of an 80-year-old client and notes
the use of diphenhydramine for insomnia. Using Beers Criteria, why should the nurse
question this prescription?
A. It causes severe hypoglycemia
B. It has strong anticholinergic properties that increase confusion and fall risks
C. It interacts dangerously with low-dose aspirin
COMPLETE STUDY GUIDE | PRACTICE QUESTIONS AND
ANSWERS-RATIONALES | EXAM PREP | DOWNLOAD INSTANT
PDF |GUARANTEED PASS || LATEST EXAM 2026-2027
1. Which physiological age-related change in the cardiovascular system primarily
contributes to systolic hypertension in older adults?
A. Increased myocardial contractility
B. Decreased arterial compliance and arterial stiffening
C. Dilation of the ascending aorta
D. Enhanced baroreceptor sensitivity
As people age, collagen deposition and elastin degradation lead to arterial stiffening and
decreased compliance, widening pulse pressure and elevating systolic blood pressure.
2. A 78-year-old client with chronic heart failure is prescribed a new loop diuretic. Which
electrolyte imbalance should the nurse monitor for most closely during routine lab draws?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Loop diuretics inhibit sodium and chloride reabsorption in the ascending loop of Henle,
leading to significant renal excretion of potassium and subsequent hypokalemia.
3. When assessing an 82-year-old resident in a long-term care facility, which finding is
considered a normal, age-related change in the integumentary system rather than a
pathological lesion?
A. Purpura caused by minor trauma
B. Solar lentigines on sun-exposed skin
C. Development of new asymmetric pigmented macules
D. Diffuse scaling with intense pruritus
Solar lentigines, commonly known as liver spots or age spots, are benign hyperpigmented
macules resulting from cumulative sun exposure over time.
4. A nurse is evaluating an older adult for early signs of delirium versus dementia. Which
characteristic strongly points toward a diagnosis of delirium?
A. Insidious and slow onset over several years
B. Intact immediate memory with stable attention span
,C. Acute onset with fluctuating levels of consciousness
D. Permanent and irreversible cognitive decline
Delirium is characterized by an acute, abrupt onset and a fluctuating course with prominent
disturbances in attention and level of consciousness, unlike chronic dementia.
5. Which screening tool is widely recommended and validated for assessing geriatric
depression in primary care and acute care settings?
A. Mini-Mental State Examination (MMSE)
B. Geriatric Depression Scale (GDS)
C. Braden Scale for Predicting Pressure Sore Risk
D. Morse Fall Scale
The Geriatric Depression Scale is specifically designed and validated to screen for depressive
symptoms in older populations, minimizing somatic symptom overlap.
6. Which age-related pharmacokinetic change places the older adult at increased risk for
drug toxicity when administered fat-soluble medications such as diazepam?
A. Increased total body water
B. Decreased percentage of body fat
C. Increased ratio of adipose tissue to lean body mass
D. Enhanced hepatic phase I metabolism
Older adults experience an increase in body fat percentage and a decrease in total body water,
which expands the distribution volume for lipophilic drugs and prolongs their half-life.
7. An 85-year-old client with osteoarthritis reports chronic knee pain that worsens with
activity and improves with rest. Which pharmacological agent is typically recommended as
first-line therapy by clinical guidelines?
A. Oral ibuprofen
B. Topical diclofenac sodium
C. Systemic long-acting opioids
D. Intra-articular corticosteroids
Topical nonsteroidal anti-inflammatory drugs provide targeted pain relief for localized
osteoarthritis while minimizing systemic adverse effects common in older adults.
8. Which age-related alteration in pulmonary physiology is responsible for a progressive
decline in forced expiratory volume in one second (FEV1)?
A. Increased chest wall compliance
B. Loss of elastic recoil in lung parenchyma
C. Hypertrophy of diaphragmatic muscle fibers
, D. Increased alveolar surface area
The loss of elastic recoil in aging lung tissue leads to premature airway closure during
expiration and a reduction in maximal expiratory flow rates like FEV1.
9. A nurse is designing a fall prevention plan for a community-dwelling older adult with
peripheral neuropathy. Which intervention addresses the primary risk factor associated
with this condition?
A. Recommending high-heeled supportive footwear
B. Assessing home lighting and removing floor clutter
C. Encouraging strict bed rest during daylight hours
D. Restricting fluid intake to decrease nocturnal bathroom trips
Peripheral neuropathy impairs proprioception and tactile sensation in the lower extremities,
making environmental hazard removal essential for preventing trips and falls.
10. Which clinical manifestation is most characteristic of early-stage Parkinson disease in
an older adult?
A. Unilateral resting pill-rolling tremor
B. Symmetric proximal muscle weakness
C. Sudden catastrophic memory loss
D. Profuse generalized diaphoresis
Parkinson disease classically presents with asymmetric, insidious motor symptoms, most
commonly a resting tremor in one upper extremity, rather than symmetric weakness.
11. Which age-related renal change explains why serum creatinine alone can be a
misleading indicator of kidney function in older adults?
A. Increased glomerular filtration rate
B. Decreased muscle mass leading to lower baseline creatinine production
C. Hypertrophy of renal nephrons
D. Enhanced tubular secretion of creatinine
Because older adults often have reduced muscle mass, baseline creatinine production is lower;
thus, a normal serum creatinine can mask a significantly reduced glomerular filtration rate.
12. A home health nurse is reviewing the medication list of an 80-year-old client and notes
the use of diphenhydramine for insomnia. Using Beers Criteria, why should the nurse
question this prescription?
A. It causes severe hypoglycemia
B. It has strong anticholinergic properties that increase confusion and fall risks
C. It interacts dangerously with low-dose aspirin
