NUR 257 EXAM 4: CONCEPTS OF AGING
& CHRONIC ILLNESS REVIEW
1. A 78-year-old patient with heart failure and COPD is being discharged. Which intervention
best addresses the transition of care to reduce readmission rates?
A. Scheduling a follow-up appointment within 48 to 72 hours of discharge.
B. Providing a written list of all medications and dosages.
C. Instructing the patient to call the primary physician if symptoms worsen.
D. Ensuring the patient has a scale at home to monitor weight.
Answer: A
Conceptual Explanation: Timely follow-up (within 48-72 hours) is a evidence-based
practice in transitional care models to identify early complications and ensure medication
reconciliation is understood, significantly reducing readmission.
2. When assessing an older adult for delirium, which tool is considered the gold standard for
bedside clinical assessment?
A. Mini-Mental State Examination (MMSE)
B. Confusion Assessment Method (CAM)
C. Geriatric Depression Scale (GDS)
,D. The Clock Drawing Test
Answer: B
Conceptual Explanation: The CAM is specifically designed to identify delirium by
assessing acute onset, inattention, disorganized thinking, and altered level of
consciousness.
3. Which physiological change of aging increases an older adult’s risk for toxicity when taking
lipid-soluble medications?
A. Decreased total body water
B. Increased glomerular filtration rate
C. Increased percentage of body fat
D. Decreased gastric acidity
Answer: C
Conceptual Explanation: Older adults experience an increase in adipose tissue and a
decrease in lean muscle mass. Lipid-soluble drugs (like diazepam) persist longer in the
body because they are stored in the fat.
4. A patient with advanced Parkinson’s disease is experiencing ‘off’ periods where mobility
suddenly stops. What is the most appropriate nursing priority?
A. Increase the dose of levodopa immediately.
B. Restrict protein intake to the evening meal.
, C. Implement strict fall precautions and provide assistive devices.
D. Encourage bed rest during ‘off’ episodes.
Answer: C
Conceptual Explanation: Safety is the priority. ‘Off’ periods significantly increase the risk
of falls and injury. While protein timing (C) may help absorption, safety (B) is the
immediate nursing priority.
5. In the ‘SPICES’ geriatric assessment tool, what does the ‘E’ represent?
A. Edema
B. Elimination issues
C. Exercise intolerance
D. Eating problems
Answer: D
Conceptual Explanation: SPICES stands for Sleep disorders, Problems with
eating/feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown.
6. An 82-year-old patient is prescribed a new NSAID for osteoarthritis. Which lab value is the
most critical for the nurse to monitor?
A. Serum Albumin
B. White Blood Cell count
C. Serum Sodium
& CHRONIC ILLNESS REVIEW
1. A 78-year-old patient with heart failure and COPD is being discharged. Which intervention
best addresses the transition of care to reduce readmission rates?
A. Scheduling a follow-up appointment within 48 to 72 hours of discharge.
B. Providing a written list of all medications and dosages.
C. Instructing the patient to call the primary physician if symptoms worsen.
D. Ensuring the patient has a scale at home to monitor weight.
Answer: A
Conceptual Explanation: Timely follow-up (within 48-72 hours) is a evidence-based
practice in transitional care models to identify early complications and ensure medication
reconciliation is understood, significantly reducing readmission.
2. When assessing an older adult for delirium, which tool is considered the gold standard for
bedside clinical assessment?
A. Mini-Mental State Examination (MMSE)
B. Confusion Assessment Method (CAM)
C. Geriatric Depression Scale (GDS)
,D. The Clock Drawing Test
Answer: B
Conceptual Explanation: The CAM is specifically designed to identify delirium by
assessing acute onset, inattention, disorganized thinking, and altered level of
consciousness.
3. Which physiological change of aging increases an older adult’s risk for toxicity when taking
lipid-soluble medications?
A. Decreased total body water
B. Increased glomerular filtration rate
C. Increased percentage of body fat
D. Decreased gastric acidity
Answer: C
Conceptual Explanation: Older adults experience an increase in adipose tissue and a
decrease in lean muscle mass. Lipid-soluble drugs (like diazepam) persist longer in the
body because they are stored in the fat.
4. A patient with advanced Parkinson’s disease is experiencing ‘off’ periods where mobility
suddenly stops. What is the most appropriate nursing priority?
A. Increase the dose of levodopa immediately.
B. Restrict protein intake to the evening meal.
, C. Implement strict fall precautions and provide assistive devices.
D. Encourage bed rest during ‘off’ episodes.
Answer: C
Conceptual Explanation: Safety is the priority. ‘Off’ periods significantly increase the risk
of falls and injury. While protein timing (C) may help absorption, safety (B) is the
immediate nursing priority.
5. In the ‘SPICES’ geriatric assessment tool, what does the ‘E’ represent?
A. Edema
B. Elimination issues
C. Exercise intolerance
D. Eating problems
Answer: D
Conceptual Explanation: SPICES stands for Sleep disorders, Problems with
eating/feeding, Incontinence, Confusion, Evidence of falls, and Skin breakdown.
6. An 82-year-old patient is prescribed a new NSAID for osteoarthritis. Which lab value is the
most critical for the nurse to monitor?
A. Serum Albumin
B. White Blood Cell count
C. Serum Sodium
