NUR 257 EXAM 4: CONCEPTS OF AGING
& CHRONIC ILLNESS
COMPREHENSIVE REVIEW
1. When assessing an elderly patient for delirium, which characteristic is considered the
hallmark differentiator from dementia?
A. Acute onset with fluctuating levels of consciousness
B. Slow, progressive decline in cognitive function
C. Permanent impairment of long-term memory
D. Occurs only in patients with a history of psychiatric illness
Answer: A
Conceptual Explanation: Delirium is characterized by an acute onset, a fluctuating course,
and disturbances in attention and consciousness, whereas dementia is typically gradual
and progressive.
2. An 82-year-old patient is experiencing orthostatic hypotension. Which age-related
physiological change contributes most to this condition?
A. Increased sensitivity of baroreceptors
,B. Decreased peripheral vascular resistance
C. Decreased baroreceptor sensitivity
D. Increased cardiac output during position changes
Answer: C
Conceptual Explanation: Aging leads to decreased baroreceptor sensitivity, making it
harder for the body to regulate blood pressure quickly during position changes.
3. Which pharmacological consideration is most critical when prescribing medications for a
patient with polypharmacy concerns?
A. The half-life of medications is usually shorter in the elderly
B. Reduced glomerular filtration rate (GFR) leads to slower drug clearance
C. Elderly patients have increased total body water, affecting drug distribution
D. Serum albumin levels increase, providing more binding sites for drugs
Answer: B
Conceptual Explanation: Decreased renal function (lowered GFR) is a primary concern in
aging because it leads to the accumulation of drugs and increased risk of toxicity.
4. A nurse is educating a family about hospice care. Which statement best describes the
primary goal of hospice?
A. To provide aggressive treatment for terminal illnesses
B. To provide comfort and quality of life for those with a prognosis of 6 months or less
, C. To prolong life through artificial nutrition and hydration
D. To offer rehabilitative services for chronic but non-terminal conditions
Answer: B
Conceptual Explanation: Hospice focuses on palliative care (comfort) rather than curative
treatment for patients expected to live 6 months or less.
5. Which assessment tool is specifically designed to screen for depression in the older adult
population?
A. Mini-Mental State Examination (MMSE)
B. Braden Scale
C. Geriatric Depression Scale (GDS)
D. CAM (Confusion Assessment Method)
Answer: C
Conceptual Explanation: The GDS is a validated tool specifically for screening depression
in older adults, using a yes/no format.
6. A patient with advanced COPD is enrolled in palliative care. What is the main difference
between palliative care and hospice?
A. Palliative care is only for the last days of life
B. Hospice allows for curative treatments while palliative does not
C. Palliative care can be initiated at any stage of a serious illness
& CHRONIC ILLNESS
COMPREHENSIVE REVIEW
1. When assessing an elderly patient for delirium, which characteristic is considered the
hallmark differentiator from dementia?
A. Acute onset with fluctuating levels of consciousness
B. Slow, progressive decline in cognitive function
C. Permanent impairment of long-term memory
D. Occurs only in patients with a history of psychiatric illness
Answer: A
Conceptual Explanation: Delirium is characterized by an acute onset, a fluctuating course,
and disturbances in attention and consciousness, whereas dementia is typically gradual
and progressive.
2. An 82-year-old patient is experiencing orthostatic hypotension. Which age-related
physiological change contributes most to this condition?
A. Increased sensitivity of baroreceptors
,B. Decreased peripheral vascular resistance
C. Decreased baroreceptor sensitivity
D. Increased cardiac output during position changes
Answer: C
Conceptual Explanation: Aging leads to decreased baroreceptor sensitivity, making it
harder for the body to regulate blood pressure quickly during position changes.
3. Which pharmacological consideration is most critical when prescribing medications for a
patient with polypharmacy concerns?
A. The half-life of medications is usually shorter in the elderly
B. Reduced glomerular filtration rate (GFR) leads to slower drug clearance
C. Elderly patients have increased total body water, affecting drug distribution
D. Serum albumin levels increase, providing more binding sites for drugs
Answer: B
Conceptual Explanation: Decreased renal function (lowered GFR) is a primary concern in
aging because it leads to the accumulation of drugs and increased risk of toxicity.
4. A nurse is educating a family about hospice care. Which statement best describes the
primary goal of hospice?
A. To provide aggressive treatment for terminal illnesses
B. To provide comfort and quality of life for those with a prognosis of 6 months or less
, C. To prolong life through artificial nutrition and hydration
D. To offer rehabilitative services for chronic but non-terminal conditions
Answer: B
Conceptual Explanation: Hospice focuses on palliative care (comfort) rather than curative
treatment for patients expected to live 6 months or less.
5. Which assessment tool is specifically designed to screen for depression in the older adult
population?
A. Mini-Mental State Examination (MMSE)
B. Braden Scale
C. Geriatric Depression Scale (GDS)
D. CAM (Confusion Assessment Method)
Answer: C
Conceptual Explanation: The GDS is a validated tool specifically for screening depression
in older adults, using a yes/no format.
6. A patient with advanced COPD is enrolled in palliative care. What is the main difference
between palliative care and hospice?
A. Palliative care is only for the last days of life
B. Hospice allows for curative treatments while palliative does not
C. Palliative care can be initiated at any stage of a serious illness
