CONCEPTS OF AGING & CHRONIC ILLNESS
NUR 257 Chronic Exam 4 A+
— 2026/2027
Official-Style Objective Assessment | STUVIAACTUALEXAM
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
■ Section 1: Promoting Healthy Skin
■ Section 2: Rest, Sleep & Activity
■ Section 3: Pain & Comfort
■ Section 4: Bone, Joint Problems & Fall Prevention
■ Section 5: Vision, Hearing & Sensory Changes
STUVIAACTUALEXAM
Passing Score: 80% | 1 Mark per Question | Application / Analysis Level
, Section 1: Promoting Healthy Skin
Q1.
An 82-year-old resident has dry, flaky, itchy skin on the lower legs. The nurse recognizes this presentation as xerosis
and plans interventions. The priority teaching point the nurse should emphasize is:
A. Bathe less frequently with mild soap, pat dry, and apply emollient while skin is still damp
B. Use hot water and vigorous scrubbing to remove all dry flakes
C. Avoid all moisturizers because they trap bacteria
D. Apply alcohol-based lotion several times daily to dry the skin further
Correct Answer: C
Rationale: Xerosis is managed by reducing bathing frequency, using lukewarm water and mild cleansers, and applying emollients to
damp skin to lock in moisture. Hot water, alcohol, and harsh scrubbing worsen dryness.
Q2.
A nurse is performing a skin assessment on an older adult and notes thin, transparent skin with multiple purple patches
on the forearms. The nurse correctly documents these findings as:
A. Stage 3 pressure injuries requiring immediate debridement
B. Senile purpura related to age-associated dermal changes and fragile capillaries
C. Acute cellulitis requiring systemic antibiotics
D. Melanoma requiring urgent biopsy
Correct Answer: B
Rationale: Senile (actinic) purpura results from loss of subcutaneous tissue and capillary fragility common in aging skin. It is not a
pressure injury, infection, or malignancy, though any new or changing lesions should still be evaluated.
Q3.
While repositioning a bedbound older adult, the nurse observes a non-blanchable area of erythema over the sacrum. The
most appropriate immediate nursing action is to:
A. Keep the patient off the affected area, document the finding, and implement a pressure-relief plan
B. Apply a heating pad directly to the site for 20 minutes
C. Ignore the finding because redness always resolves spontaneously
D. Massage the reddened area vigorously to restore circulation
Correct Answer: C
Rationale: Non-blanchable erythema is a Stage 1 pressure injury. Off-loading, documentation, and a pressure-redistribution plan are
required. Massage of reddened areas is contraindicated and can cause further tissue damage.
Q4.
An older adult with limited mobility is at high risk for pressure injuries. The nurse includes which evidence-based
intervention in the care plan?
A. Reposition the patient only once per shift to avoid sleep interruption
B. Use a validated risk-assessment tool, schedule frequent repositioning, and ensure adequate nutrition and skin moisture
management
C. Place the patient on a standard mattress without any overlays
D. Restrict protein intake to reduce metabolic demand
Correct Answer: B
Rationale: Pressure-injury prevention requires risk assessment (e.g., Braden), regular repositioning, support surfaces, skin care, and
nutritional support. Infrequent turning and inadequate surfaces increase risk.
NUR 257 Chronic Exam 4 | Page 2 | STUVIAACTUALEXAM
NUR 257 Chronic Exam 4 A+
— 2026/2027
Official-Style Objective Assessment | STUVIAACTUALEXAM
A+ QUESTIONS 5 SECTIONS 100% RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
■ Section 1: Promoting Healthy Skin
■ Section 2: Rest, Sleep & Activity
■ Section 3: Pain & Comfort
■ Section 4: Bone, Joint Problems & Fall Prevention
■ Section 5: Vision, Hearing & Sensory Changes
STUVIAACTUALEXAM
Passing Score: 80% | 1 Mark per Question | Application / Analysis Level
, Section 1: Promoting Healthy Skin
Q1.
An 82-year-old resident has dry, flaky, itchy skin on the lower legs. The nurse recognizes this presentation as xerosis
and plans interventions. The priority teaching point the nurse should emphasize is:
A. Bathe less frequently with mild soap, pat dry, and apply emollient while skin is still damp
B. Use hot water and vigorous scrubbing to remove all dry flakes
C. Avoid all moisturizers because they trap bacteria
D. Apply alcohol-based lotion several times daily to dry the skin further
Correct Answer: C
Rationale: Xerosis is managed by reducing bathing frequency, using lukewarm water and mild cleansers, and applying emollients to
damp skin to lock in moisture. Hot water, alcohol, and harsh scrubbing worsen dryness.
Q2.
A nurse is performing a skin assessment on an older adult and notes thin, transparent skin with multiple purple patches
on the forearms. The nurse correctly documents these findings as:
A. Stage 3 pressure injuries requiring immediate debridement
B. Senile purpura related to age-associated dermal changes and fragile capillaries
C. Acute cellulitis requiring systemic antibiotics
D. Melanoma requiring urgent biopsy
Correct Answer: B
Rationale: Senile (actinic) purpura results from loss of subcutaneous tissue and capillary fragility common in aging skin. It is not a
pressure injury, infection, or malignancy, though any new or changing lesions should still be evaluated.
Q3.
While repositioning a bedbound older adult, the nurse observes a non-blanchable area of erythema over the sacrum. The
most appropriate immediate nursing action is to:
A. Keep the patient off the affected area, document the finding, and implement a pressure-relief plan
B. Apply a heating pad directly to the site for 20 minutes
C. Ignore the finding because redness always resolves spontaneously
D. Massage the reddened area vigorously to restore circulation
Correct Answer: C
Rationale: Non-blanchable erythema is a Stage 1 pressure injury. Off-loading, documentation, and a pressure-redistribution plan are
required. Massage of reddened areas is contraindicated and can cause further tissue damage.
Q4.
An older adult with limited mobility is at high risk for pressure injuries. The nurse includes which evidence-based
intervention in the care plan?
A. Reposition the patient only once per shift to avoid sleep interruption
B. Use a validated risk-assessment tool, schedule frequent repositioning, and ensure adequate nutrition and skin moisture
management
C. Place the patient on a standard mattress without any overlays
D. Restrict protein intake to reduce metabolic demand
Correct Answer: B
Rationale: Pressure-injury prevention requires risk assessment (e.g., Braden), regular repositioning, support surfaces, skin care, and
nutritional support. Infrequent turning and inadequate surfaces increase risk.
NUR 257 Chronic Exam 4 | Page 2 | STUVIAACTUALEXAM
