NUR 257 CHRONIC HEALTH CONCEPTS FINAL EXAM - CONCEPTS OF
AGING AND CHRONIC ILLNESS IN NURSING - GALEN COLLEGE OF
NURSING - 2026/2027 ACADEMIC YEAR - QUESTIONS AND ANSWERS
142 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Analyze the pathophysiological basis of chronic diseases and their impact on the aging individual
2 Evaluate evidence-based interventions for chronic illness management across diverse care settings
3 Integrate ethical, legal, and interprofessional principles in the care of older adults with chronic conditions
4 Formulate comprehensive, patient-centered plans that promote health, independence, and quality of life
5 NUR 257 Chronic Health Concepts Final Exam
6 Concepts of Aging and Chronic Illness in Nursing
7 Galen College of Nursing
8 2026
9 2027 Academic Year
10 Questions and Answers Covering Four Core Domains
11 Foundations of Chronic Health Concepts and Aging in Nursing
12 Applied Chronic Health Concepts and Aging in Nursing
13 Advanced Chronic Health Concepts and Aging in Nursing
14 Chronic Health Concepts and Aging in Nursing Review
ABSTRACT
Page 1
,This study document brings together 142 carefully worded exam questions drawn from NUR 257
Chronic Health Concepts Final Exam - Concepts of Aging and Chronic Illness in Nursing - Galen
College of Nursing - 2026/2027 Academic Year - Questions and Answers Covering Four Core
Domains, with the strongest emphasis placed on Analyze the pathophysiological basis of chronic
diseases and their impact on the aging individual, Evaluate evidence-based interventions for
chronic illness management across diverse care settings, Integrate ethical, legal and and
interprofessional principles in the care of older adults with chronic conditions. Every item follows
the wording style and level of reasoning you meet in the real paper, and each one is paired with a
clear rationale so the correct choice is never a guess. Work through the set at your own pace,
mark the questions that slow you down, then come back to them until the reasoning feels
automatic. Learners who revise this way walk into the exam room recognising the pattern behind
the questions instead of meeting them for the first time. Keep going - steady, honest practice is
what turns a difficult paper into a comfortable pass.
Q1 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with heart failure and chronic kidney disease has a serum digoxin level
of 1.8 ng/mL, potassium 3.2 mEq/L, and creatinine 2.4 mg/dL. Which
electrocardiographic change best reflects the combined effect of hypokalemia and
digoxin on cardiac conduction?
A. Shortened PR interval with peaked T waves
B. Prolonged QT interval with U waves
C. Scooped ST segment with bidirectional ventricular tachycardia CORRECT
D. Widened QRS complex with tall R waves in lead V1
RATIONALE: Hypokalemia enhances digoxin binding to Na+/K+-ATPase, increasing toxicity,
which classically causes ST segment scooping and arrhythmias like bidirectional ventricular
tachycardia. Shortened PR (A) is not typical; peaked T waves (A) suggest hyperkalemia.
Prolonged QT with U waves (B) reflects hypokalemia alone but not digoxin toxicity. Widened
QRS with tall R waves (D) suggests hyperkalemia or bundle branch block, not digoxin toxicity.
Page 2
,Q2 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with type 2 diabetes and stage 3 chronic kidney disease is prescribed
metformin. Which pharmacologic principle best explains the need for dose
adjustment and monitoring?
A. Metformin is nephrotoxic and directly damages renal tubules
B. Metformin is renally excreted, and accumulation increases lactate acidosis risk CORRECT
C. Metformin competes with creatinine for tubular secretion, altering GFR estimation
D. Metformin is hepatically metabolized, and renal impairment reduces its effectiveness
RATIONALE: Metformin is primarily excreted unchanged by the kidneys; impaired renal function
leads to accumulation and increased risk of lactic acidosis. It is not directly nephrotoxic (A), does
not interfere with creatinine secretion (C), and its efficacy is not reduced by renal impairment (D).
Q3 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
Which nursing intervention demonstrates the most appropriate application of the
Health Belief Model in a patient with hypertension who is nonadherent to
medication?
A. Provide written instructions on the mechanism of action of antihypertensive drugs
B. Assess the patient's perceived susceptibility to stroke and perceived benefits of treatment
CORRECT
C. Enroll the patient in a home blood pressure monitoring program
D. Refer the patient to a pharmacist for medication reconciliation
RATIONALE: The Health Belief Model focuses on individual perceptions, including perceived
susceptibility, severity, benefits, and barriers. Assessing these perceptions directly addresses
adherence determinants. Providing instructions (A), monitoring (C), and referral (D) are
interventions but not specifically based on the model's core components.
Page 3
, Q4 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with chronic obstructive pulmonary disease (COPD) and hypercapnia is
receiving oxygen at 2 L/min via nasal cannula. Which finding indicates that the
oxygen dosage is excessive for this patient?
A. Decreased respiratory rate and increased drowsiness CORRECT
B. Increased respiratory rate and use of accessory muscles
C. Decreased oxygen saturation from 92% to 88%
D. Increased cough and sputum production
RATIONALE: In COPD patients with chronic hypercapnia, excessive oxygen can suppress the
hypoxic drive, leading to hypoventilation, decreased respiratory rate, and increased drowsiness
(CO2 narcosis). Increased respiratory rate (B) indicates distress, not oxygen toxicity. Decreased
saturation (C) suggests inadequate oxygenation. Increased cough (D) may indicate infection, not
oxygen excess.
Q5 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with advanced cancer and severe chronic pain is on a fentanyl patch.
The patient reports breakthrough pain. Which prescription is most appropriate for
the nurse to anticipate?
A. Immediate-release oral morphine sulfate 10 mg every 4 hours as needed CORRECT
B. Extended-release oxycodone 20 mg every 12 hours
C. Meperidine 50 mg intramuscular every 3 hours
D. Fentanyl transdermal patch dose increase without change in frequency
RATIONALE: Breakthrough pain in a patient on a long-acting opioid (fentanyl patch) is managed
with short-acting opioids like immediate-release morphine. Extended-release oxycodone (B) is
not for breakthrough pain. Meperidine (C) is avoided in chronic pain due to neurotoxic metabolite.
Increasing the patch dose (D) does not address breakthrough pain and increases risk of
overdose.
Page 4
AGING AND CHRONIC ILLNESS IN NURSING - GALEN COLLEGE OF
NURSING - 2026/2027 ACADEMIC YEAR - QUESTIONS AND ANSWERS
142 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Analyze the pathophysiological basis of chronic diseases and their impact on the aging individual
2 Evaluate evidence-based interventions for chronic illness management across diverse care settings
3 Integrate ethical, legal, and interprofessional principles in the care of older adults with chronic conditions
4 Formulate comprehensive, patient-centered plans that promote health, independence, and quality of life
5 NUR 257 Chronic Health Concepts Final Exam
6 Concepts of Aging and Chronic Illness in Nursing
7 Galen College of Nursing
8 2026
9 2027 Academic Year
10 Questions and Answers Covering Four Core Domains
11 Foundations of Chronic Health Concepts and Aging in Nursing
12 Applied Chronic Health Concepts and Aging in Nursing
13 Advanced Chronic Health Concepts and Aging in Nursing
14 Chronic Health Concepts and Aging in Nursing Review
ABSTRACT
Page 1
,This study document brings together 142 carefully worded exam questions drawn from NUR 257
Chronic Health Concepts Final Exam - Concepts of Aging and Chronic Illness in Nursing - Galen
College of Nursing - 2026/2027 Academic Year - Questions and Answers Covering Four Core
Domains, with the strongest emphasis placed on Analyze the pathophysiological basis of chronic
diseases and their impact on the aging individual, Evaluate evidence-based interventions for
chronic illness management across diverse care settings, Integrate ethical, legal and and
interprofessional principles in the care of older adults with chronic conditions. Every item follows
the wording style and level of reasoning you meet in the real paper, and each one is paired with a
clear rationale so the correct choice is never a guess. Work through the set at your own pace,
mark the questions that slow you down, then come back to them until the reasoning feels
automatic. Learners who revise this way walk into the exam room recognising the pattern behind
the questions instead of meeting them for the first time. Keep going - steady, honest practice is
what turns a difficult paper into a comfortable pass.
Q1 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with heart failure and chronic kidney disease has a serum digoxin level
of 1.8 ng/mL, potassium 3.2 mEq/L, and creatinine 2.4 mg/dL. Which
electrocardiographic change best reflects the combined effect of hypokalemia and
digoxin on cardiac conduction?
A. Shortened PR interval with peaked T waves
B. Prolonged QT interval with U waves
C. Scooped ST segment with bidirectional ventricular tachycardia CORRECT
D. Widened QRS complex with tall R waves in lead V1
RATIONALE: Hypokalemia enhances digoxin binding to Na+/K+-ATPase, increasing toxicity,
which classically causes ST segment scooping and arrhythmias like bidirectional ventricular
tachycardia. Shortened PR (A) is not typical; peaked T waves (A) suggest hyperkalemia.
Prolonged QT with U waves (B) reflects hypokalemia alone but not digoxin toxicity. Widened
QRS with tall R waves (D) suggests hyperkalemia or bundle branch block, not digoxin toxicity.
Page 2
,Q2 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with type 2 diabetes and stage 3 chronic kidney disease is prescribed
metformin. Which pharmacologic principle best explains the need for dose
adjustment and monitoring?
A. Metformin is nephrotoxic and directly damages renal tubules
B. Metformin is renally excreted, and accumulation increases lactate acidosis risk CORRECT
C. Metformin competes with creatinine for tubular secretion, altering GFR estimation
D. Metformin is hepatically metabolized, and renal impairment reduces its effectiveness
RATIONALE: Metformin is primarily excreted unchanged by the kidneys; impaired renal function
leads to accumulation and increased risk of lactic acidosis. It is not directly nephrotoxic (A), does
not interfere with creatinine secretion (C), and its efficacy is not reduced by renal impairment (D).
Q3 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
Which nursing intervention demonstrates the most appropriate application of the
Health Belief Model in a patient with hypertension who is nonadherent to
medication?
A. Provide written instructions on the mechanism of action of antihypertensive drugs
B. Assess the patient's perceived susceptibility to stroke and perceived benefits of treatment
CORRECT
C. Enroll the patient in a home blood pressure monitoring program
D. Refer the patient to a pharmacist for medication reconciliation
RATIONALE: The Health Belief Model focuses on individual perceptions, including perceived
susceptibility, severity, benefits, and barriers. Assessing these perceptions directly addresses
adherence determinants. Providing instructions (A), monitoring (C), and referral (D) are
interventions but not specifically based on the model's core components.
Page 3
, Q4 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with chronic obstructive pulmonary disease (COPD) and hypercapnia is
receiving oxygen at 2 L/min via nasal cannula. Which finding indicates that the
oxygen dosage is excessive for this patient?
A. Decreased respiratory rate and increased drowsiness CORRECT
B. Increased respiratory rate and use of accessory muscles
C. Decreased oxygen saturation from 92% to 88%
D. Increased cough and sputum production
RATIONALE: In COPD patients with chronic hypercapnia, excessive oxygen can suppress the
hypoxic drive, leading to hypoventilation, decreased respiratory rate, and increased drowsiness
(CO2 narcosis). Increased respiratory rate (B) indicates distress, not oxygen toxicity. Decreased
saturation (C) suggests inadequate oxygenation. Increased cough (D) may indicate infection, not
oxygen excess.
Q5 ANALYZE THE PATHOPHYSIOLOGICAL BASIS OF CHRONIC DISEASES AND THEIR
IMPACT ON THE AGING INDIVIDUAL
A patient with advanced cancer and severe chronic pain is on a fentanyl patch.
The patient reports breakthrough pain. Which prescription is most appropriate for
the nurse to anticipate?
A. Immediate-release oral morphine sulfate 10 mg every 4 hours as needed CORRECT
B. Extended-release oxycodone 20 mg every 12 hours
C. Meperidine 50 mg intramuscular every 3 hours
D. Fentanyl transdermal patch dose increase without change in frequency
RATIONALE: Breakthrough pain in a patient on a long-acting opioid (fentanyl patch) is managed
with short-acting opioids like immediate-release morphine. Extended-release oxycodone (B) is
not for breakthrough pain. Meperidine (C) is avoided in chronic pain due to neurotoxic metabolite.
Increasing the patch dose (D) does not address breakthrough pain and increases risk of
overdose.
Page 4
