NUR 257 CONCEPTS OF AGING & CHRONIC ILLNESS EXAM 4 -
GALEN COLLEGE OF NURSING - 2026/2027 ACADEMIC YEAR -
50 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 257 CONCEPTS OF AGING & CHRONIC ILLNESS EXAM 4 - GALEN COLLEGE OF NURSING -
2026/2027 ACADEMIC YEAR - 50 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED RATIONALES. It
contains 190 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NUR 257 Concepts OF Aging & Chronic Illness 4 Galen College OF Nursing
2026/2027 Academic YEAR 50 AND WITH Detailed Rationales Nursing Concepts OF Aging AND Chronic
Illness Undergraduate YEAR 3 Bachelor OF Science IN Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
NUR 257 Concepts OF Aging 1-32 Older, Adult, Disease, Chronic, Kidney
& Chronic Illness 4 Galen
College OF Nursing
2026/2027 Academic YEAR
50 AND WITH Detailed
Rationales Nursing Concepts
OF Aging AND Chronic
Illness Undergraduate YEAR
3 Bachelor OF Science IN
Nursing
Adult 33-64 Older, Chronic, Disease, Prescribed, Kidney
Chronic 65-96 Older, Disease, Adult, Failure, Appropriate
Disease 97-128 Older, Adult, Chronic, Finding, Appropriate
Kidney 129-160 Older, Adult, Intervention, Chronic, Appropriate
Appropriate 161-190 Older, Adult, Disease, Prescribed, Chronic
TOTAL 190 All questions include answers and detailed rationales
,Section A - NUR 257 Concepts OF Aging & Chronic Illness
4 Galen College OF Nursing 2026/2027 Academic YEAR 50
AND WITH Detailed Rationales Nursing Concepts OF Aging
AND Chronic Illness Undergraduate YEAR 3 Bachelor OF
Science IN Nursing
Q1.
A patient with heart failure and chronic kidney disease is prescribed a new ACE inhibitor.
Which of the following best represents the most critical nursing consideration related to
the aging renal system?
A. Monitor for hyperkalemia due to reduced B. Expect increased diuretic effect due to
renin secretion reduced tubular secretion
C. Anticipate decreased creatinine D. Assess for metabolic alkalosis due to
clearance leading to drug accumulation impaired acid-base regulation
Correct: C - Anticipate decreased creatinine clearance leading to drug accumulation
Rationale:Aging kidneys undergo nephron loss and decreased renal blood flow, reducing
creatinine clearance (GFR). ACE inhibitors are renally excreted, so accumulation occurs,
increasing toxicity risk. Hyperkalemia is a risk but not the primary renal-aging consideration.
Reduced tubular secretion affects some drugs but not the main excretion route for ACE
inhibitors. Acid-base changes are less specific.
Q2.
Which of the following assessment findings in an older adult is most indicative of delirium
rather than dementia?
A. Gradual onset of memory loss with no B. Acute onset of inattention and altered
fluctuation level of consciousness
C. Long-standing personality changes with D. Progressive difficulty with language and
social withdrawal executive function
Correct: B - Acute onset of inattention and altered level of consciousness
Rationale:Delirium is characterized by acute onset, fluctuating course, inattention, and
altered consciousness-often due to an underlying medical cause. Dementia typically has
gradual onset with progressive cognitive decline without acute consciousness changes. The
other options describe chronic, progressive dementia symptoms.
Page 3
, Section A - NUR 257 Concepts OF Aging & Chronic Illness 4 Galen College OF Nursing 2026/2027 Academic YEAR 50 AND WITH Detailed
Rationales Nursing Concepts OF Aging AND Chronic Illness Undergraduate YEAR 3 Bachelor OF Science IN Nursing
Q3.
A patient with stage 4 pressure injury on the sacrum is being considered for palliative
surgery. Which ethical principle is most directly challenged when the patient's family
insists on aggressive surgical intervention despite the patient's documented advance
directive declining such procedures?
A. Beneficence B. Nonmaleficence
C. Autonomy D. Justice
Correct: C - Autonomy
Rationale:Autonomy respects the patient's right to self-determination. The advance directive
expresses the patient's wishes; overriding it violates autonomy. Beneficence (doing good) and
nonmaleficence (avoiding harm) are relevant but secondary. Justice concerns fairness in
resource allocation, not this scenario.
Q4.
In a patient with type 2 diabetes and chronic kidney disease (GFR 30 mL/min), which of the
following medication adjustments is most appropriate?
A. Continue metformin at full dose B. Discontinue metformin
C. Increase insulin glargine dose D. Switch to glyburide
Correct: B - Discontinue metformin
Rationale:Metformin is contraindicated when GFR <30 mL/min due to increased risk of lactic
acidosis. Insulin may require dose reduction, not increase. Glyburide is also renally cleared
and can accumulate, causing hypoglycemia. Thus, discontinuing metformin is correct.
Q5.
A patient with Parkinson's disease experiences 'on-off' phenomena. Which of the
following nursing interventions is most effective in managing this complication?
A. Administer levodopa with high-protein B. Encourage consistent timing of
meals medications with meals
C. Instruct patient to take levodopa on an D. Advise patient to increase protein intake
empty stomach to enhance absorption
Correct: C - Instruct patient to take levodopa on an empty stomach
Rationale:Levodopa competes with dietary protein for absorption and transport across the
blood-brain barrier. Taking it on an empty stomach improves absorption and reduces motor
fluctuations. High-protein meals can worsen 'off' periods. Consistent timing with meals is not
sufficient; protein content matters. Increasing protein worsens symptoms.
Page 4
GALEN COLLEGE OF NURSING - 2026/2027 ACADEMIC YEAR -
50 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED
RATIONALES
190 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 257 CONCEPTS OF AGING & CHRONIC ILLNESS EXAM 4 - GALEN COLLEGE OF NURSING -
2026/2027 ACADEMIC YEAR - 50 VERIFIED QUESTIONS AND ANSWERS WITH DETAILED RATIONALES. It
contains 190 carefully selected questions that reflect the most current exam content and testing strategies. Each
question is accompanied by a correct answer and a detailed rationale that explains the underlying
pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 190 Questions
Foundations - Application - NUR 257 Concepts OF Aging & Chronic Illness 4 Galen College OF Nursing
2026/2027 Academic YEAR 50 AND WITH Detailed Rationales Nursing Concepts OF Aging AND Chronic
Illness Undergraduate YEAR 3 Bachelor OF Science IN Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
NUR 257 Concepts OF Aging 1-32 Older, Adult, Disease, Chronic, Kidney
& Chronic Illness 4 Galen
College OF Nursing
2026/2027 Academic YEAR
50 AND WITH Detailed
Rationales Nursing Concepts
OF Aging AND Chronic
Illness Undergraduate YEAR
3 Bachelor OF Science IN
Nursing
Adult 33-64 Older, Chronic, Disease, Prescribed, Kidney
Chronic 65-96 Older, Disease, Adult, Failure, Appropriate
Disease 97-128 Older, Adult, Chronic, Finding, Appropriate
Kidney 129-160 Older, Adult, Intervention, Chronic, Appropriate
Appropriate 161-190 Older, Adult, Disease, Prescribed, Chronic
TOTAL 190 All questions include answers and detailed rationales
,Section A - NUR 257 Concepts OF Aging & Chronic Illness
4 Galen College OF Nursing 2026/2027 Academic YEAR 50
AND WITH Detailed Rationales Nursing Concepts OF Aging
AND Chronic Illness Undergraduate YEAR 3 Bachelor OF
Science IN Nursing
Q1.
A patient with heart failure and chronic kidney disease is prescribed a new ACE inhibitor.
Which of the following best represents the most critical nursing consideration related to
the aging renal system?
A. Monitor for hyperkalemia due to reduced B. Expect increased diuretic effect due to
renin secretion reduced tubular secretion
C. Anticipate decreased creatinine D. Assess for metabolic alkalosis due to
clearance leading to drug accumulation impaired acid-base regulation
Correct: C - Anticipate decreased creatinine clearance leading to drug accumulation
Rationale:Aging kidneys undergo nephron loss and decreased renal blood flow, reducing
creatinine clearance (GFR). ACE inhibitors are renally excreted, so accumulation occurs,
increasing toxicity risk. Hyperkalemia is a risk but not the primary renal-aging consideration.
Reduced tubular secretion affects some drugs but not the main excretion route for ACE
inhibitors. Acid-base changes are less specific.
Q2.
Which of the following assessment findings in an older adult is most indicative of delirium
rather than dementia?
A. Gradual onset of memory loss with no B. Acute onset of inattention and altered
fluctuation level of consciousness
C. Long-standing personality changes with D. Progressive difficulty with language and
social withdrawal executive function
Correct: B - Acute onset of inattention and altered level of consciousness
Rationale:Delirium is characterized by acute onset, fluctuating course, inattention, and
altered consciousness-often due to an underlying medical cause. Dementia typically has
gradual onset with progressive cognitive decline without acute consciousness changes. The
other options describe chronic, progressive dementia symptoms.
Page 3
, Section A - NUR 257 Concepts OF Aging & Chronic Illness 4 Galen College OF Nursing 2026/2027 Academic YEAR 50 AND WITH Detailed
Rationales Nursing Concepts OF Aging AND Chronic Illness Undergraduate YEAR 3 Bachelor OF Science IN Nursing
Q3.
A patient with stage 4 pressure injury on the sacrum is being considered for palliative
surgery. Which ethical principle is most directly challenged when the patient's family
insists on aggressive surgical intervention despite the patient's documented advance
directive declining such procedures?
A. Beneficence B. Nonmaleficence
C. Autonomy D. Justice
Correct: C - Autonomy
Rationale:Autonomy respects the patient's right to self-determination. The advance directive
expresses the patient's wishes; overriding it violates autonomy. Beneficence (doing good) and
nonmaleficence (avoiding harm) are relevant but secondary. Justice concerns fairness in
resource allocation, not this scenario.
Q4.
In a patient with type 2 diabetes and chronic kidney disease (GFR 30 mL/min), which of the
following medication adjustments is most appropriate?
A. Continue metformin at full dose B. Discontinue metformin
C. Increase insulin glargine dose D. Switch to glyburide
Correct: B - Discontinue metformin
Rationale:Metformin is contraindicated when GFR <30 mL/min due to increased risk of lactic
acidosis. Insulin may require dose reduction, not increase. Glyburide is also renally cleared
and can accumulate, causing hypoglycemia. Thus, discontinuing metformin is correct.
Q5.
A patient with Parkinson's disease experiences 'on-off' phenomena. Which of the
following nursing interventions is most effective in managing this complication?
A. Administer levodopa with high-protein B. Encourage consistent timing of
meals medications with meals
C. Instruct patient to take levodopa on an D. Advise patient to increase protein intake
empty stomach to enhance absorption
Correct: C - Instruct patient to take levodopa on an empty stomach
Rationale:Levodopa competes with dietary protein for absorption and transport across the
blood-brain barrier. Taking it on an empty stomach improves absorption and reduces motor
fluctuations. High-protein meals can worsen 'off' periods. Consistent timing with meals is not
sufficient; protein content matters. Increasing protein worsens symptoms.
Page 4
