NUR 257 Concepts of Aging and Chronic
Illness in Nursing Exam 4 | Galen College
of Nursing | Gerontology & Palliative
Care Test Bank | 2026/2027 | Q&A with
Answers & Rationales | Physiological
Changes, Chronic Illness, Psychosocial,
End-of-Life
1. Which of the following is a common physiological change of the
cardiovascular system in the older adult?
A. Increased cardiac output
B. Decreased arterial stiffness
C. Decreased maximal heart rate
D. Increased baroreceptor sensitivity
Rationale: With aging, the heart's maximal rate and contractility decrease.
The other options are incorrect: cardiac output typically decreases, arterial
stiffness increases, and baroreceptor sensitivity decreases (leading to orthostatic
hypotension).
2. A nurse is assessing an older adult for signs of dehydration. Which of the
following is the most reliable indicator?
A. Dry mouth
B. Thirst
C. Changes in mental status
D. Decreased skin turgor
Rationale: Thirst sensation is often diminished in older adults. Skin turgor is
less reliable due to decreased skin elasticity. Changes in mental status (confusion,
lethargy) are often the first and most reliable sign of dehydration in this
population.
,3. The primary purpose of palliative care is to:
A. Cure the underlying disease.
B. Relieve suffering and improve quality of life.
C. Prolong the dying process.
D. Provide care only in the last 48 hours of life.
Rationale: Palliative care focuses on relief of suffering and improving quality
of life for patients with serious illness, regardless of prognosis. It can be provided
alongside curative treatment.
4. Which of the following is a key principle of hospice care?
A. The patient and family are the unit of care.
B. The focus is on curative treatment.
C. Care is provided only in an inpatient setting.
D. It is limited to patients with cancer.
Rationale: Hospice care is holistic and patient/family-centered. It focuses on
comfort, not cure, and is provided in various settings (home, inpatient). While
initially associated with cancer, it now serves patients with any terminal illness.
5. An older adult patient has a decreased sense of smell. What is the most
important nursing implication of this change?
A. Increased risk of obesity
B. Increased risk of food poisoning
C. Decreased enjoyment of food
D. Increased risk of aspiration
Rationale: A decreased sense of smell makes it difficult to detect spoiled or
tainted food, increasing the risk of foodborne illness. While it can decrease
enjoyment of food, the safety risk is the priority.
6. A nurse is teaching an older adult about medication safety. Which statement
indicates a need for further teaching?
A. "I will use a pill organizer to help me remember my medications."
B. "I will keep a list of all my medications in my wallet."
,C. "I will take my medications with grapefruit juice every morning."
D. "I will ask my pharmacist if I can take my medications together."
Rationale: Grapefruit juice interacts with many common medications (e.g.,
statins, calcium channel blockers), increasing their effects and risk of toxicity. This
indicates a need for further teaching.
7. The term "polypharmacy" refers to:
A. Taking a multivitamin daily.
B. The use of multiple medications, often concurrently.
C. A single medication with multiple side effects.
D. The use of herbal supplements only.
Rationale: Polypharmacy is the concurrent use of multiple medications. It is a
significant risk for older adults due to increased risk of drug interactions and
adverse effects.
8. Which theory of aging suggests that aging is a result of random damage to
cells over time?
A. Programmed theory
B. Stochastic theory
C. Cellular theory
D. Immunological theory
Rationale: Stochastic theories (e.g., free radical theory, wear-and-tear theory)
propose that aging is due to random, cumulative damage. Programmed theories
suggest a biological timetable.
9. A common psychosocial change in older adults is:
A. Increased social engagement.
B. Increased risk of social isolation.
C. Decreased need for relationships.
D. Increased financial security.
Rationale: Older adults often face losses (spouse, friends, mobility) that can
lead to social isolation, which is a significant risk factor for poor health outcomes.
, 10. A nurse is caring for a patient with a terminal illness who states, "I just want
to live to see my grandchild born." The patient is most likely in which stage of
grief according to Kübler-Ross?
A. Denial
B. Bargaining
C. Depression
D. Acceptance
Rationale: Bargaining involves making promises to a higher power in
exchange for more time or a different outcome. The patient's statement is a
classic example.
11. The most common cause of chronic illness in older adults is:
A. Arthritis
B. Cancer
C. Diabetes
D. Heart disease
Rationale: Arthritis (including osteoarthritis and rheumatoid arthritis) is the
most common chronic condition among older adults, often leading to pain and
disability.
12. Which of the following is a sign of impending death?
A. Increased urine output
B. Cheyne-Stokes respirations
C. Increased blood pressure
D. Warm, flushed extremities
Rationale: Cheyne-Stokes respirations (cyclic breathing with periods of apnea)
are a common sign of impending death. Other signs include decreased urine
output, hypotension, and cool, mottled extremities.
13. A nurse is providing oral care to a dying patient. The primary goal is to:
A. Prevent infection.
B. Provide comfort and maintain moisture.
Illness in Nursing Exam 4 | Galen College
of Nursing | Gerontology & Palliative
Care Test Bank | 2026/2027 | Q&A with
Answers & Rationales | Physiological
Changes, Chronic Illness, Psychosocial,
End-of-Life
1. Which of the following is a common physiological change of the
cardiovascular system in the older adult?
A. Increased cardiac output
B. Decreased arterial stiffness
C. Decreased maximal heart rate
D. Increased baroreceptor sensitivity
Rationale: With aging, the heart's maximal rate and contractility decrease.
The other options are incorrect: cardiac output typically decreases, arterial
stiffness increases, and baroreceptor sensitivity decreases (leading to orthostatic
hypotension).
2. A nurse is assessing an older adult for signs of dehydration. Which of the
following is the most reliable indicator?
A. Dry mouth
B. Thirst
C. Changes in mental status
D. Decreased skin turgor
Rationale: Thirst sensation is often diminished in older adults. Skin turgor is
less reliable due to decreased skin elasticity. Changes in mental status (confusion,
lethargy) are often the first and most reliable sign of dehydration in this
population.
,3. The primary purpose of palliative care is to:
A. Cure the underlying disease.
B. Relieve suffering and improve quality of life.
C. Prolong the dying process.
D. Provide care only in the last 48 hours of life.
Rationale: Palliative care focuses on relief of suffering and improving quality
of life for patients with serious illness, regardless of prognosis. It can be provided
alongside curative treatment.
4. Which of the following is a key principle of hospice care?
A. The patient and family are the unit of care.
B. The focus is on curative treatment.
C. Care is provided only in an inpatient setting.
D. It is limited to patients with cancer.
Rationale: Hospice care is holistic and patient/family-centered. It focuses on
comfort, not cure, and is provided in various settings (home, inpatient). While
initially associated with cancer, it now serves patients with any terminal illness.
5. An older adult patient has a decreased sense of smell. What is the most
important nursing implication of this change?
A. Increased risk of obesity
B. Increased risk of food poisoning
C. Decreased enjoyment of food
D. Increased risk of aspiration
Rationale: A decreased sense of smell makes it difficult to detect spoiled or
tainted food, increasing the risk of foodborne illness. While it can decrease
enjoyment of food, the safety risk is the priority.
6. A nurse is teaching an older adult about medication safety. Which statement
indicates a need for further teaching?
A. "I will use a pill organizer to help me remember my medications."
B. "I will keep a list of all my medications in my wallet."
,C. "I will take my medications with grapefruit juice every morning."
D. "I will ask my pharmacist if I can take my medications together."
Rationale: Grapefruit juice interacts with many common medications (e.g.,
statins, calcium channel blockers), increasing their effects and risk of toxicity. This
indicates a need for further teaching.
7. The term "polypharmacy" refers to:
A. Taking a multivitamin daily.
B. The use of multiple medications, often concurrently.
C. A single medication with multiple side effects.
D. The use of herbal supplements only.
Rationale: Polypharmacy is the concurrent use of multiple medications. It is a
significant risk for older adults due to increased risk of drug interactions and
adverse effects.
8. Which theory of aging suggests that aging is a result of random damage to
cells over time?
A. Programmed theory
B. Stochastic theory
C. Cellular theory
D. Immunological theory
Rationale: Stochastic theories (e.g., free radical theory, wear-and-tear theory)
propose that aging is due to random, cumulative damage. Programmed theories
suggest a biological timetable.
9. A common psychosocial change in older adults is:
A. Increased social engagement.
B. Increased risk of social isolation.
C. Decreased need for relationships.
D. Increased financial security.
Rationale: Older adults often face losses (spouse, friends, mobility) that can
lead to social isolation, which is a significant risk factor for poor health outcomes.
, 10. A nurse is caring for a patient with a terminal illness who states, "I just want
to live to see my grandchild born." The patient is most likely in which stage of
grief according to Kübler-Ross?
A. Denial
B. Bargaining
C. Depression
D. Acceptance
Rationale: Bargaining involves making promises to a higher power in
exchange for more time or a different outcome. The patient's statement is a
classic example.
11. The most common cause of chronic illness in older adults is:
A. Arthritis
B. Cancer
C. Diabetes
D. Heart disease
Rationale: Arthritis (including osteoarthritis and rheumatoid arthritis) is the
most common chronic condition among older adults, often leading to pain and
disability.
12. Which of the following is a sign of impending death?
A. Increased urine output
B. Cheyne-Stokes respirations
C. Increased blood pressure
D. Warm, flushed extremities
Rationale: Cheyne-Stokes respirations (cyclic breathing with periods of apnea)
are a common sign of impending death. Other signs include decreased urine
output, hypotension, and cool, mottled extremities.
13. A nurse is providing oral care to a dying patient. The primary goal is to:
A. Prevent infection.
B. Provide comfort and maintain moisture.
