Galen NUR 257 Exam 4 Concepts of Aging & Chronic
Illness | Latest Update 2026/2027 | 200 Practice
Questions & Detailed Answers | Actual Q&A with
Rationales | A+ Graded
SECTION 1: NORMAL PHYSIOLOGICAL AGING (Questions 1–25)
1. An 82yearold woman reports difficulty reading menus and threading needles despite having 20/20
distance vision. Which agerelated change best explains this?
A. Nuclear sclerosis of the lens
B. Loss of lens elasticity (presbyopia)
C. Macular degeneration
D. Increased vitreous floaters
Correct Answer: B
Rationale: Presbyopia is caused by loss of lens elasticity and reduced ciliary muscle function, impairing
near accommodation while leaving distance vision intact. Nuclear sclerosis clouds vision at all distances;
macular degeneration affects central acuity; floaters cause spotlike disturbances.
2. A 75yearold male reports needing the television volume louder and trouble understanding speech in
noisy restaurants. Audiometry shows symmetric highfrequency sensorineural loss. Which change is
responsible?
A. Cerumen impaction
B. Otosclerosis of the stapes
C. Degeneration of hair cells at the cochlear base
,D. Recurrent otitis media
Correct Answer: C
Rationale: Presbycusis involves progressive loss of cochlear hair cells, particularly at the base where high
frequencies are processed, producing symmetric highfrequency sensorineural loss. Cerumen impaction
and otitis media cause conductive loss; otosclerosis is not an agerelated change.
3. A nurse notes a 78yearold patient's skin appears paperthin with multiple ecchymoses on the dorsal
hands despite no trauma. Which agerelated skin change accounts for this?
A. Decreased melanocyte production
B. Thinning of the dermis and subcutaneous fat
C. Increased sebaceous gland activity
D. Reduced eccrine sweat gland density
Correct Answer: B
Rationale: Aging causes dermal thinning and loss of subcutaneous fat, making blood vessels more fragile
and prone to tearing with minor trauma.
4. Which theory of aging proposes that aging is caused by the accumulation of damage from free
radicals?
A. Programmed theory
B. Free radical theory
C. Wear and tear theory
D. Telomere shortening theory
,Correct Answer: B
Rationale: The free radical theory proposes that aging results from cumulative damage caused by free
radicals and oxidative stress on DNA, proteins, and lipids.
5. The telomere shortening theory of aging suggests that:
A. Aging is predetermined by genetics
B. Cells have a limited number of divisions due to progressive telomere shortening
C. Aging is caused by environmental toxins
D. Aging results from accumulated mutations
Correct Answer: B
Rationale: The telomere shortening theory posits that chromosomes have protective caps (telomeres)
that shorten with each cell division, eventually leading to cellular senescence.
6. Which of the following is a normal agerelated cardiovascular change?
A. Increased cardiac output
B. Decreased arterial stiffness
C. Decreased maximum heart rate
D. Increased baroreceptor sensitivity
Correct Answer: C
Rationale: Maximum heart rate decreases with age. Other normal changes include increased arterial
stiffness, decreased baroreceptor sensitivity, and decreased cardiac output during stress.
, 7. A 70yearold patient asks why her skin has become thinner and more fragile. The nurse explains that
this is due to:
A. Increased collagen production
B. Decreased subcutaneous fat and dermal thinning
C. Increased sebaceous gland activity
D. Decreased melanocyte production
Correct Answer: B
Rationale: Aging causes thinning of the dermis and loss of subcutaneous fat, leading to fragile skin that is
more prone to injury.
8. Which agerelated change in the gastrointestinal system increases the risk of constipation in older
adults?
A. Increased gastric acid secretion
B. Decreased gastrointestinal motility
C. Increased liver size
D. Enhanced nutrient absorption
Correct Answer: B
Rationale: Decreased gastrointestinal motility, along with reduced fluid intake and decreased physical
activity, contributes to constipation in older adults.
Illness | Latest Update 2026/2027 | 200 Practice
Questions & Detailed Answers | Actual Q&A with
Rationales | A+ Graded
SECTION 1: NORMAL PHYSIOLOGICAL AGING (Questions 1–25)
1. An 82yearold woman reports difficulty reading menus and threading needles despite having 20/20
distance vision. Which agerelated change best explains this?
A. Nuclear sclerosis of the lens
B. Loss of lens elasticity (presbyopia)
C. Macular degeneration
D. Increased vitreous floaters
Correct Answer: B
Rationale: Presbyopia is caused by loss of lens elasticity and reduced ciliary muscle function, impairing
near accommodation while leaving distance vision intact. Nuclear sclerosis clouds vision at all distances;
macular degeneration affects central acuity; floaters cause spotlike disturbances.
2. A 75yearold male reports needing the television volume louder and trouble understanding speech in
noisy restaurants. Audiometry shows symmetric highfrequency sensorineural loss. Which change is
responsible?
A. Cerumen impaction
B. Otosclerosis of the stapes
C. Degeneration of hair cells at the cochlear base
,D. Recurrent otitis media
Correct Answer: C
Rationale: Presbycusis involves progressive loss of cochlear hair cells, particularly at the base where high
frequencies are processed, producing symmetric highfrequency sensorineural loss. Cerumen impaction
and otitis media cause conductive loss; otosclerosis is not an agerelated change.
3. A nurse notes a 78yearold patient's skin appears paperthin with multiple ecchymoses on the dorsal
hands despite no trauma. Which agerelated skin change accounts for this?
A. Decreased melanocyte production
B. Thinning of the dermis and subcutaneous fat
C. Increased sebaceous gland activity
D. Reduced eccrine sweat gland density
Correct Answer: B
Rationale: Aging causes dermal thinning and loss of subcutaneous fat, making blood vessels more fragile
and prone to tearing with minor trauma.
4. Which theory of aging proposes that aging is caused by the accumulation of damage from free
radicals?
A. Programmed theory
B. Free radical theory
C. Wear and tear theory
D. Telomere shortening theory
,Correct Answer: B
Rationale: The free radical theory proposes that aging results from cumulative damage caused by free
radicals and oxidative stress on DNA, proteins, and lipids.
5. The telomere shortening theory of aging suggests that:
A. Aging is predetermined by genetics
B. Cells have a limited number of divisions due to progressive telomere shortening
C. Aging is caused by environmental toxins
D. Aging results from accumulated mutations
Correct Answer: B
Rationale: The telomere shortening theory posits that chromosomes have protective caps (telomeres)
that shorten with each cell division, eventually leading to cellular senescence.
6. Which of the following is a normal agerelated cardiovascular change?
A. Increased cardiac output
B. Decreased arterial stiffness
C. Decreased maximum heart rate
D. Increased baroreceptor sensitivity
Correct Answer: C
Rationale: Maximum heart rate decreases with age. Other normal changes include increased arterial
stiffness, decreased baroreceptor sensitivity, and decreased cardiac output during stress.
, 7. A 70yearold patient asks why her skin has become thinner and more fragile. The nurse explains that
this is due to:
A. Increased collagen production
B. Decreased subcutaneous fat and dermal thinning
C. Increased sebaceous gland activity
D. Decreased melanocyte production
Correct Answer: B
Rationale: Aging causes thinning of the dermis and loss of subcutaneous fat, leading to fragile skin that is
more prone to injury.
8. Which agerelated change in the gastrointestinal system increases the risk of constipation in older
adults?
A. Increased gastric acid secretion
B. Decreased gastrointestinal motility
C. Increased liver size
D. Enhanced nutrient absorption
Correct Answer: B
Rationale: Decreased gastrointestinal motility, along with reduced fluid intake and decreased physical
activity, contributes to constipation in older adults.
