GALEN COLLEGE OF NURSING NUR 257 CONCEPTS OF AGING AND
CHRONIC ILLNESS IN NURSING 2026/2027 - EXAM 1, EXAMINATIONS 3-4
AND FINAL EXAM QUESTIONS WITH ANSWERS
93 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Synthesize age-related physiological changes to prioritize nursing interventions and prevent
complications in older adults
2 Apply evidence-based guidelines to manage chronic illnesses and geriatric syndromes across diverse
care settings
3 Evaluate the impact of polypharmacy, functional decline, and social determinants on outcomes for older
adults with chronic conditions
4 Galen College of Nursing NUR 257 Concepts of Aging and Chronic Illness in Nursing 2026
5 2027
6 Exam 1
7 Examinations 3
8 4 and Final Exam Questions with Answers
9 Foundations of Nursing - Concepts of Aging and Chronic Illness
10 Applied Nursing - Concepts of Aging and Chronic Illness
11 Advanced Nursing - Concepts of Aging and Chronic Illness
12 Nursing - Concepts of Aging and Chronic Illness Review
ABSTRACT
Page 1
,This study document brings together 93 carefully worded exam questions drawn from Galen
College of Nursing NUR 257 Concepts of Aging and Chronic Illness in Nursing 2026/2027 - Exam
1, Examinations 3-4 and Final Exam Questions with Answers, with the strongest emphasis placed
on Synthesize age-related physiological changes to prioritize nursing interventions and prevent
complications in older adults, Apply evidence-based guidelines to manage chronic illnesses and
geriatric syndromes across diverse care settings, Evaluate the impact of polypharmacy, functional
decline and and social determinants on outcomes for 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 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
A patient with advanced heart failure and chronic kidney disease is prescribed
both furosemide and an NSAID for osteoarthritis pain. Which pathophysiological
mechanism best explains the increased risk of acute kidney injury in this patient?
A. NSAIDs enhance the diuretic effect of loop diuretics, leading to excessive volume depletion.
B. NSAIDs inhibit prostaglandin-mediated afferent arteriolar vasodilation, while loop diuretics
reduce effective circulating volume, together decreasing glomerular filtration rate. CORRECT
C. Furosemide induces interstitial nephritis, and NSAIDs exacerbate this by increasing renal
blood flow.
D. NSAIDs decrease renal potassium excretion, causing hyperkalemia-induced tubular damage.
RATIONALE: NSAIDs block prostaglandin synthesis, reducing afferent arteriolar vasodilation,
while loop diuretics like furosemide reduce preload and renal perfusion. The combined effect
lowers glomerular filtration rate and precipitates acute kidney injury. Options A and C misattribute
mechanisms, and D incorrectly focuses on potassium.
Page 2
,Q2 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which intervention is most effective in reducing the risk of aspiration pneumonia
in an older adult with dysphagia secondary to Parkinson's disease?
A. Providing straws to facilitate liquid intake.
B. Placing the patient in a semi-Fowler's position during meals.
C. Implementing a chin-tuck maneuver during swallowing and thickening liquids. CORRECT
D. Encouraging rapid eating to minimize fatigue.
RATIONALE: Chin-tuck posture and thickened liquids reduce aspiration risk by slowing bolus
transit and protecting the airway. Semi-Fowler's is insufficient; straws and rapid eating increase
aspiration risk. Evidence supports compensatory swallowing techniques as first-line.
Q3 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which factor most significantly contributes to the increased risk of adverse drug
reactions in older adults with chronic illnesses?
A. Increased hepatic blood flow enhancing drug metabolism.
B. Decreased glomerular filtration rate and altered body composition. CORRECT
C. Enhanced gastric motility leading to faster absorption.
D. Upregulation of cytochrome P450 enzymes.
RATIONALE: Age-related decline in renal function and changes in body composition (decreased
lean mass, increased fat) alter drug distribution and elimination, increasing adverse drug
reactions. Hepatic blood flow and enzyme activity typically decrease, not increase, and gastric
motility may slow.
Page 3
, Q4 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
A patient with chronic obstructive pulmonary disease (COPD) and a history of falls
is prescribed a short-acting beta-agonist and a benzodiazepine for anxiety. Which
nursing action is most appropriate to reduce fall risk?
A. Administer both medications together to minimize dosing times.
B. Request a physical therapy consult for gait training and review medications for deprescribing.
CORRECT
C. Encourage the patient to ambulate independently to build strength.
D. Restrict fluids to prevent nocturia.
RATIONALE: Benzodiazepines increase fall risk in older adults; deprescribing and gait training
are evidence-based interventions. Combining medications or encouraging independent
ambulation without assessment increases risk. Fluid restriction is not indicated for fall prevention.
Q5 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which statement best reflects the concept of 'compression of morbidity' in the
context of aging and chronic illness?
A. Extending life expectancy regardless of disability.
B. Delaying the onset of chronic illness and compressing the period of disability to the end of life.
CORRECT
C. Increasing the prevalence of chronic diseases to improve research funding.
D. Reducing healthcare costs by limiting access to care for older adults.
RATIONALE: Compression of morbidity posits that healthy lifestyles can delay chronic illness,
shortening the disabled period before death. It does not focus on extending life with disability,
increasing disease prevalence, or limiting care.
Page 4
CHRONIC ILLNESS IN NURSING 2026/2027 - EXAM 1, EXAMINATIONS 3-4
AND FINAL EXAM QUESTIONS WITH ANSWERS
93 QUESTIONS
TABLE OF CONTENTS
# TOPIC
1 Synthesize age-related physiological changes to prioritize nursing interventions and prevent
complications in older adults
2 Apply evidence-based guidelines to manage chronic illnesses and geriatric syndromes across diverse
care settings
3 Evaluate the impact of polypharmacy, functional decline, and social determinants on outcomes for older
adults with chronic conditions
4 Galen College of Nursing NUR 257 Concepts of Aging and Chronic Illness in Nursing 2026
5 2027
6 Exam 1
7 Examinations 3
8 4 and Final Exam Questions with Answers
9 Foundations of Nursing - Concepts of Aging and Chronic Illness
10 Applied Nursing - Concepts of Aging and Chronic Illness
11 Advanced Nursing - Concepts of Aging and Chronic Illness
12 Nursing - Concepts of Aging and Chronic Illness Review
ABSTRACT
Page 1
,This study document brings together 93 carefully worded exam questions drawn from Galen
College of Nursing NUR 257 Concepts of Aging and Chronic Illness in Nursing 2026/2027 - Exam
1, Examinations 3-4 and Final Exam Questions with Answers, with the strongest emphasis placed
on Synthesize age-related physiological changes to prioritize nursing interventions and prevent
complications in older adults, Apply evidence-based guidelines to manage chronic illnesses and
geriatric syndromes across diverse care settings, Evaluate the impact of polypharmacy, functional
decline and and social determinants on outcomes for 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 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
A patient with advanced heart failure and chronic kidney disease is prescribed
both furosemide and an NSAID for osteoarthritis pain. Which pathophysiological
mechanism best explains the increased risk of acute kidney injury in this patient?
A. NSAIDs enhance the diuretic effect of loop diuretics, leading to excessive volume depletion.
B. NSAIDs inhibit prostaglandin-mediated afferent arteriolar vasodilation, while loop diuretics
reduce effective circulating volume, together decreasing glomerular filtration rate. CORRECT
C. Furosemide induces interstitial nephritis, and NSAIDs exacerbate this by increasing renal
blood flow.
D. NSAIDs decrease renal potassium excretion, causing hyperkalemia-induced tubular damage.
RATIONALE: NSAIDs block prostaglandin synthesis, reducing afferent arteriolar vasodilation,
while loop diuretics like furosemide reduce preload and renal perfusion. The combined effect
lowers glomerular filtration rate and precipitates acute kidney injury. Options A and C misattribute
mechanisms, and D incorrectly focuses on potassium.
Page 2
,Q2 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which intervention is most effective in reducing the risk of aspiration pneumonia
in an older adult with dysphagia secondary to Parkinson's disease?
A. Providing straws to facilitate liquid intake.
B. Placing the patient in a semi-Fowler's position during meals.
C. Implementing a chin-tuck maneuver during swallowing and thickening liquids. CORRECT
D. Encouraging rapid eating to minimize fatigue.
RATIONALE: Chin-tuck posture and thickened liquids reduce aspiration risk by slowing bolus
transit and protecting the airway. Semi-Fowler's is insufficient; straws and rapid eating increase
aspiration risk. Evidence supports compensatory swallowing techniques as first-line.
Q3 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which factor most significantly contributes to the increased risk of adverse drug
reactions in older adults with chronic illnesses?
A. Increased hepatic blood flow enhancing drug metabolism.
B. Decreased glomerular filtration rate and altered body composition. CORRECT
C. Enhanced gastric motility leading to faster absorption.
D. Upregulation of cytochrome P450 enzymes.
RATIONALE: Age-related decline in renal function and changes in body composition (decreased
lean mass, increased fat) alter drug distribution and elimination, increasing adverse drug
reactions. Hepatic blood flow and enzyme activity typically decrease, not increase, and gastric
motility may slow.
Page 3
, Q4 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
A patient with chronic obstructive pulmonary disease (COPD) and a history of falls
is prescribed a short-acting beta-agonist and a benzodiazepine for anxiety. Which
nursing action is most appropriate to reduce fall risk?
A. Administer both medications together to minimize dosing times.
B. Request a physical therapy consult for gait training and review medications for deprescribing.
CORRECT
C. Encourage the patient to ambulate independently to build strength.
D. Restrict fluids to prevent nocturia.
RATIONALE: Benzodiazepines increase fall risk in older adults; deprescribing and gait training
are evidence-based interventions. Combining medications or encouraging independent
ambulation without assessment increases risk. Fluid restriction is not indicated for fall prevention.
Q5 SYNTHESIZE AGE-RELATED PHYSIOLOGICAL CHANGES TO PRIORITIZE NURSING
INTERVENTIONS AND PREVENT COMPLICATIONS IN OLDER ADULTS
Which statement best reflects the concept of 'compression of morbidity' in the
context of aging and chronic illness?
A. Extending life expectancy regardless of disability.
B. Delaying the onset of chronic illness and compressing the period of disability to the end of life.
CORRECT
C. Increasing the prevalence of chronic diseases to improve research funding.
D. Reducing healthcare costs by limiting access to care for older adults.
RATIONALE: Compression of morbidity posits that healthy lifestyles can delay chronic illness,
shortening the disabled period before death. It does not focus on extending life with disability,
increasing disease prevalence, or limiting care.
Page 4
