NUR 257 Exam 2 | Concepts of Aging and Chronic Illness (2026)
Q&A | Galen College
1. Which statement best describes the purpose of the FANCAPES assessment tool in geriatric
nursing?
A) It evaluates only the patient's cognitive status
B) It provides a comprehensive framework for assessing older adults across multiple domains
C) It measures the patient's financial capacity
D) It focuses exclusively on physical mobility
Correct Answer: B) It provides a comprehensive framework for assessing older adults across
multiple domains
Rationale: FANCAPES stands for Fluids, Aeration, Nutrition, Communication, Activity, Pain,
Elimination, and Socialization. It is a holistic assessment framework specifically designed for
older adults, covering physiological, functional, and psychosocial domains. This tool helps
nurses identify areas requiring intervention and monitor changes over time .
2. A nurse is assessing an older adult's hydration status. Which age-related change increases the
risk for dehydration?
A) Increased thirst sensation
B) Decreased renal concentrating ability and reduced sense of thirst
C) Increased total body water
D) Enhanced ability to conserve sodium
Correct Answer: B) Decreased renal concentrating ability and reduced sense of thirst
,Rationale: Older adults experience a reduced sense of thirst and decreased renal concentrating
ability, making them more susceptible to dehydration. Total body water decreases with age, and
the kidneys are less efficient at conserving water. Nurses must assess hydration status carefully,
especially in patients with functional limitations or those taking psychotropic medications .
3. Which statement by a patient indicates correct understanding of osteoarthritis pain
management?
A) "I should exercise during periods of severe pain to work through the stiffness."
B) "My pain is usually worse in the morning and improves as I move throughout the day."
C) "My pain typically worsens with activity and improves with rest."
D) "I should avoid all physical activity to prevent further joint damage."
Correct Answer: C) "My pain typically worsens with activity and improves with rest."
Rationale: Osteoarthritis is characterized by mechanical pain that worsens with weight-bearing
activity and improves with rest. In contrast, rheumatoid arthritis pain typically improves with
activity and is worse with rest or in the morning with prolonged stiffness. Exercise is encouraged
during periods of low pain to maintain joint function, but complete avoidance of activity leads
to deconditioning .
4. A nurse is reviewing medications for a 76-year-old patient with multiple chronic conditions.
Which medication class should the nurse identify as potentially inappropriate based on the
Beers Criteria?
A) Acetaminophen
B) Metoprolol
C) Diphenhydramine
D) Aspirin for secondary prevention
,Correct Answer: C) Diphenhydramine
Rationale: Diphenhydramine is an anticholinergic medication included in the Beers Criteria as
potentially inappropriate for older adults. Anticholinergic effects include confusion, dry mouth,
urinary retention, and increased fall risk. Acetaminophen, metoprolol, and aspirin for secondary
prevention are generally considered appropriate when clinically indicated .
5. Which finding should the nurse recognize as a normal age-related change in the
cardiovascular system?
A) Decreased systolic blood pressure
B) Increased cardiac output at rest
C) Increased vascular stiffness and decreased arterial compliance
D) Decreased left ventricular wall thickness
Correct Answer: C) Increased vascular stiffness and decreased arterial compliance
Rationale: Normal aging results in increased vascular stiffness and decreased arterial
compliance due to changes in elastin and collagen content of vessel walls. This leads to
increased systolic blood pressure, not decreased. Cardiac output typically decreases with age,
and left ventricular wall thickness often increases .
6. An 82-year-old patient asks the nurse why she feels colder than when she was younger.
Which age-related change best explains this?
A) Increased metabolic rate
B) Decreased subcutaneous fat and diminished thermoregulatory efficiency
C) Enhanced peripheral circulation
, D) Increased thyroid hormone production
Correct Answer: B) Decreased subcutaneous fat and diminished thermoregulatory efficiency
Rationale: Older adults experience decreased subcutaneous fat, which provides insulation, and
diminished thermoregulatory efficiency. Metabolic rate typically decreases with age, peripheral
circulation often diminishes, and thyroid hormone production may decrease. These changes
make older adults more sensitive to cold .
7. Which finding is consistent with normal age-related changes in the respiratory system?
A) Increased vital capacity
B) Decreased chest wall compliance and increased residual volume
C) Increased arterial oxygen tension (PaO2)
D) Decreased residual volume
Correct Answer: B) Decreased chest wall compliance and increased residual volume
Rationale: Normal aging results in decreased chest wall compliance, increased residual volume,
and decreased vital capacity. PaO2 decreases with age. These changes are due to loss of elastic
recoil and stiffening of the chest wall, which increase the risk for respiratory complications .
8. A 75-year-old patient reports difficulty hearing high-pitched sounds. The nurse recognizes this
as which condition?
A) Otosclerosis requiring surgical intervention
B) Presbycusis, a normal age-related sensorineural hearing loss
C) Cerumen impaction requiring immediate removal
Q&A | Galen College
1. Which statement best describes the purpose of the FANCAPES assessment tool in geriatric
nursing?
A) It evaluates only the patient's cognitive status
B) It provides a comprehensive framework for assessing older adults across multiple domains
C) It measures the patient's financial capacity
D) It focuses exclusively on physical mobility
Correct Answer: B) It provides a comprehensive framework for assessing older adults across
multiple domains
Rationale: FANCAPES stands for Fluids, Aeration, Nutrition, Communication, Activity, Pain,
Elimination, and Socialization. It is a holistic assessment framework specifically designed for
older adults, covering physiological, functional, and psychosocial domains. This tool helps
nurses identify areas requiring intervention and monitor changes over time .
2. A nurse is assessing an older adult's hydration status. Which age-related change increases the
risk for dehydration?
A) Increased thirst sensation
B) Decreased renal concentrating ability and reduced sense of thirst
C) Increased total body water
D) Enhanced ability to conserve sodium
Correct Answer: B) Decreased renal concentrating ability and reduced sense of thirst
,Rationale: Older adults experience a reduced sense of thirst and decreased renal concentrating
ability, making them more susceptible to dehydration. Total body water decreases with age, and
the kidneys are less efficient at conserving water. Nurses must assess hydration status carefully,
especially in patients with functional limitations or those taking psychotropic medications .
3. Which statement by a patient indicates correct understanding of osteoarthritis pain
management?
A) "I should exercise during periods of severe pain to work through the stiffness."
B) "My pain is usually worse in the morning and improves as I move throughout the day."
C) "My pain typically worsens with activity and improves with rest."
D) "I should avoid all physical activity to prevent further joint damage."
Correct Answer: C) "My pain typically worsens with activity and improves with rest."
Rationale: Osteoarthritis is characterized by mechanical pain that worsens with weight-bearing
activity and improves with rest. In contrast, rheumatoid arthritis pain typically improves with
activity and is worse with rest or in the morning with prolonged stiffness. Exercise is encouraged
during periods of low pain to maintain joint function, but complete avoidance of activity leads
to deconditioning .
4. A nurse is reviewing medications for a 76-year-old patient with multiple chronic conditions.
Which medication class should the nurse identify as potentially inappropriate based on the
Beers Criteria?
A) Acetaminophen
B) Metoprolol
C) Diphenhydramine
D) Aspirin for secondary prevention
,Correct Answer: C) Diphenhydramine
Rationale: Diphenhydramine is an anticholinergic medication included in the Beers Criteria as
potentially inappropriate for older adults. Anticholinergic effects include confusion, dry mouth,
urinary retention, and increased fall risk. Acetaminophen, metoprolol, and aspirin for secondary
prevention are generally considered appropriate when clinically indicated .
5. Which finding should the nurse recognize as a normal age-related change in the
cardiovascular system?
A) Decreased systolic blood pressure
B) Increased cardiac output at rest
C) Increased vascular stiffness and decreased arterial compliance
D) Decreased left ventricular wall thickness
Correct Answer: C) Increased vascular stiffness and decreased arterial compliance
Rationale: Normal aging results in increased vascular stiffness and decreased arterial
compliance due to changes in elastin and collagen content of vessel walls. This leads to
increased systolic blood pressure, not decreased. Cardiac output typically decreases with age,
and left ventricular wall thickness often increases .
6. An 82-year-old patient asks the nurse why she feels colder than when she was younger.
Which age-related change best explains this?
A) Increased metabolic rate
B) Decreased subcutaneous fat and diminished thermoregulatory efficiency
C) Enhanced peripheral circulation
, D) Increased thyroid hormone production
Correct Answer: B) Decreased subcutaneous fat and diminished thermoregulatory efficiency
Rationale: Older adults experience decreased subcutaneous fat, which provides insulation, and
diminished thermoregulatory efficiency. Metabolic rate typically decreases with age, peripheral
circulation often diminishes, and thyroid hormone production may decrease. These changes
make older adults more sensitive to cold .
7. Which finding is consistent with normal age-related changes in the respiratory system?
A) Increased vital capacity
B) Decreased chest wall compliance and increased residual volume
C) Increased arterial oxygen tension (PaO2)
D) Decreased residual volume
Correct Answer: B) Decreased chest wall compliance and increased residual volume
Rationale: Normal aging results in decreased chest wall compliance, increased residual volume,
and decreased vital capacity. PaO2 decreases with age. These changes are due to loss of elastic
recoil and stiffening of the chest wall, which increase the risk for respiratory complications .
8. A 75-year-old patient reports difficulty hearing high-pitched sounds. The nurse recognizes this
as which condition?
A) Otosclerosis requiring surgical intervention
B) Presbycusis, a normal age-related sensorineural hearing loss
C) Cerumen impaction requiring immediate removal
