NUR 257 Exam 3 | Concepts of Aging and Chronic Illness (2026)
Q&A | Galen College
1. A nurse is assessing an older adult with heart failure. Which finding is most consistent with
left-sided heart failure?
A) Jugular venous distention and peripheral edema
B) Crackles in the lung bases and orthopnea
C) Hepatomegaly and ascites
D) Weight gain and dependent edema
Correct Answer: B) Crackles in the lung bases and orthopnea
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea,
orthopnea, and paroxysmal nocturnal dyspnea. Right-sided heart failure presents with systemic
congestion such as jugular venous distention, peripheral edema, hepatomegaly, and ascites.
2. A nurse is teaching an older adult about digoxin therapy. Which statement indicates a need
for further teaching?
A) "I will check my pulse before taking the medication."
B) "I will report any visual changes such as yellow-green halos."
C) "I will take an extra dose if I miss one."
D) "I will report nausea or vomiting to my provider."
Correct Answer: C) "I will take an extra dose if I miss one."
,Rationale: Digoxin has a narrow therapeutic index; taking an extra dose increases the risk of
toxicity. Patients should check their pulse before taking digoxin, report visual disturbances
(yellow-green halos), nausea, and vomiting, which are signs of toxicity. If a dose is missed, the
patient should not double the dose.
3. Which medication is the antidote for digoxin toxicity?
A) Protamine sulfate
B) Vitamin K
C) Digoxin immune Fab
D) Naloxone
Correct Answer: C) Digoxin immune Fab
Rationale: Digoxin immune Fab (Digibind) is the antidote for severe digoxin toxicity. Protamine
sulfate reverses heparin, vitamin K reverses warfarin, and naloxone reverses opioids.
4. A nurse is assessing an older adult with peripheral arterial disease (PAD). Which finding is
most characteristic?
A) Warm, erythematous extremities
B) Cool, pale extremities with diminished pulses
C) Bounding pulses and edema
D) Varicose veins and brown pigmentation
Correct Answer: B) Cool, pale extremities with diminished pulses
,Rationale: PAD results from decreased arterial blood flow, leading to cool, pale extremities with
diminished or absent pulses. Venous insufficiency presents with warm extremities, edema, and
brown pigmentation.
5. A nurse is teaching an older adult with PAD about lifestyle modifications. Which statement
indicates understanding?
A) "I will keep my legs elevated above my heart."
B) "I will stop smoking to improve circulation."
C) "I will avoid walking to prevent pain."
D) "I will apply heating pads to my feet."
Correct Answer: B) "I will stop smoking to improve circulation."
Rationale: Smoking cessation is essential for patients with PAD because smoking causes
vasoconstriction and accelerates atherosclerosis. Legs should be kept in a dependent position to
improve arterial flow. Walking is encouraged to promote collateral circulation. Heating pads can
cause burns due to decreased sensation.
6. Which finding indicates worsening heart failure in an older adult?
A) Weight loss
B) Increased urine output
C) Weight gain of 2-3 pounds in one day
D) Decreased peripheral edema
Correct Answer: C) Weight gain of 2-3 pounds in one day
, Rationale: Weight gain of 2-3 pounds in one day or 5 pounds in one week indicates fluid
retention and worsening heart failure. Daily weights are the most sensitive indicator of fluid
status.
7. A nurse is caring for an older adult with atrial fibrillation. Which assessment finding is most
concerning?
A) Heart rate of 88 bpm
B) Irregular pulse with a rate of 130 bpm
C) Blood pressure of 120/80 mmHg
D) Occasional palpitations
Correct Answer: B) Irregular pulse with a rate of 130 bpm
Rationale: A rapid, irregular pulse in atrial fibrillation can lead to decreased cardiac output,
thrombus formation, and stroke. The nurse should notify the provider for rate control and
anticoagulation.
8. A nurse is teaching an older adult about warfarin therapy. Which statement indicates a need
for further teaching?
A) "I will keep my INR checked regularly."
B) "I will increase my intake of leafy green vegetables."
C) "I will report any unusual bleeding or bruising."
D) "I will use a soft toothbrush."
Correct Answer: B) "I will increase my intake of leafy green vegetables."
Q&A | Galen College
1. A nurse is assessing an older adult with heart failure. Which finding is most consistent with
left-sided heart failure?
A) Jugular venous distention and peripheral edema
B) Crackles in the lung bases and orthopnea
C) Hepatomegaly and ascites
D) Weight gain and dependent edema
Correct Answer: B) Crackles in the lung bases and orthopnea
Rationale: Left-sided heart failure causes pulmonary congestion, leading to crackles, dyspnea,
orthopnea, and paroxysmal nocturnal dyspnea. Right-sided heart failure presents with systemic
congestion such as jugular venous distention, peripheral edema, hepatomegaly, and ascites.
2. A nurse is teaching an older adult about digoxin therapy. Which statement indicates a need
for further teaching?
A) "I will check my pulse before taking the medication."
B) "I will report any visual changes such as yellow-green halos."
C) "I will take an extra dose if I miss one."
D) "I will report nausea or vomiting to my provider."
Correct Answer: C) "I will take an extra dose if I miss one."
,Rationale: Digoxin has a narrow therapeutic index; taking an extra dose increases the risk of
toxicity. Patients should check their pulse before taking digoxin, report visual disturbances
(yellow-green halos), nausea, and vomiting, which are signs of toxicity. If a dose is missed, the
patient should not double the dose.
3. Which medication is the antidote for digoxin toxicity?
A) Protamine sulfate
B) Vitamin K
C) Digoxin immune Fab
D) Naloxone
Correct Answer: C) Digoxin immune Fab
Rationale: Digoxin immune Fab (Digibind) is the antidote for severe digoxin toxicity. Protamine
sulfate reverses heparin, vitamin K reverses warfarin, and naloxone reverses opioids.
4. A nurse is assessing an older adult with peripheral arterial disease (PAD). Which finding is
most characteristic?
A) Warm, erythematous extremities
B) Cool, pale extremities with diminished pulses
C) Bounding pulses and edema
D) Varicose veins and brown pigmentation
Correct Answer: B) Cool, pale extremities with diminished pulses
,Rationale: PAD results from decreased arterial blood flow, leading to cool, pale extremities with
diminished or absent pulses. Venous insufficiency presents with warm extremities, edema, and
brown pigmentation.
5. A nurse is teaching an older adult with PAD about lifestyle modifications. Which statement
indicates understanding?
A) "I will keep my legs elevated above my heart."
B) "I will stop smoking to improve circulation."
C) "I will avoid walking to prevent pain."
D) "I will apply heating pads to my feet."
Correct Answer: B) "I will stop smoking to improve circulation."
Rationale: Smoking cessation is essential for patients with PAD because smoking causes
vasoconstriction and accelerates atherosclerosis. Legs should be kept in a dependent position to
improve arterial flow. Walking is encouraged to promote collateral circulation. Heating pads can
cause burns due to decreased sensation.
6. Which finding indicates worsening heart failure in an older adult?
A) Weight loss
B) Increased urine output
C) Weight gain of 2-3 pounds in one day
D) Decreased peripheral edema
Correct Answer: C) Weight gain of 2-3 pounds in one day
, Rationale: Weight gain of 2-3 pounds in one day or 5 pounds in one week indicates fluid
retention and worsening heart failure. Daily weights are the most sensitive indicator of fluid
status.
7. A nurse is caring for an older adult with atrial fibrillation. Which assessment finding is most
concerning?
A) Heart rate of 88 bpm
B) Irregular pulse with a rate of 130 bpm
C) Blood pressure of 120/80 mmHg
D) Occasional palpitations
Correct Answer: B) Irregular pulse with a rate of 130 bpm
Rationale: A rapid, irregular pulse in atrial fibrillation can lead to decreased cardiac output,
thrombus formation, and stroke. The nurse should notify the provider for rate control and
anticoagulation.
8. A nurse is teaching an older adult about warfarin therapy. Which statement indicates a need
for further teaching?
A) "I will keep my INR checked regularly."
B) "I will increase my intake of leafy green vegetables."
C) "I will report any unusual bleeding or bruising."
D) "I will use a soft toothbrush."
Correct Answer: B) "I will increase my intake of leafy green vegetables."
