NUR 257 Exam 4 | Concepts of Aging and Chronic Illness (2026)
Q&A | Galen College
1. A nurse is assessing an older adult for signs of fluid volume deficit. Which finding is most
concerning?
A) Dry mucous membranes
B) New-onset confusion
C) Decreased skin turgor
D) Thirst
Correct Answer: B) New-onset confusion
Rationale: Confusion in an older adult may indicate severe dehydration and electrolyte
imbalance. Dry mucous membranes, decreased skin turgor, and thirst are signs of dehydration
but confusion suggests neurological compromise requiring immediate intervention .
2. Which lab value requires immediate notification of the provider in an older adult?
A) Hemoglobin 15.6 g/dL
B) Hematocrit 22%
C) White blood cell count 9,000/mm³
D) Platelet count 300,000/mm³
Correct Answer: B) Hematocrit 22%
,Rationale: A hematocrit of 22% is critically low and indicates severe anemia, which can lead to
death due to decreased oxygen-carrying capacity. Normal values for females are approximately
37-47%. The other values are within normal ranges .
3. A nurse is preparing a patient for a barium swallow test. Which statement by the patient
indicates understanding?
A) "I should increase fluids after the test."
B) "Barium can cause constipation and I may need a mild laxative."
C) "I will be NPO for 8 hours after the test."
D) "My stools may turn black for a few days afterward."
Correct Answer: B) "Barium can cause constipation and I may need a mild laxative."
Rationale: Barium can cause constipation, and a mild laxative may be needed after the test.
Patients should increase fluids after the test. The patient is NPO before the test, not after. Stools
may turn white for a few days, not black .
4. Which blood test requires the patient to be fasting?
A) Hemoglobin
B) Prothrombin time
C) Cholesterol
D) Creatinine
Correct Answer: C) Cholesterol
,Rationale: A cholesterol panel requires the patient to be fasting for accurate results.
Hemoglobin, prothrombin time, and creatinine do not require fasting .
5. For a patient on a high-protein, low-carbohydrate diet, which lab value would be influenced?
A) Bilirubin
B) Creatinine
C) Blood urea nitrogen (BUN)
D) Creatine kinase
Correct Answer: C) Blood urea nitrogen (BUN)
Rationale: A high-protein diet increases protein metabolism, which elevates BUN levels.
Creatinine is not significantly affected by protein intake. Bilirubin and creatine kinase are
unrelated to dietary protein .
6. A nurse is caring for a patient after a lumbar puncture. Which post-procedure intervention is
appropriate?
A) Position the patient with head of bed elevated 90 degrees for 4 hours
B) Assess the puncture site for drainage or bleeding
C) Encourage ambulation immediately
D) Maintain NPO until gag reflex returns
Correct Answer: B) Assess the puncture site for drainage or bleeding
, Rationale: After a lumbar puncture, the nurse should assess the puncture site for drainage or
bleeding and encourage oral fluids. The patient should remain flat for several hours to prevent
post-lumbar puncture headache. Ambulation is not encouraged immediately .
7. Which patient is not a candidate for magnetic resonance imaging (MRI)?
A) A patient with an allergy to latex
B) A patient with an infection
C) A patient with a pacemaker
D) A patient with a head injury
Correct Answer: C) A patient with a pacemaker
Rationale: MRI uses strong magnetic fields, making it contraindicated for patients with
pacemakers or other metal implants. Latex allergy, infection, and head injury do not
contraindicate MRI .
8. Which noninvasive procedure provides information about the physiology or function of an
organ?
A) Angiography
B) Computerized tomography (CT)
C) Magnetic resonance imaging (MRI)
D) Positron emission tomography (PET)
Correct Answer: D) Positron emission tomography (PET)
Q&A | Galen College
1. A nurse is assessing an older adult for signs of fluid volume deficit. Which finding is most
concerning?
A) Dry mucous membranes
B) New-onset confusion
C) Decreased skin turgor
D) Thirst
Correct Answer: B) New-onset confusion
Rationale: Confusion in an older adult may indicate severe dehydration and electrolyte
imbalance. Dry mucous membranes, decreased skin turgor, and thirst are signs of dehydration
but confusion suggests neurological compromise requiring immediate intervention .
2. Which lab value requires immediate notification of the provider in an older adult?
A) Hemoglobin 15.6 g/dL
B) Hematocrit 22%
C) White blood cell count 9,000/mm³
D) Platelet count 300,000/mm³
Correct Answer: B) Hematocrit 22%
,Rationale: A hematocrit of 22% is critically low and indicates severe anemia, which can lead to
death due to decreased oxygen-carrying capacity. Normal values for females are approximately
37-47%. The other values are within normal ranges .
3. A nurse is preparing a patient for a barium swallow test. Which statement by the patient
indicates understanding?
A) "I should increase fluids after the test."
B) "Barium can cause constipation and I may need a mild laxative."
C) "I will be NPO for 8 hours after the test."
D) "My stools may turn black for a few days afterward."
Correct Answer: B) "Barium can cause constipation and I may need a mild laxative."
Rationale: Barium can cause constipation, and a mild laxative may be needed after the test.
Patients should increase fluids after the test. The patient is NPO before the test, not after. Stools
may turn white for a few days, not black .
4. Which blood test requires the patient to be fasting?
A) Hemoglobin
B) Prothrombin time
C) Cholesterol
D) Creatinine
Correct Answer: C) Cholesterol
,Rationale: A cholesterol panel requires the patient to be fasting for accurate results.
Hemoglobin, prothrombin time, and creatinine do not require fasting .
5. For a patient on a high-protein, low-carbohydrate diet, which lab value would be influenced?
A) Bilirubin
B) Creatinine
C) Blood urea nitrogen (BUN)
D) Creatine kinase
Correct Answer: C) Blood urea nitrogen (BUN)
Rationale: A high-protein diet increases protein metabolism, which elevates BUN levels.
Creatinine is not significantly affected by protein intake. Bilirubin and creatine kinase are
unrelated to dietary protein .
6. A nurse is caring for a patient after a lumbar puncture. Which post-procedure intervention is
appropriate?
A) Position the patient with head of bed elevated 90 degrees for 4 hours
B) Assess the puncture site for drainage or bleeding
C) Encourage ambulation immediately
D) Maintain NPO until gag reflex returns
Correct Answer: B) Assess the puncture site for drainage or bleeding
, Rationale: After a lumbar puncture, the nurse should assess the puncture site for drainage or
bleeding and encourage oral fluids. The patient should remain flat for several hours to prevent
post-lumbar puncture headache. Ambulation is not encouraged immediately .
7. Which patient is not a candidate for magnetic resonance imaging (MRI)?
A) A patient with an allergy to latex
B) A patient with an infection
C) A patient with a pacemaker
D) A patient with a head injury
Correct Answer: C) A patient with a pacemaker
Rationale: MRI uses strong magnetic fields, making it contraindicated for patients with
pacemakers or other metal implants. Latex allergy, infection, and head injury do not
contraindicate MRI .
8. Which noninvasive procedure provides information about the physiology or function of an
organ?
A) Angiography
B) Computerized tomography (CT)
C) Magnetic resonance imaging (MRI)
D) Positron emission tomography (PET)
Correct Answer: D) Positron emission tomography (PET)
