,NUR 257 Exam 2 | Concepts of Aging and Chronic Illness (2026) Q&A | Galen
College
1. The nurse is planning care for an older adult patient with a new diagnosis of heart failure.
Which chronic illness trajectory model best describes the expected course for this patient?
A) A slow, steady decline with periods of stability
B) A rapid and unpredictable decline followed by death
C) An acute episode followed by a return to baseline
D) A gradual decline with acute exacerbations and partial recoveries
Correct Answer: A gradual decline with acute exacerbations and partial recoveries
Rationale: The trajectory model for heart failure is characterized by a gradual decline in
function punctuated by acute exacerbations, with some recovery after each episode. This is
distinct from the steady decline seen in some cancers (slow decline) or the sudden decline of
a stroke (rapid decline). The patient does not return to a full baseline.
2. The nurse is assessing a patient for possible elder abuse. Which finding is the most
concerning and requires immediate reporting?
A) The patient is wearing dirty, mismatched clothing
B) The patient has a new bruise on the forearm and gives inconsistent explanations for it
C) The patient's room is cluttered with old newspapers
D) The patient is reluctant to discuss their financial situation
Correct Answer: The patient has a new bruise on the forearm and gives inconsistent
explanations for it
Rationale: A bruise with an inconsistent or implausible explanation is a classic red flag for
potential physical abuse. Dirty clothing, a cluttered room, and reluctance to discuss finances
are concerning but are not as directly indicative of an immediate, acute abusive situation as
a suspicious injury.
,3. A patient with Parkinson's disease is experiencing a "freezing" episode while walking.
What is the priority nursing intervention?
A) Encourage the patient to take longer strides
B) Have the patient stop, shift their weight, and march in place
C) Ask the patient to walk faster to overcome the freeze
D) Gently pull the patient forward by their arm
Correct Answer: Have the patient stop, shift their weight, and march in place
Rationale: The most effective strategies for a freezing episode are to stop, shift weight, and
use a cue like marching in place or stepping over an imaginary line. Trying to walk faster or
having someone pull the patient can increase the risk of a fall.
4. The nurse is administering an enteral feeding via a percutaneous endoscopic gastrostomy
(PEG) tube. Which action is essential to prevent aspiration?
A) Flush the tube with 30 mL of water after each medication
B) Keep the head of the bed elevated to at least 30 degrees during and for 30-60 minutes
after the feeding
C) Administer the feeding at a cold temperature to stimulate gastric emptying
D) Check for bowel sounds before starting the feeding
Correct Answer: Keep the head of the bed elevated to at least 30 degrees during and for 30-
60 minutes after the feeding
Rationale: Elevating the head of the bed uses gravity to help keep the feeding in the
stomach and is the most critical intervention to prevent aspiration. Checking tube placement
and residual volumes are also important, but elevation is the primary prevention strategy.
5. An older adult patient is admitted with hyperthermia. What is the priority nursing
intervention?
, A) Administer antipyretics as prescribed
B) Apply cool compresses to the groin, axillae, and neck
C) Increase the patient's oral fluid intake
D) Place the patient in a cool bath
Correct Answer: Apply cool compresses to the groin, axillae, and neck
Rationale: In older adults, hyperthermia is often treated with external cooling methods like
cool compresses to large blood vessels to promote heat dissipation. Antipyretics are less
effective for environmental hyperthermia. A cool bath can cause shivering, which increases
heat production.
6. The nurse is teaching a patient about the proper use of a hearing aid. Which statement by
the patient indicates a need for further teaching?
A) "I will turn the hearing aid off before inserting it into my ear."
B) "I will change the batteries regularly and keep extras on hand."
C) "I will clean the earmold with alcohol and water once a week."
D) "I will report any pain or irritation in my ear canal."
Correct Answer: "I will clean the earmold with alcohol and water once a week."
Rationale: Hearing aid earmolds should be cleaned with a mild soap and water, not alcohol,
which can damage the material. The other statements reflect correct understanding of
hearing aid care.
7. The nurse is conducting a community education session on risk factors for depression in
older adults. Which risk factor should the nurse include in the teaching?
A) Active participation in social groups
B) A history of chronic medical conditions
C) Having a strong support system
College
1. The nurse is planning care for an older adult patient with a new diagnosis of heart failure.
Which chronic illness trajectory model best describes the expected course for this patient?
A) A slow, steady decline with periods of stability
B) A rapid and unpredictable decline followed by death
C) An acute episode followed by a return to baseline
D) A gradual decline with acute exacerbations and partial recoveries
Correct Answer: A gradual decline with acute exacerbations and partial recoveries
Rationale: The trajectory model for heart failure is characterized by a gradual decline in
function punctuated by acute exacerbations, with some recovery after each episode. This is
distinct from the steady decline seen in some cancers (slow decline) or the sudden decline of
a stroke (rapid decline). The patient does not return to a full baseline.
2. The nurse is assessing a patient for possible elder abuse. Which finding is the most
concerning and requires immediate reporting?
A) The patient is wearing dirty, mismatched clothing
B) The patient has a new bruise on the forearm and gives inconsistent explanations for it
C) The patient's room is cluttered with old newspapers
D) The patient is reluctant to discuss their financial situation
Correct Answer: The patient has a new bruise on the forearm and gives inconsistent
explanations for it
Rationale: A bruise with an inconsistent or implausible explanation is a classic red flag for
potential physical abuse. Dirty clothing, a cluttered room, and reluctance to discuss finances
are concerning but are not as directly indicative of an immediate, acute abusive situation as
a suspicious injury.
,3. A patient with Parkinson's disease is experiencing a "freezing" episode while walking.
What is the priority nursing intervention?
A) Encourage the patient to take longer strides
B) Have the patient stop, shift their weight, and march in place
C) Ask the patient to walk faster to overcome the freeze
D) Gently pull the patient forward by their arm
Correct Answer: Have the patient stop, shift their weight, and march in place
Rationale: The most effective strategies for a freezing episode are to stop, shift weight, and
use a cue like marching in place or stepping over an imaginary line. Trying to walk faster or
having someone pull the patient can increase the risk of a fall.
4. The nurse is administering an enteral feeding via a percutaneous endoscopic gastrostomy
(PEG) tube. Which action is essential to prevent aspiration?
A) Flush the tube with 30 mL of water after each medication
B) Keep the head of the bed elevated to at least 30 degrees during and for 30-60 minutes
after the feeding
C) Administer the feeding at a cold temperature to stimulate gastric emptying
D) Check for bowel sounds before starting the feeding
Correct Answer: Keep the head of the bed elevated to at least 30 degrees during and for 30-
60 minutes after the feeding
Rationale: Elevating the head of the bed uses gravity to help keep the feeding in the
stomach and is the most critical intervention to prevent aspiration. Checking tube placement
and residual volumes are also important, but elevation is the primary prevention strategy.
5. An older adult patient is admitted with hyperthermia. What is the priority nursing
intervention?
, A) Administer antipyretics as prescribed
B) Apply cool compresses to the groin, axillae, and neck
C) Increase the patient's oral fluid intake
D) Place the patient in a cool bath
Correct Answer: Apply cool compresses to the groin, axillae, and neck
Rationale: In older adults, hyperthermia is often treated with external cooling methods like
cool compresses to large blood vessels to promote heat dissipation. Antipyretics are less
effective for environmental hyperthermia. A cool bath can cause shivering, which increases
heat production.
6. The nurse is teaching a patient about the proper use of a hearing aid. Which statement by
the patient indicates a need for further teaching?
A) "I will turn the hearing aid off before inserting it into my ear."
B) "I will change the batteries regularly and keep extras on hand."
C) "I will clean the earmold with alcohol and water once a week."
D) "I will report any pain or irritation in my ear canal."
Correct Answer: "I will clean the earmold with alcohol and water once a week."
Rationale: Hearing aid earmolds should be cleaned with a mild soap and water, not alcohol,
which can damage the material. The other statements reflect correct understanding of
hearing aid care.
7. The nurse is conducting a community education session on risk factors for depression in
older adults. Which risk factor should the nurse include in the teaching?
A) Active participation in social groups
B) A history of chronic medical conditions
C) Having a strong support system
