,NUR 257 Final Exam | Concepts of Aging and Chronic Illness (2026)
Q&A | Galen College
1. The nurse is caring for an 82-year-old patient with chronic heart failure who reports a
weight gain of 3 pounds in 2 days. What is the priority nursing intervention?
A) Increase fluid intake to flush sodium from the body
B) Restrict activity to conserve energy and reduce oxygen demand
C) Assess for edema and notify the healthcare provider
D) Encourage increased sodium intake for better hydration
Correct Answer: Assess for edema and notify the healthcare provider
Rationale: Rapid weight gain in heart failure indicates fluid retention, which can lead to
acute decompensation. The provider should be notified promptly for assessment and
possible diuretic adjustment. Increasing fluids or sodium would worsen the condition, and
activity restriction, while important, is not the priority.
2. A 78-year-old patient is admitted with pneumonia and is acutely confused. The daughter
states this confusion is new. What is the most appropriate nursing action?
A) Restrain the patient to prevent falls
B) Administer sedatives to calm the patient
C) Evaluate for delirium and treat the underlying cause
D) Ignore the confusion as a normal part of aging
Correct Answer: Evaluate for delirium and treat the underlying cause
Rationale: Delirium in older adults is often triggered by an underlying medical condition like
infection. It requires prompt evaluation and treatment of the cause rather than being
dismissed as normal aging or managed with restraints or sedatives, which can worsen the
condition.
,3. Which physiological change of aging increases the risk of medication toxicity in older
adults?
A) Increased hepatic blood flow
B) Decreased gastric emptying
C) Decreased renal function
D) Increased total body water percentage
Correct Answer: Decreased renal function
Rationale: Decreased glomerular filtration rate reduces drug clearance. This age-related
change requires careful medication dosing and monitoring to prevent accumulation and
toxicity in older adults with reduced renal function.
4. An 88-year-old patient with advanced dementia is refusing to eat and has lost 10 pounds
in one month. What is the most appropriate initial intervention?
A) Insert a nasogastric tube
B) Initiate total parenteral nutrition
C) Provide small, frequent meals with favorite foods
D) Force-feed the patient to maintain nutrition
Correct Answer: Provide small, frequent meals with favorite foods
Rationale: Providing small, frequent meals with preferred foods respects the patient's
autonomy while addressing nutritional needs. This less invasive approach is more
appropriate than tube feeding or force-feeding in advanced dementia.
5. A 75-year-old patient with type 2 diabetes has an HbA1c of 8.5%. The patient reports
forgetting to take medications. What is the priority nursing diagnosis?
A) Ineffective Health Maintenance
, B) Imbalanced Nutrition: More Than Body Requirements
C) Risk for Infection
D) Impaired Skin Integrity
Correct Answer: Ineffective Health Maintenance
Rationale: Forgetting medications indicates ineffective health maintenance, which is the
priority problem contributing to poor glycemic control. The nurse should assess barriers and
implement adherence strategies.
6. An 80-year-old patient has a new diagnosis of urinary incontinence. What is the most
appropriate initial nursing assessment?
A) Recommend adult diapers immediately
B) Encourage bladder training with timed voiding
C) Assess for reversible causes (UTI, medications, constipation)
D) Start a bowel and bladder training program
Correct Answer: Assess for reversible causes (UTI, medications, constipation)
Rationale: Incontinence in older adults often has reversible causes, including infection,
medication effects, and constipation. Identifying these treatable factors should be the first
step before implementing management strategies.
7. A 76-year-old patient with osteoarthritis reports chronic knee pain. Which intervention is
most appropriate for pain management?
A) Encourage complete bed rest to reduce joint stress
B) Apply heat and provide regular, low-impact exercise
C) Limit all activity to prevent injury
D) Administer opioids around the clock
Q&A | Galen College
1. The nurse is caring for an 82-year-old patient with chronic heart failure who reports a
weight gain of 3 pounds in 2 days. What is the priority nursing intervention?
A) Increase fluid intake to flush sodium from the body
B) Restrict activity to conserve energy and reduce oxygen demand
C) Assess for edema and notify the healthcare provider
D) Encourage increased sodium intake for better hydration
Correct Answer: Assess for edema and notify the healthcare provider
Rationale: Rapid weight gain in heart failure indicates fluid retention, which can lead to
acute decompensation. The provider should be notified promptly for assessment and
possible diuretic adjustment. Increasing fluids or sodium would worsen the condition, and
activity restriction, while important, is not the priority.
2. A 78-year-old patient is admitted with pneumonia and is acutely confused. The daughter
states this confusion is new. What is the most appropriate nursing action?
A) Restrain the patient to prevent falls
B) Administer sedatives to calm the patient
C) Evaluate for delirium and treat the underlying cause
D) Ignore the confusion as a normal part of aging
Correct Answer: Evaluate for delirium and treat the underlying cause
Rationale: Delirium in older adults is often triggered by an underlying medical condition like
infection. It requires prompt evaluation and treatment of the cause rather than being
dismissed as normal aging or managed with restraints or sedatives, which can worsen the
condition.
,3. Which physiological change of aging increases the risk of medication toxicity in older
adults?
A) Increased hepatic blood flow
B) Decreased gastric emptying
C) Decreased renal function
D) Increased total body water percentage
Correct Answer: Decreased renal function
Rationale: Decreased glomerular filtration rate reduces drug clearance. This age-related
change requires careful medication dosing and monitoring to prevent accumulation and
toxicity in older adults with reduced renal function.
4. An 88-year-old patient with advanced dementia is refusing to eat and has lost 10 pounds
in one month. What is the most appropriate initial intervention?
A) Insert a nasogastric tube
B) Initiate total parenteral nutrition
C) Provide small, frequent meals with favorite foods
D) Force-feed the patient to maintain nutrition
Correct Answer: Provide small, frequent meals with favorite foods
Rationale: Providing small, frequent meals with preferred foods respects the patient's
autonomy while addressing nutritional needs. This less invasive approach is more
appropriate than tube feeding or force-feeding in advanced dementia.
5. A 75-year-old patient with type 2 diabetes has an HbA1c of 8.5%. The patient reports
forgetting to take medications. What is the priority nursing diagnosis?
A) Ineffective Health Maintenance
, B) Imbalanced Nutrition: More Than Body Requirements
C) Risk for Infection
D) Impaired Skin Integrity
Correct Answer: Ineffective Health Maintenance
Rationale: Forgetting medications indicates ineffective health maintenance, which is the
priority problem contributing to poor glycemic control. The nurse should assess barriers and
implement adherence strategies.
6. An 80-year-old patient has a new diagnosis of urinary incontinence. What is the most
appropriate initial nursing assessment?
A) Recommend adult diapers immediately
B) Encourage bladder training with timed voiding
C) Assess for reversible causes (UTI, medications, constipation)
D) Start a bowel and bladder training program
Correct Answer: Assess for reversible causes (UTI, medications, constipation)
Rationale: Incontinence in older adults often has reversible causes, including infection,
medication effects, and constipation. Identifying these treatable factors should be the first
step before implementing management strategies.
7. A 76-year-old patient with osteoarthritis reports chronic knee pain. Which intervention is
most appropriate for pain management?
A) Encourage complete bed rest to reduce joint stress
B) Apply heat and provide regular, low-impact exercise
C) Limit all activity to prevent injury
D) Administer opioids around the clock
