Galen College of Nursing
NUR 257 Exam 4: Concepts of Aging and Chronic Illness
Questions and Answers| Latest Update
,Section 42 total marks
Multiple Choice
Select the single most appropriate answer for each clinical scenario. Each question is worth 1.5 marks.
Question 1 42 total marks
A 78-year-old resident in a long-term care facility is diagnosed with Scabies following an outbreak
in the unit. The patient is experiencing intense nocturnal pruritus and has visible linear ridges in the
finger webs. The nurse is preparing to implement the treatment plan and provide discharge/isolation
education.
A A patient asks the nurse, 'When will the itching finally stop now that I am starting the cream?'
Based on evidence-based protocols for Scabies management in older adults, which response
by the nurse is most accurate?
A The itching will subside immediately after the first application of the cream.
B Itching is expected to continue for several weeks after the mites are killed.
C The presence of itching after 24 hours indicates the treatment was ineffective.
D Itching only continues if the patient has been re-infected by contaminated linens.
B The nurse is reviewing the pharmacological profile of an older adult patient who is prescribed
Zolpidem (Ambien) for comorbid insomnia. Which finding in the patient's history represents the
most significant safety risk associated with this medication?
A Recent episodes of sleepwalking or complex sleep behaviors.
B A history of morning headaches and snoring.
C Current use of a Continuous Positive Airway Pressure (CPAP) machine.
D A history of nocturnal wandering and frequent awakenings.
C An older adult patient with advanced dementia is exhibiting new-onset agitation, repetitive
vocalizations, and facial grimacing during morning care. Following the clinical judgment model
for pain in non-verbal patients, which action should the nurse take first?
A Attempt to use the Numerical Rating Scale (NRS) to quantify the distress.
B Reposition the patient and provide a distraction like music.
C Administer the prescribed PRN sedative to manage the agitation.
D Assess the patient using the PAINAD scale to determine if the behavior is pain-related.
, D A nurse is providing teaching to a patient newly prescribed Alendronate (Fosamax) for osteo-
porosis. To ensure patient safety and prevent esophageal erosion, which instruction is the most
critical?
A Take the medication with a full glass of water and remain upright for at least 30 minutes.
B Take the medication immediately before bedtime to avoid daytime side effects.
C Crush the tablet if you have difficulty swallowing to ensure full absorption.
D Take the medication with a small snack to prevent GI upset.
E The nurse is evaluating the fall risk of four patients on a geriatric unit. Which patient should the
nurse identify as having the highest intrinsic risk for an injurious fall?
A A patient with a poorly lit room and cluttered floor.
B A patient who uses a cane improperly for long-distance walking.
C A patient with stable macular degeneration and hearing aids.
D A patient with a history of a hip fracture and current use of a diuretic.
F An older adult patient presents to the emergency department with sudden, severe eye pain,
blurred vision, and nausea. The nurse notes redness around the eye and a fixed, dilated pupil.
Which condition should the nurse prioritize as a medical emergency?
A Angle-Closure Glaucoma
B Cataracts
C Diabetic Retinopathy
D Primary Open-Angle Glaucoma (POAG)
G To prevent pressure injuries in an immobilized older adult, the nurse should maintain the head of
the bed (HOB) at what maximum angle, unless clinically contraindicated?
A 45 degrees
B 15 degrees
C 90 degrees
D 30 degrees
NUR 257 Exam 4: Concepts of Aging and Chronic Illness
Questions and Answers| Latest Update
,Section 42 total marks
Multiple Choice
Select the single most appropriate answer for each clinical scenario. Each question is worth 1.5 marks.
Question 1 42 total marks
A 78-year-old resident in a long-term care facility is diagnosed with Scabies following an outbreak
in the unit. The patient is experiencing intense nocturnal pruritus and has visible linear ridges in the
finger webs. The nurse is preparing to implement the treatment plan and provide discharge/isolation
education.
A A patient asks the nurse, 'When will the itching finally stop now that I am starting the cream?'
Based on evidence-based protocols for Scabies management in older adults, which response
by the nurse is most accurate?
A The itching will subside immediately after the first application of the cream.
B Itching is expected to continue for several weeks after the mites are killed.
C The presence of itching after 24 hours indicates the treatment was ineffective.
D Itching only continues if the patient has been re-infected by contaminated linens.
B The nurse is reviewing the pharmacological profile of an older adult patient who is prescribed
Zolpidem (Ambien) for comorbid insomnia. Which finding in the patient's history represents the
most significant safety risk associated with this medication?
A Recent episodes of sleepwalking or complex sleep behaviors.
B A history of morning headaches and snoring.
C Current use of a Continuous Positive Airway Pressure (CPAP) machine.
D A history of nocturnal wandering and frequent awakenings.
C An older adult patient with advanced dementia is exhibiting new-onset agitation, repetitive
vocalizations, and facial grimacing during morning care. Following the clinical judgment model
for pain in non-verbal patients, which action should the nurse take first?
A Attempt to use the Numerical Rating Scale (NRS) to quantify the distress.
B Reposition the patient and provide a distraction like music.
C Administer the prescribed PRN sedative to manage the agitation.
D Assess the patient using the PAINAD scale to determine if the behavior is pain-related.
, D A nurse is providing teaching to a patient newly prescribed Alendronate (Fosamax) for osteo-
porosis. To ensure patient safety and prevent esophageal erosion, which instruction is the most
critical?
A Take the medication with a full glass of water and remain upright for at least 30 minutes.
B Take the medication immediately before bedtime to avoid daytime side effects.
C Crush the tablet if you have difficulty swallowing to ensure full absorption.
D Take the medication with a small snack to prevent GI upset.
E The nurse is evaluating the fall risk of four patients on a geriatric unit. Which patient should the
nurse identify as having the highest intrinsic risk for an injurious fall?
A A patient with a poorly lit room and cluttered floor.
B A patient who uses a cane improperly for long-distance walking.
C A patient with stable macular degeneration and hearing aids.
D A patient with a history of a hip fracture and current use of a diuretic.
F An older adult patient presents to the emergency department with sudden, severe eye pain,
blurred vision, and nausea. The nurse notes redness around the eye and a fixed, dilated pupil.
Which condition should the nurse prioritize as a medical emergency?
A Angle-Closure Glaucoma
B Cataracts
C Diabetic Retinopathy
D Primary Open-Angle Glaucoma (POAG)
G To prevent pressure injuries in an immobilized older adult, the nurse should maintain the head of
the bed (HOB) at what maximum angle, unless clinically contraindicated?
A 45 degrees
B 15 degrees
C 90 degrees
D 30 degrees
