NUR 257 EXAM 4: CONCEPTS OF AGING AND CHRONIC
ILLNESS QUESTIONS AND CORRECT ANSWERS |
LATEST UPDATE 2026/2027 PDF
CORE DOMAINS
Normal Physiological Aging
Chronic Illness Foundations and Models
Geriatric Syndromes and Functional Assessment
Chronic Disease Management and Pharmacologic Considerations
Sensory Changes, Sleep, and Elimination
INTRODUCTION
The NUR 257 Exam 4 assesses the competency of nursing students at Galen
College of Nursing in caring for aging adults with chronic illness. This
comprehensive assessment evaluates knowledge across critical domains including
normal physiological aging, chronic illness characteristics, geriatric syndromes,
polypharmacy, sensory changes, and elimination disorders . The examination
employs multiple-choice and scenario-based questions requiring candidates to
demonstrate applied clinical judgment and decision-making skills essential for
gerontological nursing practice. Emphasis is placed on evidence-based
interventions, patient-centered care, and understanding the unique physiological
and psychosocial needs of the aging population .
SECTION ONE: QUESTIONS 1–100
Question 1
An 82-year-old woman visits the clinic reporting difficulty reading restaurant
menus and threading needles despite having 20/20 distance vision. Pupillary
response is intact. Which age-related change best explains her complaint?
,A. Loss of lens elasticity (presbyopia)
B. Nuclear sclerosis of the lens
C. Macular degeneration
D. Increased vitreous floaters
A. Loss of lens elasticity (presbyopia)
RATIONALE: Presbyopia is caused by loss of lens elasticity and reduced
ciliary muscle function, which impairs near accommodation while leaving distance
vision intact. Nuclear sclerosis would cloud vision at all distances; macular
degeneration affects central acuity; floaters cause spot-like visual disturbances
rather than reading difficulty .
Question 2
A 75-year-old male reports gradually needing the television volume louder and
having more trouble understanding speech in noisy restaurants. Audiometry shows
symmetric high-frequency sensorineural loss. Which age-related auditory change is
most likely responsible?
A. Cerumen impaction in the external canal
B. Otosclerosis of the stapes
C. Degeneration of hair cells at the cochlear base
D. Recurrent otitis media with effusion
C. Degeneration of hair cells at the cochlear base
RATIONALE: Presbycusis involves progressive loss of cochlear hair cells,
particularly at the base where high frequencies are processed, producing
symmetric high-frequency sensorineural loss. Cerumen impaction and otitis media
cause conductive loss; otosclerosis is not an age-related change .
Question 3
A nurse notes a 78-year-old patient's skin appears paper-thin with multiple
ecchymoses on the dorsal hands despite no trauma. Which age-related skin change
most directly accounts for this finding?
,A. Decreased melanocyte production
B. Thinning of the dermis and subcutaneous fat
C. Increased sebaceous gland activity
D. Reduced eccrine sweat gland density
B. Thinning of the dermis and subcutaneous fat
RATIONALE: Aging causes dermal thinning and loss of subcutaneous fat,
making blood vessels more fragile and prone to tearing with minor trauma .
Question 4
Which of the following would be a characteristic of a chronic illness?
A. Reversible pathology
B. Requires short-term surveillance
C. Cure likely
D. Slow, progressive decline
D. Slow, progressive decline
RATIONALE: Chronic illnesses are characterized by a slow, progressive
decline in function over time. They typically involve ongoing management rather
than cure, require long-term surveillance, and are not reversible .
Question 5
A nurse is caring for a client with multiple chronic conditions and some physical
disabilities. The nurse is using "people-first" language. Which statement during
end-of-shift report best demonstrates this?
A. "Mr. Rudd is a 44-year-old diabetic patient who was admitted last evening."
B. "Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to
the unit."
C. "I admitted another diabetic patient last evening; his name is Mr. Rudd."
D. "A new diabetic admit came to the floor last night during my shift."
B. "Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted
to the unit."
, RATIONALE: People-first language emphasizes the person before the
condition. The correct statement places "patient with diabetes" rather than
labeling the person as "diabetic," respecting the individual's identity .
Question 6
Which model of disability views disability as a problem of the person, focusing on
impairment and treatment?
A. Social model
B. Medical model
C. Chronic care model
D. Rehabilitation model
B. Medical model
RATIONALE: The medical model views disability as a problem of the person,
focusing on impairment and treatment. The social model, in contrast, views
disability as a societal issue requiring environmental and social adaptations .
Question 7
By 2050, approximately what percent of the population is projected to have a
chronic illness?
A. 25%
B. 50%
C. 35%
D. 40%
B. 50%
RATIONALE: By 2050, approximately 50% of the population is projected to
have a chronic illness. This reflects the aging population and increasing
prevalence of chronic conditions .
Question 8
ILLNESS QUESTIONS AND CORRECT ANSWERS |
LATEST UPDATE 2026/2027 PDF
CORE DOMAINS
Normal Physiological Aging
Chronic Illness Foundations and Models
Geriatric Syndromes and Functional Assessment
Chronic Disease Management and Pharmacologic Considerations
Sensory Changes, Sleep, and Elimination
INTRODUCTION
The NUR 257 Exam 4 assesses the competency of nursing students at Galen
College of Nursing in caring for aging adults with chronic illness. This
comprehensive assessment evaluates knowledge across critical domains including
normal physiological aging, chronic illness characteristics, geriatric syndromes,
polypharmacy, sensory changes, and elimination disorders . The examination
employs multiple-choice and scenario-based questions requiring candidates to
demonstrate applied clinical judgment and decision-making skills essential for
gerontological nursing practice. Emphasis is placed on evidence-based
interventions, patient-centered care, and understanding the unique physiological
and psychosocial needs of the aging population .
SECTION ONE: QUESTIONS 1–100
Question 1
An 82-year-old woman visits the clinic reporting difficulty reading restaurant
menus and threading needles despite having 20/20 distance vision. Pupillary
response is intact. Which age-related change best explains her complaint?
,A. Loss of lens elasticity (presbyopia)
B. Nuclear sclerosis of the lens
C. Macular degeneration
D. Increased vitreous floaters
A. Loss of lens elasticity (presbyopia)
RATIONALE: Presbyopia is caused by loss of lens elasticity and reduced
ciliary muscle function, which impairs near accommodation while leaving distance
vision intact. Nuclear sclerosis would cloud vision at all distances; macular
degeneration affects central acuity; floaters cause spot-like visual disturbances
rather than reading difficulty .
Question 2
A 75-year-old male reports gradually needing the television volume louder and
having more trouble understanding speech in noisy restaurants. Audiometry shows
symmetric high-frequency sensorineural loss. Which age-related auditory change is
most likely responsible?
A. Cerumen impaction in the external canal
B. Otosclerosis of the stapes
C. Degeneration of hair cells at the cochlear base
D. Recurrent otitis media with effusion
C. Degeneration of hair cells at the cochlear base
RATIONALE: Presbycusis involves progressive loss of cochlear hair cells,
particularly at the base where high frequencies are processed, producing
symmetric high-frequency sensorineural loss. Cerumen impaction and otitis media
cause conductive loss; otosclerosis is not an age-related change .
Question 3
A nurse notes a 78-year-old patient's skin appears paper-thin with multiple
ecchymoses on the dorsal hands despite no trauma. Which age-related skin change
most directly accounts for this finding?
,A. Decreased melanocyte production
B. Thinning of the dermis and subcutaneous fat
C. Increased sebaceous gland activity
D. Reduced eccrine sweat gland density
B. Thinning of the dermis and subcutaneous fat
RATIONALE: Aging causes dermal thinning and loss of subcutaneous fat,
making blood vessels more fragile and prone to tearing with minor trauma .
Question 4
Which of the following would be a characteristic of a chronic illness?
A. Reversible pathology
B. Requires short-term surveillance
C. Cure likely
D. Slow, progressive decline
D. Slow, progressive decline
RATIONALE: Chronic illnesses are characterized by a slow, progressive
decline in function over time. They typically involve ongoing management rather
than cure, require long-term surveillance, and are not reversible .
Question 5
A nurse is caring for a client with multiple chronic conditions and some physical
disabilities. The nurse is using "people-first" language. Which statement during
end-of-shift report best demonstrates this?
A. "Mr. Rudd is a 44-year-old diabetic patient who was admitted last evening."
B. "Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted to
the unit."
C. "I admitted another diabetic patient last evening; his name is Mr. Rudd."
D. "A new diabetic admit came to the floor last night during my shift."
B. "Last evening, Mr. Rudd, a 44-year-old patient with diabetes was admitted
to the unit."
, RATIONALE: People-first language emphasizes the person before the
condition. The correct statement places "patient with diabetes" rather than
labeling the person as "diabetic," respecting the individual's identity .
Question 6
Which model of disability views disability as a problem of the person, focusing on
impairment and treatment?
A. Social model
B. Medical model
C. Chronic care model
D. Rehabilitation model
B. Medical model
RATIONALE: The medical model views disability as a problem of the person,
focusing on impairment and treatment. The social model, in contrast, views
disability as a societal issue requiring environmental and social adaptations .
Question 7
By 2050, approximately what percent of the population is projected to have a
chronic illness?
A. 25%
B. 50%
C. 35%
D. 40%
B. 50%
RATIONALE: By 2050, approximately 50% of the population is projected to
have a chronic illness. This reflects the aging population and increasing
prevalence of chronic conditions .
Question 8
