NUR 257 EXAM 4 – CONCEPTS OF AGING AND CHRONIC ILLNESS
ACTUAL EXAM 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. An 82-year-old patient tells the nurse, “I have slowed down a lot since I
became older, so I assume these changes are just normal aging.” Which
response best distinguishes normal physiologic aging from disease-related
changes?
A. “All physical decline in older adults should be considered a normal
consequence of aging.”
B. “Aging can cause gradual physiologic changes, but significant functional
decline or new symptoms should be assessed for potentially treatable
causes.”
C. “Chronic diseases are expected in every older adult and usually do not
require intervention.”
D. “Most new symptoms in older adults should be managed without
diagnostic evaluation.”
Answer: B
2. A 79-year-old woman has thinner, drier skin and reports increased itching
during the winter. Which nursing intervention is most appropriate to
protect her aging skin?
A. Encourage frequent hot showers to remove dry skin
B. Apply alcohol-based products after bathing
C. Use mild cleansers, lukewarm water, and moisturizers after bathing
D. Scrub the skin vigorously with a rough washcloth
Answer: C
3. A 76-year-old man asks why he becomes chilled more easily than he did
when he was younger. Which explanation is most accurate?
A. Older adults generally have reduced ability to regulate body temperature
because of changes in metabolism, subcutaneous tissue, and physiologic
responses.
B. Aging consistently causes excessive thyroid activity that makes
pg. 1
, temperature regulation unstable.
C. Older adults produce substantially more body heat during periods of rest.
D. Aging increases the thickness of subcutaneous tissue and therefore
causes excessive heat loss.
Answer: A
4. An 84-year-old patient is admitted with pneumonia and has a temperature
of 99.5°F, new confusion, weakness, and tachypnea. Which nursing
interpretation is most appropriate?
A. The absence of a high fever excludes a significant infection.
B. Confusion is an expected and harmless consequence of aging.
C. The patient's symptoms indicate only chronic dementia.
D. Older adults may have atypical presentations of infection, so the change
in cognition and respiratory status requires prompt assessment.
Answer: D
5. A 77-year-old woman reports waking several times during the night and
sleeping more lightly than she did in middle age. Which nursing response is
most appropriate?
A. Explain that some changes in sleep architecture occur with aging, but
persistent insomnia should still be evaluated for contributing factors.
B. Explain that older adults should sleep continuously for at least 10 hours
every night.
C. Recommend sedative medication as the first intervention for every older
adult with nighttime awakening.
D. Tell her that sleep disruption is always caused by dementia.
Answer: A
6. A 81-year-old patient has difficulty hearing conversations in a crowded
dining room but understands speech clearly in a quiet room. Which
intervention would best promote communication?
A. Speak rapidly and loudly from another room.
B. Face the patient, reduce background noise, and speak clearly at a normal
pace.
pg. 2
, C. Assume the patient has cognitive impairment.
D. Avoid using verbal communication and provide no alternative.
Answer: B
7. An older adult with presbyopia reports difficulty reading medication labels.
Which intervention should the nurse recommend?
A. Hold reading material farther away from the face.
B. Reduce lighting to decrease visual stimulation.
C. Use adequate lighting and appropriate corrective lenses.
D. Stop reading medication labels and rely on memory.
Answer: C
8. A 74-year-old patient has gradual hearing loss and asks whether it means
that cognitive impairment has developed. Which response is most
appropriate?
A. “Hearing loss always indicates dementia.”
B. “Hearing loss and cognitive impairment are completely unrelated.”
C. “You should avoid social interactions until your hearing improves.”
D. “Hearing loss can interfere with communication, but it does not by itself
establish cognitive impairment.”
Answer: D
9. A 80-year-old patient experiences decreased muscle mass and reduced
strength compared with earlier adulthood. Which nursing intervention is
most appropriate for maintaining function when medically appropriate?
A. Encourage resistance and strength-training activities appropriate to the
patient's condition.
B. Recommend prolonged bed rest.
C. Eliminate weight-bearing activity.
D. Encourage only passive range-of-motion exercises regardless of ability.
Answer: A
10. A 78-year-old patient has decreased bone density but no history of
fractures. Which intervention is most appropriate for reducing future
fracture risk?
pg. 3
, A. Encourage prolonged inactivity.
B. Avoid all weight-bearing activity.
C. Promote appropriate weight-bearing exercise, fall prevention, and
adequate nutritional support.
D. Recommend bed rest whenever the patient experiences mild
musculoskeletal discomfort.
Answer: C
11. A 81-year-old woman has a history of osteoporosis and asks why preventing
falls is emphasized even though she takes osteoporosis medication. Which
explanation is best?
A. Osteoporosis medications eliminate all fracture risk.
B. Falls can cause fractures in individuals with reduced bone strength, so fall
prevention remains important.
C. Falls have no relationship to fracture occurrence.
D. Bone density increases immediately after a fall.
Answer: B
12. A 79-year-old patient has decreased renal function associated with aging.
Which medication-related concern should the nurse recognize?
A. Older adults always eliminate medications more rapidly.
B. Renal function has no effect on medication clearance.
C. Reduced renal clearance may increase exposure to medications
eliminated through the kidneys.
D. Renal function normally doubles after age 70.
Answer: C
13. A 83-year-old patient has decreased hepatic blood flow and takes several
medications metabolized by the liver. Which nursing consideration is most
appropriate?
A. Monitor for medication accumulation and adverse effects when hepatic
metabolism may be reduced.
B. Assume all medications will be eliminated more rapidly.
C. Automatically double medication doses.
pg. 4
ACTUAL EXAM 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. An 82-year-old patient tells the nurse, “I have slowed down a lot since I
became older, so I assume these changes are just normal aging.” Which
response best distinguishes normal physiologic aging from disease-related
changes?
A. “All physical decline in older adults should be considered a normal
consequence of aging.”
B. “Aging can cause gradual physiologic changes, but significant functional
decline or new symptoms should be assessed for potentially treatable
causes.”
C. “Chronic diseases are expected in every older adult and usually do not
require intervention.”
D. “Most new symptoms in older adults should be managed without
diagnostic evaluation.”
Answer: B
2. A 79-year-old woman has thinner, drier skin and reports increased itching
during the winter. Which nursing intervention is most appropriate to
protect her aging skin?
A. Encourage frequent hot showers to remove dry skin
B. Apply alcohol-based products after bathing
C. Use mild cleansers, lukewarm water, and moisturizers after bathing
D. Scrub the skin vigorously with a rough washcloth
Answer: C
3. A 76-year-old man asks why he becomes chilled more easily than he did
when he was younger. Which explanation is most accurate?
A. Older adults generally have reduced ability to regulate body temperature
because of changes in metabolism, subcutaneous tissue, and physiologic
responses.
B. Aging consistently causes excessive thyroid activity that makes
pg. 1
, temperature regulation unstable.
C. Older adults produce substantially more body heat during periods of rest.
D. Aging increases the thickness of subcutaneous tissue and therefore
causes excessive heat loss.
Answer: A
4. An 84-year-old patient is admitted with pneumonia and has a temperature
of 99.5°F, new confusion, weakness, and tachypnea. Which nursing
interpretation is most appropriate?
A. The absence of a high fever excludes a significant infection.
B. Confusion is an expected and harmless consequence of aging.
C. The patient's symptoms indicate only chronic dementia.
D. Older adults may have atypical presentations of infection, so the change
in cognition and respiratory status requires prompt assessment.
Answer: D
5. A 77-year-old woman reports waking several times during the night and
sleeping more lightly than she did in middle age. Which nursing response is
most appropriate?
A. Explain that some changes in sleep architecture occur with aging, but
persistent insomnia should still be evaluated for contributing factors.
B. Explain that older adults should sleep continuously for at least 10 hours
every night.
C. Recommend sedative medication as the first intervention for every older
adult with nighttime awakening.
D. Tell her that sleep disruption is always caused by dementia.
Answer: A
6. A 81-year-old patient has difficulty hearing conversations in a crowded
dining room but understands speech clearly in a quiet room. Which
intervention would best promote communication?
A. Speak rapidly and loudly from another room.
B. Face the patient, reduce background noise, and speak clearly at a normal
pace.
pg. 2
, C. Assume the patient has cognitive impairment.
D. Avoid using verbal communication and provide no alternative.
Answer: B
7. An older adult with presbyopia reports difficulty reading medication labels.
Which intervention should the nurse recommend?
A. Hold reading material farther away from the face.
B. Reduce lighting to decrease visual stimulation.
C. Use adequate lighting and appropriate corrective lenses.
D. Stop reading medication labels and rely on memory.
Answer: C
8. A 74-year-old patient has gradual hearing loss and asks whether it means
that cognitive impairment has developed. Which response is most
appropriate?
A. “Hearing loss always indicates dementia.”
B. “Hearing loss and cognitive impairment are completely unrelated.”
C. “You should avoid social interactions until your hearing improves.”
D. “Hearing loss can interfere with communication, but it does not by itself
establish cognitive impairment.”
Answer: D
9. A 80-year-old patient experiences decreased muscle mass and reduced
strength compared with earlier adulthood. Which nursing intervention is
most appropriate for maintaining function when medically appropriate?
A. Encourage resistance and strength-training activities appropriate to the
patient's condition.
B. Recommend prolonged bed rest.
C. Eliminate weight-bearing activity.
D. Encourage only passive range-of-motion exercises regardless of ability.
Answer: A
10. A 78-year-old patient has decreased bone density but no history of
fractures. Which intervention is most appropriate for reducing future
fracture risk?
pg. 3
, A. Encourage prolonged inactivity.
B. Avoid all weight-bearing activity.
C. Promote appropriate weight-bearing exercise, fall prevention, and
adequate nutritional support.
D. Recommend bed rest whenever the patient experiences mild
musculoskeletal discomfort.
Answer: C
11. A 81-year-old woman has a history of osteoporosis and asks why preventing
falls is emphasized even though she takes osteoporosis medication. Which
explanation is best?
A. Osteoporosis medications eliminate all fracture risk.
B. Falls can cause fractures in individuals with reduced bone strength, so fall
prevention remains important.
C. Falls have no relationship to fracture occurrence.
D. Bone density increases immediately after a fall.
Answer: B
12. A 79-year-old patient has decreased renal function associated with aging.
Which medication-related concern should the nurse recognize?
A. Older adults always eliminate medications more rapidly.
B. Renal function has no effect on medication clearance.
C. Reduced renal clearance may increase exposure to medications
eliminated through the kidneys.
D. Renal function normally doubles after age 70.
Answer: C
13. A 83-year-old patient has decreased hepatic blood flow and takes several
medications metabolized by the liver. Which nursing consideration is most
appropriate?
A. Monitor for medication accumulation and adverse effects when hepatic
metabolism may be reduced.
B. Assume all medications will be eliminated more rapidly.
C. Automatically double medication doses.
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