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 client tells the nurse, “I have noticed that my skin is much
thinner and drier than it used to be, and small bruises seem to appear more
easily.” Which age-related physiological change best explains these
findings?
A. Increased subcutaneous fat and sebaceous gland activity
B. Increased collagen production and dermal thickness
C. Reduced dermal thickness, decreased subcutaneous tissue, and reduced
glandular activity
D. Increased peripheral circulation and increased sweat production
Answer: C
2. An older adult reports becoming chilled easily while sitting in an air-
conditioned room. The nurse explains that normal aging can affect
thermoregulation primarily because of which change?
A. Reduced metabolic rate, diminished subcutaneous insulation, and
impaired vasomotor responses
B. Increased thyroid hormone secretion and increased muscle mass
C. Increased brown fat production and enhanced shivering
D. Increased peripheral blood flow and increased sweat gland activity
Answer: A
3. A 79-year-old client asks whether needing additional time to remember a
person's name always indicates dementia. Which response by the nurse is
most appropriate?
A. “Any memory change after age 65 indicates early dementia.”
B. “Normal aging may slow retrieval of information, but significant
progressive impairment affecting daily function requires evaluation.”
C. “Dementia occurs whenever an older adult needs more time to learn
new information.”
pg. 1
, D. “Memory loss is expected with aging and should never be evaluated.”
Answer: B
4. An older adult is being assessed for sensory changes associated with normal
aging. Which finding should the nurse recognize as an expected age-related
change?
A. Complete loss of the ability to recognize familiar voices
B. Sudden unilateral hearing loss
C. Persistent double vision
D. Increased difficulty distinguishing certain high-frequency sounds
Answer: D
5. A nurse is teaching an older adult about maintaining bone health. Which
intervention is most appropriate for reducing age-related bone loss when
medically appropriate?
A. Regular weight-bearing activity combined with adequate calcium and
vitamin D intake
B. Prolonged bed rest to prevent skeletal stress
C. Avoidance of all resistance exercises after age 65
D. Increasing sodium intake to improve calcium retention
Answer: A
6. An 84-year-old client has become increasingly dependent on others for
bathing, dressing, and toileting following a prolonged hospitalization. Which
concept best describes these abilities?
A. Instrumental activities of daily living
B. Health promotion behaviors
C. Activities of daily living
D. Advanced cognitive functions
Answer: C
7. A nurse is assessing an older adult who independently manages finances,
prepares meals, shops for groceries, and uses public transportation. Which
category of function is the nurse primarily evaluating?
A. Basic activities of daily living
pg. 2
, B. Instrumental activities of daily living
C. Reflexive motor function
D. Physical reserve
Answer: B
8. An older client who normally lives independently develops confusion,
fluctuating attention, and disorganized thinking over several hours after
being admitted with a urinary infection. Which condition should the nurse
suspect?
A. Normal cognitive aging
B. Chronic dementia
C. Depression
D. Delirium
Answer: D
9. A nurse is caring for an older adult with chronic illness who says, “I can
manage my condition, but I need to know how it will affect my ability to live
independently.” Which nursing response best reflects person-centered
chronic illness care?
A. “Your diagnosis determines exactly what your future will be.”
B. “You should allow your family to make most of your decisions.”
C. “Let’s identify the activities and goals that are most important to you and
develop strategies to support them.”
D. “The safest approach is to avoid activities that might worsen your
condition.”
Answer: C
10. An older adult with multiple chronic conditions takes eight prescription
medications and several over-the-counter products. Which nursing action is
most important for reducing medication-related harm?
A. Perform a comprehensive medication reconciliation that includes
prescription, nonprescription, and herbal products.
B. Encourage the client to stop all nonessential medications independently.
C. Recommend taking all medications together to simplify the schedule.
pg. 3
, D. Tell the client to use another person's medication list if questions arise.
Answer: A
11. A frail older adult becomes weak and dizzy after developing a mild
respiratory infection. Which characteristic of frailty best explains the client's
increased vulnerability?
A. Increased physiological reserve
B. Decreased physiological reserve and reduced ability to recover from
stressors
C. Complete absence of chronic illness
D. Increased ability to compensate for physiological stress
Answer: B
12. A nurse is assessing an older adult for frailty. Which cluster of findings is
most concerning for a frailty syndrome?
A. Stable weight, regular exercise, and strong grip
B. Increased appetite, rapid gait, and improved endurance
C. Mild presbyopia, gray hair, and decreased hearing
D. Unintentional weight loss, weakness, exhaustion, and slowed mobility
Answer: D
13. An older adult with chronic heart failure says, “Some days I feel almost
normal, and other days I cannot walk across the room without becoming
short of breath.” Which concept should the nurse use when planning care?
A. Chronic illness can follow a fluctuating trajectory with periods of stability
and exacerbation.
B. Chronic illnesses always progress at a constant rate.
C. Symptoms that fluctuate indicate that the original diagnosis was
incorrect.
D. Functional limitations in chronic illness are always permanent and
irreversible.
Answer: A
14. A client with chronic obstructive pulmonary disease asks why conserving
energy is important. Which explanation by the nurse is most appropriate?
pg. 4
ACTUAL EXAM 2026/2027 PRACTICE QUESTIONS AND STUDY GUIDE
COMPLETE ACCURATE EXAM
1. An 82-year-old client tells the nurse, “I have noticed that my skin is much
thinner and drier than it used to be, and small bruises seem to appear more
easily.” Which age-related physiological change best explains these
findings?
A. Increased subcutaneous fat and sebaceous gland activity
B. Increased collagen production and dermal thickness
C. Reduced dermal thickness, decreased subcutaneous tissue, and reduced
glandular activity
D. Increased peripheral circulation and increased sweat production
Answer: C
2. An older adult reports becoming chilled easily while sitting in an air-
conditioned room. The nurse explains that normal aging can affect
thermoregulation primarily because of which change?
A. Reduced metabolic rate, diminished subcutaneous insulation, and
impaired vasomotor responses
B. Increased thyroid hormone secretion and increased muscle mass
C. Increased brown fat production and enhanced shivering
D. Increased peripheral blood flow and increased sweat gland activity
Answer: A
3. A 79-year-old client asks whether needing additional time to remember a
person's name always indicates dementia. Which response by the nurse is
most appropriate?
A. “Any memory change after age 65 indicates early dementia.”
B. “Normal aging may slow retrieval of information, but significant
progressive impairment affecting daily function requires evaluation.”
C. “Dementia occurs whenever an older adult needs more time to learn
new information.”
pg. 1
, D. “Memory loss is expected with aging and should never be evaluated.”
Answer: B
4. An older adult is being assessed for sensory changes associated with normal
aging. Which finding should the nurse recognize as an expected age-related
change?
A. Complete loss of the ability to recognize familiar voices
B. Sudden unilateral hearing loss
C. Persistent double vision
D. Increased difficulty distinguishing certain high-frequency sounds
Answer: D
5. A nurse is teaching an older adult about maintaining bone health. Which
intervention is most appropriate for reducing age-related bone loss when
medically appropriate?
A. Regular weight-bearing activity combined with adequate calcium and
vitamin D intake
B. Prolonged bed rest to prevent skeletal stress
C. Avoidance of all resistance exercises after age 65
D. Increasing sodium intake to improve calcium retention
Answer: A
6. An 84-year-old client has become increasingly dependent on others for
bathing, dressing, and toileting following a prolonged hospitalization. Which
concept best describes these abilities?
A. Instrumental activities of daily living
B. Health promotion behaviors
C. Activities of daily living
D. Advanced cognitive functions
Answer: C
7. A nurse is assessing an older adult who independently manages finances,
prepares meals, shops for groceries, and uses public transportation. Which
category of function is the nurse primarily evaluating?
A. Basic activities of daily living
pg. 2
, B. Instrumental activities of daily living
C. Reflexive motor function
D. Physical reserve
Answer: B
8. An older client who normally lives independently develops confusion,
fluctuating attention, and disorganized thinking over several hours after
being admitted with a urinary infection. Which condition should the nurse
suspect?
A. Normal cognitive aging
B. Chronic dementia
C. Depression
D. Delirium
Answer: D
9. A nurse is caring for an older adult with chronic illness who says, “I can
manage my condition, but I need to know how it will affect my ability to live
independently.” Which nursing response best reflects person-centered
chronic illness care?
A. “Your diagnosis determines exactly what your future will be.”
B. “You should allow your family to make most of your decisions.”
C. “Let’s identify the activities and goals that are most important to you and
develop strategies to support them.”
D. “The safest approach is to avoid activities that might worsen your
condition.”
Answer: C
10. An older adult with multiple chronic conditions takes eight prescription
medications and several over-the-counter products. Which nursing action is
most important for reducing medication-related harm?
A. Perform a comprehensive medication reconciliation that includes
prescription, nonprescription, and herbal products.
B. Encourage the client to stop all nonessential medications independently.
C. Recommend taking all medications together to simplify the schedule.
pg. 3
, D. Tell the client to use another person's medication list if questions arise.
Answer: A
11. A frail older adult becomes weak and dizzy after developing a mild
respiratory infection. Which characteristic of frailty best explains the client's
increased vulnerability?
A. Increased physiological reserve
B. Decreased physiological reserve and reduced ability to recover from
stressors
C. Complete absence of chronic illness
D. Increased ability to compensate for physiological stress
Answer: B
12. A nurse is assessing an older adult for frailty. Which cluster of findings is
most concerning for a frailty syndrome?
A. Stable weight, regular exercise, and strong grip
B. Increased appetite, rapid gait, and improved endurance
C. Mild presbyopia, gray hair, and decreased hearing
D. Unintentional weight loss, weakness, exhaustion, and slowed mobility
Answer: D
13. An older adult with chronic heart failure says, “Some days I feel almost
normal, and other days I cannot walk across the room without becoming
short of breath.” Which concept should the nurse use when planning care?
A. Chronic illness can follow a fluctuating trajectory with periods of stability
and exacerbation.
B. Chronic illnesses always progress at a constant rate.
C. Symptoms that fluctuate indicate that the original diagnosis was
incorrect.
D. Functional limitations in chronic illness are always permanent and
irreversible.
Answer: A
14. A client with chronic obstructive pulmonary disease asks why conserving
energy is important. Which explanation by the nurse is most appropriate?
pg. 4
