NUR257 Aging and Chronic Illness in Nursing Exam 3
Question Bank (Latest 2026/2027 Edition) – Questions,
Answers & Detailed Rationales
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SECTION 1: Foundations of Gerontological Nursing and Theories of Aging
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Question 1
A nursing student is developing a care plan for an 82-year-old patient and applies the
Roy Adaptation Model. The patient recently experienced a hip fracture and is struggling
with changes in mobility, self-concept, and social role. Which nursing action best aligns
with this theoretical framework?
A. Focusing exclusively on physical rehabilitation to restore pre-injury function
B. Assessing the patient across all four adaptive modes (physiological, self-concept,
role function, interdependence) and promoting adaptive responses
C. Prioritizing discharge planning to minimize length of stay and hospital costs
D. Encouraging the patient to accept dependency as an inevitable consequence of aging
Correct Answer:
B — Assessing the patient across all four adaptive modes (physiological, self-concept,
role function, interdependence) and promoting adaptive responses
Rationale:
The Roy Adaptation Model emphasizes holistic assessment across four adaptive
modes to identify ineffective responses and promote adaptation; the patient's hip
fracture affects multiple modes simultaneously, requiring comprehensive intervention.
Distractor A reduces the patient to a single physiological dimension, contradicting the
model's holistic premise.
,Question 2
A nurse is caring for a 78-year-old patient who believes that aging inevitably means
physical and mental decline. The nurse plans education using the Theory of
Gerotranscendence. Which intervention best supports this theoretical perspective?
A. Encouraging the patient to maintain a busy schedule to avoid thinking about aging
B. Supporting the patient in finding new meaning, wisdom, and connection beyond
physical decline
C. Providing reality orientation to correct the patient's negative perceptions about aging
D. Focusing on reminiscence therapy to dwell exclusively on past accomplishments
Correct Answer:
B — Supporting the patient in finding new meaning, wisdom, and connection beyond
physical decline
Rationale:
Gerotranscendence theory posits that successful aging involves a shift from
materialistic and rational perspectives to cosmic transcendence, finding new meaning
and wisdom; the nurse should facilitate this developmental transition rather than deny
or correct it. Distractor A represents avoidance, while C pathologizes a normal
developmental perspective.
Question 3
A nurse is evaluating research on biological aging for a graduate-level project. Which
statement best reflects the current understanding of cellular senescence and its role in
aging?
A. Cellular senescence is entirely pathological and should be eliminated to prevent
aging
B. Senescent cells contribute to tissue repair and embryonic development but
accumulate with age, driving chronic inflammation and tissue dysfunction
C. Telomere shortening is the sole mechanism responsible for all age-related diseases
,D. Senescence only occurs in cancer cells and has no relevance to normal aging
processes
Correct Answer:
B — Senescent cells contribute to tissue repair and embryonic development but
accumulate with age, driving chronic inflammation and tissue dysfunction
Rationale:
Cellular senescence is a double-edged sword: it prevents cancer by halting proliferation
of damaged cells and contributes to wound healing, but senescent cell accumulation
with aging drives the senescence-associated secretory phenotype (SASP), promoting
chronic inflammation and tissue dysfunction. Distractor A oversimplifies by ignoring the
beneficial roles of senescence.
Question 4
A 75-year-old patient asks the nurse why older adults are more susceptible to
infections. The nurse explains that immunosenescence affects both innate and
adaptive immunity. Which specific change best explains increased infection
susceptibility in older adults?
A. Increased production of naive T-cells from the thymus
B. Decreased diversity of the T-cell receptor repertoire and impaired antigen
presentation
C. Enhanced macrophage phagocytic activity with age
D. Increased antibody affinity maturation in response to novel antigens
Correct Answer:
B — Decreased diversity of the T-cell receptor repertoire and impaired antigen
presentation
Rationale:
, Immunosenescence involves thymic involution reducing naive T-cell output, decreased
T-cell receptor diversity, impaired dendritic cell antigen presentation, and diminished
B-cell function, collectively reducing responses to novel pathogens and vaccines.
Distractor A is incorrect because thymic involution decreases, not increases, naive T-cell
production.
Question 5
A nurse is caring for a 68-year-old patient with early-stage Parkinson disease. The
patient asks about the relationship between aging and neurodegeneration. Which
explanation best reflects current understanding of the "multiple hit" hypothesis?
A. A single genetic mutation is sufficient to cause neurodegeneration regardless of age
B. Multiple interacting factors including genetic predisposition, environmental
exposures, and age-related cellular changes converge to exceed a threshold for
neurodegeneration
C. Aging alone causes neurodegeneration through inevitable neuronal death
D. Neurodegeneration is primarily caused by acute brain injury earlier in life
Correct Answer:
B — Multiple interacting factors including genetic predisposition, environmental
exposures, and age-related cellular changes converge to exceed a threshold for
neurodegeneration
Rationale:
The multiple hit hypothesis proposes that neurodegenerative diseases result from the
cumulative burden of genetic susceptibility, environmental toxins, lifestyle factors, and
age-related cellular changes (mitochondrial dysfunction, proteostasis failure) that
collectively exceed neuronal resilience capacity. Distractor C represents outdated
deterministic views of aging.
──────────────────────────────
SECTION 2: Physiological Changes of Aging and Functional Assessment
Question Bank (Latest 2026/2027 Edition) – Questions,
Answers & Detailed Rationales
──────────────────────────────
SECTION 1: Foundations of Gerontological Nursing and Theories of Aging
──────────────────────────────
Question 1
A nursing student is developing a care plan for an 82-year-old patient and applies the
Roy Adaptation Model. The patient recently experienced a hip fracture and is struggling
with changes in mobility, self-concept, and social role. Which nursing action best aligns
with this theoretical framework?
A. Focusing exclusively on physical rehabilitation to restore pre-injury function
B. Assessing the patient across all four adaptive modes (physiological, self-concept,
role function, interdependence) and promoting adaptive responses
C. Prioritizing discharge planning to minimize length of stay and hospital costs
D. Encouraging the patient to accept dependency as an inevitable consequence of aging
Correct Answer:
B — Assessing the patient across all four adaptive modes (physiological, self-concept,
role function, interdependence) and promoting adaptive responses
Rationale:
The Roy Adaptation Model emphasizes holistic assessment across four adaptive
modes to identify ineffective responses and promote adaptation; the patient's hip
fracture affects multiple modes simultaneously, requiring comprehensive intervention.
Distractor A reduces the patient to a single physiological dimension, contradicting the
model's holistic premise.
,Question 2
A nurse is caring for a 78-year-old patient who believes that aging inevitably means
physical and mental decline. The nurse plans education using the Theory of
Gerotranscendence. Which intervention best supports this theoretical perspective?
A. Encouraging the patient to maintain a busy schedule to avoid thinking about aging
B. Supporting the patient in finding new meaning, wisdom, and connection beyond
physical decline
C. Providing reality orientation to correct the patient's negative perceptions about aging
D. Focusing on reminiscence therapy to dwell exclusively on past accomplishments
Correct Answer:
B — Supporting the patient in finding new meaning, wisdom, and connection beyond
physical decline
Rationale:
Gerotranscendence theory posits that successful aging involves a shift from
materialistic and rational perspectives to cosmic transcendence, finding new meaning
and wisdom; the nurse should facilitate this developmental transition rather than deny
or correct it. Distractor A represents avoidance, while C pathologizes a normal
developmental perspective.
Question 3
A nurse is evaluating research on biological aging for a graduate-level project. Which
statement best reflects the current understanding of cellular senescence and its role in
aging?
A. Cellular senescence is entirely pathological and should be eliminated to prevent
aging
B. Senescent cells contribute to tissue repair and embryonic development but
accumulate with age, driving chronic inflammation and tissue dysfunction
C. Telomere shortening is the sole mechanism responsible for all age-related diseases
,D. Senescence only occurs in cancer cells and has no relevance to normal aging
processes
Correct Answer:
B — Senescent cells contribute to tissue repair and embryonic development but
accumulate with age, driving chronic inflammation and tissue dysfunction
Rationale:
Cellular senescence is a double-edged sword: it prevents cancer by halting proliferation
of damaged cells and contributes to wound healing, but senescent cell accumulation
with aging drives the senescence-associated secretory phenotype (SASP), promoting
chronic inflammation and tissue dysfunction. Distractor A oversimplifies by ignoring the
beneficial roles of senescence.
Question 4
A 75-year-old patient asks the nurse why older adults are more susceptible to
infections. The nurse explains that immunosenescence affects both innate and
adaptive immunity. Which specific change best explains increased infection
susceptibility in older adults?
A. Increased production of naive T-cells from the thymus
B. Decreased diversity of the T-cell receptor repertoire and impaired antigen
presentation
C. Enhanced macrophage phagocytic activity with age
D. Increased antibody affinity maturation in response to novel antigens
Correct Answer:
B — Decreased diversity of the T-cell receptor repertoire and impaired antigen
presentation
Rationale:
, Immunosenescence involves thymic involution reducing naive T-cell output, decreased
T-cell receptor diversity, impaired dendritic cell antigen presentation, and diminished
B-cell function, collectively reducing responses to novel pathogens and vaccines.
Distractor A is incorrect because thymic involution decreases, not increases, naive T-cell
production.
Question 5
A nurse is caring for a 68-year-old patient with early-stage Parkinson disease. The
patient asks about the relationship between aging and neurodegeneration. Which
explanation best reflects current understanding of the "multiple hit" hypothesis?
A. A single genetic mutation is sufficient to cause neurodegeneration regardless of age
B. Multiple interacting factors including genetic predisposition, environmental
exposures, and age-related cellular changes converge to exceed a threshold for
neurodegeneration
C. Aging alone causes neurodegeneration through inevitable neuronal death
D. Neurodegeneration is primarily caused by acute brain injury earlier in life
Correct Answer:
B — Multiple interacting factors including genetic predisposition, environmental
exposures, and age-related cellular changes converge to exceed a threshold for
neurodegeneration
Rationale:
The multiple hit hypothesis proposes that neurodegenerative diseases result from the
cumulative burden of genetic susceptibility, environmental toxins, lifestyle factors, and
age-related cellular changes (mitochondrial dysfunction, proteostasis failure) that
collectively exceed neuronal resilience capacity. Distractor C represents outdated
deterministic views of aging.
──────────────────────────────
SECTION 2: Physiological Changes of Aging and Functional Assessment
