NUR 257 Chronic Exam 4 Galen College of
Nursing - Concepts of Aging & Chronic
Illness 100% Correct Questions and Answers
| 206/2027 Update
COVERAGE OVERVIEW
This comprehensive guide provides 100 verified multiple-choice questions and
answers for Galen College of Nursing's NUR 257 Chronic Exam 4. The exam covers
concepts of aging and chronic illness, with emphasis on pain management, musculoskeletal
disorders, sensory alterations, neurological conditions, endocrine disorders, and end-of-life
Topic Area
Pain & Comfort Management
Musculoskeletal Disorders
Sensory Alterations
Sleep Disorders & Neurological
Conditions
Endocrine & Metabolic Disorders
Cardiovascular & Respiratory
Palliative & End-of-Life Care
Safety & Polypharmacy
,SECTION 1: PAIN & COMFORT MANAGEMENT
Question 1
An 82-year-old patient with chronic osteoarthritis rates their pain as 6/10. The patient has a
history of gastric ulcers. Which analgesic order should the nurse question?
A. Acetaminophen 650 mg PO every 6 hours PRN
B. Ibuprofen 600 mg PO every 8 hours PRN
C. Lidocaine patch 5% applied to affected joint
D. Tramadol 50 mg PO every 6 hours PRN
Explanation: Ibuprofen is an NSAID that can cause GI bleeding and is contraindicated in
patients with a history of gastric ulcers. The Beers Criteria also recommends avoiding
NSAIDs in older adults due to GI and renal risks .
Question 2
A patient with chronic low back pain has been using a fentanyl patch for 6 months. The
nurse notes the patient has a respiratory rate of 10 breaths/minute and is difficult to arouse.
What is the priority action?
A. Remove the fentanyl patch immediately
B. Apply oxygen via nasal cannula
C. Administer naloxone (Narcan) per protocol
D. Stimulate the patient to wake up
Explanation: Respiratory depression (RR <12) with altered mental status indicates opioid
toxicity. Naloxone is the antidote and should be administered immediately per protocol .
Question 3
A patient with diabetic neuropathy reports burning and tingling in both feet. Which
medication does the nurse anticipate the provider will prescribe?
A. Hydromorphone (Dilaudid)
B. Gabapentin (Neurontin)
C. Ketorolac (Toradol)
D. Cyclobenzaprine (Flexeril)
,Explanation: Neuropathic pain is managed with adjuvant analgesics such as gabapentin,
pregabalin, or duloxetine. Opioids are not first-line treatment for neuropathic pain .
Question 4
The nurse is teaching a patient about non-pharmacological pain management for chronic
arthritis. Which statement indicates correct understanding?
A. "I should avoid moving my joints to prevent pain."
B. "Applying heat before activity can help reduce stiffness."
C. "Cold packs should be used for at least 45 minutes."
D. "Exercise will make my arthritis worse over time."
Explanation: Heat therapy before activity reduces joint stiffness. Cold packs are used for
acute inflammation, but should be applied for 15-20 minutes only. Regular exercise is
essential for maintaining joint function .
Question 5
An older adult patient with dementia is moaning, guarding their abdomen, and refusing to
eat. The patient cannot self-report pain. What should the nurse do first?
A. Notify the healthcare provider
B. Administer PRN acetaminophen
C. Use a behavioral pain assessment scale
D. Distract the patient with music
Explanation: When patients cannot self-report pain (e.g., due to dementia, cognitive
impairment, or aphasia), a validated behavioral pain assessment scale such as PAINAD or
PACSLAC should be used to assess pain. The nurse should assess first, then intervene .
Question 6
A patient with chronic pain has been taking oxycodone for 3 months. The patient reports
needing higher doses to achieve the same relief. The nurse recognizes this as:
A. Addiction
B. Tolerance
C. Dependence
D. Pseudoaddiction
, Explanation: Tolerance is a normal physiologic response where increasing doses are
needed to achieve the same effect. It is not addiction (which includes compulsive use) .
Question 7
Which of the following is a COMMON misconception about pain management in older
adults?
A. Older adults have a higher incidence of chronic illness
B. Chronic pain patients have a higher tolerance to pain
C. Older adults have decreased liver and renal function affecting drug metabolism
D. Pain is subjective and should be assessed based on patient report
Explanation: A common misconception is that chronic pain patients have a higher tolerance
to pain. Other misconceptions include that chronic pain is related to psychological disease,
or that patients with chronic pain are manipulative or exaggerating their symptoms .
Question 8
The most serious side effect of opioid analgesics is:
A. Constipation
B. Nausea and vomiting
C. Respiratory depression
D. Pruritus
Explanation: Respiratory depression is the most serious side effect of opioids. Notable
changes include shallow respirations and decreased respiratory rate. Constipation is a
common but not life-threatening side effect .
Question 9
A patient with chronic pain is prescribed a fentanyl patch. What is the most important
instruction for the nurse to provide?
A. Apply heat to the patch site for better absorption
B. Do not apply heat or use heating pads near the patch
C. Change the patch every 24 hours
D. Apply the patch to a hairy area for better adhesion
Nursing - Concepts of Aging & Chronic
Illness 100% Correct Questions and Answers
| 206/2027 Update
COVERAGE OVERVIEW
This comprehensive guide provides 100 verified multiple-choice questions and
answers for Galen College of Nursing's NUR 257 Chronic Exam 4. The exam covers
concepts of aging and chronic illness, with emphasis on pain management, musculoskeletal
disorders, sensory alterations, neurological conditions, endocrine disorders, and end-of-life
Topic Area
Pain & Comfort Management
Musculoskeletal Disorders
Sensory Alterations
Sleep Disorders & Neurological
Conditions
Endocrine & Metabolic Disorders
Cardiovascular & Respiratory
Palliative & End-of-Life Care
Safety & Polypharmacy
,SECTION 1: PAIN & COMFORT MANAGEMENT
Question 1
An 82-year-old patient with chronic osteoarthritis rates their pain as 6/10. The patient has a
history of gastric ulcers. Which analgesic order should the nurse question?
A. Acetaminophen 650 mg PO every 6 hours PRN
B. Ibuprofen 600 mg PO every 8 hours PRN
C. Lidocaine patch 5% applied to affected joint
D. Tramadol 50 mg PO every 6 hours PRN
Explanation: Ibuprofen is an NSAID that can cause GI bleeding and is contraindicated in
patients with a history of gastric ulcers. The Beers Criteria also recommends avoiding
NSAIDs in older adults due to GI and renal risks .
Question 2
A patient with chronic low back pain has been using a fentanyl patch for 6 months. The
nurse notes the patient has a respiratory rate of 10 breaths/minute and is difficult to arouse.
What is the priority action?
A. Remove the fentanyl patch immediately
B. Apply oxygen via nasal cannula
C. Administer naloxone (Narcan) per protocol
D. Stimulate the patient to wake up
Explanation: Respiratory depression (RR <12) with altered mental status indicates opioid
toxicity. Naloxone is the antidote and should be administered immediately per protocol .
Question 3
A patient with diabetic neuropathy reports burning and tingling in both feet. Which
medication does the nurse anticipate the provider will prescribe?
A. Hydromorphone (Dilaudid)
B. Gabapentin (Neurontin)
C. Ketorolac (Toradol)
D. Cyclobenzaprine (Flexeril)
,Explanation: Neuropathic pain is managed with adjuvant analgesics such as gabapentin,
pregabalin, or duloxetine. Opioids are not first-line treatment for neuropathic pain .
Question 4
The nurse is teaching a patient about non-pharmacological pain management for chronic
arthritis. Which statement indicates correct understanding?
A. "I should avoid moving my joints to prevent pain."
B. "Applying heat before activity can help reduce stiffness."
C. "Cold packs should be used for at least 45 minutes."
D. "Exercise will make my arthritis worse over time."
Explanation: Heat therapy before activity reduces joint stiffness. Cold packs are used for
acute inflammation, but should be applied for 15-20 minutes only. Regular exercise is
essential for maintaining joint function .
Question 5
An older adult patient with dementia is moaning, guarding their abdomen, and refusing to
eat. The patient cannot self-report pain. What should the nurse do first?
A. Notify the healthcare provider
B. Administer PRN acetaminophen
C. Use a behavioral pain assessment scale
D. Distract the patient with music
Explanation: When patients cannot self-report pain (e.g., due to dementia, cognitive
impairment, or aphasia), a validated behavioral pain assessment scale such as PAINAD or
PACSLAC should be used to assess pain. The nurse should assess first, then intervene .
Question 6
A patient with chronic pain has been taking oxycodone for 3 months. The patient reports
needing higher doses to achieve the same relief. The nurse recognizes this as:
A. Addiction
B. Tolerance
C. Dependence
D. Pseudoaddiction
, Explanation: Tolerance is a normal physiologic response where increasing doses are
needed to achieve the same effect. It is not addiction (which includes compulsive use) .
Question 7
Which of the following is a COMMON misconception about pain management in older
adults?
A. Older adults have a higher incidence of chronic illness
B. Chronic pain patients have a higher tolerance to pain
C. Older adults have decreased liver and renal function affecting drug metabolism
D. Pain is subjective and should be assessed based on patient report
Explanation: A common misconception is that chronic pain patients have a higher tolerance
to pain. Other misconceptions include that chronic pain is related to psychological disease,
or that patients with chronic pain are manipulative or exaggerating their symptoms .
Question 8
The most serious side effect of opioid analgesics is:
A. Constipation
B. Nausea and vomiting
C. Respiratory depression
D. Pruritus
Explanation: Respiratory depression is the most serious side effect of opioids. Notable
changes include shallow respirations and decreased respiratory rate. Constipation is a
common but not life-threatening side effect .
Question 9
A patient with chronic pain is prescribed a fentanyl patch. What is the most important
instruction for the nurse to provide?
A. Apply heat to the patch site for better absorption
B. Do not apply heat or use heating pads near the patch
C. Change the patch every 24 hours
D. Apply the patch to a hairy area for better adhesion
