NUR 257 Exam 4 V1 | NUR 257 Concepts
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is caring for an older adult client diagnosed with Parkinson’s Disease. Which clinical
manifestation should the nurse prioritize when planning safety interventions?
A. Fine tremors of the hands at rest
B. Propulsive gait and postural instability
C. Difficulty swallowing and increased salivation
D. Slightly slurred or slow speech
Answer: B
Rationale: Postural instability and a propulsive gait significantly increase the risk for falls
in Parkinson’s patients. While tremors and speech issues are common, they do not pose the
same immediate physical safety threat as impaired mobility. The nurse must implement fall
precautions and provide assistive devices to ensure the patient’s physical safety in the
environment.
2. An older adult patient is admitted with symptoms of confusion and agitation that started
suddenly 24 hours ago. Which condition should the nurse investigate first?
A. Alzheimer’s Disease
,B. Normal age-related cognitive decline
C. Vascular Dementia
D. Delirium secondary to an underlying infection
Answer: D
Rationale: Delirium is characterized by an acute onset and fluctuating course, often
triggered by physiological stressors like a Urinary Tract Infection (UTI). Dementia, whether
Alzheimer’s or vascular, typically has a slow and progressive onset over years. The nurse
must identify and treat the underlying cause of delirium immediately to prevent further
cognitive decline or injury.
3. When discussing palliative care with the family of a patient with end-stage heart failure,
which statement by the nurse is most accurate?
A. Palliative care is only available for patients with less than six months to live.
B. Palliative care focuses on symptom management while allowing curative treatments.
C. Palliative care replaces all medications used for chronic disease management.
D. Palliative care is synonymous with hospice and requires stopping all active treatment.
Answer: B
Rationale: Palliative care is specialized medical care for people living with a serious illness
that focuses on providing relief from symptoms and stress. Unlike hospice, it can be
provided at any stage of a serious illness and can be integrated with curative or life-
,prolonging treatments. The goal is to improve the quality of life for both the patient and the
family through comprehensive assessment and management.
4. A nurse is teaching an older adult about the prevention of osteoporosis. Which dietary
recommendation is most appropriate?
A. Consume adequate amounts of Vitamin D and Calcium-rich foods.
B. Limit fluid intake to prevent calcium excretion through the kidneys.
C. Increase intake of red meats and iron-rich vegetables.
D. Follow a high-protein, low-carbohydrate diet to maintain bone mass.
Answer: A
Rationale: Vitamin D is essential for the absorption of calcium in the gastrointestinal tract,
and both are critical for maintaining bone density. Postmenopausal women and older men
are at high risk for bone loss, making dietary supplementation or intake vital. The nurse
should encourage foods like fortified milk, leafy greens, and fatty fish to support skeletal
health.
5. The nurse is assessing a patient with suspected cataracts. Which visual change is the
patient most likely to report?
A. Loss of peripheral vision resulting in tunnel vision
B. Blurred or cloudy vision with increased sensitivity to glare
C. Sudden onset of severe eye pain and seeing halos around lights
, D. Floating spots and flashes of light in the field of vision
Answer: B
Rationale: Cataracts involve the gradual clouding of the lens, which leads to blurred vision
and difficulty seeing clearly at night. Patients often report that their vision seems dimmed
or that colors appear faded. This condition differs from glaucoma, which affects peripheral
vision, or retinal detachment, which involves flashes and floaters.
6. Which assessment finding is a hallmark sign of Rheumatoid Arthritis (RA) that distinguishes
it from Osteoarthritis (OA)?
A. Symmetrical joint swelling and morning stiffness lasting over an hour
B. Asymmetrical joint involvement in the hips and knees
C. Pain that worsens with activity and improves with rest
D. Formation of Heberden’s nodes on the distal interphalangeal joints
Answer: A
Rationale: Rheumatoid Arthritis is a systemic autoimmune disease characterized by
symmetrical inflammation of the joints. Morning stiffness in RA typically lasts longer than
60 minutes, whereas stiffness in OA usually resolves within 30 minutes. The systemic
nature of RA often involves other symptoms like fatigue and malaise, which are not
characteristic of the localized wear-and-tear of OA.
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is caring for an older adult client diagnosed with Parkinson’s Disease. Which clinical
manifestation should the nurse prioritize when planning safety interventions?
A. Fine tremors of the hands at rest
B. Propulsive gait and postural instability
C. Difficulty swallowing and increased salivation
D. Slightly slurred or slow speech
Answer: B
Rationale: Postural instability and a propulsive gait significantly increase the risk for falls
in Parkinson’s patients. While tremors and speech issues are common, they do not pose the
same immediate physical safety threat as impaired mobility. The nurse must implement fall
precautions and provide assistive devices to ensure the patient’s physical safety in the
environment.
2. An older adult patient is admitted with symptoms of confusion and agitation that started
suddenly 24 hours ago. Which condition should the nurse investigate first?
A. Alzheimer’s Disease
,B. Normal age-related cognitive decline
C. Vascular Dementia
D. Delirium secondary to an underlying infection
Answer: D
Rationale: Delirium is characterized by an acute onset and fluctuating course, often
triggered by physiological stressors like a Urinary Tract Infection (UTI). Dementia, whether
Alzheimer’s or vascular, typically has a slow and progressive onset over years. The nurse
must identify and treat the underlying cause of delirium immediately to prevent further
cognitive decline or injury.
3. When discussing palliative care with the family of a patient with end-stage heart failure,
which statement by the nurse is most accurate?
A. Palliative care is only available for patients with less than six months to live.
B. Palliative care focuses on symptom management while allowing curative treatments.
C. Palliative care replaces all medications used for chronic disease management.
D. Palliative care is synonymous with hospice and requires stopping all active treatment.
Answer: B
Rationale: Palliative care is specialized medical care for people living with a serious illness
that focuses on providing relief from symptoms and stress. Unlike hospice, it can be
provided at any stage of a serious illness and can be integrated with curative or life-
,prolonging treatments. The goal is to improve the quality of life for both the patient and the
family through comprehensive assessment and management.
4. A nurse is teaching an older adult about the prevention of osteoporosis. Which dietary
recommendation is most appropriate?
A. Consume adequate amounts of Vitamin D and Calcium-rich foods.
B. Limit fluid intake to prevent calcium excretion through the kidneys.
C. Increase intake of red meats and iron-rich vegetables.
D. Follow a high-protein, low-carbohydrate diet to maintain bone mass.
Answer: A
Rationale: Vitamin D is essential for the absorption of calcium in the gastrointestinal tract,
and both are critical for maintaining bone density. Postmenopausal women and older men
are at high risk for bone loss, making dietary supplementation or intake vital. The nurse
should encourage foods like fortified milk, leafy greens, and fatty fish to support skeletal
health.
5. The nurse is assessing a patient with suspected cataracts. Which visual change is the
patient most likely to report?
A. Loss of peripheral vision resulting in tunnel vision
B. Blurred or cloudy vision with increased sensitivity to glare
C. Sudden onset of severe eye pain and seeing halos around lights
, D. Floating spots and flashes of light in the field of vision
Answer: B
Rationale: Cataracts involve the gradual clouding of the lens, which leads to blurred vision
and difficulty seeing clearly at night. Patients often report that their vision seems dimmed
or that colors appear faded. This condition differs from glaucoma, which affects peripheral
vision, or retinal detachment, which involves flashes and floaters.
6. Which assessment finding is a hallmark sign of Rheumatoid Arthritis (RA) that distinguishes
it from Osteoarthritis (OA)?
A. Symmetrical joint swelling and morning stiffness lasting over an hour
B. Asymmetrical joint involvement in the hips and knees
C. Pain that worsens with activity and improves with rest
D. Formation of Heberden’s nodes on the distal interphalangeal joints
Answer: A
Rationale: Rheumatoid Arthritis is a systemic autoimmune disease characterized by
symmetrical inflammation of the joints. Morning stiffness in RA typically lasts longer than
60 minutes, whereas stiffness in OA usually resolves within 30 minutes. The systemic
nature of RA often involves other symptoms like fatigue and malaise, which are not
characteristic of the localized wear-and-tear of OA.
