NUR 257 Exam 4 V3 | NUR 257 Concepts
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is assessing an older adult patient who presents with a sudden onset of confusion
and altered level of consciousness. Which condition is the most likely cause?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Depression
Answer: C
Rationale: Delirium is characterized by an acute onset and a fluctuating course of cognitive
impairment. Unlike dementia, which is progressive and irreversible, delirium is often
caused by an underlying medical issue such as infection or dehydration. Prompt
identification and treatment of the cause are essential for the patient’s recovery.
2. Which of the following is a primary goal of palliative care for a patient with a chronic, life-
limiting illness?
A. Providing curative treatments for the underlying disease
B. Accelerating the end-of-life process
,C. Improving quality of life through symptom management
D. Limiting the involvement of family members in care
Answer: C
Rationale: Palliative care focuses on the relief of physical, emotional, and spiritual
suffering for patients with serious illnesses. It can be provided at any stage of a disease and
works alongside curative treatments if appropriate. The multidisciplinary team aims to
optimize the patient’s daily functioning and comfort.
3. An older adult patient reports experiencing ‘halos’ around lights and blurred vision. The
nurse recognizes these as classic symptoms of which condition?
A. Cataracts
B. Macular Degeneration
C. Glaucoma
D. Retinal Detachment
Answer: A
Rationale: Cataracts involve a clouding of the lens which leads to symptoms like blurred
vision and sensitivity to glare. Seeing halos around lights is a hallmark sign that light is
being scattered as it enters the eye. Surgery is typically the effective treatment when these
symptoms interfere with daily living activities.
, 4. A nurse is teaching a family about the ‘Sundowning’ phenomenon in Alzheimer’s disease.
What information should the nurse include?
A. It refers to improved cognitive function in the evening.
B. It is a period of increased confusion and agitation late in the day.
C. It only occurs in the early stages of the disease.
D. It is best managed by increasing caffeine intake in the afternoon.
Answer: B
Rationale: Sundowning is a clinical phenomenon where patients with dementia experience
worsening behavioral symptoms as natural light fades. Factors like fatigue, reduced
lighting, and disrupted circadian rhythms contribute to this distress. Maintaining a calm
environment and consistent routine in the late afternoon can help mitigate these
symptoms.
5. When assessing an older adult for depression, the nurse should be aware that which of the
following is a common atypical presentation in this population?
A. Crying spells
B. Explicit statements of sadness
C. Physical complaints or somatic symptoms
D. Increased social engagement
Answer: C
of Aging & Chronic Illness | Q&A with
Rationale (NUR257 Exam 4) | Galen
College of Nursing
1. A nurse is assessing an older adult patient who presents with a sudden onset of confusion
and altered level of consciousness. Which condition is the most likely cause?
A. Alzheimer’s Disease
B. Vascular Dementia
C. Delirium
D. Depression
Answer: C
Rationale: Delirium is characterized by an acute onset and a fluctuating course of cognitive
impairment. Unlike dementia, which is progressive and irreversible, delirium is often
caused by an underlying medical issue such as infection or dehydration. Prompt
identification and treatment of the cause are essential for the patient’s recovery.
2. Which of the following is a primary goal of palliative care for a patient with a chronic, life-
limiting illness?
A. Providing curative treatments for the underlying disease
B. Accelerating the end-of-life process
,C. Improving quality of life through symptom management
D. Limiting the involvement of family members in care
Answer: C
Rationale: Palliative care focuses on the relief of physical, emotional, and spiritual
suffering for patients with serious illnesses. It can be provided at any stage of a disease and
works alongside curative treatments if appropriate. The multidisciplinary team aims to
optimize the patient’s daily functioning and comfort.
3. An older adult patient reports experiencing ‘halos’ around lights and blurred vision. The
nurse recognizes these as classic symptoms of which condition?
A. Cataracts
B. Macular Degeneration
C. Glaucoma
D. Retinal Detachment
Answer: A
Rationale: Cataracts involve a clouding of the lens which leads to symptoms like blurred
vision and sensitivity to glare. Seeing halos around lights is a hallmark sign that light is
being scattered as it enters the eye. Surgery is typically the effective treatment when these
symptoms interfere with daily living activities.
, 4. A nurse is teaching a family about the ‘Sundowning’ phenomenon in Alzheimer’s disease.
What information should the nurse include?
A. It refers to improved cognitive function in the evening.
B. It is a period of increased confusion and agitation late in the day.
C. It only occurs in the early stages of the disease.
D. It is best managed by increasing caffeine intake in the afternoon.
Answer: B
Rationale: Sundowning is a clinical phenomenon where patients with dementia experience
worsening behavioral symptoms as natural light fades. Factors like fatigue, reduced
lighting, and disrupted circadian rhythms contribute to this distress. Maintaining a calm
environment and consistent routine in the late afternoon can help mitigate these
symptoms.
5. When assessing an older adult for depression, the nurse should be aware that which of the
following is a common atypical presentation in this population?
A. Crying spells
B. Explicit statements of sadness
C. Physical complaints or somatic symptoms
D. Increased social engagement
Answer: C
