NUR 258 Exam 3 V2 | NUR 258 Concepts
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 3) | Galen
1. A nurse is assessing an 82-year-old patient who suddenly became confused and agitated.
Which underlying condition should the nurse prioritize investigating as the most common
cause of delirium in the elderly?
A. New onset of Alzheimer’s disease
B. Normal aging process
C. Urinary tract infection (UTI)
D. Severe clinical depression
Correct Answer: C
Explanation: AI Analysis: This exam focuses on clinical judgment regarding the complex
needs of aging populations and those with chronic diseases. It emphasizes the
differentiation between normal aging and pathological changes, alongside the legal and
ethical considerations of end-of-life care. Students are evaluated on their ability to
prioritize safety, manage polypharmacy, and provide holistic support to both patients and
families. Rationale: In older adults, infection (particularly UTIs) is a leading cause of acute
delirium; Alzheimer’s is a slow, progressive decline, and delirium is never a normal part of
aging.
,2. The nurse is discussing palliative care with a family. Which statement by the nurse best
describes the primary goal of palliative care?
A. Palliative care is only provided when a patient has less than 6 months to live.
B. Palliative care focuses on providing relief from symptoms and stress of a serious illness.
C. Palliative care is used to replace curative treatments for chronic diseases.
D. Palliative care is strictly for patients who have signed a DNR order.
Correct Answer: B
Explanation: Palliative care aims to improve quality of life for both the patient and the
family by providing symptom management and psychosocial support at any stage of a
serious illness, regardless of life expectancy.
3. An older adult patient is prescribed an anticholinergic medication. The nurse should
monitor for which of the following adverse effects? (Select all that apply)
A. Blurred vision
B. Urinary retention
C. Increased salivation
D. Confusion
E. Diarrhea
F. Dry mouth
Correct Answer: A,B,D,F
, Explanation: Anticholinergic effects (the ‘can’ts’) include ‘can’t see’ (blurred vision), ‘can’t
pee’ (urinary retention), ‘can’t spit’ (dry mouth), and ‘can’t poop’ (constipation). In the
elderly, they also significantly increase the risk of confusion and falls.
4. The nurse is reviewing the Beers Criteria list. What is the primary purpose of this resource
in geriatric nursing?
A. To list the standard dosages for pediatric patients.
B. To identify medications that are generally considered inappropriate for older adults.
C. To provide a guide for emergency trauma interventions.
D. To determine the cost-effectiveness of generic medications.
Correct Answer: B
Explanation: The Beers Criteria identify medications that pose a higher risk of adverse
drug reactions or have limited effectiveness in older adults compared to alternative
treatments.
5. A patient with advanced dementia is exhibiting ‘sundowning’ behavior. Which intervention
should the nurse implement first?
A. Administer a PRN sedative medication.
B. Move the patient to a different room to provide a change of scenery.
C. Ensure the environment is well-lit and eliminate loud noises in the late afternoon.
D. Apply physical restraints to prevent wandering during the night.
of Aging & Chronic Illness | Actual Q&A
with Rationale (NUR258 Exam 3) | Galen
1. A nurse is assessing an 82-year-old patient who suddenly became confused and agitated.
Which underlying condition should the nurse prioritize investigating as the most common
cause of delirium in the elderly?
A. New onset of Alzheimer’s disease
B. Normal aging process
C. Urinary tract infection (UTI)
D. Severe clinical depression
Correct Answer: C
Explanation: AI Analysis: This exam focuses on clinical judgment regarding the complex
needs of aging populations and those with chronic diseases. It emphasizes the
differentiation between normal aging and pathological changes, alongside the legal and
ethical considerations of end-of-life care. Students are evaluated on their ability to
prioritize safety, manage polypharmacy, and provide holistic support to both patients and
families. Rationale: In older adults, infection (particularly UTIs) is a leading cause of acute
delirium; Alzheimer’s is a slow, progressive decline, and delirium is never a normal part of
aging.
,2. The nurse is discussing palliative care with a family. Which statement by the nurse best
describes the primary goal of palliative care?
A. Palliative care is only provided when a patient has less than 6 months to live.
B. Palliative care focuses on providing relief from symptoms and stress of a serious illness.
C. Palliative care is used to replace curative treatments for chronic diseases.
D. Palliative care is strictly for patients who have signed a DNR order.
Correct Answer: B
Explanation: Palliative care aims to improve quality of life for both the patient and the
family by providing symptom management and psychosocial support at any stage of a
serious illness, regardless of life expectancy.
3. An older adult patient is prescribed an anticholinergic medication. The nurse should
monitor for which of the following adverse effects? (Select all that apply)
A. Blurred vision
B. Urinary retention
C. Increased salivation
D. Confusion
E. Diarrhea
F. Dry mouth
Correct Answer: A,B,D,F
, Explanation: Anticholinergic effects (the ‘can’ts’) include ‘can’t see’ (blurred vision), ‘can’t
pee’ (urinary retention), ‘can’t spit’ (dry mouth), and ‘can’t poop’ (constipation). In the
elderly, they also significantly increase the risk of confusion and falls.
4. The nurse is reviewing the Beers Criteria list. What is the primary purpose of this resource
in geriatric nursing?
A. To list the standard dosages for pediatric patients.
B. To identify medications that are generally considered inappropriate for older adults.
C. To provide a guide for emergency trauma interventions.
D. To determine the cost-effectiveness of generic medications.
Correct Answer: B
Explanation: The Beers Criteria identify medications that pose a higher risk of adverse
drug reactions or have limited effectiveness in older adults compared to alternative
treatments.
5. A patient with advanced dementia is exhibiting ‘sundowning’ behavior. Which intervention
should the nurse implement first?
A. Administer a PRN sedative medication.
B. Move the patient to a different room to provide a change of scenery.
C. Ensure the environment is well-lit and eliminate loud noises in the late afternoon.
D. Apply physical restraints to prevent wandering during the night.
