NUR 257 CHRONIC EXAM 1 ACTUAL
QUESTIONS AND ANSWERS WITH
SOLUTIONS NEWEST UPDATE 2025/2026
UPDATE GRADED A+ BUNDLE
Question 1
A community health nurse is conducting an assessment on a 74-year-old patient
living with multiple chronic conditions. According to the Trajectory Model of
Chronic Illness, which phase is characterized by a sudden, life-threatening onset
of symptoms requiring urgent hospitalization?
A) Stable phase
B) Unstable phase
C) Crisis phase
, D) Comeback phase
Verified Answer: C) Crisis phase
Explanation: The crisis phase of the chronic illness trajectory involves a
critical or life-threatening situation that demands emergency or intensive
medical intervention. The unstable phase involves an exacerbation that can
typically be managed in outpatient or home settings, whereas the crisis phase
represents immediate danger to life or functional stability.
Question 2
When assessing an 81-year-old patient following a stroke, the home health
nurse distinguishes between Activities of Daily Living (ADLs) and Instrumental
Activities of Daily Living (IADLs). Which of the following tasks should the
nurse document as an IADL?
A) Transferring from the bed to a wheelchair
B) Buttoning a front-closing shirt
C) Organizing and taking monthly prescriptions
D) Eating a mechanical soft diet independently
Verified Answer: C) Organizing and taking monthly prescriptions
Explanation: Instrumental Activities of Daily Living (IADLs) involve more
complex cognitive and environmental synthesis required to live independently
in the community. Managing medications, balancing a checkbook, shopping,
and cooking fall under IADLs. Transferring, dressing, and eating are basic,
foundational self-care activities categorized as ADLs.
, Question 3
An older adult patient is admitted with an acute urinary tract infection (UTI).
The nurse notes a sudden onset of fluctuating confusion, visual hallucinations,
and inattention that began 12 hours ago. Which condition do these
manifestations represent?
A) Early-onset Alzheimer’s disease
B) Vascular dementia
C) Major depressive disorder
D) Delirium
Verified Answer: D) Delirium
Explanation: Delirium is an acute, fluctuating change in mental status
characterized by inattention, disorganized thinking, and altered levels of
consciousness, often triggered by an underlying medical issue like an
infection. Dementia features a gradual, progressive decline without an acute
onset, and depression does not cause acute visual hallucinations or
fluctuating levels of consciousness.
Question 4
A nurse is reviewing the medication profile of a 79-year-old patient who has
been experiencing frequent falls. Which class of medications on the patient's
chart is most critical to evaluate using the Beers Criteria for Potentially
Inappropriate Medication Use in Older Adults?
A) Long-acting benzodiazepines
, B) HMG-CoA reductase inhibitors (Statins)
C) Biguanides (Metformin)
D) Angiotensin-converting enzyme (ACE) inhibitors
Verified Answer: A) Long-acting benzodiazepines
Explanation: Long-acting benzodiazepines are strictly highlighted on the
Beers Criteria due to their prolonged half-life in older adults, which
significantly increases the risk of prolonged sedation, cognitive impairment,
psychomotor slowing, and severe falls. The other listed options are standard
maintenance medications that do not carry the same high-level alert for
geriatric toxicity.
Question 5
During a routine home visit, a nurse suspects an older adult patient is
experiencing emotional and financial elder abuse by a resident family member.
What is the priority nursing action?
A) Confront the family caregiver directly and demand an explanation.
B) Document the objective findings and report the suspicion to Adult Protective
Services (APS).
C) Advise the patient to move out of the house immediately.
D) Wait until physical signs of abuse appear before taking official action.
Verified Answer: B) Document the objective findings and report the suspicion
to Adult Protective Services (APS).
Explanation: Nurses are mandatory reporters of suspected elder abuse. The
priority action is to document objective, detailed physical and behavioral
observations and submit a formal report to APS. Confronting the abuser can
QUESTIONS AND ANSWERS WITH
SOLUTIONS NEWEST UPDATE 2025/2026
UPDATE GRADED A+ BUNDLE
Question 1
A community health nurse is conducting an assessment on a 74-year-old patient
living with multiple chronic conditions. According to the Trajectory Model of
Chronic Illness, which phase is characterized by a sudden, life-threatening onset
of symptoms requiring urgent hospitalization?
A) Stable phase
B) Unstable phase
C) Crisis phase
, D) Comeback phase
Verified Answer: C) Crisis phase
Explanation: The crisis phase of the chronic illness trajectory involves a
critical or life-threatening situation that demands emergency or intensive
medical intervention. The unstable phase involves an exacerbation that can
typically be managed in outpatient or home settings, whereas the crisis phase
represents immediate danger to life or functional stability.
Question 2
When assessing an 81-year-old patient following a stroke, the home health
nurse distinguishes between Activities of Daily Living (ADLs) and Instrumental
Activities of Daily Living (IADLs). Which of the following tasks should the
nurse document as an IADL?
A) Transferring from the bed to a wheelchair
B) Buttoning a front-closing shirt
C) Organizing and taking monthly prescriptions
D) Eating a mechanical soft diet independently
Verified Answer: C) Organizing and taking monthly prescriptions
Explanation: Instrumental Activities of Daily Living (IADLs) involve more
complex cognitive and environmental synthesis required to live independently
in the community. Managing medications, balancing a checkbook, shopping,
and cooking fall under IADLs. Transferring, dressing, and eating are basic,
foundational self-care activities categorized as ADLs.
, Question 3
An older adult patient is admitted with an acute urinary tract infection (UTI).
The nurse notes a sudden onset of fluctuating confusion, visual hallucinations,
and inattention that began 12 hours ago. Which condition do these
manifestations represent?
A) Early-onset Alzheimer’s disease
B) Vascular dementia
C) Major depressive disorder
D) Delirium
Verified Answer: D) Delirium
Explanation: Delirium is an acute, fluctuating change in mental status
characterized by inattention, disorganized thinking, and altered levels of
consciousness, often triggered by an underlying medical issue like an
infection. Dementia features a gradual, progressive decline without an acute
onset, and depression does not cause acute visual hallucinations or
fluctuating levels of consciousness.
Question 4
A nurse is reviewing the medication profile of a 79-year-old patient who has
been experiencing frequent falls. Which class of medications on the patient's
chart is most critical to evaluate using the Beers Criteria for Potentially
Inappropriate Medication Use in Older Adults?
A) Long-acting benzodiazepines
, B) HMG-CoA reductase inhibitors (Statins)
C) Biguanides (Metformin)
D) Angiotensin-converting enzyme (ACE) inhibitors
Verified Answer: A) Long-acting benzodiazepines
Explanation: Long-acting benzodiazepines are strictly highlighted on the
Beers Criteria due to their prolonged half-life in older adults, which
significantly increases the risk of prolonged sedation, cognitive impairment,
psychomotor slowing, and severe falls. The other listed options are standard
maintenance medications that do not carry the same high-level alert for
geriatric toxicity.
Question 5
During a routine home visit, a nurse suspects an older adult patient is
experiencing emotional and financial elder abuse by a resident family member.
What is the priority nursing action?
A) Confront the family caregiver directly and demand an explanation.
B) Document the objective findings and report the suspicion to Adult Protective
Services (APS).
C) Advise the patient to move out of the house immediately.
D) Wait until physical signs of abuse appear before taking official action.
Verified Answer: B) Document the objective findings and report the suspicion
to Adult Protective Services (APS).
Explanation: Nurses are mandatory reporters of suspected elder abuse. The
priority action is to document objective, detailed physical and behavioral
observations and submit a formal report to APS. Confronting the abuser can
