GALEN COLLEGE OF NURSING
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 3 Practice
Question 1
The nurse is caring for a client diagnosed with hyperthyroidism. Which signs and symptoms indicate
hyperthyroidism? (Select all that apply.)
A. Heart failure
B. Cold intolerance
C. Sudden onset of symptoms
D. Constipation
E. Atrial fibrillation
Correct answer: A. Heart failure, C. Sudden onset of symptoms, D. Constipation, E. Atrial fibrillation
Rationale:
Hyperthyroidism in older adults can present with atypical signs including heart failure (high-output), sudden
symptom onset, constipation (instead of diarrhea), and atrial fibrillation. Cold intolerance is a symptom of
hypothyroidism. The correct selections are A, C, D, and E.
Question 2
Which of the following statements is true about cardiopulmonary disease in older adults?
A. Mouth hygiene is essential to prevent and treat pneumonia
B. Cardiopulmonary disease is unavoidable in older adults
C. Older adults do not respond to cardiac medications
D. Pneumonia is not a concern in older adults
Correct answer: A. Mouth hygiene is essential to prevent and treat pneumonia
Rationale:
Good oral hygiene is essential in older adults to prevent aspiration pneumonia, as oral bacteria can be aspirated
into the lungs. This is a key preventive measure. The other statements are incorrect.
, Question 3
An older adult man diagnosed with diabetes mellitus complains to the nurse that his feet feel like
they are burning. Which of the following interventions should the nurse recommend to this older
adult to reduce his discomfort?
A. Apply heat packs to the feet
B. Wear well-fitting shoes
C. Soak feet in hot water
D. Use over-the-counter pain relievers
Correct answer: B. Wear well-fitting shoes
Rationale:
Burning feet in a client with diabetes is a sign of peripheral neuropathy. Wearing well-fitting, supportive shoes
can help reduce discomfort and prevent further injury. Heat packs and hot water can cause burns due to
decreased sensation; OTC pain relievers may not address the underlying neuropathy.
Question 4
Symptoms of a TIA resolve within which time frame?
A. 30-60 minutes
B. 1-2 hours
C. 24 hours
D. Immediately
Correct answer: A. 30-60 minutes
Rationale:
Symptoms of a transient ischemic attack (TIA) typically resolve within 30 to 60 minutes, although they can last up
to 24 hours. Resolution within this timeframe differentiates TIA from stroke.
Question 5
A patient with heart failure who reports intermittent shortness of breath during the night is
experiencing which condition?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Dyspnea on exertion
D. Sleep apnea
Correct answer: B. Paroxysmal nocturnal dyspnea
Rationale:
Paroxysmal nocturnal dyspnea (PND) is characterized by intermittent shortness of breath during the night that
wakes the patient from sleep. It occurs due to fluid redistribution from the legs to the lungs when lying flat,
causing pulmonary congestion.
, Question 6
What self-management skill would you not teach to an older adult client who has diabetes mellitus?
A. The importance of eating fats and carbohydrates
B. Blood glucose monitoring
C. Foot care
D. Medication adherence
Correct answer: A. The importance of eating fats and carbohydrates
Rationale:
Teaching the importance of eating fats and carbohydrates without specific guidance on carbohydrate counting
and fat moderation is not appropriate for diabetes self-management. Clients need to know how to balance
carbohydrates, monitor fats, and maintain a healthy diet. The other options are essential self-management skills.
Question 7
Obstructive disorders are associated with which of the following?
A. Low expiratory flow rates
B. High expiratory flow rates
C. Increased lung volumes
D. Decreased residual volume
Correct answer: A. Low expiratory flow rates
Rationale:
Obstructive pulmonary disorders are characterized by airway obstruction leading to low expiratory flow rates
(decreased FEV1/FVC ratio). This is due to increased resistance to airflow. Examples include asthma and COPD.
Question 8
The nurse recognizes which of the following signs and symptoms as an indication of hypothyroidism
in an older adult? (Select all that apply.)
A. Decrease in TSH and T4
B. Heat intolerance
C. Gait disturbances
D. Palpitations
E. Decline in cognitive function
Correct answer: C. Gait disturbances, D. Palpitations, E. Decline in cognitive function
Rationale:
Hypothyroidism in older adults can present with atypical signs including gait disturbances, palpitations (due to
bradycardia or arrhythmias), and cognitive decline. Heat intolerance and decreased TSH/T4 are more
characteristic of hyperthyroidism. The correct selections are C, D, and E.
, Question 9
A client with Type 2 diabetes is prescribed metformin. What is the most important instruction the
nurse should give?
A. Take with food to avoid GI upset
B. Avoid alcohol while on this medication
C. Monitor for signs of hypoglycemia
D. Take on an empty stomach
Correct answer: B. Avoid alcohol while on this medication
Rationale:
The most important instruction for a client taking metformin is to avoid alcohol, as alcohol increases the risk of
lactic acidosis, a rare but serious complication. While taking with food helps reduce GI side effects, alcohol
avoidance is the priority safety teaching.
Question 10
The breakdown of stored glycogen in the liver and muscles is called which of the following?
A. Glycogenesis
B. Glycogenolysis
C. Gluconeogenesis
D. Lipolysis
Correct answer: B. Glycogenolysis
Rationale:
Glycogenolysis is the breakdown of stored glycogen into glucose, which occurs in the liver and muscles.
Glycogenesis is the synthesis of glycogen; gluconeogenesis is the production of glucose from non-carbohydrate
sources; lipolysis is fat breakdown.
Question 11
A 78-year-old client with type 2 diabetes has a recent diagnosis of diabetic retinopathy. The nurse
should explain that which of the following could contribute to the progression of this condition?
A. High blood pressure
B. High cholesterol
C. Smoking
D. All of the above
Correct answer: A. High blood pressure
Rationale:
High blood pressure is a major risk factor for the progression of diabetic retinopathy due to increased retinal
vascular pressure and damage. While cholesterol and smoking are risk factors, hypertension is the most
significant contributor to retinopathy progression.
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 3 Practice
Question 1
The nurse is caring for a client diagnosed with hyperthyroidism. Which signs and symptoms indicate
hyperthyroidism? (Select all that apply.)
A. Heart failure
B. Cold intolerance
C. Sudden onset of symptoms
D. Constipation
E. Atrial fibrillation
Correct answer: A. Heart failure, C. Sudden onset of symptoms, D. Constipation, E. Atrial fibrillation
Rationale:
Hyperthyroidism in older adults can present with atypical signs including heart failure (high-output), sudden
symptom onset, constipation (instead of diarrhea), and atrial fibrillation. Cold intolerance is a symptom of
hypothyroidism. The correct selections are A, C, D, and E.
Question 2
Which of the following statements is true about cardiopulmonary disease in older adults?
A. Mouth hygiene is essential to prevent and treat pneumonia
B. Cardiopulmonary disease is unavoidable in older adults
C. Older adults do not respond to cardiac medications
D. Pneumonia is not a concern in older adults
Correct answer: A. Mouth hygiene is essential to prevent and treat pneumonia
Rationale:
Good oral hygiene is essential in older adults to prevent aspiration pneumonia, as oral bacteria can be aspirated
into the lungs. This is a key preventive measure. The other statements are incorrect.
, Question 3
An older adult man diagnosed with diabetes mellitus complains to the nurse that his feet feel like
they are burning. Which of the following interventions should the nurse recommend to this older
adult to reduce his discomfort?
A. Apply heat packs to the feet
B. Wear well-fitting shoes
C. Soak feet in hot water
D. Use over-the-counter pain relievers
Correct answer: B. Wear well-fitting shoes
Rationale:
Burning feet in a client with diabetes is a sign of peripheral neuropathy. Wearing well-fitting, supportive shoes
can help reduce discomfort and prevent further injury. Heat packs and hot water can cause burns due to
decreased sensation; OTC pain relievers may not address the underlying neuropathy.
Question 4
Symptoms of a TIA resolve within which time frame?
A. 30-60 minutes
B. 1-2 hours
C. 24 hours
D. Immediately
Correct answer: A. 30-60 minutes
Rationale:
Symptoms of a transient ischemic attack (TIA) typically resolve within 30 to 60 minutes, although they can last up
to 24 hours. Resolution within this timeframe differentiates TIA from stroke.
Question 5
A patient with heart failure who reports intermittent shortness of breath during the night is
experiencing which condition?
A. Orthopnea
B. Paroxysmal nocturnal dyspnea
C. Dyspnea on exertion
D. Sleep apnea
Correct answer: B. Paroxysmal nocturnal dyspnea
Rationale:
Paroxysmal nocturnal dyspnea (PND) is characterized by intermittent shortness of breath during the night that
wakes the patient from sleep. It occurs due to fluid redistribution from the legs to the lungs when lying flat,
causing pulmonary congestion.
, Question 6
What self-management skill would you not teach to an older adult client who has diabetes mellitus?
A. The importance of eating fats and carbohydrates
B. Blood glucose monitoring
C. Foot care
D. Medication adherence
Correct answer: A. The importance of eating fats and carbohydrates
Rationale:
Teaching the importance of eating fats and carbohydrates without specific guidance on carbohydrate counting
and fat moderation is not appropriate for diabetes self-management. Clients need to know how to balance
carbohydrates, monitor fats, and maintain a healthy diet. The other options are essential self-management skills.
Question 7
Obstructive disorders are associated with which of the following?
A. Low expiratory flow rates
B. High expiratory flow rates
C. Increased lung volumes
D. Decreased residual volume
Correct answer: A. Low expiratory flow rates
Rationale:
Obstructive pulmonary disorders are characterized by airway obstruction leading to low expiratory flow rates
(decreased FEV1/FVC ratio). This is due to increased resistance to airflow. Examples include asthma and COPD.
Question 8
The nurse recognizes which of the following signs and symptoms as an indication of hypothyroidism
in an older adult? (Select all that apply.)
A. Decrease in TSH and T4
B. Heat intolerance
C. Gait disturbances
D. Palpitations
E. Decline in cognitive function
Correct answer: C. Gait disturbances, D. Palpitations, E. Decline in cognitive function
Rationale:
Hypothyroidism in older adults can present with atypical signs including gait disturbances, palpitations (due to
bradycardia or arrhythmias), and cognitive decline. Heat intolerance and decreased TSH/T4 are more
characteristic of hyperthyroidism. The correct selections are C, D, and E.
, Question 9
A client with Type 2 diabetes is prescribed metformin. What is the most important instruction the
nurse should give?
A. Take with food to avoid GI upset
B. Avoid alcohol while on this medication
C. Monitor for signs of hypoglycemia
D. Take on an empty stomach
Correct answer: B. Avoid alcohol while on this medication
Rationale:
The most important instruction for a client taking metformin is to avoid alcohol, as alcohol increases the risk of
lactic acidosis, a rare but serious complication. While taking with food helps reduce GI side effects, alcohol
avoidance is the priority safety teaching.
Question 10
The breakdown of stored glycogen in the liver and muscles is called which of the following?
A. Glycogenesis
B. Glycogenolysis
C. Gluconeogenesis
D. Lipolysis
Correct answer: B. Glycogenolysis
Rationale:
Glycogenolysis is the breakdown of stored glycogen into glucose, which occurs in the liver and muscles.
Glycogenesis is the synthesis of glycogen; gluconeogenesis is the production of glucose from non-carbohydrate
sources; lipolysis is fat breakdown.
Question 11
A 78-year-old client with type 2 diabetes has a recent diagnosis of diabetic retinopathy. The nurse
should explain that which of the following could contribute to the progression of this condition?
A. High blood pressure
B. High cholesterol
C. Smoking
D. All of the above
Correct answer: A. High blood pressure
Rationale:
High blood pressure is a major risk factor for the progression of diabetic retinopathy due to increased retinal
vascular pressure and damage. While cholesterol and smoking are risk factors, hypertension is the most
significant contributor to retinopathy progression.
