GALEN COLLEGE OF NURSING
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 4
Question 1
You are orienting a new nurse and reviewing her plan of care for the day to prevent pressure injury
for her patients. Which of the following would you re-educate her about?
A. She should reposition patients every 2 hours
B. She should not position a paraplegic patient for comfort so that they can rest for the day
C. She should use pressure-relieving devices
D. She should inspect skin daily
Correct answer: B. She should not position a paraplegic patient for comfort so that they can rest for the
day
Rationale:
Paraplegic patients cannot feel pressure areas and must be repositioned regularly, not left in one position for
comfort. Leaving them in one position increases the risk of pressure injuries. Regular repositioning is essential for
pressure ulcer prevention.
Question 2
Which of the following has the highest risk for falls?
A. A patient with a shuffling gait
B. A patient with a steady gait
C. A patient who uses a walker
D. A patient with good balance
Correct answer: A. A patient with a shuffling gait
Rationale:
A shuffling gait is a significant fall risk factor, as it indicates impaired mobility, poor balance, and potential
neurological or musculoskeletal issues. Patients with shuffling gait are more likely to trip and fall, especially on
uneven surfaces or when turning.
, Question 3
You were educating your silver sneakers group about sleeping patterns in the older adult. Which of
the following when stated by members of the group indicates correct understanding?
A. Older adults need less sleep than younger adults
B. Chronic illnesses can affect the quality of my sleep
C. Sleep disturbances are a normal part of aging
D. Napping during the day is harmful
Correct answer: B. Chronic illnesses can affect the quality of my sleep
Rationale:
Chronic illnesses such as arthritis, heart failure, COPD, and diabetes can significantly affect sleep quality due to
pain, discomfort, nocturia, or dyspnea. This statement indicates correct understanding of sleep patterns in older
adults.
Question 4
You are working on the palliative care unit. It is appropriate to decrease the amount of pain
medication when a patient does which of the following?
A. Requests a smaller dose so they can be awake for family visits
B. Reports no pain
C. Is sleeping peacefully
D. Has stable vital signs
Correct answer: A. Requests a smaller dose so they can be awake for family visits
Rationale:
In palliative care, the patient's goals and preferences guide pain management. If a patient requests a smaller
dose to remain awake for family visits, it is appropriate to honor that request while still managing their pain
effectively. Patient-centered care is the priority.
, Question 5
You were taking care of a patient with primary open angle glaucoma. Which of the following would
you expect to find during your assessment?
A. Sudden severe eye pain and nausea
B. Eye ache, headache, fixed and dilated pupil and complaints of tired eyes
C. Redness and discharge from the eye
D. Floaters and flashes of light
Correct answer: B. Eye ache, headache, fixed and dilated pupil and complaints of tired eyes
Rationale:
Primary open-angle glaucoma often presents with mild eye ache, headache, sensitivity to glare, progressive
peripheral vision loss, and complaints of tired eyes. Fixed and dilated pupils can occur with advanced disease.
The classic presentation is gradual and often asymptomatic until significant vision loss occurs.
Question 6
A patient who was newly diagnosed with osteoporosis, what would you teach this patient about
safety in their home?
A. Remove rugs from the floor
B. Use a cane for stability
C. Wear shoes with good support
D. All of the above
Correct answer: A. Remove rugs from the floor
Rationale:
Removing rugs from the floor is a key safety measure for patients with osteoporosis to prevent falls that could
result in fractures. Loose rugs are a significant tripping hazard. While canes and supportive shoes are beneficial,
fall prevention starts with removing environmental hazards.
, Question 7
You just received your patient assignment for the day. They are all day postop hip replacements.
Which of the following patients would you assess first?
A. The patient that has not had a bowel movement since surgery
B. The patient with a temperature of 99.5°F
C. The patient with mild incisional pain
D. The patient with a heart rate of 95
Correct answer: A. The patient that has not had a bowel movement since surgery
Rationale:
Postoperative ileus or constipation is a common concern after hip replacement surgery, especially with opioid
use. The patient who has not had a bowel movement requires focused assessment for bowel sounds, abdominal
distention, and signs of obstruction. This is the priority over mild pain, low-grade fever, or mild tachycardia.
Question 8
You are working at a rehab facility and admitted a client who has had difficulty sleeping since
admission. Which of the following actions should you implement first?
A. Cluster care to minimize disruptions
B. Ask the patient what time they typically go to bed at home and implement into the plan of care
C. Administer a sleeping aid
D. Keep the room dark and quiet
Correct answer: B. Ask the patient what time they typically go to bed at home and implement into the
plan of care
Rationale:
The first action should be to assess the patient's usual sleep habits and preferences at home, then incorporate
these into the care plan to promote sleep continuity. Clustering care is important but should be based on the
patient's individual sleep patterns.
Bachelor of Science in Nursing (BSN)
NUR257 — Concepts of Aging & Chronic Illness
Academic Year: 2026/2027
Comprehensive Question Bank — Exam 4
Question 1
You are orienting a new nurse and reviewing her plan of care for the day to prevent pressure injury
for her patients. Which of the following would you re-educate her about?
A. She should reposition patients every 2 hours
B. She should not position a paraplegic patient for comfort so that they can rest for the day
C. She should use pressure-relieving devices
D. She should inspect skin daily
Correct answer: B. She should not position a paraplegic patient for comfort so that they can rest for the
day
Rationale:
Paraplegic patients cannot feel pressure areas and must be repositioned regularly, not left in one position for
comfort. Leaving them in one position increases the risk of pressure injuries. Regular repositioning is essential for
pressure ulcer prevention.
Question 2
Which of the following has the highest risk for falls?
A. A patient with a shuffling gait
B. A patient with a steady gait
C. A patient who uses a walker
D. A patient with good balance
Correct answer: A. A patient with a shuffling gait
Rationale:
A shuffling gait is a significant fall risk factor, as it indicates impaired mobility, poor balance, and potential
neurological or musculoskeletal issues. Patients with shuffling gait are more likely to trip and fall, especially on
uneven surfaces or when turning.
, Question 3
You were educating your silver sneakers group about sleeping patterns in the older adult. Which of
the following when stated by members of the group indicates correct understanding?
A. Older adults need less sleep than younger adults
B. Chronic illnesses can affect the quality of my sleep
C. Sleep disturbances are a normal part of aging
D. Napping during the day is harmful
Correct answer: B. Chronic illnesses can affect the quality of my sleep
Rationale:
Chronic illnesses such as arthritis, heart failure, COPD, and diabetes can significantly affect sleep quality due to
pain, discomfort, nocturia, or dyspnea. This statement indicates correct understanding of sleep patterns in older
adults.
Question 4
You are working on the palliative care unit. It is appropriate to decrease the amount of pain
medication when a patient does which of the following?
A. Requests a smaller dose so they can be awake for family visits
B. Reports no pain
C. Is sleeping peacefully
D. Has stable vital signs
Correct answer: A. Requests a smaller dose so they can be awake for family visits
Rationale:
In palliative care, the patient's goals and preferences guide pain management. If a patient requests a smaller
dose to remain awake for family visits, it is appropriate to honor that request while still managing their pain
effectively. Patient-centered care is the priority.
, Question 5
You were taking care of a patient with primary open angle glaucoma. Which of the following would
you expect to find during your assessment?
A. Sudden severe eye pain and nausea
B. Eye ache, headache, fixed and dilated pupil and complaints of tired eyes
C. Redness and discharge from the eye
D. Floaters and flashes of light
Correct answer: B. Eye ache, headache, fixed and dilated pupil and complaints of tired eyes
Rationale:
Primary open-angle glaucoma often presents with mild eye ache, headache, sensitivity to glare, progressive
peripheral vision loss, and complaints of tired eyes. Fixed and dilated pupils can occur with advanced disease.
The classic presentation is gradual and often asymptomatic until significant vision loss occurs.
Question 6
A patient who was newly diagnosed with osteoporosis, what would you teach this patient about
safety in their home?
A. Remove rugs from the floor
B. Use a cane for stability
C. Wear shoes with good support
D. All of the above
Correct answer: A. Remove rugs from the floor
Rationale:
Removing rugs from the floor is a key safety measure for patients with osteoporosis to prevent falls that could
result in fractures. Loose rugs are a significant tripping hazard. While canes and supportive shoes are beneficial,
fall prevention starts with removing environmental hazards.
, Question 7
You just received your patient assignment for the day. They are all day postop hip replacements.
Which of the following patients would you assess first?
A. The patient that has not had a bowel movement since surgery
B. The patient with a temperature of 99.5°F
C. The patient with mild incisional pain
D. The patient with a heart rate of 95
Correct answer: A. The patient that has not had a bowel movement since surgery
Rationale:
Postoperative ileus or constipation is a common concern after hip replacement surgery, especially with opioid
use. The patient who has not had a bowel movement requires focused assessment for bowel sounds, abdominal
distention, and signs of obstruction. This is the priority over mild pain, low-grade fever, or mild tachycardia.
Question 8
You are working at a rehab facility and admitted a client who has had difficulty sleeping since
admission. Which of the following actions should you implement first?
A. Cluster care to minimize disruptions
B. Ask the patient what time they typically go to bed at home and implement into the plan of care
C. Administer a sleeping aid
D. Keep the room dark and quiet
Correct answer: B. Ask the patient what time they typically go to bed at home and implement into the
plan of care
Rationale:
The first action should be to assess the patient's usual sleep habits and preferences at home, then incorporate
these into the care plan to promote sleep continuity. Clustering care is important but should be based on the
patient's individual sleep patterns.
