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Galen College of Nursing NUR 257 Chronic Conditions
Examination 3 | Latest Verified Questions and Detailed
Answers
OVERVIEW DESCRIPTION
This comprehensive set of multiple choice questions is designed for the NUR 257 Exam
3, a chronic conditions assessment that evaluates core geriatric nursing concepts and
the management of chronic illnesses in older adults. The exam features NCLEX-style
questions—including multiple-choice and select-all-that-apply formats—that test
recall, comprehension, application, and analysis. Content areas include physiological
aging changes, geriatric syndromes (falls, frailty, incontinence, pressure injuries),
diabetes mellitus management, cardiovascular and respiratory conditions (heart
failure, hypertension), renal function and chronic kidney disease, cognitive and
neurological health (delirium vs. dementia), and vital nursing interventions such as
medication reconciliation, fall risk assessment, and non-pharmacological pain
management.
QUESTION 1
The nurse is teaching an older adult about age-related cardiovascular changes. Which
statement by the patient indicates understanding?
A) "My heart rate will increase significantly at rest."
B) "My blood vessels become more elastic, decreasing blood pressure."
C) "My cardiac output may decrease, leading to fatigue with activity."
D) "I will have a higher stroke volume due to ventricular hypertrophy."
CORRECT ANSWER: C
EXPERT RATIONALE: Aging causes decreased cardiac output and reduced maximum
heart rate, often leading to activity intolerance. Vessels stiffen, not become more elastic.
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QUESTION 2
An 82-year-old patient reports increasing dyspnea on exertion. Which age-related
respiratory change best explains this?
A) Increased lung elasticity
B) Enlarged alveoli and decreased surface area for gas exchange
C) Hypertrophy of intercostal muscles
D) Increased ciliary action
CORRECT ANSWER: B
EXPERT RATIONALE: Aging leads to alveolar enlargement and loss of elastic recoil,
reducing gas exchange efficiency and causing dyspnea. Ciliary action decreases, not
increases.
QUESTION 3
Which intervention is most important to prevent falls related to age-related sensory
decline?
A) Keeping the room dark during the night
B) Using night lights and removing scatter rugs
C) Encouraging use of multifocal lenses at all times
D) Keeping the bed in highest position
CORRECT ANSWER: B
EXPERT RATIONALE: Decreased vision and depth perception increase fall risk; night
lights and clutter-free floors improve safety. Multifocal lenses can impair depth
perception on stairs.
QUESTION 4
The nurse is assessing an older adult with frailty. Which finding is a hallmark of frailty?
A) Increased muscle mass and strength
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B) Weight gain and edema
C) Unintentional weight loss and exhaustion
D) Rapid cognitive improvement
CORRECT ANSWER: C
EXPERT RATIONALE: Frailty syndrome includes weight loss, weakness, exhaustion, slow
gait, and low physical activity. Muscle mass decreases, not increases.
QUESTION 5
An older adult is admitted with a urinary tract infection. Which geriatric syndrome
should the nurse prioritize preventing?
A) Falls and functional decline
B) Hyperglycemia
C) Hypertensive crisis
D) Osteoporosis
CORRECT ANSWER: A
EXPERT RATIONALE: Hospitalized older adults are at high risk for falls and rapid
functional decline; UTI can cause delirium and weakness, increasing fall risk.
QUESTION 6
Which question best screens for sleep disorders in an older adult?
A) "Do you drink caffeine in the morning?"
B) "Do you snore loudly or feel tired during the day?"
C) "How many meals do you eat daily?"
D) "Do you wear glasses?"
CORRECT ANSWER: B
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EXPERT RATIONALE: Snoring and daytime sleepiness suggest sleep apnea, common in
older adults. Fatigue and poor sleep quality are key indicators.
QUESTION 7
The nurse identifies a stage 1 pressure injury on an older patient's sacrum. Which
intervention is priority?
A) Massaging the reddened area
B) Applying a dry gauze dressing
C) Relieving pressure by repositioning every 2 hours
D) Using a donut-shaped cushion
CORRECT ANSWER: C
EXPERT RATIONALE: Pressure relief through frequent repositioning prevents
progression. Massage and donut cushions can worsen tissue damage.
QUESTION 8
An older adult reports new-onset urinary incontinence when laughing. What type is
most likely?
A) Urge incontinence
B) Stress incontinence
C) Overflow incontinence
D) Functional incontinence
CORRECT ANSWER: B
EXPERT RATIONALE: Leakage with coughing, laughing, or exertion indicates stress
incontinence due to weakened pelvic floor muscles. Urge involves urgency.
QUESTION 9
Which factor most increases dehydration risk in older adults?
Galen College of Nursing NUR 257 Chronic Conditions
Examination 3 | Latest Verified Questions and Detailed
Answers
OVERVIEW DESCRIPTION
This comprehensive set of multiple choice questions is designed for the NUR 257 Exam
3, a chronic conditions assessment that evaluates core geriatric nursing concepts and
the management of chronic illnesses in older adults. The exam features NCLEX-style
questions—including multiple-choice and select-all-that-apply formats—that test
recall, comprehension, application, and analysis. Content areas include physiological
aging changes, geriatric syndromes (falls, frailty, incontinence, pressure injuries),
diabetes mellitus management, cardiovascular and respiratory conditions (heart
failure, hypertension), renal function and chronic kidney disease, cognitive and
neurological health (delirium vs. dementia), and vital nursing interventions such as
medication reconciliation, fall risk assessment, and non-pharmacological pain
management.
QUESTION 1
The nurse is teaching an older adult about age-related cardiovascular changes. Which
statement by the patient indicates understanding?
A) "My heart rate will increase significantly at rest."
B) "My blood vessels become more elastic, decreasing blood pressure."
C) "My cardiac output may decrease, leading to fatigue with activity."
D) "I will have a higher stroke volume due to ventricular hypertrophy."
CORRECT ANSWER: C
EXPERT RATIONALE: Aging causes decreased cardiac output and reduced maximum
heart rate, often leading to activity intolerance. Vessels stiffen, not become more elastic.
,2|Page
QUESTION 2
An 82-year-old patient reports increasing dyspnea on exertion. Which age-related
respiratory change best explains this?
A) Increased lung elasticity
B) Enlarged alveoli and decreased surface area for gas exchange
C) Hypertrophy of intercostal muscles
D) Increased ciliary action
CORRECT ANSWER: B
EXPERT RATIONALE: Aging leads to alveolar enlargement and loss of elastic recoil,
reducing gas exchange efficiency and causing dyspnea. Ciliary action decreases, not
increases.
QUESTION 3
Which intervention is most important to prevent falls related to age-related sensory
decline?
A) Keeping the room dark during the night
B) Using night lights and removing scatter rugs
C) Encouraging use of multifocal lenses at all times
D) Keeping the bed in highest position
CORRECT ANSWER: B
EXPERT RATIONALE: Decreased vision and depth perception increase fall risk; night
lights and clutter-free floors improve safety. Multifocal lenses can impair depth
perception on stairs.
QUESTION 4
The nurse is assessing an older adult with frailty. Which finding is a hallmark of frailty?
A) Increased muscle mass and strength
,3|Page
B) Weight gain and edema
C) Unintentional weight loss and exhaustion
D) Rapid cognitive improvement
CORRECT ANSWER: C
EXPERT RATIONALE: Frailty syndrome includes weight loss, weakness, exhaustion, slow
gait, and low physical activity. Muscle mass decreases, not increases.
QUESTION 5
An older adult is admitted with a urinary tract infection. Which geriatric syndrome
should the nurse prioritize preventing?
A) Falls and functional decline
B) Hyperglycemia
C) Hypertensive crisis
D) Osteoporosis
CORRECT ANSWER: A
EXPERT RATIONALE: Hospitalized older adults are at high risk for falls and rapid
functional decline; UTI can cause delirium and weakness, increasing fall risk.
QUESTION 6
Which question best screens for sleep disorders in an older adult?
A) "Do you drink caffeine in the morning?"
B) "Do you snore loudly or feel tired during the day?"
C) "How many meals do you eat daily?"
D) "Do you wear glasses?"
CORRECT ANSWER: B
, 4|Page
EXPERT RATIONALE: Snoring and daytime sleepiness suggest sleep apnea, common in
older adults. Fatigue and poor sleep quality are key indicators.
QUESTION 7
The nurse identifies a stage 1 pressure injury on an older patient's sacrum. Which
intervention is priority?
A) Massaging the reddened area
B) Applying a dry gauze dressing
C) Relieving pressure by repositioning every 2 hours
D) Using a donut-shaped cushion
CORRECT ANSWER: C
EXPERT RATIONALE: Pressure relief through frequent repositioning prevents
progression. Massage and donut cushions can worsen tissue damage.
QUESTION 8
An older adult reports new-onset urinary incontinence when laughing. What type is
most likely?
A) Urge incontinence
B) Stress incontinence
C) Overflow incontinence
D) Functional incontinence
CORRECT ANSWER: B
EXPERT RATIONALE: Leakage with coughing, laughing, or exertion indicates stress
incontinence due to weakened pelvic floor muscles. Urge involves urgency.
QUESTION 9
Which factor most increases dehydration risk in older adults?
