Exam 2: NUR 257 / NUR257 (Latest 2026/2027 Update)
Aging and Chronic Illness in Nursing Exam Review
100% Correct | Grade A - Galen
Comprehensive Gerontological Nursing and Chronic Illness Management Assessment
Aligned with Galen College of Nursing NUR257 Course Objectives and 2026/2027 Competencies
75 Questions | Theories of Aging | Chronic Illness Models | Common Chronic Conditions |
Pharmacological Management | Functional Assessment | Psychosocial and End-of-Life Care
,Section 1: Theories of Aging and Physiological Changes (Biological, Psychological,
Sociological Theories; Age-Related Body System Changes)
Q1: A nurse is caring for a 78-year-old patient who has smoked for 50 years and worked in a factory with chemical
exposure. The nurse explains that certain aging theories propose accumulated damage from environmental factors
contributes to aging. Which category of biological aging theory best describes this explanation?
A. A. Non-stochastic theory, which attributes aging to genetically programmed processes
B. B. Stochastic theory, which attributes aging to random accumulated damage from environmental factors
**[CORRECT]**
C. C. Immunological theory, which attributes aging to a progressive decline in immune function
D. D. Neuroendocrine theory, which attributes aging to hormonal dysregulation over the lifespan
Correct Answer: B
Rationale: Stochastic theories of aging, including the free radical theory and wear-and-tear theory, propose that aging results from random,
accumulated damage from environmental exposures, lifestyle factors, and random molecular events. This patient's long smoking history and
occupational chemical exposure align with stochastic mechanisms that cause cumulative cellular damage over time. Non-stochastic theories,
such as the programmed aging theory, propose that aging follows a genetically predetermined biological timeline and are not primarily driven
by environmental factors. The gerontological nurse should understand this distinction because it supports health teaching about modifiable risk
factors and reinforces that some aspects of aging can be influenced by lifestyle choices.
Q2: An 82-year-old patient asks the nurse why their provider recommended a diet rich in fruits and vegetables. The
nurse explains that antioxidants help neutralize substances that damage cells and contribute to aging. Which
biological theory of aging supports this nutritional teaching?
A. A. Telomere theory, which explains that chromosome caps shorten with each cell division
B. B. Free radical theory, which explains that reactive oxygen species cause cumulative cellular damage
**[CORRECT]**
C. C. Immunological theory, which explains that immune system decline leads to increased infections
D. D. Cross-linking theory, which explains that protein cross-links impair tissue function over time
Correct Answer: B
Rationale: The free radical theory of aging proposes that accumulated oxidative damage from reactive oxygen species (free radicals) damages
cellular components including DNA, proteins, and lipids, contributing to aging and age-related diseases. Antioxidants found in fruits and
vegetables neutralize free radicals and may slow this oxidative damage process. Understanding this theory helps the gerontological nurse
promote nutritional interventions that support healthy aging and reduce modifiable risk factors. The nurse should educate older adults on
dietary sources of antioxidants such as vitamins C and E, beta-carotene, and polyphenols as part of a comprehensive wellness plan.
Q3: A researcher is studying two groups of older adults: one with a family history of exceptional longevity and one
without. The researcher finds that individuals in the longevity group have cells that can undergo significantly more
divisions before reaching senescence. Which biological theory best explains this finding?
A. A. Free radical theory, because fewer oxidative events preserve overall cellular function
B. B. Neuroendocrine theory, because hormonal differences slow the systemic aging process
C. C. Telomere theory, because longer telomeres allow more cell divisions before reaching the Hayflick limit
**[CORRECT]**
D. D. Immunological theory, because enhanced immune surveillance prevents cumulative cellular damage
Correct Answer: C
Rationale: The telomere theory of aging proposes that telomeres, protective caps on chromosome ends, shorten with each cell division until a
critical length triggers cellular senescence or apoptosis, known as the Hayflick limit. Individuals with genetic predispositions to longer telomeres
or more active telomerase can sustain more cell divisions before reaching this limit, potentially contributing to exceptional longevity. This theory
is fundamental to understanding cellular aging and has important implications for regenerative medicine approaches in gerontological nursing.
While free radical reduction and immune function also influence aging, they do not directly explain the observed difference in replicative
capacity between the two groups.
, Q4: A 75-year-old retired teacher reflects on her life, stating, 'I have made a difference in so many students' lives,
and I can face the end with a sense of peace.' Which of Erikson's psychosocial stages is this patient demonstrating
successful resolution of?
A. A. Generativity vs. stagnation, because she is reflecting on her contributions to others
B. B. Integrity vs. despair, because she has achieved a sense of life fulfillment and wisdom **[CORRECT]**
C. C. Ego integrity vs. role confusion, because she is evaluating her identity in retrospect
D. D. Autonomy vs. shame and doubt, because she expresses confidence in her life decisions
Correct Answer: B
Rationale: Erikson's final psychosocial stage, integrity vs. despair (ages 65 and older), involves reflecting on one's life and either achieving a
sense of fulfillment and wisdom (integrity) or experiencing regret and dissatisfaction (despair). This patient's expression of peace and sense of
having made a meaningful difference indicates successful resolution of this stage. Generativity vs. stagnation is the preceding stage (middle
adulthood) focused on contributing to the next generation through work and parenting, but the key here is the retrospective life review and
acceptance of mortality. The gerontological nurse can use understanding of this stage to support life review therapy and promote ego integrity
in older adults.
Q5: A 72-year-old retired accountant who derived his identity entirely from his career becomes depressed after
retirement, telling the nurse, 'Without my work, I am nobody.' The nurse plans interventions based on Peck's
expansion of Erikson's theory. Which of Peck's developmental tasks is most relevant to this patient's struggle?
A. A. Ego differentiation vs. work-role preoccupation, because the patient's self-worth was tied exclusively to his
occupation **[CORRECT]**
B. B. Body transcendence vs. body preoccupation, because the patient is struggling with physical limitations of aging
C. C. Ego transcendence vs. ego preoccupation, because the patient cannot accept the reality of death
D. D. Activity vs. disengagement, because the patient needs to find new social roles to replace work
Correct Answer: A
Rationale: Peck's task of ego differentiation vs. work-role preoccupation addresses the challenge older adults face when their self-worth has
been tied exclusively to their occupational role. This patient's depression and statement that he is 'nobody' without work directly illustrate failure
to differentiate his sense of self from his professional identity. The gerontological nurse should help the patient explore other sources of identity
and meaning beyond the work role, such as hobbies, volunteer work, relationships, and community involvement. Body transcendence vs. body
preoccupation relates to coping with physical changes of aging, while ego transcendence vs. ego preoccupation involves accepting the reality of
death and finding meaning in one's legacy rather than personal achievement.
Q6: An 80-year-old woman who was an avid gardener her entire adult life moves to an assisted living facility. She
immediately joins the facility's gardening club and begins teaching other residents about plant care. Which
sociological theory of aging best describes her adaptation?
A. A. Disengagement theory, because she is gradually reducing her social obligations in the new environment
B. B. Activity theory, because she is staying physically and socially active in the facility
C. C. Continuity theory, because she is maintaining consistent patterns of behavior and interests from her earlier life
**[CORRECT]**
D. D. Age stratification theory, because she is interacting with peers in the same age cohort
Correct Answer: C
Rationale: Continuity theory proposes that older adults maintain consistent patterns of behavior, preferences, values, and roles from their
earlier life when adapting to aging and environmental changes. This patient's continuation of gardening and teaching in a new setting
exemplifies how maintaining continuity in meaningful activities and roles supports successful adaptation to life transitions. While activity theory
also emphasizes staying active, it does not specifically address the maintenance of prior patterns and personal identity. Disengagement theory
suggests a mutual withdrawal between the individual and society, which does not fit this patient's proactive engagement. The gerontological
nurse should support continuity in meaningful activities during care transitions to promote adjustment and well-being.
Q7: A nurse overhears a colleague say, 'It is not worth teaching that 85-year-old patient how to use the new insulin
pen because elderly patients cannot learn new things.' Which concept should the nurse address when responding to
this colleague?
Aging and Chronic Illness in Nursing Exam Review
100% Correct | Grade A - Galen
Comprehensive Gerontological Nursing and Chronic Illness Management Assessment
Aligned with Galen College of Nursing NUR257 Course Objectives and 2026/2027 Competencies
75 Questions | Theories of Aging | Chronic Illness Models | Common Chronic Conditions |
Pharmacological Management | Functional Assessment | Psychosocial and End-of-Life Care
,Section 1: Theories of Aging and Physiological Changes (Biological, Psychological,
Sociological Theories; Age-Related Body System Changes)
Q1: A nurse is caring for a 78-year-old patient who has smoked for 50 years and worked in a factory with chemical
exposure. The nurse explains that certain aging theories propose accumulated damage from environmental factors
contributes to aging. Which category of biological aging theory best describes this explanation?
A. A. Non-stochastic theory, which attributes aging to genetically programmed processes
B. B. Stochastic theory, which attributes aging to random accumulated damage from environmental factors
**[CORRECT]**
C. C. Immunological theory, which attributes aging to a progressive decline in immune function
D. D. Neuroendocrine theory, which attributes aging to hormonal dysregulation over the lifespan
Correct Answer: B
Rationale: Stochastic theories of aging, including the free radical theory and wear-and-tear theory, propose that aging results from random,
accumulated damage from environmental exposures, lifestyle factors, and random molecular events. This patient's long smoking history and
occupational chemical exposure align with stochastic mechanisms that cause cumulative cellular damage over time. Non-stochastic theories,
such as the programmed aging theory, propose that aging follows a genetically predetermined biological timeline and are not primarily driven
by environmental factors. The gerontological nurse should understand this distinction because it supports health teaching about modifiable risk
factors and reinforces that some aspects of aging can be influenced by lifestyle choices.
Q2: An 82-year-old patient asks the nurse why their provider recommended a diet rich in fruits and vegetables. The
nurse explains that antioxidants help neutralize substances that damage cells and contribute to aging. Which
biological theory of aging supports this nutritional teaching?
A. A. Telomere theory, which explains that chromosome caps shorten with each cell division
B. B. Free radical theory, which explains that reactive oxygen species cause cumulative cellular damage
**[CORRECT]**
C. C. Immunological theory, which explains that immune system decline leads to increased infections
D. D. Cross-linking theory, which explains that protein cross-links impair tissue function over time
Correct Answer: B
Rationale: The free radical theory of aging proposes that accumulated oxidative damage from reactive oxygen species (free radicals) damages
cellular components including DNA, proteins, and lipids, contributing to aging and age-related diseases. Antioxidants found in fruits and
vegetables neutralize free radicals and may slow this oxidative damage process. Understanding this theory helps the gerontological nurse
promote nutritional interventions that support healthy aging and reduce modifiable risk factors. The nurse should educate older adults on
dietary sources of antioxidants such as vitamins C and E, beta-carotene, and polyphenols as part of a comprehensive wellness plan.
Q3: A researcher is studying two groups of older adults: one with a family history of exceptional longevity and one
without. The researcher finds that individuals in the longevity group have cells that can undergo significantly more
divisions before reaching senescence. Which biological theory best explains this finding?
A. A. Free radical theory, because fewer oxidative events preserve overall cellular function
B. B. Neuroendocrine theory, because hormonal differences slow the systemic aging process
C. C. Telomere theory, because longer telomeres allow more cell divisions before reaching the Hayflick limit
**[CORRECT]**
D. D. Immunological theory, because enhanced immune surveillance prevents cumulative cellular damage
Correct Answer: C
Rationale: The telomere theory of aging proposes that telomeres, protective caps on chromosome ends, shorten with each cell division until a
critical length triggers cellular senescence or apoptosis, known as the Hayflick limit. Individuals with genetic predispositions to longer telomeres
or more active telomerase can sustain more cell divisions before reaching this limit, potentially contributing to exceptional longevity. This theory
is fundamental to understanding cellular aging and has important implications for regenerative medicine approaches in gerontological nursing.
While free radical reduction and immune function also influence aging, they do not directly explain the observed difference in replicative
capacity between the two groups.
, Q4: A 75-year-old retired teacher reflects on her life, stating, 'I have made a difference in so many students' lives,
and I can face the end with a sense of peace.' Which of Erikson's psychosocial stages is this patient demonstrating
successful resolution of?
A. A. Generativity vs. stagnation, because she is reflecting on her contributions to others
B. B. Integrity vs. despair, because she has achieved a sense of life fulfillment and wisdom **[CORRECT]**
C. C. Ego integrity vs. role confusion, because she is evaluating her identity in retrospect
D. D. Autonomy vs. shame and doubt, because she expresses confidence in her life decisions
Correct Answer: B
Rationale: Erikson's final psychosocial stage, integrity vs. despair (ages 65 and older), involves reflecting on one's life and either achieving a
sense of fulfillment and wisdom (integrity) or experiencing regret and dissatisfaction (despair). This patient's expression of peace and sense of
having made a meaningful difference indicates successful resolution of this stage. Generativity vs. stagnation is the preceding stage (middle
adulthood) focused on contributing to the next generation through work and parenting, but the key here is the retrospective life review and
acceptance of mortality. The gerontological nurse can use understanding of this stage to support life review therapy and promote ego integrity
in older adults.
Q5: A 72-year-old retired accountant who derived his identity entirely from his career becomes depressed after
retirement, telling the nurse, 'Without my work, I am nobody.' The nurse plans interventions based on Peck's
expansion of Erikson's theory. Which of Peck's developmental tasks is most relevant to this patient's struggle?
A. A. Ego differentiation vs. work-role preoccupation, because the patient's self-worth was tied exclusively to his
occupation **[CORRECT]**
B. B. Body transcendence vs. body preoccupation, because the patient is struggling with physical limitations of aging
C. C. Ego transcendence vs. ego preoccupation, because the patient cannot accept the reality of death
D. D. Activity vs. disengagement, because the patient needs to find new social roles to replace work
Correct Answer: A
Rationale: Peck's task of ego differentiation vs. work-role preoccupation addresses the challenge older adults face when their self-worth has
been tied exclusively to their occupational role. This patient's depression and statement that he is 'nobody' without work directly illustrate failure
to differentiate his sense of self from his professional identity. The gerontological nurse should help the patient explore other sources of identity
and meaning beyond the work role, such as hobbies, volunteer work, relationships, and community involvement. Body transcendence vs. body
preoccupation relates to coping with physical changes of aging, while ego transcendence vs. ego preoccupation involves accepting the reality of
death and finding meaning in one's legacy rather than personal achievement.
Q6: An 80-year-old woman who was an avid gardener her entire adult life moves to an assisted living facility. She
immediately joins the facility's gardening club and begins teaching other residents about plant care. Which
sociological theory of aging best describes her adaptation?
A. A. Disengagement theory, because she is gradually reducing her social obligations in the new environment
B. B. Activity theory, because she is staying physically and socially active in the facility
C. C. Continuity theory, because she is maintaining consistent patterns of behavior and interests from her earlier life
**[CORRECT]**
D. D. Age stratification theory, because she is interacting with peers in the same age cohort
Correct Answer: C
Rationale: Continuity theory proposes that older adults maintain consistent patterns of behavior, preferences, values, and roles from their
earlier life when adapting to aging and environmental changes. This patient's continuation of gardening and teaching in a new setting
exemplifies how maintaining continuity in meaningful activities and roles supports successful adaptation to life transitions. While activity theory
also emphasizes staying active, it does not specifically address the maintenance of prior patterns and personal identity. Disengagement theory
suggests a mutual withdrawal between the individual and society, which does not fit this patient's proactive engagement. The gerontological
nurse should support continuity in meaningful activities during care transitions to promote adjustment and well-being.
Q7: A nurse overhears a colleague say, 'It is not worth teaching that 85-year-old patient how to use the new insulin
pen because elderly patients cannot learn new things.' Which concept should the nurse address when responding to
this colleague?
