NUR 257 CHRONIC HEALTH CONCEPTS
NUR 257 | Concepts of Aging and Chronic Illness in Nursing
Final Comprehensive Examination Actual Exam |
Academic Year 2026/2027
A+ GRADED!
This document contains 250 verified questions spanning four core domains
aligned with the official final examination blueprint: Promoting Healthy
Aging and Chronic Illness Management; Cardiovascular, Respiratory, and
Endocrine Chronic Conditions; Neurological, Musculoskeletal, and Sensory
Chronic Conditions; and Psychosocial, Cognitive, and Palliative Care in
Aging. Every question has been written originally for the Academic Year
2026/2027 to reinforce the official Concepts of Aging and Chronic Illness
in Nursing Final Comprehensive Examination objectives, supporting actual
exam readiness, clinical proficiency, and compassionate, evidence-based
care of older adults. Each item pairs a clinically accurate stem with
four options and a concise rationale grounded in foundational
gerontological nursing textbooks and current evidence-based guidance for
aging populations, so the reasoning behind every correct option is
transparent and instructive. Work through each domain in sequence,
record your results on the domain score tracker, and revisit the
rationales for any question you miss before sitting your actual exam.
Domain 1 (Questions 1-65): Promoting Healthy Aging and Chronic Illness Management
Domain 2 (Questions 66-130): Cardiovascular, Respiratory, and Endocrine Chronic Conditions
Domain 3 (Questions 131-195): Neurological, Musculoskeletal, and Sensory Chronic
Conditions
Domain 4 (Questions 196-250): Psychosocial, Cognitive, and Palliative Care in Aging
DOMAIN 1: PROMOTING HEALTHY AGING AND CHRONIC ILLNESS MANAGEMENT
Questions 1-65
Question 1. An 82-year-old asks why she should bother exercising at her age.
Which response reflects healthy-aging evidence?
A. Exercise offers little benefit after eighty
,B. Rest is the safest plan for all older adults
C. Regular activity preserves mobility, balance, and independence in later life
D. Only vigorous gym training counts as exercise
Correct Answer: C
Rationale: Aerobic, strength, and balance work remain protective into the
oldest decades, delaying frailty and falls.
Question 2. Which physiologic change of normal aging most increases medication
risk in older adults?
A. Faster hepatic first-pass metabolism
B. Reduced renal clearance prolonging drug action
C. Increased total body water diluting doses
D. Heightened thirst sharpening hydration
Correct Answer: B
Rationale: Glomerular filtration declines with age, so renally cleared drugs
accumulate—dosing must follow kidney function.
Question 3. Why does the comprehensive geriatric assessment differ from a
standard adult workup?
A. It evaluates function, cognition, mood, nutrition, social supports, and
environment together
B. It replaces all laboratory work
C. It focuses exclusively on vital signs
D. It applies only to hospitalized patients
Correct Answer: A
Rationale: Chronic illness management is multidimensional; the integrated
assessment finds the interacting problems a single-system workup misses.
Question 4. Which screening belongs routinely in the care of community-dwelling
older adults?
A. Monthly chest radiographs
B. Weekly liver biopsies
C. Falls and functional status inquiry at each visit
,D. Daily spinal taps
Correct Answer: C
Rationale: Falls and functional decline are the sentinel geriatric
syndromes—asking about them is fast, evidence-supported screening.
Question 5. A 79-year-old takes nine daily medications. What is the priority
nursing contribution?
A. Reconcile the list for duplication, interactions, and deprescribing
opportunities at every transition
B. Encourage doubling vitamins to offset the load
C. Space all doses within one morning hour
D. Suggest stopping every medication at once
Correct Answer: A
Rationale: Polypharmacy multiplies interaction and fall risk; systematic
reconciliation with gradual deprescribing is the standard of care.
Question 6. Which nutrition guidance fits a 76-year-old with reduced appetite
and mild weight loss?
A. Restricting protein to protect the kidneys
B. Large single meals once daily
C. Nutrient-dense foods, protein at each meal, and flavorful, social mealtimes
D. Liquid-only dieting for simplicity
Correct Answer: C
Rationale: Anabolic resistance makes protein and nutrient density critical;
social, flavorful meals counter sensory decline.
Question 7. What is the most reliable indicator of hydration status in an
older adult?
A. Skin turgor
B. Urine output
C. Serum osmolality
D. Thirst sensation
, Correct Answer: C
Rationale: Thirst sensation diminishes with age; serum osmolality provides
objective data on hydration status.
Question 8. Which vaccine is recommended for all adults aged 65 and older?
A. MMR vaccine
B. Pneumococcal vaccine
C. Hepatitis A vaccine
D. Varicella vaccine
Correct Answer: B
Rationale: Pneumococcal vaccination is recommended for all adults 65+ to
prevent pneumonia and invasive pneumococcal disease.
Question 9. What is the recommended frequency of influenza vaccination for
older adults?
A. Every 5 years
B. Every 2 years
C. Annually
D. Only once after age 65
Correct Answer: C
Rationale: Annual influenza vaccination is recommended due to changing viral
strains and waning immunity.
Question 10. Which shingles vaccine is preferred for adults aged 50 and older?
A. Zostavax
B. Shingrix
C. Varivax
D. MMR-II
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine) is preferred over Zostavax
due to higher efficacy and longer duration of protection.
NUR 257 | Concepts of Aging and Chronic Illness in Nursing
Final Comprehensive Examination Actual Exam |
Academic Year 2026/2027
A+ GRADED!
This document contains 250 verified questions spanning four core domains
aligned with the official final examination blueprint: Promoting Healthy
Aging and Chronic Illness Management; Cardiovascular, Respiratory, and
Endocrine Chronic Conditions; Neurological, Musculoskeletal, and Sensory
Chronic Conditions; and Psychosocial, Cognitive, and Palliative Care in
Aging. Every question has been written originally for the Academic Year
2026/2027 to reinforce the official Concepts of Aging and Chronic Illness
in Nursing Final Comprehensive Examination objectives, supporting actual
exam readiness, clinical proficiency, and compassionate, evidence-based
care of older adults. Each item pairs a clinically accurate stem with
four options and a concise rationale grounded in foundational
gerontological nursing textbooks and current evidence-based guidance for
aging populations, so the reasoning behind every correct option is
transparent and instructive. Work through each domain in sequence,
record your results on the domain score tracker, and revisit the
rationales for any question you miss before sitting your actual exam.
Domain 1 (Questions 1-65): Promoting Healthy Aging and Chronic Illness Management
Domain 2 (Questions 66-130): Cardiovascular, Respiratory, and Endocrine Chronic Conditions
Domain 3 (Questions 131-195): Neurological, Musculoskeletal, and Sensory Chronic
Conditions
Domain 4 (Questions 196-250): Psychosocial, Cognitive, and Palliative Care in Aging
DOMAIN 1: PROMOTING HEALTHY AGING AND CHRONIC ILLNESS MANAGEMENT
Questions 1-65
Question 1. An 82-year-old asks why she should bother exercising at her age.
Which response reflects healthy-aging evidence?
A. Exercise offers little benefit after eighty
,B. Rest is the safest plan for all older adults
C. Regular activity preserves mobility, balance, and independence in later life
D. Only vigorous gym training counts as exercise
Correct Answer: C
Rationale: Aerobic, strength, and balance work remain protective into the
oldest decades, delaying frailty and falls.
Question 2. Which physiologic change of normal aging most increases medication
risk in older adults?
A. Faster hepatic first-pass metabolism
B. Reduced renal clearance prolonging drug action
C. Increased total body water diluting doses
D. Heightened thirst sharpening hydration
Correct Answer: B
Rationale: Glomerular filtration declines with age, so renally cleared drugs
accumulate—dosing must follow kidney function.
Question 3. Why does the comprehensive geriatric assessment differ from a
standard adult workup?
A. It evaluates function, cognition, mood, nutrition, social supports, and
environment together
B. It replaces all laboratory work
C. It focuses exclusively on vital signs
D. It applies only to hospitalized patients
Correct Answer: A
Rationale: Chronic illness management is multidimensional; the integrated
assessment finds the interacting problems a single-system workup misses.
Question 4. Which screening belongs routinely in the care of community-dwelling
older adults?
A. Monthly chest radiographs
B. Weekly liver biopsies
C. Falls and functional status inquiry at each visit
,D. Daily spinal taps
Correct Answer: C
Rationale: Falls and functional decline are the sentinel geriatric
syndromes—asking about them is fast, evidence-supported screening.
Question 5. A 79-year-old takes nine daily medications. What is the priority
nursing contribution?
A. Reconcile the list for duplication, interactions, and deprescribing
opportunities at every transition
B. Encourage doubling vitamins to offset the load
C. Space all doses within one morning hour
D. Suggest stopping every medication at once
Correct Answer: A
Rationale: Polypharmacy multiplies interaction and fall risk; systematic
reconciliation with gradual deprescribing is the standard of care.
Question 6. Which nutrition guidance fits a 76-year-old with reduced appetite
and mild weight loss?
A. Restricting protein to protect the kidneys
B. Large single meals once daily
C. Nutrient-dense foods, protein at each meal, and flavorful, social mealtimes
D. Liquid-only dieting for simplicity
Correct Answer: C
Rationale: Anabolic resistance makes protein and nutrient density critical;
social, flavorful meals counter sensory decline.
Question 7. What is the most reliable indicator of hydration status in an
older adult?
A. Skin turgor
B. Urine output
C. Serum osmolality
D. Thirst sensation
, Correct Answer: C
Rationale: Thirst sensation diminishes with age; serum osmolality provides
objective data on hydration status.
Question 8. Which vaccine is recommended for all adults aged 65 and older?
A. MMR vaccine
B. Pneumococcal vaccine
C. Hepatitis A vaccine
D. Varicella vaccine
Correct Answer: B
Rationale: Pneumococcal vaccination is recommended for all adults 65+ to
prevent pneumonia and invasive pneumococcal disease.
Question 9. What is the recommended frequency of influenza vaccination for
older adults?
A. Every 5 years
B. Every 2 years
C. Annually
D. Only once after age 65
Correct Answer: C
Rationale: Annual influenza vaccination is recommended due to changing viral
strains and waning immunity.
Question 10. Which shingles vaccine is preferred for adults aged 50 and older?
A. Zostavax
B. Shingrix
C. Varivax
D. MMR-II
Correct Answer: B
Rationale: Shingrix (recombinant zoster vaccine) is preferred over Zostavax
due to higher efficacy and longer duration of protection.
