NURSING · AGING & CHRONIC ILLNESS
NUR 257 Chronic Exam 4
2026/2027 Official Exam
A+ 5 100%
QUESTIONS EXAM DOMAINS RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
■ Section 1: Sleep and Rest in the Older Adult (Q1–10)
■ Section 2: Chronic Pain Assessment and Management (Q11–20)
■ Section 3: Musculoskeletal Disorders: Osteoporosis, OA, RA, Gout (Q21–30)
■ Section 4: Sensory Impairments: Vision and Hearing (Q31–40)
■ Section 5: Falls, Safety, and Injury Prevention (Q41–50)
STUVIAACTUALEXAM
Original practice content aligned to publicly available course topics for Concepts of Aging & Chronic Illness. Not an official product of any college.
, SECTION 1: SLEEP AND REST IN THE OLDER ADULT
Q1. An 82-year-old client reports lying awake for two hours most nights and then feeling exhausted during the day. The
nurse notes the client drinks two cups of coffee after dinner and watches television in bed until midnight. Which
intervention should the nurse implement first to improve sleep hygiene?
A. Suggest the client remain in bed longer in the morning to catch up on rest.
B. Teach the client to limit caffeine after early afternoon and reserve the bed for sleep only.
C. Advise the client to take long daytime naps to compensate for lost sleep.
D. Immediately request a prescription for a benzodiazepine hypnotic.
Correct Answer: B
Rationale: Caffeine late in the day and using the bed for activities other than sleep are modifiable sleep-hygiene factors. Addressing
these first is safer and more effective than starting a hypnotic in an older adult.
Q2. A nurse is planning care for a resident with dementia who becomes agitated and wanders during the night. Which
environmental modification is most appropriate to promote safer nighttime rest?
A. Lock the resident in the room from 9 p.m. until morning to prevent exits.
B. Keep the room brightly lit all night so the resident can see clearly while wandering.
C. Administer a sedative at 6 p.m. regardless of the resident’s activity level.
D. Maintain a consistent bedtime routine, reduce evening stimulation, and provide soft night lighting to orient the resident.
Correct Answer: D
Rationale: Consistent routines, reduced stimulation, and adequate but soft lighting support circadian rhythm and safety without the
risks of chemical or physical restraint.
Q3. An older adult with chronic heart failure reports frequent nighttime awakenings to urinate. The nurse reviews the
medication list and finds a loop diuretic scheduled at 8 p.m. What is the priority nursing action?
A. Encourage the client to ignore the urge to void so sleep is not interrupted.
B. Add a bedside commode but leave the diuretic timing unchanged.
C. Collaborate with the provider to move the diuretic dose to earlier in the day to reduce nocturia.
D. Instruct the client to restrict all fluids after noon regardless of thirst.
Correct Answer: C
Rationale: Evening diuretic dosing commonly causes nocturia that fragments sleep. Adjusting the schedule is a simple,
evidence-based intervention that improves rest without compromising fluid management.
Q4. A client recovering from hip surgery is having difficulty falling asleep because of unfamiliar hospital noises. Which
non-pharmacologic strategy should the nurse try first?
A. Move the client to a private room at the far end of the unit without discussion.
B. Tell the client that hospital noise is unavoidable and to expect poor sleep.
C. Administer the PRN opioid earlier than ordered to induce drowsiness.
D. Offer earplugs or a white-noise machine and dim the lights during designated quiet hours.
Correct Answer: D
Rationale: Reducing environmental noise and light are first-line, low-risk interventions that support sleep in the acute-care setting
before escalating to medication.
STUVIAACTUALEXAM | Page 2 of 15
NUR 257 Chronic Exam 4
2026/2027 Official Exam
A+ 5 100%
QUESTIONS EXAM DOMAINS RATIONALES
VERIFIED COVERED INCLUDED
CATEGORIES
■ Section 1: Sleep and Rest in the Older Adult (Q1–10)
■ Section 2: Chronic Pain Assessment and Management (Q11–20)
■ Section 3: Musculoskeletal Disorders: Osteoporosis, OA, RA, Gout (Q21–30)
■ Section 4: Sensory Impairments: Vision and Hearing (Q31–40)
■ Section 5: Falls, Safety, and Injury Prevention (Q41–50)
STUVIAACTUALEXAM
Original practice content aligned to publicly available course topics for Concepts of Aging & Chronic Illness. Not an official product of any college.
, SECTION 1: SLEEP AND REST IN THE OLDER ADULT
Q1. An 82-year-old client reports lying awake for two hours most nights and then feeling exhausted during the day. The
nurse notes the client drinks two cups of coffee after dinner and watches television in bed until midnight. Which
intervention should the nurse implement first to improve sleep hygiene?
A. Suggest the client remain in bed longer in the morning to catch up on rest.
B. Teach the client to limit caffeine after early afternoon and reserve the bed for sleep only.
C. Advise the client to take long daytime naps to compensate for lost sleep.
D. Immediately request a prescription for a benzodiazepine hypnotic.
Correct Answer: B
Rationale: Caffeine late in the day and using the bed for activities other than sleep are modifiable sleep-hygiene factors. Addressing
these first is safer and more effective than starting a hypnotic in an older adult.
Q2. A nurse is planning care for a resident with dementia who becomes agitated and wanders during the night. Which
environmental modification is most appropriate to promote safer nighttime rest?
A. Lock the resident in the room from 9 p.m. until morning to prevent exits.
B. Keep the room brightly lit all night so the resident can see clearly while wandering.
C. Administer a sedative at 6 p.m. regardless of the resident’s activity level.
D. Maintain a consistent bedtime routine, reduce evening stimulation, and provide soft night lighting to orient the resident.
Correct Answer: D
Rationale: Consistent routines, reduced stimulation, and adequate but soft lighting support circadian rhythm and safety without the
risks of chemical or physical restraint.
Q3. An older adult with chronic heart failure reports frequent nighttime awakenings to urinate. The nurse reviews the
medication list and finds a loop diuretic scheduled at 8 p.m. What is the priority nursing action?
A. Encourage the client to ignore the urge to void so sleep is not interrupted.
B. Add a bedside commode but leave the diuretic timing unchanged.
C. Collaborate with the provider to move the diuretic dose to earlier in the day to reduce nocturia.
D. Instruct the client to restrict all fluids after noon regardless of thirst.
Correct Answer: C
Rationale: Evening diuretic dosing commonly causes nocturia that fragments sleep. Adjusting the schedule is a simple,
evidence-based intervention that improves rest without compromising fluid management.
Q4. A client recovering from hip surgery is having difficulty falling asleep because of unfamiliar hospital noises. Which
non-pharmacologic strategy should the nurse try first?
A. Move the client to a private room at the far end of the unit without discussion.
B. Tell the client that hospital noise is unavoidable and to expect poor sleep.
C. Administer the PRN opioid earlier than ordered to induce drowsiness.
D. Offer earplugs or a white-noise machine and dim the lights during designated quiet hours.
Correct Answer: D
Rationale: Reducing environmental noise and light are first-line, low-risk interventions that support sleep in the acute-care setting
before escalating to medication.
STUVIAACTUALEXAM | Page 2 of 15
