,NUR 257 Exam 4 | Aging & Chronic Illness
(2026/2027) PDF | Nursing | Galen
1. An older adult client presents with sudden onset of confusion and fluctuating
level of consciousness. Which condition is most likely?
A) Delirium
B) Alzheimer's disease
C) Vascular dementia
D) Depression
Correct Answer: A) Delirium
Rationale: Delirium has an acute onset and fluctuating course, often caused by
an underlying medical condition. Alzheimer's disease and vascular dementia
have gradual, progressive decline. Depression can cause cognitive changes but
not acute fluctuating confusion.
2. Which statement best describes the primary goal of palliative care for a client
with a chronic, life-limiting illness?
A) Providing curative treatment for the underlying disease
B) Improving quality of life through symptom management
C) Accelerating the end-of-life process
D) Limiting family involvement in care
Correct Answer: B) Improving quality of life through symptom management
,Rationale: Palliative care focuses on relieving physical, emotional, and spiritual
suffering and can be provided alongside curative treatment. It aims to optimize
daily functioning and comfort. It does not hasten death or exclude family.
3. An older adult reports seeing halos around lights and blurred vision. Which
condition should the nurse suspect?
A) Macular degeneration
B) Glaucoma
C) Cataracts
D) Retinal detachment
Correct Answer: C) Cataracts
Rationale: Cataracts cause clouding of the lens, leading to blurred vision, glare
sensitivity, and halos around lights. Surgery is effective when symptoms
interfere with daily living. The other conditions have different symptom
patterns.
4. A nurse is teaching a family about sundowning in Alzheimer's disease. Which
statement should be included?
A) Sundowning refers to improved cognitive function in the evening
B) Sundowning occurs only in early-stage disease
C) Sundowning is best managed by increasing caffeine in the afternoon
D) Sundowning is increased confusion and agitation late in the day
Correct Answer: D) Sundowning is increased confusion and agitation late in the
day
, Rationale: Sundowning is worsening behavioral symptoms as natural light fades,
related to fatigue, reduced lighting, and disrupted circadian rhythms. A calm
environment and consistent routine in the late afternoon help manage it.
5. A client with osteoporosis asks how to stay safe at home. Which instruction is
appropriate?
A) Remove throw rugs from the floor
B) Use soft slippers indoors
C) Reduce dietary calcium
D) Dim hallway lighting
Correct Answer: A) Remove throw rugs from the floor
Rationale: Throw rugs are a leading cause of falls in clients with osteoporosis.
Removing loose carpets and clutter prevents fragility fractures. Soft slippers
increase fall risk, and adequate lighting and calcium are important.
6. A client with chronic arthritis pain has a pulse of 115 bpm and blood pressure
170/80 mm Hg. What should the nurse do first?
A) Notify the provider immediately
B) Assess the client's pain level
C) Administer an antihypertensive
D) Apply oxygen
Correct Answer: B) Assess the client's pain level
(2026/2027) PDF | Nursing | Galen
1. An older adult client presents with sudden onset of confusion and fluctuating
level of consciousness. Which condition is most likely?
A) Delirium
B) Alzheimer's disease
C) Vascular dementia
D) Depression
Correct Answer: A) Delirium
Rationale: Delirium has an acute onset and fluctuating course, often caused by
an underlying medical condition. Alzheimer's disease and vascular dementia
have gradual, progressive decline. Depression can cause cognitive changes but
not acute fluctuating confusion.
2. Which statement best describes the primary goal of palliative care for a client
with a chronic, life-limiting illness?
A) Providing curative treatment for the underlying disease
B) Improving quality of life through symptom management
C) Accelerating the end-of-life process
D) Limiting family involvement in care
Correct Answer: B) Improving quality of life through symptom management
,Rationale: Palliative care focuses on relieving physical, emotional, and spiritual
suffering and can be provided alongside curative treatment. It aims to optimize
daily functioning and comfort. It does not hasten death or exclude family.
3. An older adult reports seeing halos around lights and blurred vision. Which
condition should the nurse suspect?
A) Macular degeneration
B) Glaucoma
C) Cataracts
D) Retinal detachment
Correct Answer: C) Cataracts
Rationale: Cataracts cause clouding of the lens, leading to blurred vision, glare
sensitivity, and halos around lights. Surgery is effective when symptoms
interfere with daily living. The other conditions have different symptom
patterns.
4. A nurse is teaching a family about sundowning in Alzheimer's disease. Which
statement should be included?
A) Sundowning refers to improved cognitive function in the evening
B) Sundowning occurs only in early-stage disease
C) Sundowning is best managed by increasing caffeine in the afternoon
D) Sundowning is increased confusion and agitation late in the day
Correct Answer: D) Sundowning is increased confusion and agitation late in the
day
, Rationale: Sundowning is worsening behavioral symptoms as natural light fades,
related to fatigue, reduced lighting, and disrupted circadian rhythms. A calm
environment and consistent routine in the late afternoon help manage it.
5. A client with osteoporosis asks how to stay safe at home. Which instruction is
appropriate?
A) Remove throw rugs from the floor
B) Use soft slippers indoors
C) Reduce dietary calcium
D) Dim hallway lighting
Correct Answer: A) Remove throw rugs from the floor
Rationale: Throw rugs are a leading cause of falls in clients with osteoporosis.
Removing loose carpets and clutter prevents fragility fractures. Soft slippers
increase fall risk, and adequate lighting and calcium are important.
6. A client with chronic arthritis pain has a pulse of 115 bpm and blood pressure
170/80 mm Hg. What should the nurse do first?
A) Notify the provider immediately
B) Assess the client's pain level
C) Administer an antihypertensive
D) Apply oxygen
Correct Answer: B) Assess the client's pain level
