1|Page
NUR 257 Exam 2 Concepts of Aging &
Chronic Illness | Galen Nursing – 200
Practice Questions with Answers &
Rationales
This comprehensive NUR 257 Exam 2 study guide features 200 multiple-
choice questions covering all core Concepts of Aging & Chronic Illness
tested at Galen College of Nursing. Topics include: urinary incontinence
(stress, urge, overflow, functional – causes, interventions, bladder
training, pelvic floor/Kegel exercises, medications like anticholinergics),
urinary tract infections (UTIs) in older adults (atypical presentation –
confusion, falls, delirium; antibiotics, fluid intake, prevention),
constipation (age-related decreased motility, fiber/fluid, stool softeners,
bulk-forming vs. stimulant laxatives, bowel obstruction risk), anemia (iron
deficiency, heme vs. non-heme iron, vitamin C absorption, hemoglobin
levels, orthostatic hypotension, fall risk), benign prostatic hyperplasia
(BPH) (tamsulosin, finasteride, dutasteride, alpha-blockers, 5-alpha-
reductase inhibitors, nocturia, hesitancy, urinary retention, TURP,
orthostatic hypotension, side effects), dehydration (decreased thirst
sensation, daily weights, skin turgor limitations), malnutrition
(unintentional weight loss, serum albumin, muscle wasting), and skin
breakdown prevention (repositioning, incontinence care, pressure ulcers,
Braden Scale). Every question includes the correct answer in bold italic
plus a detailed rationale to reinforce clinical reasoning and NCLEX-style
critical thinking. Perfect for exam prep, remediation, and clinical
simulation review. Instant digital download – study on the go and ace
your NUR 257 Exam 2! 📚✅
,2|Page
Question 1
The nurse is caring for an older adult patient with pneumonia. Which age-related
change in the respiratory system increases this patient's risk for complications?
A) Increased chest wall compliance
B) Decreased cough reflex and mucociliary clearance
C) Increased vital capacity
D) Increased alveolar surface area
Answer: B) Decreased cough reflex and mucociliary clearance
Rationale: Aging is associated with decreased cough reflex, reduced mucociliary
clearance, and increased chest wall stiffness. These changes impair the ability
to clear secretions, increasing the risk of respiratory infections such as
pneumonia. Vital capacity decreases, not increases, and alveolar surface area
decreases with age.
Question 2
An 82-year-old patient is admitted with community-acquired pneumonia. Which
symptom is most commonly seen in older adults with pneumonia?
A) High fever and chills
B) Productive cough with green sputum
C) Confusion and falls
D) Sharp chest pain
Answer: C) Confusion and falls
Rationale: Older adults with pneumonia often present with atypical symptoms
such as confusion, falls, lethargy, and anorexia rather than classic symptoms
like high fever, chills, and productive cough. This can delay diagnosis and
increase morbidity.
Question 3
The nurse is assessing an older adult patient for signs of dehydration. Which age-
related change contributes to the risk of dehydration?
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A) Increased total body water
B) Decreased thirst sensation
C) Increased renal concentrating ability
D) Increased antidiuretic hormone (ADH) secretion
Answer: B) Decreased thirst sensation
Rationale: Aging is associated with a decreased thirst sensation, making older
adults less likely to drink adequate fluids. Total body water decreases with age,
renal concentrating ability decreases, and ADH response may be altered, all
contributing to dehydration risk.
Question 4
The nurse is caring for a patient with urinary incontinence. Which type of
incontinence is characterized by a sudden, strong urge to urinate?
A) Stress incontinence
B) Urge incontinence
C) Overflow incontinence
D) Functional incontinence
Answer: B) Urge incontinence
Rationale: Urge incontinence is characterized by a sudden, strong urge to
urinate followed by involuntary leakage. Stress incontinence is leakage with
coughing, sneezing, or lifting. Overflow incontinence is leakage due to an
overfull bladder. Functional incontinence is due to physical or cognitive
barriers.
Question 5
The nurse is teaching a patient with stress incontinence about pelvic floor exercises.
Which instruction is correct?
A) "Tighten your pelvic muscles as if you are stopping urine flow, hold for 10
seconds, and relax."
B) "Tighten your abdominal muscles and bear down."
, 4|Page
C) "Perform exercises only when you feel the urge to urinate."
D) "Avoid exercising if you have incontinence."
Answer: A) "Tighten your pelvic muscles as if you are stopping urine flow, hold
for 10 seconds, and relax."
Rationale: Kegel exercises involve tightening the pelvic floor muscles (as if
stopping urine flow), holding for 10 seconds, and relaxing. They should be
performed daily, not only when feeling the urge. Abdominal exercises are not
pelvic floor exercises.
Question 6
An 88-year-old patient is admitted with a urinary tract infection (UTI). Which
symptom is most commonly seen in older adults with UTI?
A) Dysuria
B) Fever and chills
C) Confusion and behavioral changes
D) Flank pain
Answer: C) Confusion and behavioral changes
Rationale: Older adults with UTIs often present with atypical symptoms such as
confusion, agitation, lethargy, and falls rather than classic symptoms like
dysuria, fever, and flank pain. This is known as "silent" or atypical UTI.
Question 7
The nurse is assessing an older adult patient for signs of constipation. Which age-
related change contributes to this condition?
A) Increased gastric emptying
B) Decreased intestinal motility
C) Increased peristalsis
D) Increased fluid absorption
Answer: B) Decreased intestinal motility
NUR 257 Exam 2 Concepts of Aging &
Chronic Illness | Galen Nursing – 200
Practice Questions with Answers &
Rationales
This comprehensive NUR 257 Exam 2 study guide features 200 multiple-
choice questions covering all core Concepts of Aging & Chronic Illness
tested at Galen College of Nursing. Topics include: urinary incontinence
(stress, urge, overflow, functional – causes, interventions, bladder
training, pelvic floor/Kegel exercises, medications like anticholinergics),
urinary tract infections (UTIs) in older adults (atypical presentation –
confusion, falls, delirium; antibiotics, fluid intake, prevention),
constipation (age-related decreased motility, fiber/fluid, stool softeners,
bulk-forming vs. stimulant laxatives, bowel obstruction risk), anemia (iron
deficiency, heme vs. non-heme iron, vitamin C absorption, hemoglobin
levels, orthostatic hypotension, fall risk), benign prostatic hyperplasia
(BPH) (tamsulosin, finasteride, dutasteride, alpha-blockers, 5-alpha-
reductase inhibitors, nocturia, hesitancy, urinary retention, TURP,
orthostatic hypotension, side effects), dehydration (decreased thirst
sensation, daily weights, skin turgor limitations), malnutrition
(unintentional weight loss, serum albumin, muscle wasting), and skin
breakdown prevention (repositioning, incontinence care, pressure ulcers,
Braden Scale). Every question includes the correct answer in bold italic
plus a detailed rationale to reinforce clinical reasoning and NCLEX-style
critical thinking. Perfect for exam prep, remediation, and clinical
simulation review. Instant digital download – study on the go and ace
your NUR 257 Exam 2! 📚✅
,2|Page
Question 1
The nurse is caring for an older adult patient with pneumonia. Which age-related
change in the respiratory system increases this patient's risk for complications?
A) Increased chest wall compliance
B) Decreased cough reflex and mucociliary clearance
C) Increased vital capacity
D) Increased alveolar surface area
Answer: B) Decreased cough reflex and mucociliary clearance
Rationale: Aging is associated with decreased cough reflex, reduced mucociliary
clearance, and increased chest wall stiffness. These changes impair the ability
to clear secretions, increasing the risk of respiratory infections such as
pneumonia. Vital capacity decreases, not increases, and alveolar surface area
decreases with age.
Question 2
An 82-year-old patient is admitted with community-acquired pneumonia. Which
symptom is most commonly seen in older adults with pneumonia?
A) High fever and chills
B) Productive cough with green sputum
C) Confusion and falls
D) Sharp chest pain
Answer: C) Confusion and falls
Rationale: Older adults with pneumonia often present with atypical symptoms
such as confusion, falls, lethargy, and anorexia rather than classic symptoms
like high fever, chills, and productive cough. This can delay diagnosis and
increase morbidity.
Question 3
The nurse is assessing an older adult patient for signs of dehydration. Which age-
related change contributes to the risk of dehydration?
,3|Page
A) Increased total body water
B) Decreased thirst sensation
C) Increased renal concentrating ability
D) Increased antidiuretic hormone (ADH) secretion
Answer: B) Decreased thirst sensation
Rationale: Aging is associated with a decreased thirst sensation, making older
adults less likely to drink adequate fluids. Total body water decreases with age,
renal concentrating ability decreases, and ADH response may be altered, all
contributing to dehydration risk.
Question 4
The nurse is caring for a patient with urinary incontinence. Which type of
incontinence is characterized by a sudden, strong urge to urinate?
A) Stress incontinence
B) Urge incontinence
C) Overflow incontinence
D) Functional incontinence
Answer: B) Urge incontinence
Rationale: Urge incontinence is characterized by a sudden, strong urge to
urinate followed by involuntary leakage. Stress incontinence is leakage with
coughing, sneezing, or lifting. Overflow incontinence is leakage due to an
overfull bladder. Functional incontinence is due to physical or cognitive
barriers.
Question 5
The nurse is teaching a patient with stress incontinence about pelvic floor exercises.
Which instruction is correct?
A) "Tighten your pelvic muscles as if you are stopping urine flow, hold for 10
seconds, and relax."
B) "Tighten your abdominal muscles and bear down."
, 4|Page
C) "Perform exercises only when you feel the urge to urinate."
D) "Avoid exercising if you have incontinence."
Answer: A) "Tighten your pelvic muscles as if you are stopping urine flow, hold
for 10 seconds, and relax."
Rationale: Kegel exercises involve tightening the pelvic floor muscles (as if
stopping urine flow), holding for 10 seconds, and relaxing. They should be
performed daily, not only when feeling the urge. Abdominal exercises are not
pelvic floor exercises.
Question 6
An 88-year-old patient is admitted with a urinary tract infection (UTI). Which
symptom is most commonly seen in older adults with UTI?
A) Dysuria
B) Fever and chills
C) Confusion and behavioral changes
D) Flank pain
Answer: C) Confusion and behavioral changes
Rationale: Older adults with UTIs often present with atypical symptoms such as
confusion, agitation, lethargy, and falls rather than classic symptoms like
dysuria, fever, and flank pain. This is known as "silent" or atypical UTI.
Question 7
The nurse is assessing an older adult patient for signs of constipation. Which age-
related change contributes to this condition?
A) Increased gastric emptying
B) Decreased intestinal motility
C) Increased peristalsis
D) Increased fluid absorption
Answer: B) Decreased intestinal motility
