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NUR 257 Exam 3 Concepts of Aging
& Chronic Illness | Galen Nursing –
200 Practice Questions with
Answers & Rationales
This comprehensive NUR 257 Exam 3 study guide features 200
multiple-choice questions covering all core Concepts of Aging &
Chronic Illness tested at Galen College of Nursing. Topics include:
endocrine disorders – hypothyroidism (levothyroxine, TSH
monitoring, myxedema coma), hyperthyroidism (Graves' disease,
methimazole, PTU, thyroid storm, exophthalmos), osteoporosis
(bisphosphonates, alendronate, calcium/vitamin D, fall prevention,
raloxifene), benign prostatic hyperplasia (BPH) (tamsulosin,
finasteride, alpha-blockers, 5-alpha-reductase inhibitors, urinary
retention, TURP), and type 2 diabetes (metformin, sulfonylureas,
insulin storage, hypoglycemia/hyperglycemia, A1C, foot care). 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 3! 📚✅
,2|Page
Question 1
The nurse is caring for an older adult patient who reports chronic constipation.
Which age-related change contributes most to this condition?
A) Increased gastric acid secretion
B) Decreased intestinal motility
C) Increased liver enzyme activity
D) Decreased pancreatic enzyme production
Answer: B) Decreased intestinal motility
Rationale: Aging is associated with decreased gastrointestinal motility, which
prolongs transit time and contributes to constipation. Gastric acid secretion
typically decreases with age, not increases. Liver enzyme activity may decrease,
and pancreatic enzyme production may also decline, but decreased motility is
the primary factor in constipation.
Question 2
An 80-year-old patient is admitted with dehydration. Which finding is most reliable
in assessing fluid status in this patient?
A) Skin turgor over the sternum
B) Dry mucous membranes
C) Daily weight
D) Thirst
Answer: C) Daily weight
Rationale: Daily weight is the most reliable indicator of fluid status in older
adults. Skin turgor is less reliable due to age-related loss of skin elasticity. Dry
mucous membranes can be caused by medications or mouth breathing. Thirst
sensation diminishes with age and is not a reliable indicator.
Question 3
The nurse is teaching a patient about age-related changes in the renal system. Which
change should the nurse include?
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A) Increased glomerular filtration rate
B) Decreased number of nephrons
C) Increased renal blood flow
D) Enhanced drug excretion
Answer: B) Decreased number of nephrons
Rationale: Aging leads to a progressive loss of nephrons, reduced glomerular
filtration rate (GFR), and decreased renal blood flow. These changes result in
decreased drug excretion and increased risk for medication toxicity. GFR
decreases, not increases, with age.
Question 4
A 75-year-old patient with diabetes is at risk for which age-related change affecting
glucose metabolism?
A) Increased insulin sensitivity
B) Decreased insulin production and peripheral resistance
C) Enhanced glucose tolerance
D) Decreased blood glucose levels
Answer: B) Decreased insulin production and peripheral resistance
Rationale: Aging is associated with decreased insulin production by the
pancreas and increased peripheral insulin resistance, leading to impaired
glucose tolerance and increased risk of type 2 diabetes. Insulin sensitivity
decreases, not increases, with age.
Question 5
The nurse is assessing an older adult patient for signs of polypharmacy. Which
statement best defines polypharmacy?
A) Taking five or more medications daily
B) Taking two medications from the same class
C) Taking medications prescribed by multiple providers
D) Taking over-the-counter medications without a prescription
Answer: A) Taking five or more medications daily
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Rationale: Polypharmacy is commonly defined as the concurrent use of five or
more medications. It increases the risk of adverse drug reactions, drug-drug
interactions, and non-adherence. While multiple providers and OTC use
contribute to polypharmacy, the numerical definition is five or more
medications.
Question 6
The nurse is educating a patient about age-related changes in the cardiovascular
system. Which change is expected?
A) Increased cardiac output
B) Decreased peripheral vascular resistance
C) Increased systolic blood pressure
D) Decreased left ventricular hypertrophy
Answer: C) Increased systolic blood pressure
Rationale: Aging causes arterial stiffness and decreased elasticity, leading to
increased systolic blood pressure and widened pulse pressure. Cardiac output
typically decreases, peripheral vascular resistance increases, and left ventricular
hypertrophy develops as a compensatory mechanism.
Question 7
A patient with hypertension is prescribed a calcium channel blocker. Which side
effect is most concerning in an older adult?
A) Constipation
B) Peripheral edema
C) Dizziness and falls
D) Headache
Answer: C) Dizziness and falls
Rationale: Calcium channel blockers can cause hypotension and dizziness,
increasing fall risk in older adults. While constipation and peripheral edema are
common side effects, dizziness and falls pose the greatest safety risk. Headache
is less common.
NUR 257 Exam 3 Concepts of Aging
& Chronic Illness | Galen Nursing –
200 Practice Questions with
Answers & Rationales
This comprehensive NUR 257 Exam 3 study guide features 200
multiple-choice questions covering all core Concepts of Aging &
Chronic Illness tested at Galen College of Nursing. Topics include:
endocrine disorders – hypothyroidism (levothyroxine, TSH
monitoring, myxedema coma), hyperthyroidism (Graves' disease,
methimazole, PTU, thyroid storm, exophthalmos), osteoporosis
(bisphosphonates, alendronate, calcium/vitamin D, fall prevention,
raloxifene), benign prostatic hyperplasia (BPH) (tamsulosin,
finasteride, alpha-blockers, 5-alpha-reductase inhibitors, urinary
retention, TURP), and type 2 diabetes (metformin, sulfonylureas,
insulin storage, hypoglycemia/hyperglycemia, A1C, foot care). 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 3! 📚✅
,2|Page
Question 1
The nurse is caring for an older adult patient who reports chronic constipation.
Which age-related change contributes most to this condition?
A) Increased gastric acid secretion
B) Decreased intestinal motility
C) Increased liver enzyme activity
D) Decreased pancreatic enzyme production
Answer: B) Decreased intestinal motility
Rationale: Aging is associated with decreased gastrointestinal motility, which
prolongs transit time and contributes to constipation. Gastric acid secretion
typically decreases with age, not increases. Liver enzyme activity may decrease,
and pancreatic enzyme production may also decline, but decreased motility is
the primary factor in constipation.
Question 2
An 80-year-old patient is admitted with dehydration. Which finding is most reliable
in assessing fluid status in this patient?
A) Skin turgor over the sternum
B) Dry mucous membranes
C) Daily weight
D) Thirst
Answer: C) Daily weight
Rationale: Daily weight is the most reliable indicator of fluid status in older
adults. Skin turgor is less reliable due to age-related loss of skin elasticity. Dry
mucous membranes can be caused by medications or mouth breathing. Thirst
sensation diminishes with age and is not a reliable indicator.
Question 3
The nurse is teaching a patient about age-related changes in the renal system. Which
change should the nurse include?
,3|Page
A) Increased glomerular filtration rate
B) Decreased number of nephrons
C) Increased renal blood flow
D) Enhanced drug excretion
Answer: B) Decreased number of nephrons
Rationale: Aging leads to a progressive loss of nephrons, reduced glomerular
filtration rate (GFR), and decreased renal blood flow. These changes result in
decreased drug excretion and increased risk for medication toxicity. GFR
decreases, not increases, with age.
Question 4
A 75-year-old patient with diabetes is at risk for which age-related change affecting
glucose metabolism?
A) Increased insulin sensitivity
B) Decreased insulin production and peripheral resistance
C) Enhanced glucose tolerance
D) Decreased blood glucose levels
Answer: B) Decreased insulin production and peripheral resistance
Rationale: Aging is associated with decreased insulin production by the
pancreas and increased peripheral insulin resistance, leading to impaired
glucose tolerance and increased risk of type 2 diabetes. Insulin sensitivity
decreases, not increases, with age.
Question 5
The nurse is assessing an older adult patient for signs of polypharmacy. Which
statement best defines polypharmacy?
A) Taking five or more medications daily
B) Taking two medications from the same class
C) Taking medications prescribed by multiple providers
D) Taking over-the-counter medications without a prescription
Answer: A) Taking five or more medications daily
, 4|Page
Rationale: Polypharmacy is commonly defined as the concurrent use of five or
more medications. It increases the risk of adverse drug reactions, drug-drug
interactions, and non-adherence. While multiple providers and OTC use
contribute to polypharmacy, the numerical definition is five or more
medications.
Question 6
The nurse is educating a patient about age-related changes in the cardiovascular
system. Which change is expected?
A) Increased cardiac output
B) Decreased peripheral vascular resistance
C) Increased systolic blood pressure
D) Decreased left ventricular hypertrophy
Answer: C) Increased systolic blood pressure
Rationale: Aging causes arterial stiffness and decreased elasticity, leading to
increased systolic blood pressure and widened pulse pressure. Cardiac output
typically decreases, peripheral vascular resistance increases, and left ventricular
hypertrophy develops as a compensatory mechanism.
Question 7
A patient with hypertension is prescribed a calcium channel blocker. Which side
effect is most concerning in an older adult?
A) Constipation
B) Peripheral edema
C) Dizziness and falls
D) Headache
Answer: C) Dizziness and falls
Rationale: Calcium channel blockers can cause hypotension and dizziness,
increasing fall risk in older adults. While constipation and peripheral edema are
common side effects, dizziness and falls pose the greatest safety risk. Headache
is less common.
