GALEN NUR 257 EXAMS 1–
4 – CONCEPTS OF AGING &
CHRONIC ILLNESS –
(2026/2027) ACTUAL
QUESTIONS & ANSWERS,
100% GUARANTEE PASS
NUR 257 Concepts of Aging & Chronic Illness
Comprehensive Practice Exam | Exams 1–4 Coverage
Galen College of Nursing | 2026/2027 Curriculum Aligned
Section 1: Geriatric Assessment & Functional Status
1. A nurse is performing a comprehensive geriatric assessment on a newly
admitted 82-year-old patient. Which screening tool is specifically designed to alert
the nurse to the six most common health problems in older adults: Sleep
disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and
Skin breakdown?
,A. Katz Index of Independence in Activities of Daily Living
B. Mini-Mental State Examination (MMSE)
C. SPICES screening tool
D. Lawton Instrumental Activities of Daily Living Scale
Rationale: The SPICES tool, developed by Terry Fulmer, is an evidence-based screening
tool that serves as an alert system for the six most frequently occurring health problems
in older adults: Sleep disorders, Problems with eating or feeding, Incontinence,
Confusion, Evidence of falls, and Skin breakdown .
2. An 80-year-old patient is being discharged to home. The nurse needs to assess
the patient's ability to live independently in the community. Which assessment
tool is most appropriate for evaluating instrumental activities of daily living
(IADLs)?
A. Barthel Index
B. Katz Index of Independence in ADLs
C. Lawton Instrumental Activities of Daily Living Scale
D. Braden Scale
Rationale: The Lawton IADL Scale measures complex skills needed for independent
community living, including managing finances, managing medications, shopping, meal
preparation, housework, telephone use, and transportation .
3. Which activities are considered basic activities of daily living (ADLs)?
A. Managing investments and transportation
B. Bathing, dressing, toileting, and feeding
C. Shopping and managing finances only
D. Using a computer and telephone
Rationale: Basic activities of daily living include fundamental self-care tasks such as
bathing, dressing, toileting, transferring, continence, and eating .
4. An older adult can bathe and dress independently but cannot manage
medications or finances. How should the nurse interpret this finding?
A. The client is completely dependent
B. Basic ADLs are preserved, but some IADLs are impaired
C. The client has no functional limitations
D. The client necessarily has dementia
,Rationale: IADL impairment can occur before basic self-care abilities are lost and does
not by itself establish a diagnosis of dementia .
5. Which finding requires further assessment rather than being automatically
attributed to normal aging?
A. Mildly slower movement
B. Progressive inability to perform familiar daily activities
C. Gray hair
D. Decreased skin elasticity
Rationale: Progressive functional decline may indicate illness or cognitive impairment
and warrants further assessment .
Section 2: Normal Age-Related Changes
6. Which finding is most consistent with presbycusis?
A. Difficulty hearing low-pitched sounds
B. Difficulty hearing high-pitched sounds
C. Sudden onset of hearing loss
D. Complete hearing loss in both ears
Rationale: Presbycusis typically causes loss of high-frequency hearing, making it
difficult to hear consonant sounds and understand speech in noisy environments. It has
a gradual onset and is not complete .
7. An older adult reports difficulty reading small print and holding books at arm's
length. This is most consistent with:
A. Cataracts
B. Glaucoma
C. Presbyopia
D. Macular degeneration
Rationale: Presbyopia is the age-related loss of near vision due to hardening of the
lens. It is a normal age-related change, unlike cataracts, glaucoma, and macular
degeneration, which are pathological conditions .
, 8. A nurse is caring for an older adult in a cool environment. Which age-related
change increases the risk of hypothermia?
A. Increased metabolic rate
B. Decreased subcutaneous fat and impaired vasoconstriction
C. Increased muscle mass
D. Increased shivering response
Rationale: Decreased subcutaneous fat and impaired vasoconstriction are normal age-
related changes that reduce the ability to conserve heat, increasing the risk of
hypothermia .
9. Which sleep pattern change is considered a normal part of aging?
A. Increased deep sleep (Stage 3 and 4)
B. Decreased total sleep time with more frequent awakenings
C. Increased REM sleep
D. No change in sleep patterns
Rationale: Normal aging includes decreased total sleep time and more frequent
awakenings .
10. An older adult patient has dry, flaky skin with decreased turgor. Which age-
related change is most likely responsible?
A. Increased sebaceous gland activity
B. Decreased collagen and elastin
C. Increased sweat gland activity
D. Thickening of the epidermis
Rationale: Age-related skin changes include decreased collagen and elastin, leading to
thinner, less elastic skin with decreased turgor. Sebaceous and sweat gland activity
decreases, causing dryness. The epidermis thins with age .
11. Which age-related musculoskeletal change increases fracture risk?
A. Increased bone density
B. Increased muscle mass
C. Increased joint flexibility
D. Reduced bone mineral density
Rationale: Reduced bone mineral density increases the risk for both spontaneous and
traumatic fractures .
4 – CONCEPTS OF AGING &
CHRONIC ILLNESS –
(2026/2027) ACTUAL
QUESTIONS & ANSWERS,
100% GUARANTEE PASS
NUR 257 Concepts of Aging & Chronic Illness
Comprehensive Practice Exam | Exams 1–4 Coverage
Galen College of Nursing | 2026/2027 Curriculum Aligned
Section 1: Geriatric Assessment & Functional Status
1. A nurse is performing a comprehensive geriatric assessment on a newly
admitted 82-year-old patient. Which screening tool is specifically designed to alert
the nurse to the six most common health problems in older adults: Sleep
disorders, Problems with eating, Incontinence, Confusion, Evidence of falls, and
Skin breakdown?
,A. Katz Index of Independence in Activities of Daily Living
B. Mini-Mental State Examination (MMSE)
C. SPICES screening tool
D. Lawton Instrumental Activities of Daily Living Scale
Rationale: The SPICES tool, developed by Terry Fulmer, is an evidence-based screening
tool that serves as an alert system for the six most frequently occurring health problems
in older adults: Sleep disorders, Problems with eating or feeding, Incontinence,
Confusion, Evidence of falls, and Skin breakdown .
2. An 80-year-old patient is being discharged to home. The nurse needs to assess
the patient's ability to live independently in the community. Which assessment
tool is most appropriate for evaluating instrumental activities of daily living
(IADLs)?
A. Barthel Index
B. Katz Index of Independence in ADLs
C. Lawton Instrumental Activities of Daily Living Scale
D. Braden Scale
Rationale: The Lawton IADL Scale measures complex skills needed for independent
community living, including managing finances, managing medications, shopping, meal
preparation, housework, telephone use, and transportation .
3. Which activities are considered basic activities of daily living (ADLs)?
A. Managing investments and transportation
B. Bathing, dressing, toileting, and feeding
C. Shopping and managing finances only
D. Using a computer and telephone
Rationale: Basic activities of daily living include fundamental self-care tasks such as
bathing, dressing, toileting, transferring, continence, and eating .
4. An older adult can bathe and dress independently but cannot manage
medications or finances. How should the nurse interpret this finding?
A. The client is completely dependent
B. Basic ADLs are preserved, but some IADLs are impaired
C. The client has no functional limitations
D. The client necessarily has dementia
,Rationale: IADL impairment can occur before basic self-care abilities are lost and does
not by itself establish a diagnosis of dementia .
5. Which finding requires further assessment rather than being automatically
attributed to normal aging?
A. Mildly slower movement
B. Progressive inability to perform familiar daily activities
C. Gray hair
D. Decreased skin elasticity
Rationale: Progressive functional decline may indicate illness or cognitive impairment
and warrants further assessment .
Section 2: Normal Age-Related Changes
6. Which finding is most consistent with presbycusis?
A. Difficulty hearing low-pitched sounds
B. Difficulty hearing high-pitched sounds
C. Sudden onset of hearing loss
D. Complete hearing loss in both ears
Rationale: Presbycusis typically causes loss of high-frequency hearing, making it
difficult to hear consonant sounds and understand speech in noisy environments. It has
a gradual onset and is not complete .
7. An older adult reports difficulty reading small print and holding books at arm's
length. This is most consistent with:
A. Cataracts
B. Glaucoma
C. Presbyopia
D. Macular degeneration
Rationale: Presbyopia is the age-related loss of near vision due to hardening of the
lens. It is a normal age-related change, unlike cataracts, glaucoma, and macular
degeneration, which are pathological conditions .
, 8. A nurse is caring for an older adult in a cool environment. Which age-related
change increases the risk of hypothermia?
A. Increased metabolic rate
B. Decreased subcutaneous fat and impaired vasoconstriction
C. Increased muscle mass
D. Increased shivering response
Rationale: Decreased subcutaneous fat and impaired vasoconstriction are normal age-
related changes that reduce the ability to conserve heat, increasing the risk of
hypothermia .
9. Which sleep pattern change is considered a normal part of aging?
A. Increased deep sleep (Stage 3 and 4)
B. Decreased total sleep time with more frequent awakenings
C. Increased REM sleep
D. No change in sleep patterns
Rationale: Normal aging includes decreased total sleep time and more frequent
awakenings .
10. An older adult patient has dry, flaky skin with decreased turgor. Which age-
related change is most likely responsible?
A. Increased sebaceous gland activity
B. Decreased collagen and elastin
C. Increased sweat gland activity
D. Thickening of the epidermis
Rationale: Age-related skin changes include decreased collagen and elastin, leading to
thinner, less elastic skin with decreased turgor. Sebaceous and sweat gland activity
decreases, causing dryness. The epidermis thins with age .
11. Which age-related musculoskeletal change increases fracture risk?
A. Increased bone density
B. Increased muscle mass
C. Increased joint flexibility
D. Reduced bone mineral density
Rationale: Reduced bone mineral density increases the risk for both spontaneous and
traumatic fractures .
