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NUR 257 / NUR257 Exam 4: Concepts of
Aging & Chronic Illness Review | 2026
Update | Galen College | Verified
Correct Answers | Grade A Guide
Exam Structure:
Subject: Gerontology, Chronic Illness, Aging, Musculoskeletal, Integumentary,
Sensory, Pain, and Mobility
Source: Exam Preparation Document (Galen College NUR 257)
Format: Multiple Choice, Select All That Apply (SATA), True/False, and Short Answer
1. Which of the following is a true statement about osteoporosis?
A. A high risk of death follows an osteoporosis-related fracture.
Correct Answer: A. A high risk of death follows an osteoporosis-related
fracture.
Rationale:
1. Osteoporosis-related fractures, particularly hip fractures, are
associated with significant morbidity and mortality in older adults.
2. Complications such as pneumonia, pulmonary embolism, and
sepsis can occur due to immobility following a fracture.
3. The one-year mortality rate after a hip fracture can be as high as
20-30%, making fracture prevention a critical goal in osteoporosis
management.
2. Which of the following nursing interventions are suitable as a last
resort treatment for gout?
A. Colchicine by mouth
Correct Answer: A. Colchicine by mouth
Rationale:
, 2|Page
1. Colchicine is an anti-inflammatory medication used to treat acute
gout attacks and prevent flares.
2. It is not typically a "last resort" but a first-line treatment for acute
gouty arthritis due to its efficacy in reducing inflammation and pain.
3. Last-resort treatments for refractory gout might include urate-
lowering therapies (allopurinol, febuxostat) or, in severe
cases, pegloticase.
3. The nurse sees an older adult diagnosed with osteoarthritis (OA)
who presents with a low-grade fever. The client tells the nurse that the
pain is changing; it is worse at night and in the shoulder muscles.
Which of the following does the nurse perform to prevent
complications of this client's condition?
A. Direct the client to report temporal or scalp pain.
Correct Answer: A. Direct the client to report temporal or scalp pain.
Rationale:
1. The symptoms described (low-grade fever, worsening night pain,
muscle pain) are not typical of uncomplicated osteoarthritis.
2. These symptoms, especially temporal or scalp pain, raise concern
for polymyalgia rheumatica (PMR) or giant cell arteritis
(temporal arteritis), which can occur in older adults and require
immediate steroid treatment to prevent blindness (from GCA) or
other complications.
3. Prompt reporting allows for timely diagnosis and intervention to
prevent ischemic optic neuropathy and permanent vision loss.
4. The nurse prepares an older adult diagnosed with osteoarthritis
(OA) for discharge. Which instruction does the nurse include in client
teaching to maintain safety for this client?
A. Report joint instability to the health care provider.
Correct Answer: A. Report joint instability to the health care provider.
Rationale:
1. Joint instability in OA results from cartilage loss, ligament laxity, and
muscle weakness.
2. Instability increases the risk of falls and injuries. Reporting it allows
for interventions such as physical therapy, bracing, or possible
surgical evaluation.
, 3|Page
3. Safety education for OA also includes energy conservation, proper
footwear, and home modification, but joint instability is a direct
indicator of increased fall risk.
5. Which of the following is a true statement about joints in older
adults?
A. Surgical joint replacement can effectively manage OA pain.
Correct Answer: A. Surgical joint replacement can effectively manage OA
pain.
Rationale:
1. For severe osteoarthritis unresponsive to conservative
measures, total joint arthroplasty (replacement) is a highly
effective surgical intervention to relieve pain, improve function,
and enhance quality of life.
2. It is considered when there is significant disability and radiographic
evidence of joint damage.
3. Other true statements could include increased prevalence of OA with
age, but the most definitive and evidence-based truth among typical
options is the efficacy of joint replacement.
6. A nurse is teaching an older adult who is experiencing an acute
attack of gout. Which of the following instructions should the nurse
include in the teaching? (Select all that apply.)
A. Take ASA to relieve pain.
B. Increase fluid intake to 2 L/day.
C. Walk barefooted as much as possible.
D. Avoid foods high in purine.
E. Avoid alcoholic beverages.
Correct Answer: B, D, E.
Rationale:
1. Increase fluids (B) to promote renal excretion of uric acid and
prevent urate crystal formation.
2. Avoid high-purine foods (D) like organ meats, shellfish, and some
fish to reduce uric acid production.
3. Avoid alcohol (E), especially beer and spirits, as it impairs uric acid
excretion and can trigger attacks.
, 4|Page
4. ASA (aspirin) (A) is not recommended; it can alter uric acid levels
and is not a first-line gout pain reliever (NSAIDs or colchicine are
preferred).
5. Walking barefoot (C) is unrelated and could increase injury risk;
comfortable, supportive footwear is advised.
7. Contact dermatitis is caused by:
A. contact with skin allergens.
Correct Answer: A. contact with skin allergens.
Rationale:
1. Contact dermatitis is an inflammatory skin reaction caused by
direct exposure to an irritant (irritant contact dermatitis) or
an allergen (allergic contact dermatitis).
2. Allergens (e.g., poison ivy, nickel, fragrances) trigger a type IV
hypersensitivity reaction.
3. Management involves identifying and avoiding the trigger, along
with topical corticosteroids for inflammation.
8. What is the deadliest form of skin cancer?
A. Melanoma
Correct Answer: A. Melanoma
Rationale:
1. Melanoma accounts for only about 1% of skin cancers but causes
the majority of skin cancer deaths due to its high potential
for metastasis.
2. Early detection (using the ABCDE rule) and excision are crucial for
cure.
3. Basal and squamous cell carcinomas are more common but far less
likely to metastasize.
9. Which finding is characteristic of oral candidiasis?
A. Whitish coating on the tongue
Correct Answer: A. Whitish coating on the tongue
Rationale:
1. Oral candidiasis (thrush) appears as creamy white, curd-like
plaques on the tongue, buccal mucosa, or palate that can be scraped
off, often leaving a red, bleeding base.
NUR 257 / NUR257 Exam 4: Concepts of
Aging & Chronic Illness Review | 2026
Update | Galen College | Verified
Correct Answers | Grade A Guide
Exam Structure:
Subject: Gerontology, Chronic Illness, Aging, Musculoskeletal, Integumentary,
Sensory, Pain, and Mobility
Source: Exam Preparation Document (Galen College NUR 257)
Format: Multiple Choice, Select All That Apply (SATA), True/False, and Short Answer
1. Which of the following is a true statement about osteoporosis?
A. A high risk of death follows an osteoporosis-related fracture.
Correct Answer: A. A high risk of death follows an osteoporosis-related
fracture.
Rationale:
1. Osteoporosis-related fractures, particularly hip fractures, are
associated with significant morbidity and mortality in older adults.
2. Complications such as pneumonia, pulmonary embolism, and
sepsis can occur due to immobility following a fracture.
3. The one-year mortality rate after a hip fracture can be as high as
20-30%, making fracture prevention a critical goal in osteoporosis
management.
2. Which of the following nursing interventions are suitable as a last
resort treatment for gout?
A. Colchicine by mouth
Correct Answer: A. Colchicine by mouth
Rationale:
, 2|Page
1. Colchicine is an anti-inflammatory medication used to treat acute
gout attacks and prevent flares.
2. It is not typically a "last resort" but a first-line treatment for acute
gouty arthritis due to its efficacy in reducing inflammation and pain.
3. Last-resort treatments for refractory gout might include urate-
lowering therapies (allopurinol, febuxostat) or, in severe
cases, pegloticase.
3. The nurse sees an older adult diagnosed with osteoarthritis (OA)
who presents with a low-grade fever. The client tells the nurse that the
pain is changing; it is worse at night and in the shoulder muscles.
Which of the following does the nurse perform to prevent
complications of this client's condition?
A. Direct the client to report temporal or scalp pain.
Correct Answer: A. Direct the client to report temporal or scalp pain.
Rationale:
1. The symptoms described (low-grade fever, worsening night pain,
muscle pain) are not typical of uncomplicated osteoarthritis.
2. These symptoms, especially temporal or scalp pain, raise concern
for polymyalgia rheumatica (PMR) or giant cell arteritis
(temporal arteritis), which can occur in older adults and require
immediate steroid treatment to prevent blindness (from GCA) or
other complications.
3. Prompt reporting allows for timely diagnosis and intervention to
prevent ischemic optic neuropathy and permanent vision loss.
4. The nurse prepares an older adult diagnosed with osteoarthritis
(OA) for discharge. Which instruction does the nurse include in client
teaching to maintain safety for this client?
A. Report joint instability to the health care provider.
Correct Answer: A. Report joint instability to the health care provider.
Rationale:
1. Joint instability in OA results from cartilage loss, ligament laxity, and
muscle weakness.
2. Instability increases the risk of falls and injuries. Reporting it allows
for interventions such as physical therapy, bracing, or possible
surgical evaluation.
, 3|Page
3. Safety education for OA also includes energy conservation, proper
footwear, and home modification, but joint instability is a direct
indicator of increased fall risk.
5. Which of the following is a true statement about joints in older
adults?
A. Surgical joint replacement can effectively manage OA pain.
Correct Answer: A. Surgical joint replacement can effectively manage OA
pain.
Rationale:
1. For severe osteoarthritis unresponsive to conservative
measures, total joint arthroplasty (replacement) is a highly
effective surgical intervention to relieve pain, improve function,
and enhance quality of life.
2. It is considered when there is significant disability and radiographic
evidence of joint damage.
3. Other true statements could include increased prevalence of OA with
age, but the most definitive and evidence-based truth among typical
options is the efficacy of joint replacement.
6. A nurse is teaching an older adult who is experiencing an acute
attack of gout. Which of the following instructions should the nurse
include in the teaching? (Select all that apply.)
A. Take ASA to relieve pain.
B. Increase fluid intake to 2 L/day.
C. Walk barefooted as much as possible.
D. Avoid foods high in purine.
E. Avoid alcoholic beverages.
Correct Answer: B, D, E.
Rationale:
1. Increase fluids (B) to promote renal excretion of uric acid and
prevent urate crystal formation.
2. Avoid high-purine foods (D) like organ meats, shellfish, and some
fish to reduce uric acid production.
3. Avoid alcohol (E), especially beer and spirits, as it impairs uric acid
excretion and can trigger attacks.
, 4|Page
4. ASA (aspirin) (A) is not recommended; it can alter uric acid levels
and is not a first-line gout pain reliever (NSAIDs or colchicine are
preferred).
5. Walking barefoot (C) is unrelated and could increase injury risk;
comfortable, supportive footwear is advised.
7. Contact dermatitis is caused by:
A. contact with skin allergens.
Correct Answer: A. contact with skin allergens.
Rationale:
1. Contact dermatitis is an inflammatory skin reaction caused by
direct exposure to an irritant (irritant contact dermatitis) or
an allergen (allergic contact dermatitis).
2. Allergens (e.g., poison ivy, nickel, fragrances) trigger a type IV
hypersensitivity reaction.
3. Management involves identifying and avoiding the trigger, along
with topical corticosteroids for inflammation.
8. What is the deadliest form of skin cancer?
A. Melanoma
Correct Answer: A. Melanoma
Rationale:
1. Melanoma accounts for only about 1% of skin cancers but causes
the majority of skin cancer deaths due to its high potential
for metastasis.
2. Early detection (using the ABCDE rule) and excision are crucial for
cure.
3. Basal and squamous cell carcinomas are more common but far less
likely to metastasize.
9. Which finding is characteristic of oral candidiasis?
A. Whitish coating on the tongue
Correct Answer: A. Whitish coating on the tongue
Rationale:
1. Oral candidiasis (thrush) appears as creamy white, curd-like
plaques on the tongue, buccal mucosa, or palate that can be scraped
off, often leaving a red, bleeding base.
