NUR257 Aging and Chronic Illness in
Nursing Exam Review (2025/2026 Update) –
Complete Study Guide with Key Concepts
and Exam-Focused Material
This comprehensive study guide for NUR257 Aging and Chronic Illness in Nursing is updated
for the 2025/2026 academic year. It covers core concepts in geriatric nursing, chronic disease
management, ethical considerations, and interdisciplinary care. The guide includes key
definitions, nursing interventions, evidence-based practices (aligned with AGS and ANA
guidelines), and 50 exam-focused multiple-choice questions with detailed rationales.
Key Concepts and Topics
1. Aging Theories and Physiological Changes
Biological Theories: Wear-and-tear (cumulative damage), free radical (oxidative stress),
telomere shortening (cellular senescence).
Physiological Changes: Decreased lean mass (sarcopenia), reduced bone density
(osteoporosis), sensory decline (vision/hearing), cognitive (mild decline normal,
dementia pathological).
Nursing Implications: Fall prevention (assistive devices), nutrition (high-protein for
sarcopenia), screening (Mini-Mental State Exam for cognition).
2. Chronic Illness Management
Common Conditions: Heart failure (HF), COPD, diabetes, arthritis, dementia.
Holistic Care: Polypharmacy (Beers Criteria to avoid high-risk meds), pain management
(non-opioid first), self-management (teach-back method).
Interdisciplinary Team: RN, PT, OT, SW, pharmacist; care coordination reduces
hospitalizations (CMMI models).
3. Ethical and Legal Issues
Advance Directives: Living wills, durable power of attorney; MOLST/POLST for
emergencies.
Elder Abuse: Types (physical, neglect); mandatory reporting (Adult Protective
Services).
, End-of-Life: Palliative care, hospice eligibility (prognosis <6 months); ethical principles
(autonomy, beneficence).
4. Cultural and Psychosocial Considerations
Cultural Competence: LEARN model (Listen, Explain, Acknowledge, Recommend,
Negotiate).
Psychosocial: Social isolation (loneliness epidemic), depression screening (PHQ-2).
Family Dynamics: Caregiver burden; respite care.
5. Evidence-Based Practices and Quality Improvement
Falls Prevention: STEADI tool, vitamin D.
Delirium: CAM screening, non-pharm (orientation, sleep).
Quality Metrics: HEDIS for chronic care, HCAHPS patient satisfaction.
Exam-Focused Multiple-Choice Questions
Section 1: Physiological Changes in Aging (Questions 1-10)
Question 1: Which physiological change is most commonly associated with normal aging and
contributes to increased fall risk in older adults?
A. Increased bone density and muscle mass
B. Decreased visual acuity and proprioception
C. Enhanced reaction time and balance
D. Stable cardiovascular endurance
Correct Answer: B. Decreased visual acuity and proprioception
Rationale: Normal aging leads to presbyopia (visual decline) and proprioceptive loss, increasing
fall risk (CDC STEADI). Interventions include vision screening and balance training (tai chi).
A/C/D are incorrect as they describe youth or pathology.
Question 2: Sarcopenia, the age-related loss of muscle mass and strength, is primarily driven by
which process?
A. Increased protein synthesis
B. Chronic low-grade inflammation (inflammaging)
C. Excessive physical activity
D. High-calorie intake
Correct Answer: B. Chronic low-grade inflammation (inflammaging)
Rationale: Inflammaging promotes catabolism; AGS recommends resistance training and
protein (1.2g/kg/day). A/C/D are incorrect; they would prevent sarcopenia.
Nursing Exam Review (2025/2026 Update) –
Complete Study Guide with Key Concepts
and Exam-Focused Material
This comprehensive study guide for NUR257 Aging and Chronic Illness in Nursing is updated
for the 2025/2026 academic year. It covers core concepts in geriatric nursing, chronic disease
management, ethical considerations, and interdisciplinary care. The guide includes key
definitions, nursing interventions, evidence-based practices (aligned with AGS and ANA
guidelines), and 50 exam-focused multiple-choice questions with detailed rationales.
Key Concepts and Topics
1. Aging Theories and Physiological Changes
Biological Theories: Wear-and-tear (cumulative damage), free radical (oxidative stress),
telomere shortening (cellular senescence).
Physiological Changes: Decreased lean mass (sarcopenia), reduced bone density
(osteoporosis), sensory decline (vision/hearing), cognitive (mild decline normal,
dementia pathological).
Nursing Implications: Fall prevention (assistive devices), nutrition (high-protein for
sarcopenia), screening (Mini-Mental State Exam for cognition).
2. Chronic Illness Management
Common Conditions: Heart failure (HF), COPD, diabetes, arthritis, dementia.
Holistic Care: Polypharmacy (Beers Criteria to avoid high-risk meds), pain management
(non-opioid first), self-management (teach-back method).
Interdisciplinary Team: RN, PT, OT, SW, pharmacist; care coordination reduces
hospitalizations (CMMI models).
3. Ethical and Legal Issues
Advance Directives: Living wills, durable power of attorney; MOLST/POLST for
emergencies.
Elder Abuse: Types (physical, neglect); mandatory reporting (Adult Protective
Services).
, End-of-Life: Palliative care, hospice eligibility (prognosis <6 months); ethical principles
(autonomy, beneficence).
4. Cultural and Psychosocial Considerations
Cultural Competence: LEARN model (Listen, Explain, Acknowledge, Recommend,
Negotiate).
Psychosocial: Social isolation (loneliness epidemic), depression screening (PHQ-2).
Family Dynamics: Caregiver burden; respite care.
5. Evidence-Based Practices and Quality Improvement
Falls Prevention: STEADI tool, vitamin D.
Delirium: CAM screening, non-pharm (orientation, sleep).
Quality Metrics: HEDIS for chronic care, HCAHPS patient satisfaction.
Exam-Focused Multiple-Choice Questions
Section 1: Physiological Changes in Aging (Questions 1-10)
Question 1: Which physiological change is most commonly associated with normal aging and
contributes to increased fall risk in older adults?
A. Increased bone density and muscle mass
B. Decreased visual acuity and proprioception
C. Enhanced reaction time and balance
D. Stable cardiovascular endurance
Correct Answer: B. Decreased visual acuity and proprioception
Rationale: Normal aging leads to presbyopia (visual decline) and proprioceptive loss, increasing
fall risk (CDC STEADI). Interventions include vision screening and balance training (tai chi).
A/C/D are incorrect as they describe youth or pathology.
Question 2: Sarcopenia, the age-related loss of muscle mass and strength, is primarily driven by
which process?
A. Increased protein synthesis
B. Chronic low-grade inflammation (inflammaging)
C. Excessive physical activity
D. High-calorie intake
Correct Answer: B. Chronic low-grade inflammation (inflammaging)
Rationale: Inflammaging promotes catabolism; AGS recommends resistance training and
protein (1.2g/kg/day). A/C/D are incorrect; they would prevent sarcopenia.
