PSU
Penn State University
152 • 3 MAXE
NURS College of Nursing — NURS 251 Exam 3 (Part 3)
W E A R E · P E N N S TAT E
251
NURS 251 — Exam 3 (Part 3)
G E R O N TO LO G Y, PA I N , N U R S I N G P R O C E SS , CO M M U N I C AT I O N , S E N S O R Y & CO G N I T I O N
INSTITUTION Penn State University EXAM CODE PSU-NURS251-EX3C-2026
PROGRAM NURS 251 — Health Assessment ACADEMIC YEAR
EXAM TITLE Exam 3 — Gerontology, Pain, TOTAL QUESTIONS 25 Questions — Comprehensive Review
Communication & Cognition
COURSE TITLE Health Assessment FORMAT Multiple Choice / True-False
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover gerontology/aging demographics and health, pain assessment and management, the nursing process,
therapeutic communication, sensory perception, and cognition.
▸ Distinguish carefully between acute vs. chronic pain, nociceptive vs. neuropathic pain, and therapeutic vs. non-therapeutic
communication techniques.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — GERONTOLOGY, PAIN, COMMUNICATION & COGNITION Questions 1 – 25
1. Approximately what percentage of Americans are 65 years or older?
A. One in twenty
B. One in seven Americans — approximately 15.6% of the total population
C. One in three
D. One in ten
CORRECT ANSWER B — One in seven Americans (approximately 15.6%). In 2017, 50.9 million Americans were 65+. By
2060, projected to reach 90.7 million. The fastest-growing subgroup is those 85+.
RATIONALE The aging population is growing rapidly. Life expectancy has increased from 47 years (1900) to 78.7 years
(2016). Key demographics: 23% of older adults are racial/ethnic minorities; up to 2.4 million identify as LGBT;
70% of older men and 46% of older women are married; 8.9 million widows vs. 2.6 million widowers (2018);
1.2 million live in institutional settings. Poverty rate: 10.5% women vs. 7.5% men. 93% covered by Medicare.
24% of workforce is over 65 (2022).
, 2. Which of the following is a common MISCONCEPTION about aging?
A. Urinary incontinence is NOT a normal part of aging
B. Depression and cognitive decline are NORMAL and INEVITABLE parts of aging — this is FALSE. Many older adults
retain full cognitive function, and depression is a treatable condition, not a normal consequence of aging
C. Food intake generally declines with age
D. Stage 1 sleep increases and deep sleep decreases in older adults
CORRECT ANSWER B — Depression and cognitive decline are NOT normal/inevitable parts of aging. Depression is the
most unrecognized mood disorder in older adults. Older white men have the highest suicide rate in
the US.
RATIONALE Common myths about aging: cognitive decline is inevitable (FALSE — many retain full function); depression is
normal (FALSE — it's treatable and should be assessed); urinary incontinence is normal (FALSE — always
pathological); older adults are asexual (FALSE — many remain sexually active into advanced age). Facts: Stage
1 sleep increases, deep sleep decreases (awakenings are normal); food intake declines; falls are the leading
cause of fatal/nonfatal injuries; balanced nutrition and physical activity improve outcomes; routine
screenings and vaccinations remain important.
3. Pain is best defined as:
A. An objective finding that can be measured with vital signs
B. An unpleasant sensory and emotional experience associated with actual or potential tissue damage — pain is
whatever the experiencing person says it is, existing whenever they say it does
C. A purely physical sensation with no emotional component
D. A condition that can only be diagnosed through imaging
CORRECT ANSWER B — Pain is SUBJECTIVE — defined by the patient's self-report. McCaffery's definition: "Pain is
whatever the experiencing person says it is, existing whenever he says it does."
RATIONALE Pain assessment principles: (1) Self-report is the GOLD STANDARD; (2) Believe the patient — never prioritize
objective data over subjective report; (3) Use validated pain scales (Numeric Rating Scale 0–10, Wong-Baker
FACES for children, PAINAD for advanced dementia); (4) Assess PQRST/COLDSPA. Pain types: Acute (tissue
injury, nociceptive activation, resolves with healing); Chronic/persistent (>3 months, abnormal pain
signaling); Nociceptive (somatic — well-localized; visceral — diffuse); Neuropathic (nerve damage — burning,
shooting); Nociplastic (altered nociception without clear tissue damage — fibromyalgia).
4. The most common side effect of opioid analgesics is:
A. Hypertension
B. Constipation — opioids slow GI motility; a bowel regimen (stool softener + stimulant laxative) should be initiated
with opioid therapy
C. Insomnia
D. Tachycardia
CORRECT ANSWER B — Constipation is the most common opioid side effect and tolerance does NOT develop to it. All
patients on opioids should receive a prophylactic bowel regimen.
RATIONALE Opioid side effects: Constipation (MOST common — tolerance does NOT develop); Nausea/vomiting
(tolerance develops); Sedation (tolerance develops); Respiratory depression (MOST SERIOUS — monitor with
sedation scale and pulse oximetry; <8 breaths/min = emergency); Pruritus (histamine release); Urinary
retention. Adjuvant analgesics: medications with primary indications other than pain but effective for certain
pain types (anticonvulsants for neuropathic pain, antidepressants, corticosteroids). NSAID risks: GI bleeding,
renal impairment, cardiovascular events. Acetaminophen: hepatotoxicity at >4,000 mg/day.
Penn State University
152 • 3 MAXE
NURS College of Nursing — NURS 251 Exam 3 (Part 3)
W E A R E · P E N N S TAT E
251
NURS 251 — Exam 3 (Part 3)
G E R O N TO LO G Y, PA I N , N U R S I N G P R O C E SS , CO M M U N I C AT I O N , S E N S O R Y & CO G N I T I O N
INSTITUTION Penn State University EXAM CODE PSU-NURS251-EX3C-2026
PROGRAM NURS 251 — Health Assessment ACADEMIC YEAR
EXAM TITLE Exam 3 — Gerontology, Pain, TOTAL QUESTIONS 25 Questions — Comprehensive Review
Communication & Cognition
COURSE TITLE Health Assessment FORMAT Multiple Choice / True-False
EXAMINATION INSTRUCTIONS
▸ Select the single best answer for each question.
▸ Questions cover gerontology/aging demographics and health, pain assessment and management, the nursing process,
therapeutic communication, sensory perception, and cognition.
▸ Distinguish carefully between acute vs. chronic pain, nociceptive vs. neuropathic pain, and therapeutic vs. non-therapeutic
communication techniques.
▸ Correct answers and detailed rationales appear below each question.
SECTION I — GERONTOLOGY, PAIN, COMMUNICATION & COGNITION Questions 1 – 25
1. Approximately what percentage of Americans are 65 years or older?
A. One in twenty
B. One in seven Americans — approximately 15.6% of the total population
C. One in three
D. One in ten
CORRECT ANSWER B — One in seven Americans (approximately 15.6%). In 2017, 50.9 million Americans were 65+. By
2060, projected to reach 90.7 million. The fastest-growing subgroup is those 85+.
RATIONALE The aging population is growing rapidly. Life expectancy has increased from 47 years (1900) to 78.7 years
(2016). Key demographics: 23% of older adults are racial/ethnic minorities; up to 2.4 million identify as LGBT;
70% of older men and 46% of older women are married; 8.9 million widows vs. 2.6 million widowers (2018);
1.2 million live in institutional settings. Poverty rate: 10.5% women vs. 7.5% men. 93% covered by Medicare.
24% of workforce is over 65 (2022).
, 2. Which of the following is a common MISCONCEPTION about aging?
A. Urinary incontinence is NOT a normal part of aging
B. Depression and cognitive decline are NORMAL and INEVITABLE parts of aging — this is FALSE. Many older adults
retain full cognitive function, and depression is a treatable condition, not a normal consequence of aging
C. Food intake generally declines with age
D. Stage 1 sleep increases and deep sleep decreases in older adults
CORRECT ANSWER B — Depression and cognitive decline are NOT normal/inevitable parts of aging. Depression is the
most unrecognized mood disorder in older adults. Older white men have the highest suicide rate in
the US.
RATIONALE Common myths about aging: cognitive decline is inevitable (FALSE — many retain full function); depression is
normal (FALSE — it's treatable and should be assessed); urinary incontinence is normal (FALSE — always
pathological); older adults are asexual (FALSE — many remain sexually active into advanced age). Facts: Stage
1 sleep increases, deep sleep decreases (awakenings are normal); food intake declines; falls are the leading
cause of fatal/nonfatal injuries; balanced nutrition and physical activity improve outcomes; routine
screenings and vaccinations remain important.
3. Pain is best defined as:
A. An objective finding that can be measured with vital signs
B. An unpleasant sensory and emotional experience associated with actual or potential tissue damage — pain is
whatever the experiencing person says it is, existing whenever they say it does
C. A purely physical sensation with no emotional component
D. A condition that can only be diagnosed through imaging
CORRECT ANSWER B — Pain is SUBJECTIVE — defined by the patient's self-report. McCaffery's definition: "Pain is
whatever the experiencing person says it is, existing whenever he says it does."
RATIONALE Pain assessment principles: (1) Self-report is the GOLD STANDARD; (2) Believe the patient — never prioritize
objective data over subjective report; (3) Use validated pain scales (Numeric Rating Scale 0–10, Wong-Baker
FACES for children, PAINAD for advanced dementia); (4) Assess PQRST/COLDSPA. Pain types: Acute (tissue
injury, nociceptive activation, resolves with healing); Chronic/persistent (>3 months, abnormal pain
signaling); Nociceptive (somatic — well-localized; visceral — diffuse); Neuropathic (nerve damage — burning,
shooting); Nociplastic (altered nociception without clear tissue damage — fibromyalgia).
4. The most common side effect of opioid analgesics is:
A. Hypertension
B. Constipation — opioids slow GI motility; a bowel regimen (stool softener + stimulant laxative) should be initiated
with opioid therapy
C. Insomnia
D. Tachycardia
CORRECT ANSWER B — Constipation is the most common opioid side effect and tolerance does NOT develop to it. All
patients on opioids should receive a prophylactic bowel regimen.
RATIONALE Opioid side effects: Constipation (MOST common — tolerance does NOT develop); Nausea/vomiting
(tolerance develops); Sedation (tolerance develops); Respiratory depression (MOST SERIOUS — monitor with
sedation scale and pulse oximetry; <8 breaths/min = emergency); Pruritus (histamine release); Urinary
retention. Adjuvant analgesics: medications with primary indications other than pain but effective for certain
pain types (anticonvulsants for neuropathic pain, antidepressants, corticosteroids). NSAID risks: GI bleeding,
renal impairment, cardiovascular events. Acetaminophen: hepatotoxicity at >4,000 mg/day.
