NUR 257 Chronic Exam 2 – Practice Questions &
Answer Review
Section 1: Functional Assessment & Aging Changes
Question 1: 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
Correct Answer: BNUR
257 Chronic Exam 2 – Practice
Questions & Answer Review
Section 1: Functional Assessment & Aging Changes
Question 1: 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
Correct Answer: B
Rationale: Basic activities of daily living (ADLs) include bathing, dressing, toileting,
transferring, continence, and feeding. Instrumental activities of daily living (IADLs)
involve more complex tasks for independent community living, including medication
management, finances, shopping, and transportation. IADL impairment can occur before
basic self-care abilities are lost and does not by itself establish a diagnosis of dementia .
,Question 2: 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
Correct Answer: B
Rationale: Progressive functional decline may indicate illness or cognitive impairment
and warrants further assessment. The other findings are expected age-related changes .
Question 3: 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
Correct Answer: B
Rationale: Older adults experience a significant reduction in slow-wave sleep (Stages 3
and 4) and REM sleep, leading to more fragmented sleep and the perception of lighter,
less restorative rest. Total sleep time typically decreases, not increases .
Section 2: Sensory Changes & Communication
Question 4: A nurse is assessing an older adult for presbycusis. Which finding is most
consistent with this condition?
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
, Correct Answer: B
Rationale: Presbycusis typically causes loss of high-frequency hearing, making it
difficult to hear consonant sounds and understand speech in noisy environments. Low-
pitched sounds are usually preserved. It has a gradual onset and is not complete .
Question 5: A nurse is caring for a client with a hearing deficit. Which action should the
nurse take?
A. Stand behind the client when speaking to avoid startling them
B. Speak in a very loud voice, regardless of distance
C. Directly face the client when speaking in good lighting if possible
D. Keep the television on for background noise while talking
Correct Answer: C
Rationale: Facing the client and ensuring good lighting helps them use visual cues and
lip-reading to supplement hearing, which is crucial in age-related hearing loss. Yelling or
speaking from behind may distort sound and increase confusion. Background noise
should be minimized .
Question 6: 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
Correct Answer: C
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 .
Answer Review
Section 1: Functional Assessment & Aging Changes
Question 1: 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
Correct Answer: BNUR
257 Chronic Exam 2 – Practice
Questions & Answer Review
Section 1: Functional Assessment & Aging Changes
Question 1: 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
Correct Answer: B
Rationale: Basic activities of daily living (ADLs) include bathing, dressing, toileting,
transferring, continence, and feeding. Instrumental activities of daily living (IADLs)
involve more complex tasks for independent community living, including medication
management, finances, shopping, and transportation. IADL impairment can occur before
basic self-care abilities are lost and does not by itself establish a diagnosis of dementia .
,Question 2: 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
Correct Answer: B
Rationale: Progressive functional decline may indicate illness or cognitive impairment
and warrants further assessment. The other findings are expected age-related changes .
Question 3: 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
Correct Answer: B
Rationale: Older adults experience a significant reduction in slow-wave sleep (Stages 3
and 4) and REM sleep, leading to more fragmented sleep and the perception of lighter,
less restorative rest. Total sleep time typically decreases, not increases .
Section 2: Sensory Changes & Communication
Question 4: A nurse is assessing an older adult for presbycusis. Which finding is most
consistent with this condition?
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
, Correct Answer: B
Rationale: Presbycusis typically causes loss of high-frequency hearing, making it
difficult to hear consonant sounds and understand speech in noisy environments. Low-
pitched sounds are usually preserved. It has a gradual onset and is not complete .
Question 5: A nurse is caring for a client with a hearing deficit. Which action should the
nurse take?
A. Stand behind the client when speaking to avoid startling them
B. Speak in a very loud voice, regardless of distance
C. Directly face the client when speaking in good lighting if possible
D. Keep the television on for background noise while talking
Correct Answer: C
Rationale: Facing the client and ensuring good lighting helps them use visual cues and
lip-reading to supplement hearing, which is crucial in age-related hearing loss. Yelling or
speaking from behind may distort sound and increase confusion. Background noise
should be minimized .
Question 6: 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
Correct Answer: C
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 .
