Galen NUR 257 Exams 1–4 – Concepts of Aging &
Chronic Illness | Latest Update 2026/2027 | 200
Practice Questions & Detailed Answers | Verified
Answers with Rationales | Guarantee Pass A+
Graded
1. Which theory of aging proposes that cells have a limited number of divisions due to the shortening of
chromosomal ends?
A. Free radical theory
B. Telomere shortening theory
C. Wearandtear theory
D. Crosslinkage theory
Correct Answer: B. Telomere shortening theory
Explanation: The telomere shortening theory posits that each cell division shortens the telomeres
(protective caps at the ends of chromosomes), eventually leading to cellular senescence and aging. The
free radical theory attributes aging to cumulative oxidative damage; the wearandtear theory suggests
aging results from repeated use and environmental stressors; crosslinkage theory involves the formation
of abnormal bonds between molecules.
2. A 78yearold patient tells the nurse, "I don't see why I should bother exercising; I'm old and my body is
just wearing out." Which response best reflects current evidencebased gerontologic nursing?
A. "You are right; at your age, exercise is not very beneficial."
B. "Some physical changes occur with aging, but regular activity can help maintain function."
C. "Exercise will reverse all the changes of aging."
D. "You should only exercise if you have no chronic conditions."
Correct Answer: B. "Some physical changes occur with aging, but regular activity can help maintain
function."
Explanation: While aging involves physiologic changes, regular physical activity helps maintain functional
capacity, muscle strength, balance, and independence. Exercise cannot reverse all aging changes, but it
is one of the most effective interventions for preserving function and preventing frailty.
,3. Which finding is most consistent with normal aging rather than acute illness in an older adult?
A. Sudden confusion
B. New urinary incontinence
C. Gradual decrease in skin elasticity
D. Sudden inability to ambulate
Correct Answer: C. Gradual decrease in skin elasticity
Explanation: Reduced skin elasticity is an expected agerelated change due to loss of elastin and collagen
and decreased subcutaneous fat. Sudden confusion, new incontinence, or sudden mobility loss are red
flags that require prompt evaluation for acute pathology such as infection, stroke, or delirium.
4. Which statement best describes frailty in older adults?
A. It is an inevitable part of normal aging.
B. It is a state of decreased physiologic reserve and increased vulnerability.
C. It is caused exclusively by chronic disease.
D. It can always be reversed with medication.
Correct Answer: B. It is a state of decreased physiologic reserve and increased vulnerability.
Explanation: Frailty is a geriatric syndrome characterized by diminished physiologic reserve across
multiple systems, increasing susceptibility to stressors and adverse outcomes. It is not synonymous with
normal aging, is multifactorial (not caused solely by chronic disease), and while it can be managed, it is
not always reversible with medication alone.
5. A nurse assessing an older adult notices slower gait, generalized weakness, and unintentional weight
loss. These findings suggest:
A. Frailty
B. Normal aging only
C. Acute delirium
D. Sensory adaptation
Correct Answer: A. Frailty
Explanation: Slowed gait, weakness, and unintentional weight loss are core indicators of the frailty
phenotype. While these can occur with aging, their clustering suggests frailty rather than normal aging
alone; delirium presents with acute confusion and inattention, not these chronic signs.
,6. The concept of "homeostenosis" in aging refers to:
A. Increased receptor sensitivity requiring higher drug doses.
B. Reduced physiologic reserve narrowing the margin between health and illness.
C. Inevitable chronic illness progression independent of modifiable factors.
D. Increased immune function with age.
Correct Answer: B. Reduced physiologic reserve narrowing the margin between health and illness.
Explanation: Homeostenosis describes the diminished reserve across organ systems in aging, meaning
minor stressors can precipitate disproportionate decompensation. This principle drives the need for
early, aggressive management of seemingly small clinical changes in older adults.
7. Which activity is classified as an activity of daily living (ADL)?
A. Managing finances
B. Bathing
C. Shopping for groceries
D. Using public transportation
Correct Answer: B. Bathing
Explanation: Basic ADLs include bathing, dressing, toileting, eating, transferring, and continence.
Managing finances, shopping, and using transportation are instrumental activities of daily living (IADLs),
which require higherlevel cognitive and organizational skills.
8. Which assessment tool is most useful for evaluating basic functional independence in an older adult?
A. Katz Index
B. Braden Scale
C. Morse Fall Scale
D. Epworth Sleepiness Scale
Correct Answer: A. Katz Index
Explanation: The Katz Index of Independence in Activities of Daily Living evaluates independence in basic
ADLs such as bathing, dressing, toileting, transferring, continence, and feeding. The Braden Scale
assesses pressure injury risk, the Morse Fall Scale assesses fall risk, and the Epworth Sleepiness Scale
measures daytime sleepiness.
, 9. The Lawton IADL scale primarily evaluates an older adult's ability to:
A. Describe pain intensity
B. Maintain oxygen saturation
C. Assess pressure injury risk
D. Perform complex activities required for independent living
Correct Answer: D. Perform complex activities required for independent living
Explanation: The Lawton Instrumental Activities of Daily Living (IADL) scale assesses higherlevel tasks
such as managing finances, medications, shopping, transportation, meal preparation, and telephone
use. These skills are essential for community independence and are more cognitively demanding than
basic ADLs.
10. A hospitalized older adult with pneumonia and baseline mild cognitive impairment becomes acutely
confused, inattentive, and disoriented over 12 hours. Which action is the priority nursing intervention?
A. Administer haloperidol 2 mg IM for agitation.
B. Apply physical restraints to prevent falls.
C. Identify and treat the underlying precipitant (e.g., infection, hypoxia, medications).
D. Request an order for a benzodiazepine to promote sleep.
Correct Answer: C. Identify and treat the underlying precipitant (e.g., infection, hypoxia, medications).
Explanation: Delirium is a medical emergency; the priority is to identify and correct the underlying
cause, such as infection, hypoxia, metabolic derangement, or medication effects. Antipsychotics and
benzodiazepines do not treat the cause and may worsen outcomes; restraints increase injury risk and
exacerbate delirium.
11. Which of the following is a key difference between delirium and dementia?
A. Delirium has an acute onset and fluctuating course; dementia is chronic and progressive.
B. Dementia always involves hallucinations; delirium does not.
C. Delirium is irreversible; dementia is reversible.
D. Dementia has a sudden onset; delirium is gradual.
Correct Answer: A. Delirium has an acute onset and fluctuating course; dementia is chronic and
progressive.
Chronic Illness | Latest Update 2026/2027 | 200
Practice Questions & Detailed Answers | Verified
Answers with Rationales | Guarantee Pass A+
Graded
1. Which theory of aging proposes that cells have a limited number of divisions due to the shortening of
chromosomal ends?
A. Free radical theory
B. Telomere shortening theory
C. Wearandtear theory
D. Crosslinkage theory
Correct Answer: B. Telomere shortening theory
Explanation: The telomere shortening theory posits that each cell division shortens the telomeres
(protective caps at the ends of chromosomes), eventually leading to cellular senescence and aging. The
free radical theory attributes aging to cumulative oxidative damage; the wearandtear theory suggests
aging results from repeated use and environmental stressors; crosslinkage theory involves the formation
of abnormal bonds between molecules.
2. A 78yearold patient tells the nurse, "I don't see why I should bother exercising; I'm old and my body is
just wearing out." Which response best reflects current evidencebased gerontologic nursing?
A. "You are right; at your age, exercise is not very beneficial."
B. "Some physical changes occur with aging, but regular activity can help maintain function."
C. "Exercise will reverse all the changes of aging."
D. "You should only exercise if you have no chronic conditions."
Correct Answer: B. "Some physical changes occur with aging, but regular activity can help maintain
function."
Explanation: While aging involves physiologic changes, regular physical activity helps maintain functional
capacity, muscle strength, balance, and independence. Exercise cannot reverse all aging changes, but it
is one of the most effective interventions for preserving function and preventing frailty.
,3. Which finding is most consistent with normal aging rather than acute illness in an older adult?
A. Sudden confusion
B. New urinary incontinence
C. Gradual decrease in skin elasticity
D. Sudden inability to ambulate
Correct Answer: C. Gradual decrease in skin elasticity
Explanation: Reduced skin elasticity is an expected agerelated change due to loss of elastin and collagen
and decreased subcutaneous fat. Sudden confusion, new incontinence, or sudden mobility loss are red
flags that require prompt evaluation for acute pathology such as infection, stroke, or delirium.
4. Which statement best describes frailty in older adults?
A. It is an inevitable part of normal aging.
B. It is a state of decreased physiologic reserve and increased vulnerability.
C. It is caused exclusively by chronic disease.
D. It can always be reversed with medication.
Correct Answer: B. It is a state of decreased physiologic reserve and increased vulnerability.
Explanation: Frailty is a geriatric syndrome characterized by diminished physiologic reserve across
multiple systems, increasing susceptibility to stressors and adverse outcomes. It is not synonymous with
normal aging, is multifactorial (not caused solely by chronic disease), and while it can be managed, it is
not always reversible with medication alone.
5. A nurse assessing an older adult notices slower gait, generalized weakness, and unintentional weight
loss. These findings suggest:
A. Frailty
B. Normal aging only
C. Acute delirium
D. Sensory adaptation
Correct Answer: A. Frailty
Explanation: Slowed gait, weakness, and unintentional weight loss are core indicators of the frailty
phenotype. While these can occur with aging, their clustering suggests frailty rather than normal aging
alone; delirium presents with acute confusion and inattention, not these chronic signs.
,6. The concept of "homeostenosis" in aging refers to:
A. Increased receptor sensitivity requiring higher drug doses.
B. Reduced physiologic reserve narrowing the margin between health and illness.
C. Inevitable chronic illness progression independent of modifiable factors.
D. Increased immune function with age.
Correct Answer: B. Reduced physiologic reserve narrowing the margin between health and illness.
Explanation: Homeostenosis describes the diminished reserve across organ systems in aging, meaning
minor stressors can precipitate disproportionate decompensation. This principle drives the need for
early, aggressive management of seemingly small clinical changes in older adults.
7. Which activity is classified as an activity of daily living (ADL)?
A. Managing finances
B. Bathing
C. Shopping for groceries
D. Using public transportation
Correct Answer: B. Bathing
Explanation: Basic ADLs include bathing, dressing, toileting, eating, transferring, and continence.
Managing finances, shopping, and using transportation are instrumental activities of daily living (IADLs),
which require higherlevel cognitive and organizational skills.
8. Which assessment tool is most useful for evaluating basic functional independence in an older adult?
A. Katz Index
B. Braden Scale
C. Morse Fall Scale
D. Epworth Sleepiness Scale
Correct Answer: A. Katz Index
Explanation: The Katz Index of Independence in Activities of Daily Living evaluates independence in basic
ADLs such as bathing, dressing, toileting, transferring, continence, and feeding. The Braden Scale
assesses pressure injury risk, the Morse Fall Scale assesses fall risk, and the Epworth Sleepiness Scale
measures daytime sleepiness.
, 9. The Lawton IADL scale primarily evaluates an older adult's ability to:
A. Describe pain intensity
B. Maintain oxygen saturation
C. Assess pressure injury risk
D. Perform complex activities required for independent living
Correct Answer: D. Perform complex activities required for independent living
Explanation: The Lawton Instrumental Activities of Daily Living (IADL) scale assesses higherlevel tasks
such as managing finances, medications, shopping, transportation, meal preparation, and telephone
use. These skills are essential for community independence and are more cognitively demanding than
basic ADLs.
10. A hospitalized older adult with pneumonia and baseline mild cognitive impairment becomes acutely
confused, inattentive, and disoriented over 12 hours. Which action is the priority nursing intervention?
A. Administer haloperidol 2 mg IM for agitation.
B. Apply physical restraints to prevent falls.
C. Identify and treat the underlying precipitant (e.g., infection, hypoxia, medications).
D. Request an order for a benzodiazepine to promote sleep.
Correct Answer: C. Identify and treat the underlying precipitant (e.g., infection, hypoxia, medications).
Explanation: Delirium is a medical emergency; the priority is to identify and correct the underlying
cause, such as infection, hypoxia, metabolic derangement, or medication effects. Antipsychotics and
benzodiazepines do not treat the cause and may worsen outcomes; restraints increase injury risk and
exacerbate delirium.
11. Which of the following is a key difference between delirium and dementia?
A. Delirium has an acute onset and fluctuating course; dementia is chronic and progressive.
B. Dementia always involves hallucinations; delirium does not.
C. Delirium is irreversible; dementia is reversible.
D. Dementia has a sudden onset; delirium is gradual.
Correct Answer: A. Delirium has an acute onset and fluctuating course; dementia is chronic and
progressive.
