AGING & CHRONIC ILLNESS
NUR 257 Chronic Exam 4
A+
2026/2027 Official Exam — Concepts of Aging & Chronic Illness
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Pain & Comfort Management in Older Adults
■ 2. Bone & Joint Problems (Osteoporosis, Osteoarthritis, Rheumatoid Arthritis)
■ 3. Falls & Fall Risk Reduction
■ 4. Sensory Impairments (Vision & Hearing)
■ 5. Promoting Healthy Skin, Rest, Sleep & Activity
Passing Score: 80% | Marks: 1 per question | Format: Multiple Choice (A–D)
STUVIAACTUALEXAM
, SECTION 1 — Pain & Comfort Management in Older Adults
Q1. An 82-year-old resident with moderate cognitive impairment reports pain only when asked directly and often under-rates
intensity. The nurse’s priority approach to pain assessment is to:
A. Assume the resident has no pain because verbal reports are inconsistent
B. Use a combination of self-report when possible, behavioral observation tools, and caregiver input
C. Administer opioids on a fixed schedule without any assessment
D. Rely solely on the numeric rating scale without observation
Correct Answer: B
Rationale: Older adults with cognitive impairment may under-report pain. Multimodal assessment including observation and collateral history
improves detection and treatment.
Q2. A nurse is teaching an older adult about non-pharmacologic strategies for chronic osteoarthritis pain. Which recommendation is
most evidence-based and appropriate?
A. Avoidance of all joint movement indefinitely
B. Complete bed rest until pain resolves
C. High-impact running to strengthen cartilage
D. Heat or cold application, gentle range-of-motion, and paced activity as tolerated
Correct Answer: D
Rationale: Thermal modalities, gentle movement, and activity pacing reduce joint stress and pain without the risks of prolonged immobility.
Q3. An older adult is prescribed acetaminophen for mild-to-moderate musculoskeletal pain. The nurse emphasizes which safety
teaching point?
A. Combine freely with multiple over-the-counter cold remedies
B. Acetaminophen has no maximum daily dose in older adults
C. Do not exceed the recommended maximum daily dose and avoid other products containing acetaminophen to prevent hepatotoxicity
D. Take only when pain is severe and skip doses otherwise
Correct Answer: C
Rationale: Acetaminophen is often preferred for older adults, but cumulative dosing from multiple products can cause serious liver injury; clear
limits must be taught.
Q4. A resident with advanced dementia shows facial grimacing, guarding, and resistance during care. The nurse interprets these
behaviors as possible indicators of:
A. Attention-seeking only
B. A normal response that needs no intervention
C. Need for immediate physical restraint
D. Pain or discomfort requiring systematic assessment and treatment
Correct Answer: D
Rationale: Nonverbal cues such as grimacing and guarding are recognized indicators of pain in persons who cannot reliably self-report.
Q5. When considering opioid therapy for an older adult with severe cancer-related pain, the nurse prioritizes which principle?
A. Start with the highest available dose to ensure rapid relief
B. Avoid all opioids because of age alone
C. Start low and titrate slowly while monitoring for sedation, constipation, and respiratory depression
D. Use only as-needed dosing without any scheduled component
Correct Answer: C
Rationale: Older adults are more sensitive to opioids; conservative initiation, slow titration, and vigilant monitoring for adverse effects are essential.
STUVIAACTUALEXAM | Page 2 of 11
NUR 257 Chronic Exam 4
A+
2026/2027 Official Exam — Concepts of Aging & Chronic Illness
A+ 5 100%
QUESTIONS VERIFIED EXAM DOMAINS COVERED RATIONALES INCLUDED
CATEGORIES
■ 1. Pain & Comfort Management in Older Adults
■ 2. Bone & Joint Problems (Osteoporosis, Osteoarthritis, Rheumatoid Arthritis)
■ 3. Falls & Fall Risk Reduction
■ 4. Sensory Impairments (Vision & Hearing)
■ 5. Promoting Healthy Skin, Rest, Sleep & Activity
Passing Score: 80% | Marks: 1 per question | Format: Multiple Choice (A–D)
STUVIAACTUALEXAM
, SECTION 1 — Pain & Comfort Management in Older Adults
Q1. An 82-year-old resident with moderate cognitive impairment reports pain only when asked directly and often under-rates
intensity. The nurse’s priority approach to pain assessment is to:
A. Assume the resident has no pain because verbal reports are inconsistent
B. Use a combination of self-report when possible, behavioral observation tools, and caregiver input
C. Administer opioids on a fixed schedule without any assessment
D. Rely solely on the numeric rating scale without observation
Correct Answer: B
Rationale: Older adults with cognitive impairment may under-report pain. Multimodal assessment including observation and collateral history
improves detection and treatment.
Q2. A nurse is teaching an older adult about non-pharmacologic strategies for chronic osteoarthritis pain. Which recommendation is
most evidence-based and appropriate?
A. Avoidance of all joint movement indefinitely
B. Complete bed rest until pain resolves
C. High-impact running to strengthen cartilage
D. Heat or cold application, gentle range-of-motion, and paced activity as tolerated
Correct Answer: D
Rationale: Thermal modalities, gentle movement, and activity pacing reduce joint stress and pain without the risks of prolonged immobility.
Q3. An older adult is prescribed acetaminophen for mild-to-moderate musculoskeletal pain. The nurse emphasizes which safety
teaching point?
A. Combine freely with multiple over-the-counter cold remedies
B. Acetaminophen has no maximum daily dose in older adults
C. Do not exceed the recommended maximum daily dose and avoid other products containing acetaminophen to prevent hepatotoxicity
D. Take only when pain is severe and skip doses otherwise
Correct Answer: C
Rationale: Acetaminophen is often preferred for older adults, but cumulative dosing from multiple products can cause serious liver injury; clear
limits must be taught.
Q4. A resident with advanced dementia shows facial grimacing, guarding, and resistance during care. The nurse interprets these
behaviors as possible indicators of:
A. Attention-seeking only
B. A normal response that needs no intervention
C. Need for immediate physical restraint
D. Pain or discomfort requiring systematic assessment and treatment
Correct Answer: D
Rationale: Nonverbal cues such as grimacing and guarding are recognized indicators of pain in persons who cannot reliably self-report.
Q5. When considering opioid therapy for an older adult with severe cancer-related pain, the nurse prioritizes which principle?
A. Start with the highest available dose to ensure rapid relief
B. Avoid all opioids because of age alone
C. Start low and titrate slowly while monitoring for sedation, constipation, and respiratory depression
D. Use only as-needed dosing without any scheduled component
Correct Answer: C
Rationale: Older adults are more sensitive to opioids; conservative initiation, slow titration, and vigilant monitoring for adverse effects are essential.
STUVIAACTUALEXAM | Page 2 of 11
