NUR 257 Final Exam 2026/2027 | Aging and Chronic Illness | Practice Test with Verified Answers & Detailed Rationales | NGN Grade A | Gerontology & Chronic Disease Management | Nursing School Prep | Downloadable PDF

INSTANT PDF DOWNLOAD — This is the comprehensive Final Exam practice test preparation guide for NUR 257 - Aging and Chronic Illness (2026/2027), featuring practice test questions with verified answers and detailed rationales. Designed for nursing students in gerontology and chronic illness courses, this resource consolidates the essential concepts required to master the NUR 257 Final Exam and achieve a Grade A. The guide is meticulously aligned with Next Generation NCLEX (NGN) standards and current evidence-based geriatric and chronic illness nursing practice. This verified resource provides comprehensive coverage of key NUR 257 Aging and Chronic Illness Final Exam topics, including: Palliative Care and End-of-Life (hospice vs palliative care—palliative care (symptom management, quality of life, any stage of illness, continues with curative treatment, interdisciplinary team (nurse, physician, social worker, chaplain, pharmacist, nutritionist, therapist), settings (hospital, outpatient clinic, home, nursing home, assisted living)), hospice care (terminal illness with life expectancy ≤6 months (if disease runs normal course), comfort-focused, no curative treatment, Medicare hospice benefit (two 90-day benefit periods, then unlimited 60-day periods, requires certification of terminal illness by two physicians (medical director, attending), patient elects hospice (forgoes Medicare-covered curative treatments, may revoke at any time and return to standard Medicare), covered services (nursing care, physician services, medical equipment/supplies, medications for symptom management (not curative), home health aide, social work, chaplain, bereavement counseling, respite care (inpatient up to 5 days), inpatient hospice (for symptom management not manageable at home), continuous home care (crisis care, up to 24 hours/day), covered medications (opioids, antiemetics, laxatives, anticholinergics, anxiolytics, antidepressants, antipsychotics, diuretics, oxygen, not covered (chemotherapy, radiation, IV antibiotics (except for symptom management), TPN, dialysis (unless for symptom management), expensive oral medications for disease modification (e.g., apixaban for atrial fibrillation stroke prevention? may need to pay out-of-pocket or switch to warfarin)), levels of hospice care (routine home care (most common), continuous home care (crisis care for uncontrolled symptoms, at least 8 hours/day), inpatient respite care (up to 5 days, caregiver relief), general inpatient care (for symptom management in hospice facility or hospital), eligibility (patient must have terminal diagnosis with life expectancy ≤6 months, for dementia (FAST stage 7c (cannot walk, speak, hold head up), weight loss (10% in 6 months), aspiration pneumonia, urinary tract infection, sepsis, pressure injuries, feeding problems, comorbidities), for heart failure (NYHA class IV, ejection fraction ≤20%, refractory to optimal medical therapy, diuretic resistance, hypotension, arrhythmias, cachexia, recurrent hospitalizations (≥2 in 6 months)), for COPD (post-bronchodilator FEV1 30% predicted, resting hypoxia (PaO2 55 mm Hg or SpO2 ≤88% on room air), hypercapnia (PaCO2 50 mm Hg), cor pulmonale, unintentional weight loss (≥10%), hospitalization for exacerbation (≥2 in 12 months)), for cancer (metastatic disease, progression despite treatment, poor performance status (Palliative Performance Scale (PPS) ≤50% (spends 50% of day in bed/chair, extensive disease, unable to work or do housework), uncontrolled pain, dyspnea, weight loss, delirium, recurrent infections, malignant bowel obstruction, malignant ascites, superior vena cava syndrome, hypercalcemia, spinal cord compression)), pain management at end of life (around-the-clock (ATC) opioids for persistent pain (morphine (first-line, available in multiple formulations (immediate-release, sustained-release, oral solution, IV, subcutaneous, rectal, intrathecal, epidural), active metabolite morphine-6-glucuronide (M6G) contributes to analgesia, renally excreted (accumulates in renal failure, risk of neurotoxicity (myoclonus, seizures, delirium), reduce dose, use alternative (hydromorphone, fentanyl, methadone)), hydromorphone (Dilaudid) (more potent than morphine (5-7x), shorter half-life, fewer active metabolites, preferred in renal impairment), fentanyl (transdermal patch (Duragesic) (for stable pain, not for acute pain, onset 12-24 hours, duration 48-72 hours, do not apply external heat (heating pad, fever) increases absorption, risk overdose, death), IV, subcutaneous, buccal, intranasal, intrathecal, epidural), oxycodone (oral, immediate-release (Percocet with acetaminophen, OxyIR, Oxyfast), sustained-release (OxyContin), metabolized to oxymorphone (active), CYP2D6 polymorphism (poor metabolizers have reduced analgesia, ultrarapid metabolizers have increased toxicity), acetaminophen combination (limit acetaminophen to mg/day in elderly, liver disease, alcoholism, malnutrition, cachexia), oxymorphone (Opana) (oral, IV, no CYP metabolism (no drug interactions), less histamine release (less pruritus), adverse effects (dizziness, nausea, vomiting, constipation, headache, confusion, sedation, respiratory depression)), methadone (long half-life (15-60 hours), NMDA antagonist (may be effective for neuropathic pain), QTc prolongation (torsades de pointes), risk of accumulation, respiratory depression, only by experienced prescribers, drug interactions (CYP3A4, CYP2B6, CYP2D6 inducers/inhibitors), also used for opioid use disorder, for weaning off opioids), breakthrough pain (immediate-release opioid (10-20% of total daily dose (TDD) of around-the-clock (ATC) opioid, frequency up to q1-2h, if requiring 4-6 breakthrough doses per 24 hours, increase ATC dose), adjuvant analgesics (gabapentin, pregabalin (neuropathic