NUR257 EXAM 3 ACTUAL 2026/2027 | Aging and Chronic
Illness in Nursing Exam Review | 100% Correct | Galen | Pass
Guaranteed - A+ Graded
Section 1: Theories of Aging & Physiologic Changes
10 questions covering biologic and psychosocial theories, normal age-related changes by
system
Q1: A 78-year-old patient asks the nurse why their skin has become thinner and more
fragile over the years. Which explanation best describes the underlying biologic
mechanism?
A. Decreased melanin production causing lighter skin pigmentation
B. Cross-linking of collagen fibers and reduced elastin synthesis
C. Increased sebaceous gland activity leading to dryness
D. Accelerated cell turnover causing rapid aging
Correct Answer: B
Rationale: The cross-linking theory explains how collagen fibers become stiff and less
elastic over time, while elastin production drops—this is why older skin tears easily and
doesn't bounce back. For Exam 3 in NUR257, remember that cross-linking affects
connective tissue throughout the body, not just skin.
,Q2: According to the free radical theory of aging, which dietary recommendation would
be most appropriate for an older adult?
A. High-protein diet to support muscle mass
B. Antioxidant-rich foods including fruits and vegetables
C. Low-carbohydrate diet to prevent metabolic syndrome
D. Calcium-rich foods for bone health only
Correct Answer: B
Rationale: Free radicals cause cellular damage through oxidative stress, and
antioxidants neutralize them. That's the theory—whether supplements work is debated,
but dietary antioxidants from whole foods are consistently recommended. The other
options address different aging concerns but don't target free radical damage
specifically.
Q3: An 82-year-old retired teacher continues to volunteer at the local library, attend book
club, and maintain close friendships with three lifelong friends while letting go of more
superficial acquaintances. Which psychosocial theory of aging does this exemplify?
A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Socioemotional selectivity theory
Correct Answer: D
,Rationale: Socioemotional selectivity theory says older adults prioritize emotionally
meaningful relationships over expanding social networks—they're selective. This person
maintains deep connections and meaningful activity but has narrowed their social world
intentionally. Activity theory (B) would emphasize staying busy with any activity, while
continuity (C) focuses on maintaining lifelong patterns.
Q4: A nurse is assessing an 80-year-old's cardiovascular system. Which finding is an
expected age-related change rather than a sign of disease?
A. Systolic murmur at the apex radiating to the axilla
B. Decreased elasticity of arterial walls causing increased systolic BP
C. Jugular venous distension at 45-degree elevation
D. Pedal edema bilaterally with pitting
Correct Answer: B
Rationale: Arterial stiffening from reduced elastin is normal aging—it causes isolated
systolic hypertension, the most common BP pattern in older adults. The other options
are pathologic: mitral regurgitation (A), right heart failure (C), and fluid overload or
venous insufficiency (D). For Exam 3, know that systolic BP rising with age is expected;
diastolic rising is not.
Q5: Which respiratory change is a normal consequence of aging and not indicative of
pathology?
A. Increased residual volume and decreased vital capacity
B. Productive cough with yellow sputum daily
, C. Oxygen saturation 88% on room air at rest
D. Clubbing of the fingernails
Correct Answer: A
Rationale: As we age, alveoli lose elasticity and chest wall stiffens—we can't exhale as
completely, so residual volume increases, and vital capacity drops. But SpO2 should
stay above 92% (C is hypoxemic), chronic productive cough (B) is COPD or
bronchiectasis, and clubbing (D) is chronic hypoxia from lung disease or cancer.
Q6: A 75-year-old has a creatinine clearance of 55 mL/min despite serum creatinine of
1.0 mg/dL. Which explanation is correct?
A. The lab made an error; these values are incompatible
B. Reduced muscle mass produces less creatinine, masking renal decline
C. The patient is well-hydrated, causing dilute creatinine
D. Older adults normally have higher GFR than younger adults
Correct Answer: B
Rationale: This is the classic "creatinine blind spot" in geriatrics—older adults lose
muscle mass, so they produce less creatinine even as their kidneys fail. A "normal"
creatinine can hide significant renal impairment. Always calculate eGFR or CrCl in older
adults; don't trust serum creatinine alone.
Q7: Which neurologic change is expected with normal aging rather than indicating
dementia?
Illness in Nursing Exam Review | 100% Correct | Galen | Pass
Guaranteed - A+ Graded
Section 1: Theories of Aging & Physiologic Changes
10 questions covering biologic and psychosocial theories, normal age-related changes by
system
Q1: A 78-year-old patient asks the nurse why their skin has become thinner and more
fragile over the years. Which explanation best describes the underlying biologic
mechanism?
A. Decreased melanin production causing lighter skin pigmentation
B. Cross-linking of collagen fibers and reduced elastin synthesis
C. Increased sebaceous gland activity leading to dryness
D. Accelerated cell turnover causing rapid aging
Correct Answer: B
Rationale: The cross-linking theory explains how collagen fibers become stiff and less
elastic over time, while elastin production drops—this is why older skin tears easily and
doesn't bounce back. For Exam 3 in NUR257, remember that cross-linking affects
connective tissue throughout the body, not just skin.
,Q2: According to the free radical theory of aging, which dietary recommendation would
be most appropriate for an older adult?
A. High-protein diet to support muscle mass
B. Antioxidant-rich foods including fruits and vegetables
C. Low-carbohydrate diet to prevent metabolic syndrome
D. Calcium-rich foods for bone health only
Correct Answer: B
Rationale: Free radicals cause cellular damage through oxidative stress, and
antioxidants neutralize them. That's the theory—whether supplements work is debated,
but dietary antioxidants from whole foods are consistently recommended. The other
options address different aging concerns but don't target free radical damage
specifically.
Q3: An 82-year-old retired teacher continues to volunteer at the local library, attend book
club, and maintain close friendships with three lifelong friends while letting go of more
superficial acquaintances. Which psychosocial theory of aging does this exemplify?
A. Disengagement theory
B. Activity theory
C. Continuity theory
D. Socioemotional selectivity theory
Correct Answer: D
,Rationale: Socioemotional selectivity theory says older adults prioritize emotionally
meaningful relationships over expanding social networks—they're selective. This person
maintains deep connections and meaningful activity but has narrowed their social world
intentionally. Activity theory (B) would emphasize staying busy with any activity, while
continuity (C) focuses on maintaining lifelong patterns.
Q4: A nurse is assessing an 80-year-old's cardiovascular system. Which finding is an
expected age-related change rather than a sign of disease?
A. Systolic murmur at the apex radiating to the axilla
B. Decreased elasticity of arterial walls causing increased systolic BP
C. Jugular venous distension at 45-degree elevation
D. Pedal edema bilaterally with pitting
Correct Answer: B
Rationale: Arterial stiffening from reduced elastin is normal aging—it causes isolated
systolic hypertension, the most common BP pattern in older adults. The other options
are pathologic: mitral regurgitation (A), right heart failure (C), and fluid overload or
venous insufficiency (D). For Exam 3, know that systolic BP rising with age is expected;
diastolic rising is not.
Q5: Which respiratory change is a normal consequence of aging and not indicative of
pathology?
A. Increased residual volume and decreased vital capacity
B. Productive cough with yellow sputum daily
, C. Oxygen saturation 88% on room air at rest
D. Clubbing of the fingernails
Correct Answer: A
Rationale: As we age, alveoli lose elasticity and chest wall stiffens—we can't exhale as
completely, so residual volume increases, and vital capacity drops. But SpO2 should
stay above 92% (C is hypoxemic), chronic productive cough (B) is COPD or
bronchiectasis, and clubbing (D) is chronic hypoxia from lung disease or cancer.
Q6: A 75-year-old has a creatinine clearance of 55 mL/min despite serum creatinine of
1.0 mg/dL. Which explanation is correct?
A. The lab made an error; these values are incompatible
B. Reduced muscle mass produces less creatinine, masking renal decline
C. The patient is well-hydrated, causing dilute creatinine
D. Older adults normally have higher GFR than younger adults
Correct Answer: B
Rationale: This is the classic "creatinine blind spot" in geriatrics—older adults lose
muscle mass, so they produce less creatinine even as their kidneys fail. A "normal"
creatinine can hide significant renal impairment. Always calculate eGFR or CrCl in older
adults; don't trust serum creatinine alone.
Q7: Which neurologic change is expected with normal aging rather than indicating
dementia?
