NUR 257 CHRONIC EXAM/ ACTUAL NUR 257 CHRONIC EXAM 4 LATEST
2026/2027 EXAM PRACTICE QUESTIONS AND A NEW UPDATED STUDY
GUIDE ACCURATE EXAM REAL QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES (100% CORRECT VERIFIED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION |ALREADY GRADED A+
(BRAND NEW!) JUST RELEASED
1. A 78-year-old patient reports difficulty staying asleep and waking up with
persistent foot cramps. Which action by the nurse is most appropriate to promote
restful sleep?
A. Offer a late-night caffeinated beverage
B. Encourage a daytime nap of 2–3 hours
C. Establish a consistent bedtime routine and limit evening fluids
D. Advise the patient to exercise vigorously within 1 hour of bedtime
Correct Answer: C. Establish a consistent bedtime routine and limit evening fluids
Rationale: A consistent bedtime routine and limiting evening fluids are key sleep
hygiene practices that promote restful sleep in older adults. Caffeine late in the day
and vigorous exercise near bedtime disrupt sleep, while long daytime naps
interfere with nighttime sleep .
2. A patient with chronic osteoarthritis rates their pain as 6/10 and has a history of
gastric ulcers. Which analgesic order should the nurse question?
A. Acetaminophen 650 mg PO every 6 hours PRN
B. Ibuprofen 600 mg PO every 8 hours PRN
C. Lidocaine patch 5% applied to affected joint
,D. Tramadol 50 mg PO every 6 hours PRN
Correct Answer: B. Ibuprofen 600 mg PO every 8 hours PRN
Rationale: Ibuprofen is an NSAID that can cause gastric irritation and bleeding,
which is contraindicated in patients with a history of gastric ulcers.
Acetaminophen, lidocaine patches, and tramadol are safer alternatives for this
patient .
3. Which statement about Restless Leg Syndrome (RLS) is accurate?
A. It primarily affects children and young adults
B. Symptoms improve with rest and worsen with movement
C. It is a sensorimotor neurologic disorder characterized by unpleasant leg
sensations that disrupt sleep
D. It is caused by excessive dopamine in the brain
Correct Answer: C. It is a sensorimotor neurologic disorder characterized by
unpleasant leg sensations that disrupt sleep
Rationale: RLS is a sensorimotor neurologic disorder causing unpleasant
sensations in the legs that worsen with rest and improve with movement. It is
associated with dopamine dysregulation, not excessive dopamine .
4. A patient with chronic low back pain has been using a fentanyl patch for 6
months. The nurse notes the patient has a respiratory rate of 10 breaths/minute and
is difficult to arouse. What is the priority action?
,A. Remove the fentanyl patch immediately
B. Apply oxygen via nasal cannula
C. Administer naloxone (Narcan) per protocol
D. Stimulate the patient to wake up
Correct Answer: C. Administer naloxone (Narcan) per protocol
Rationale: The patient is showing signs of opioid overdose with respiratory
depression and altered mental status. Naloxone is the antidote for opioid toxicity
and should be administered immediately. While removing the patch and applying
oxygen are important, naloxone is the priority intervention .
5. Which medication reduces preload in heart failure?
A. Beta blockers
B. ACE inhibitors
C. Diuretics
D. Digoxin
Correct Answer: C. Diuretics
Rationale: Diuretics reduce circulating blood volume, which lowers preload and
decreases pulmonary congestion in heart failure patients. Beta-blockers reduce
heart rate, ACE inhibitors reduce afterload, and digoxin increases contractility .
6. The BEST indicator of fluid overload in CHF is:
, A. Crackles
B. Edema
C. Daily weight gain
D. Elevated blood pressure
Correct Answer: C. Daily weight gain
Rationale: Daily weight gain is the most reliable and sensitive indicator of fluid
retention in heart failure. A weight gain of 2-3 pounds in 3 days indicates fluid
accumulation requiring intervention .
7. A nurse would suspect sleep apnea in a patient who reports which of the
following? (Select all that apply)
A. Sleeping with 3 pillows
B. Choking or gasping during sleep
C. Falling asleep immediately upon lying down
D. Excessive daytime sleepiness
Correct Answer: A, B, D. Sleeping with 3 pillows; Choking or gasping during
sleep; Excessive daytime sleepiness
Rationale: Signs of sleep apnea include sleeping with multiple pillows to elevate
the head, choking or gasping during sleep, and excessive daytime sleepiness.
Falling asleep immediately upon lying down is not a specific sign of sleep apnea .
8. REM Sleep Behavior Disorder (RBD) is characterized by which of the
following?
2026/2027 EXAM PRACTICE QUESTIONS AND A NEW UPDATED STUDY
GUIDE ACCURATE EXAM REAL QUESTIONS AND CORRECT DETAILED
SOLUTIONS WITH RATIONALES (100% CORRECT VERIFIED ANSWERS)
NEWEST UPDATED VERSION 2026 EDITION |ALREADY GRADED A+
(BRAND NEW!) JUST RELEASED
1. A 78-year-old patient reports difficulty staying asleep and waking up with
persistent foot cramps. Which action by the nurse is most appropriate to promote
restful sleep?
A. Offer a late-night caffeinated beverage
B. Encourage a daytime nap of 2–3 hours
C. Establish a consistent bedtime routine and limit evening fluids
D. Advise the patient to exercise vigorously within 1 hour of bedtime
Correct Answer: C. Establish a consistent bedtime routine and limit evening fluids
Rationale: A consistent bedtime routine and limiting evening fluids are key sleep
hygiene practices that promote restful sleep in older adults. Caffeine late in the day
and vigorous exercise near bedtime disrupt sleep, while long daytime naps
interfere with nighttime sleep .
2. A patient with chronic osteoarthritis rates their pain as 6/10 and has a history of
gastric ulcers. Which analgesic order should the nurse question?
A. Acetaminophen 650 mg PO every 6 hours PRN
B. Ibuprofen 600 mg PO every 8 hours PRN
C. Lidocaine patch 5% applied to affected joint
,D. Tramadol 50 mg PO every 6 hours PRN
Correct Answer: B. Ibuprofen 600 mg PO every 8 hours PRN
Rationale: Ibuprofen is an NSAID that can cause gastric irritation and bleeding,
which is contraindicated in patients with a history of gastric ulcers.
Acetaminophen, lidocaine patches, and tramadol are safer alternatives for this
patient .
3. Which statement about Restless Leg Syndrome (RLS) is accurate?
A. It primarily affects children and young adults
B. Symptoms improve with rest and worsen with movement
C. It is a sensorimotor neurologic disorder characterized by unpleasant leg
sensations that disrupt sleep
D. It is caused by excessive dopamine in the brain
Correct Answer: C. It is a sensorimotor neurologic disorder characterized by
unpleasant leg sensations that disrupt sleep
Rationale: RLS is a sensorimotor neurologic disorder causing unpleasant
sensations in the legs that worsen with rest and improve with movement. It is
associated with dopamine dysregulation, not excessive dopamine .
4. A patient with chronic low back pain has been using a fentanyl patch for 6
months. The nurse notes the patient has a respiratory rate of 10 breaths/minute and
is difficult to arouse. What is the priority action?
,A. Remove the fentanyl patch immediately
B. Apply oxygen via nasal cannula
C. Administer naloxone (Narcan) per protocol
D. Stimulate the patient to wake up
Correct Answer: C. Administer naloxone (Narcan) per protocol
Rationale: The patient is showing signs of opioid overdose with respiratory
depression and altered mental status. Naloxone is the antidote for opioid toxicity
and should be administered immediately. While removing the patch and applying
oxygen are important, naloxone is the priority intervention .
5. Which medication reduces preload in heart failure?
A. Beta blockers
B. ACE inhibitors
C. Diuretics
D. Digoxin
Correct Answer: C. Diuretics
Rationale: Diuretics reduce circulating blood volume, which lowers preload and
decreases pulmonary congestion in heart failure patients. Beta-blockers reduce
heart rate, ACE inhibitors reduce afterload, and digoxin increases contractility .
6. The BEST indicator of fluid overload in CHF is:
, A. Crackles
B. Edema
C. Daily weight gain
D. Elevated blood pressure
Correct Answer: C. Daily weight gain
Rationale: Daily weight gain is the most reliable and sensitive indicator of fluid
retention in heart failure. A weight gain of 2-3 pounds in 3 days indicates fluid
accumulation requiring intervention .
7. A nurse would suspect sleep apnea in a patient who reports which of the
following? (Select all that apply)
A. Sleeping with 3 pillows
B. Choking or gasping during sleep
C. Falling asleep immediately upon lying down
D. Excessive daytime sleepiness
Correct Answer: A, B, D. Sleeping with 3 pillows; Choking or gasping during
sleep; Excessive daytime sleepiness
Rationale: Signs of sleep apnea include sleeping with multiple pillows to elevate
the head, choking or gasping during sleep, and excessive daytime sleepiness.
Falling asleep immediately upon lying down is not a specific sign of sleep apnea .
8. REM Sleep Behavior Disorder (RBD) is characterized by which of the
following?
