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Chronic Exam 3 Study Guide
50 Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION:
NUR 257 Chronic Exam 3 - 2026/2027 study guide provides comprehensive review
of chronic health alterations in older adults, focusing on diabetes, COPD, heart
failure, stroke, Parkinson's, dementia, hypertension, pneumonia, and asthma.
Designed for exam success, it highlights evidence-based nursing interventions,
prioritization, patient education, and complication prevention with rationales for
improved critical thinking and safe clinical decision making skills daily.
Answers are in bold Green, with rationales after.
1. The nurse is teaching a 75 year old client who has diabetes
mellitus about nutrition therapy when taking antidiabetic drugs.
Which of the following client statements indicates a need for
further teaching?
a. “I will eat the same amount and quality of food every day”
b. “Eating meals and snacks at the same time every day is important”
c. “I should stick to the food allowed on my diet except for special
occasions”
d. “I will consult with a dietician for meal planning and preparation”
,Rationale: Diabetic diet requires consistency EVERY day, including
special occasions. No 'cheat days'. Same amount/quality and same
timing prevents hypo/hyperglycemia. Consulting dietician is
appropriate.
2. The home health nurse is caring for an 85-year-old client who is
newly diagnosed with diabetes mellitus (type 2) and has been
prescribed metformin. The client still has questions regarding diet
and exercise. Which of the following actions by the nurse is
priority?
a. Contact the PCP regarding the most recent orders.
b. Perform assessment and answer all client questions.
c. Perform assessment and document all findings.
d. Contact the dietician and PT regarding orders.
Rationale: Verify orders before teaching to ensure accuracy. Best
practice is assessment first, but for exam, contacting PCP to clarify
diet/exercise orders is priority.
3. The nurse is providing care for an older adult client who is
suspected of having diabetes mellitus (type 2). The nurse is aware
that which of the following is often the cause of a delayed diagnosis
in the older adult population?
a. There are usually few, if any, symptoms until severe organ
damage has been done.
b. Older adults tend to avoid complaining of not feeling well due to fear
of the unknown.
c. The PCP hesitates to make the diagnosis to preserve quality of life.
, d. The symptoms come on so quickly that other body systems are
focused on first.
Rationale: Type 2 DM in older adults is insidious. Classic
polyuria/polydipsia may be absent or attributed to aging. Often
diagnosed on routine labs or when complications appear.
4. The nurse is preparing a care plan for an older adult who has
diabetes mellitus (type 2). Which interventions should the nurse
include? 1. Teach to prevent hypoglycemia. 2. Emphasize role of
physical exercise. 3. Review manifestations of complications. 4.
Stress importance of avoiding carbohydrates. 5. Instruct in self-
monitoring of blood glucose levels.
a. 1,3,4,5
b. 1,2,4,5
c. 1,2,3,5
d. 2,3,4,5
Rationale: Older adults must NOT avoid all carbohydrates; they need
balanced carbs. Need hypoglycemia prevention, exercise, complications
s/s, and SMBG.
5. The nurse is caring for a 75-year-old client who has diabetes
mellitus (type 2). Which actions should the nurse promote to delay
onset of microvascular and macrovascular complications?
a. Prevent atherosclerosis.
b. Prevent hyperglycemia
c. Avoid a sedentary lifestyle
d. Maintain an ideal weight