NUR 257 CHRONIC HEALTH EXAM
QUESTIONS AND ANSWERS 2026
1. A patient with Type 2 Diabetes reports morning hyperglycemia. The nurse finds the 3:00
AM blood glucose is low. Which condition is the patient likely experiencing?
A. Somogyi Effect
B. Dawn Phenomenon
C. Insulin Resistance
D. Diabetic Ketoacidosis
Answer: A
Conceptual Explanation: The Somogyi Effect occurs when a hypoglycemic period during
the night triggers the release of counter-regulatory hormones, leading to rebound
hyperglycemia in the morning.
2. Which assessment finding in a patient with Chronic Kidney Disease (CKD) most urgently
requires intervention?
A. Tall, peaked T-waves on an ECG
B. Glomerular Filtration Rate (GFR) of 45 mL/min
C. Serum creatinine of 2.4 mg/dL
,D. Hemoglobin level of 10 g/dL
Answer: A
Conceptual Explanation: Tall, peaked T-waves are a sign of hyperkalemia, which is life-
threatening and common in CKD due to the kidneys’ inability to excrete potassium.
3. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which physiological
drive is the primary stimulus for their breathing?
A. Hypercapnia
B. Acidosis
C. Alkalosis
D. Hypoxemia
Answer: D
Conceptual Explanation: In chronic COPD patients with retained CO2, the central
chemoreceptors become desensitized, leaving low oxygen levels (hypoxemic drive) as the
primary stimulus to breathe.
4. A patient with Right-sided Heart Failure is expected to exhibit which clinical manifestation?
A. Pulmonary edema
B. Orthopnea
C. Crackles in the lung bases
D. Jugular Venous Distention (JVD)
, Answer: D
Conceptual Explanation: Right-sided heart failure causes systemic congestion, resulting
in JVD, peripheral edema, and hepatomegaly, whereas left-sided failure causes pulmonary
symptoms.
5. Which medication is considered the gold standard for managing symptoms of Parkinson’s
Disease by increasing dopamine levels in the brain?
A. Benztropine
B. Donepezil
C. Selegiline
D. Levodopa-Carbidopa
Answer: D
Conceptual Explanation: Levodopa is converted to dopamine in the brain, and Carbidopa
prevents its peripheral breakdown, making it the most effective treatment for motor
symptoms.
6. In managing a patient with Rheumatoid Arthritis (RA), which laboratory test is most
specific for diagnosing the condition?
A. C-Reactive Protein (CRP)
B. Anti-Cyclic Citrullinated Peptide (anti-CCP)
C. Erythrocyte Sedimentation Rate (ESR)
QUESTIONS AND ANSWERS 2026
1. A patient with Type 2 Diabetes reports morning hyperglycemia. The nurse finds the 3:00
AM blood glucose is low. Which condition is the patient likely experiencing?
A. Somogyi Effect
B. Dawn Phenomenon
C. Insulin Resistance
D. Diabetic Ketoacidosis
Answer: A
Conceptual Explanation: The Somogyi Effect occurs when a hypoglycemic period during
the night triggers the release of counter-regulatory hormones, leading to rebound
hyperglycemia in the morning.
2. Which assessment finding in a patient with Chronic Kidney Disease (CKD) most urgently
requires intervention?
A. Tall, peaked T-waves on an ECG
B. Glomerular Filtration Rate (GFR) of 45 mL/min
C. Serum creatinine of 2.4 mg/dL
,D. Hemoglobin level of 10 g/dL
Answer: A
Conceptual Explanation: Tall, peaked T-waves are a sign of hyperkalemia, which is life-
threatening and common in CKD due to the kidneys’ inability to excrete potassium.
3. A patient with COPD is receiving oxygen at 2L/min via nasal cannula. Which physiological
drive is the primary stimulus for their breathing?
A. Hypercapnia
B. Acidosis
C. Alkalosis
D. Hypoxemia
Answer: D
Conceptual Explanation: In chronic COPD patients with retained CO2, the central
chemoreceptors become desensitized, leaving low oxygen levels (hypoxemic drive) as the
primary stimulus to breathe.
4. A patient with Right-sided Heart Failure is expected to exhibit which clinical manifestation?
A. Pulmonary edema
B. Orthopnea
C. Crackles in the lung bases
D. Jugular Venous Distention (JVD)
, Answer: D
Conceptual Explanation: Right-sided heart failure causes systemic congestion, resulting
in JVD, peripheral edema, and hepatomegaly, whereas left-sided failure causes pulmonary
symptoms.
5. Which medication is considered the gold standard for managing symptoms of Parkinson’s
Disease by increasing dopamine levels in the brain?
A. Benztropine
B. Donepezil
C. Selegiline
D. Levodopa-Carbidopa
Answer: D
Conceptual Explanation: Levodopa is converted to dopamine in the brain, and Carbidopa
prevents its peripheral breakdown, making it the most effective treatment for motor
symptoms.
6. In managing a patient with Rheumatoid Arthritis (RA), which laboratory test is most
specific for diagnosing the condition?
A. C-Reactive Protein (CRP)
B. Anti-Cyclic Citrullinated Peptide (anti-CCP)
C. Erythrocyte Sedimentation Rate (ESR)
