NUR 257 CHRONIC HEALTH EXAM
QUESTIONS AND ANSWERS
1. A patient with Type 2 Diabetes Mellitus presents with an HgbA1c of 8.5%. What is the most
appropriate nursing priority?
A. Instruct the patient to increase intake of complex carbohydrates.
B. Assess the patient’s adherence to their prescribed medication and lifestyle regimen.
C. Prepare the patient for immediate insulin pump initiation.
D. Inform the patient that this value is within the normal target range.
Answer: B
Conceptual Explanation: An HgbA1c of 8.5% is above the typical goal of less than 7%,
indicating poor long-term glucose control. The nurse should first assess why the
management plan is not being met.
2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. Which finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Respiration rate of 14 breaths/min
,C. Presence of a productive cough with clear sputum
D. Increasing lethargy and confusion
Answer: D
Conceptual Explanation: In COPD, excessive oxygen can sometimes lead to CO2 retention
and narcosis, manifested by lethargy and confusion. This is a medical emergency.
3. When teaching a patient with Congestive Heart Failure (CHF) about self-management,
which instruction is most critical?
A. Weigh yourself daily at the same time and report a gain of 3 lbs in 2 days.
B. Take a hot bath daily to improve circulation.
C. Limit physical activity to bedrest to conserve energy.
D. Increase sodium intake to maintain blood pressure.
Answer: A
Conceptual Explanation: Daily weights are the most sensitive indicator of fluid volume
status in CHF. Sudden weight gain indicates worsening heart failure.
4. Which laboratory value is most indicative of the progression of Chronic Kidney Disease
(CKD)?
A. Elevated Serum Sodium
B. Decreased Hemoglobin
C. Increased Blood Urea Nitrogen (BUN)
, D. Decreased Glomerular Filtration Rate (GFR)
Answer: D
Conceptual Explanation: GFR is the gold standard for determining the stage and
progression of CKD, as it measures the filtering capacity of the kidneys.
5. A patient with Hypertension is prescribed Lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A. A persistent, dry non-productive cough
B. Swelling of the face, lips, or tongue
C. Occasional dizziness when standing quickly
D. Increased frequency of urination
Answer: B
Conceptual Explanation: Angioedema (swelling of face/lips/tongue) is a life-threatening
adverse effect of ACE inhibitors like Lisinopril.
6. A patient with Rheumatoid Arthritis is prescribed Methotrexate. What should the nurse
include in the teaching?
A. This medication will cure the disease within six months.
B. Avoid taking folic acid supplements while on this drug.
C. Alcohol consumption should be strictly avoided due to liver toxicity.
D. Discontinue the medication once joint pain subsides.
QUESTIONS AND ANSWERS
1. A patient with Type 2 Diabetes Mellitus presents with an HgbA1c of 8.5%. What is the most
appropriate nursing priority?
A. Instruct the patient to increase intake of complex carbohydrates.
B. Assess the patient’s adherence to their prescribed medication and lifestyle regimen.
C. Prepare the patient for immediate insulin pump initiation.
D. Inform the patient that this value is within the normal target range.
Answer: B
Conceptual Explanation: An HgbA1c of 8.5% is above the typical goal of less than 7%,
indicating poor long-term glucose control. The nurse should first assess why the
management plan is not being met.
2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen via nasal
cannula at 2L/min. Which finding requires immediate intervention?
A. Oxygen saturation of 90%
B. Respiration rate of 14 breaths/min
,C. Presence of a productive cough with clear sputum
D. Increasing lethargy and confusion
Answer: D
Conceptual Explanation: In COPD, excessive oxygen can sometimes lead to CO2 retention
and narcosis, manifested by lethargy and confusion. This is a medical emergency.
3. When teaching a patient with Congestive Heart Failure (CHF) about self-management,
which instruction is most critical?
A. Weigh yourself daily at the same time and report a gain of 3 lbs in 2 days.
B. Take a hot bath daily to improve circulation.
C. Limit physical activity to bedrest to conserve energy.
D. Increase sodium intake to maintain blood pressure.
Answer: A
Conceptual Explanation: Daily weights are the most sensitive indicator of fluid volume
status in CHF. Sudden weight gain indicates worsening heart failure.
4. Which laboratory value is most indicative of the progression of Chronic Kidney Disease
(CKD)?
A. Elevated Serum Sodium
B. Decreased Hemoglobin
C. Increased Blood Urea Nitrogen (BUN)
, D. Decreased Glomerular Filtration Rate (GFR)
Answer: D
Conceptual Explanation: GFR is the gold standard for determining the stage and
progression of CKD, as it measures the filtering capacity of the kidneys.
5. A patient with Hypertension is prescribed Lisinopril. Which side effect should the nurse
instruct the patient to report immediately?
A. A persistent, dry non-productive cough
B. Swelling of the face, lips, or tongue
C. Occasional dizziness when standing quickly
D. Increased frequency of urination
Answer: B
Conceptual Explanation: Angioedema (swelling of face/lips/tongue) is a life-threatening
adverse effect of ACE inhibitors like Lisinopril.
6. A patient with Rheumatoid Arthritis is prescribed Methotrexate. What should the nurse
include in the teaching?
A. This medication will cure the disease within six months.
B. Avoid taking folic acid supplements while on this drug.
C. Alcohol consumption should be strictly avoided due to liver toxicity.
D. Discontinue the medication once joint pain subsides.
