NUR 257 Chronic Exam 1
Actual Practice Exam Questions And Answers
Already Graded A+
Welcome to the NUR 257 Chronic Exam 1 - Chronic Nursing Care and Management.
This comprehensive examination is designed to evaluate your knowledge and
understanding of chronic disease management, cardiovascular disorders,
anticoagulation therapy, and related nursing interventions. The exam consists
of 110 multiple-choice questions that reflect the actual NUR 257 Chronic Exam 1
content. Each question includes the correct answer and a brief rationale to
enhance your learning experience. The questions are based on evidence-based
practice guidelines and standard nursing curriculum. Good luck on your
examination!
EXAM DOMAINS
Domain 1: Cardiovascular Disorders and Management
Domain 2: Anticoagulation Therapy
Domain 3: Heart Failure and Cardiac Medications
Domain 4: Cardiac Diagnostics and Procedures
Domain 5: Peripheral Vascular Disease
Domain 6: Chronic Disease Management and Patient Education
DOMAIN 1: CARDIOVASCULAR DISORDERS AND MANAGEMENT
1. A nurse is reviewing the medical record of a client who is receiving
heparin therapy for treatment of deep-vein thrombosis. Which of the following
interventions should the nurse anticipate taking if the client's aPTT is
96 seconds?
A. Increase the heparin infusion rate
B. Continue the heparin infusion at the current rate
C. Stop the heparin infusion
D. Administer protamine sulfate
Answer: C
Rationale: An aPTT of 96 seconds is significantly elevated (therapeutic range
is typically 60-80 seconds or 1.5-2.5 times control). This indicates the client
,is at risk for bleeding, so the nurse should anticipate stopping the heparin
infusion and notifying the provider.
2. A nurse is providing health teaching for a group of clients. Which of the
following clients is at risk for developing peripheral arterial disease?
A. A client who has diabetes mellitus
B. A client who has hypertension
C. A client who has asthma
D. A client who has hypothyroidism
Answer: A
Rationale: Diabetes mellitus is a major risk factor for peripheral arterial
disease (PAD) due to accelerated atherosclerosis and microvascular damage.
Other risk factors include smoking, hypertension, hyperlipidemia, and age.
3. A nurse is watching a client's ECG monitor and notes that the client's
rhythm has changed from a normal sinus rhythm to a supraventricular tachycardia.
The client is conscious with a heart rate of 200 to 210/min and has a faint
radial pulse. The nurse should anticipate assisting with which of the following
interventions?
A. Defibrillation
B. Vagal stimulation
C. Administration of atropine
D. Chest compressions
Answer: B
Rationale: Supraventricular tachycardia (SVT) in a conscious, stable patient
with a palpable pulse is initially treated with vagal stimulation maneuvers
(such as carotid sinus massage or Valsalva maneuver) to slow the heart rate.
Adenosine may be given if vagal maneuvers are unsuccessful.
4. A nurse is caring for a client who has endocarditis. Which of the following
findings should the nurse recognize as a potential complication?
A. Valvular disease
B. Hypertension
C. Diabetes mellitus
D. Asthma
Answer: A
Rationale: Endocarditis is an infection of the endocardium and heart valves.
A major complication is valvular disease, including valve destruction, stenosis,
or regurgitation, which can lead to heart failure and embolic events.
,5. A nurse is caring for a client who is being treated for heart failure and
has prescriptions for digoxin and furosemide. The nurse should plan to monitor
for which of the following as an adverse effect of these medications?
A. Hyperkalemia
B. Lightheadedness
C. Bradycardia
D. Hypoglycemia
Answer: B
Rationale: Furosemide is a loop diuretic that can cause fluid volume depletion
and electrolyte imbalances. Digoxin toxicity can cause cardiac arrhythmias.
The combination of these medications can cause hypotension and lightheadedness
due to volume depletion and decreased cardiac output.
6. A nurse is caring for a client who has a history of angina and is scheduled
for a stress test at 1100. Which of the following statements by the client
requires the nurse to contact the provider for possible rescheduling?
A. "I had a light breakfast this morning at 0700."
B. "I took my beta-blocker this morning as prescribed."
C. "I smoked a cigarette this morning to calm my nerves about having this
procedure."
D. "I am feeling anxious about the procedure."
Answer: C
Rationale: Smoking is contraindicated before a stress test because nicotine
stimulates the sympathetic nervous system, increases heart rate and blood
pressure, and can interfere with test results. The client should not smoke
for at least 4-6 hours before the test.
7. A nurse is caring for a client following insertion of a permanent pacemaker.
Which of the following client statements indicates a potential complication of
the insertion procedure?
A. "I have some tenderness at the insertion site."
B. "I can't get rid of these hiccups."
C. "I feel tired and need to rest."
D. "I am hungry and would like something to eat."
Answer: B
Rationale: Persistent hiccups after pacemaker insertion may indicate
diaphragmatic pacing, which occurs when the pacemaker lead irritates the
phrenic nerve or diaphragm. This is a potential complication that requires
, evaluation and possible lead repositioning.
8. A nurse is providing discharge teaching for a client who has heart failure.
The nurse should instruct the client to report which of the following?
A. Weight loss of 1-2 pounds per week
B. Decreased urine output and swelling in the lower extremities
C. Mild shortness of breath with strenuous exercise
D. Occasional dizziness when standing quickly
Answer: B
Rationale: Decreased urine output and swelling in the lower extremities are
signs of worsening heart failure (fluid retention). The client should be
instructed to report these symptoms promptly to prevent complications.
9. A nurse is assessing a client with chronic heart failure. Which finding
should the nurse report to the provider immediately?
A. Weight gain of 2 pounds in 24 hours
B. Weight gain of 3 pounds in 7 days
C. Weight loss of 1 pound in 24 hours
D. Stable weight for 3 days
Answer: A
Rationale: Weight gain of 2-3 pounds in 24 hours or 5 pounds in 1 week indicates
fluid retention and worsening heart failure. This requires immediate intervention
to prevent pulmonary edema and acute decompensation.
10. A nurse is monitoring a client receiving IV heparin. Which laboratory
value should the nurse monitor to evaluate therapeutic effectiveness?
A. aPTT (activated partial thromboplastin time)
B. PT (prothrombin time)
C. INR (international normalized ratio)
D. Platelet count
Answer: A
Rationale: aPTT is the laboratory test used to monitor heparin therapy.
The therapeutic range for heparin is typically 1.5-2.5 times the control
value (approximately 60-80 seconds). PT/INR is used to monitor warfarin
therapy.
Actual Practice Exam Questions And Answers
Already Graded A+
Welcome to the NUR 257 Chronic Exam 1 - Chronic Nursing Care and Management.
This comprehensive examination is designed to evaluate your knowledge and
understanding of chronic disease management, cardiovascular disorders,
anticoagulation therapy, and related nursing interventions. The exam consists
of 110 multiple-choice questions that reflect the actual NUR 257 Chronic Exam 1
content. Each question includes the correct answer and a brief rationale to
enhance your learning experience. The questions are based on evidence-based
practice guidelines and standard nursing curriculum. Good luck on your
examination!
EXAM DOMAINS
Domain 1: Cardiovascular Disorders and Management
Domain 2: Anticoagulation Therapy
Domain 3: Heart Failure and Cardiac Medications
Domain 4: Cardiac Diagnostics and Procedures
Domain 5: Peripheral Vascular Disease
Domain 6: Chronic Disease Management and Patient Education
DOMAIN 1: CARDIOVASCULAR DISORDERS AND MANAGEMENT
1. A nurse is reviewing the medical record of a client who is receiving
heparin therapy for treatment of deep-vein thrombosis. Which of the following
interventions should the nurse anticipate taking if the client's aPTT is
96 seconds?
A. Increase the heparin infusion rate
B. Continue the heparin infusion at the current rate
C. Stop the heparin infusion
D. Administer protamine sulfate
Answer: C
Rationale: An aPTT of 96 seconds is significantly elevated (therapeutic range
is typically 60-80 seconds or 1.5-2.5 times control). This indicates the client
,is at risk for bleeding, so the nurse should anticipate stopping the heparin
infusion and notifying the provider.
2. A nurse is providing health teaching for a group of clients. Which of the
following clients is at risk for developing peripheral arterial disease?
A. A client who has diabetes mellitus
B. A client who has hypertension
C. A client who has asthma
D. A client who has hypothyroidism
Answer: A
Rationale: Diabetes mellitus is a major risk factor for peripheral arterial
disease (PAD) due to accelerated atherosclerosis and microvascular damage.
Other risk factors include smoking, hypertension, hyperlipidemia, and age.
3. A nurse is watching a client's ECG monitor and notes that the client's
rhythm has changed from a normal sinus rhythm to a supraventricular tachycardia.
The client is conscious with a heart rate of 200 to 210/min and has a faint
radial pulse. The nurse should anticipate assisting with which of the following
interventions?
A. Defibrillation
B. Vagal stimulation
C. Administration of atropine
D. Chest compressions
Answer: B
Rationale: Supraventricular tachycardia (SVT) in a conscious, stable patient
with a palpable pulse is initially treated with vagal stimulation maneuvers
(such as carotid sinus massage or Valsalva maneuver) to slow the heart rate.
Adenosine may be given if vagal maneuvers are unsuccessful.
4. A nurse is caring for a client who has endocarditis. Which of the following
findings should the nurse recognize as a potential complication?
A. Valvular disease
B. Hypertension
C. Diabetes mellitus
D. Asthma
Answer: A
Rationale: Endocarditis is an infection of the endocardium and heart valves.
A major complication is valvular disease, including valve destruction, stenosis,
or regurgitation, which can lead to heart failure and embolic events.
,5. A nurse is caring for a client who is being treated for heart failure and
has prescriptions for digoxin and furosemide. The nurse should plan to monitor
for which of the following as an adverse effect of these medications?
A. Hyperkalemia
B. Lightheadedness
C. Bradycardia
D. Hypoglycemia
Answer: B
Rationale: Furosemide is a loop diuretic that can cause fluid volume depletion
and electrolyte imbalances. Digoxin toxicity can cause cardiac arrhythmias.
The combination of these medications can cause hypotension and lightheadedness
due to volume depletion and decreased cardiac output.
6. A nurse is caring for a client who has a history of angina and is scheduled
for a stress test at 1100. Which of the following statements by the client
requires the nurse to contact the provider for possible rescheduling?
A. "I had a light breakfast this morning at 0700."
B. "I took my beta-blocker this morning as prescribed."
C. "I smoked a cigarette this morning to calm my nerves about having this
procedure."
D. "I am feeling anxious about the procedure."
Answer: C
Rationale: Smoking is contraindicated before a stress test because nicotine
stimulates the sympathetic nervous system, increases heart rate and blood
pressure, and can interfere with test results. The client should not smoke
for at least 4-6 hours before the test.
7. A nurse is caring for a client following insertion of a permanent pacemaker.
Which of the following client statements indicates a potential complication of
the insertion procedure?
A. "I have some tenderness at the insertion site."
B. "I can't get rid of these hiccups."
C. "I feel tired and need to rest."
D. "I am hungry and would like something to eat."
Answer: B
Rationale: Persistent hiccups after pacemaker insertion may indicate
diaphragmatic pacing, which occurs when the pacemaker lead irritates the
phrenic nerve or diaphragm. This is a potential complication that requires
, evaluation and possible lead repositioning.
8. A nurse is providing discharge teaching for a client who has heart failure.
The nurse should instruct the client to report which of the following?
A. Weight loss of 1-2 pounds per week
B. Decreased urine output and swelling in the lower extremities
C. Mild shortness of breath with strenuous exercise
D. Occasional dizziness when standing quickly
Answer: B
Rationale: Decreased urine output and swelling in the lower extremities are
signs of worsening heart failure (fluid retention). The client should be
instructed to report these symptoms promptly to prevent complications.
9. A nurse is assessing a client with chronic heart failure. Which finding
should the nurse report to the provider immediately?
A. Weight gain of 2 pounds in 24 hours
B. Weight gain of 3 pounds in 7 days
C. Weight loss of 1 pound in 24 hours
D. Stable weight for 3 days
Answer: A
Rationale: Weight gain of 2-3 pounds in 24 hours or 5 pounds in 1 week indicates
fluid retention and worsening heart failure. This requires immediate intervention
to prevent pulmonary edema and acute decompensation.
10. A nurse is monitoring a client receiving IV heparin. Which laboratory
value should the nurse monitor to evaluate therapeutic effectiveness?
A. aPTT (activated partial thromboplastin time)
B. PT (prothrombin time)
C. INR (international normalized ratio)
D. Platelet count
Answer: A
Rationale: aPTT is the laboratory test used to monitor heparin therapy.
The therapeutic range for heparin is typically 1.5-2.5 times the control
value (approximately 60-80 seconds). PT/INR is used to monitor warfarin
therapy.
