NUR 257 Chronic Conditions | Galen College of Nursing Exam 4
Comprehensive Examination | Academic Year 2026/2027
Preparation with Complete Questions and Correct Answers
with Rationales | Already Graded A+||Brand New Version!!
SECTION 1: CARDIOVASCULAR CONDITIONS (Questions 1-40)
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates a therapeutic response?
A) Weight loss of 2 kg in 24 hours
B) Blood pressure 88/52 mm Hg
C) Serum potassium 2.8 mEq/L
D) Urine output 20 mL/hr
Correct Answer: A
Rationale: Weight loss of 2 kg in 24 hours indicates effective diuresis and fluid
removal in heart failure. Option B indicates hypotension (adverse effect), option C
indicates hypokalemia (adverse effect), and option D indicates inadequate urine
output.
2. A nurse is teaching a patient about managing hypertension. Which statement
indicates understanding?
A) "I should stop taking my medication when my blood pressure is normal."
B) "I will limit my sodium intake to less than 1,500 mg per day."
C) "I can continue smoking as long as I take my medication."
D) "I only need to check my blood pressure when I feel dizzy."
Correct Answer: B
Rationale: The AHA recommends sodium restriction to less than 1,500 mg/day for
hypertension management. Antihypertensives must be continued even when BP is
1
,normal. Smoking cessation is essential. Regular BP monitoring is required
regardless of symptoms.
3. Which clinical manifestation is most characteristic of left-sided heart failure?
A) Dependent edema
B) Jugular venous distention
C) Crackles in the lung bases
D) Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as
crackles, dyspnea, and orthopnea. Options A, B, and D are signs of right-sided
heart failure.
4. A patient with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: B
Rationale: INR (International Normalized Ratio) is used to monitor warfarin
therapy, with a therapeutic range of 2.0-3.0 for atrial fibrillation. aPTT monitors
heparin therapy.
5. A patient reports chest pain that radiates to the left arm and jaw. Which
action should the nurse take first?
A) Administer aspirin 325 mg chewed
B) Obtain a 12-lead ECG
2
,C) Administer nitroglycerin sublingually
D) Establish IV access
Correct Answer: B
Rationale: Obtaining a 12-lead ECG within 10 minutes of arrival is the priority for
suspected MI to determine if ST-elevation MI is present, guiding immediate
treatment decisions.
6. Which medication is contraindicated in a patient with severe aortic stenosis?
A) Metoprolol
B) Lisinopril
C) Nitroglycerin
D) Amlodipine
Correct Answer: C
Rationale: Nitroglycerin causes vasodilation and reduces preload, which can cause
severe hypotension and syncope in patients with aortic stenosis who have fixed
cardiac output.
7. A patient with heart failure has a BNP level of 1,200 pg/mL. What does this
indicate?
A) Normal cardiac function
B) Worsening heart failure
C) Improved heart failure
D) Renal failure
Correct Answer: B
Rationale: BNP levels >100 pg/mL suggest heart failure. A level of 1,200 pg/mL
indicates significant ventricular stretch and worsening heart failure.
3
, 8. Which assessment finding requires immediate intervention in a patient
receiving digoxin?
A) Heart rate 58 beats per minute
B) Serum digoxin level 1.2 ng/mL
C) Visual disturbances and nausea
D) Blood pressure 110/70 mm Hg
Correct Answer: C
Rationale: Visual disturbances (yellow-green halos) and nausea are signs of
digoxin toxicity. Therapeutic digoxin level is 0.5-2.0 ng/mL. Heart rate <60 requires
holding the dose but is not immediately life-threatening.
9. A patient is scheduled for a cardiac catheterization. Which instruction should
the nurse include?
A) "You will need to be NPO for 24 hours before the procedure."
B) "You may feel a warm sensation when the contrast dye is injected."
C) "You can resume strenuous activity immediately after."
D) "You will receive general anesthesia for the procedure."
Correct Answer: B
Rationale: A warm flushing sensation is expected when contrast dye is injected.
NPO status is typically 6-8 hours. Bed rest is required post-procedure. Local
anesthesia is used, not general.
10. Which finding indicates digoxin toxicity?
A) Heart rate 72 beats per minute
B) Serum potassium 4.0 mEq/L
C) Anorexia and bradycardia
D) Blood pressure 130/80 mm Hg
4
Comprehensive Examination | Academic Year 2026/2027
Preparation with Complete Questions and Correct Answers
with Rationales | Already Graded A+||Brand New Version!!
SECTION 1: CARDIOVASCULAR CONDITIONS (Questions 1-40)
1. A patient with heart failure is prescribed furosemide. Which assessment
finding indicates a therapeutic response?
A) Weight loss of 2 kg in 24 hours
B) Blood pressure 88/52 mm Hg
C) Serum potassium 2.8 mEq/L
D) Urine output 20 mL/hr
Correct Answer: A
Rationale: Weight loss of 2 kg in 24 hours indicates effective diuresis and fluid
removal in heart failure. Option B indicates hypotension (adverse effect), option C
indicates hypokalemia (adverse effect), and option D indicates inadequate urine
output.
2. A nurse is teaching a patient about managing hypertension. Which statement
indicates understanding?
A) "I should stop taking my medication when my blood pressure is normal."
B) "I will limit my sodium intake to less than 1,500 mg per day."
C) "I can continue smoking as long as I take my medication."
D) "I only need to check my blood pressure when I feel dizzy."
Correct Answer: B
Rationale: The AHA recommends sodium restriction to less than 1,500 mg/day for
hypertension management. Antihypertensives must be continued even when BP is
1
,normal. Smoking cessation is essential. Regular BP monitoring is required
regardless of symptoms.
3. Which clinical manifestation is most characteristic of left-sided heart failure?
A) Dependent edema
B) Jugular venous distention
C) Crackles in the lung bases
D) Hepatomegaly
Correct Answer: C
Rationale: Left-sided heart failure causes pulmonary congestion, manifesting as
crackles, dyspnea, and orthopnea. Options A, B, and D are signs of right-sided
heart failure.
4. A patient with atrial fibrillation is prescribed warfarin. Which laboratory value
should the nurse monitor?
A) aPTT
B) INR
C) Platelet count
D) Hemoglobin
Correct Answer: B
Rationale: INR (International Normalized Ratio) is used to monitor warfarin
therapy, with a therapeutic range of 2.0-3.0 for atrial fibrillation. aPTT monitors
heparin therapy.
5. A patient reports chest pain that radiates to the left arm and jaw. Which
action should the nurse take first?
A) Administer aspirin 325 mg chewed
B) Obtain a 12-lead ECG
2
,C) Administer nitroglycerin sublingually
D) Establish IV access
Correct Answer: B
Rationale: Obtaining a 12-lead ECG within 10 minutes of arrival is the priority for
suspected MI to determine if ST-elevation MI is present, guiding immediate
treatment decisions.
6. Which medication is contraindicated in a patient with severe aortic stenosis?
A) Metoprolol
B) Lisinopril
C) Nitroglycerin
D) Amlodipine
Correct Answer: C
Rationale: Nitroglycerin causes vasodilation and reduces preload, which can cause
severe hypotension and syncope in patients with aortic stenosis who have fixed
cardiac output.
7. A patient with heart failure has a BNP level of 1,200 pg/mL. What does this
indicate?
A) Normal cardiac function
B) Worsening heart failure
C) Improved heart failure
D) Renal failure
Correct Answer: B
Rationale: BNP levels >100 pg/mL suggest heart failure. A level of 1,200 pg/mL
indicates significant ventricular stretch and worsening heart failure.
3
, 8. Which assessment finding requires immediate intervention in a patient
receiving digoxin?
A) Heart rate 58 beats per minute
B) Serum digoxin level 1.2 ng/mL
C) Visual disturbances and nausea
D) Blood pressure 110/70 mm Hg
Correct Answer: C
Rationale: Visual disturbances (yellow-green halos) and nausea are signs of
digoxin toxicity. Therapeutic digoxin level is 0.5-2.0 ng/mL. Heart rate <60 requires
holding the dose but is not immediately life-threatening.
9. A patient is scheduled for a cardiac catheterization. Which instruction should
the nurse include?
A) "You will need to be NPO for 24 hours before the procedure."
B) "You may feel a warm sensation when the contrast dye is injected."
C) "You can resume strenuous activity immediately after."
D) "You will receive general anesthesia for the procedure."
Correct Answer: B
Rationale: A warm flushing sensation is expected when contrast dye is injected.
NPO status is typically 6-8 hours. Bed rest is required post-procedure. Local
anesthesia is used, not general.
10. Which finding indicates digoxin toxicity?
A) Heart rate 72 beats per minute
B) Serum potassium 4.0 mEq/L
C) Anorexia and bradycardia
D) Blood pressure 130/80 mm Hg
4
