NUR 257 Chronic Exam 4 | Questions and Answers | 2025 New Update
| 100% Correct - Galen College of Nursing
Question 1
A nurse is assessing a client with Parkinson's disease. Which of the following findings is a
cardinal manifestation of this condition?
A) Intention tremor
B) Flaccid paralysis
C) Bradykinesia
D) Spasticity
E) Nystagmus
Correct Answer: C) Bradykinesia
Rationale: Bradykinesia, or slowness in the initiation and execution of voluntary
movement, is one of the four cardinal signs of Parkinson's disease. The other cardinal signs
are resting tremor, muscle rigidity, and postural instability. An intention tremor (tremor
with purposeful movement) is more characteristic of cerebellar dysfunction, such as that
seen in Multiple Sclerosis. Flaccidity and spasticity are related to upper and lower motor
neuron damage, and nystagmus (involuntary eye movement) is not a cardinal sign of
Parkinson's.
Question 2
A client with chronic liver cirrhosis develops portal hypertension. The nurse should monitor the
client for which of the following potential complications?
A) Bacterial pneumonia
B) Esophageal varices
C) Deep vein thrombosis
D) Cholecystitis
E) Renal calculi
Correct Answer: B) Esophageal varices
Rationale: Portal hypertension is a primary complication of cirrhosis, where scarring of
the liver obstructs blood flow from the portal vein. This increased pressure causes blood to
be shunted to collateral vessels, including the fragile, thin-walled veins in the esophagus.
,[Type here]
These veins become distended (varices) and are at very high risk for life-threatening
rupture and hemorrhage.
Question 3
A nurse is educating a client newly diagnosed with open-angle glaucoma. Which statement by
the client indicates an understanding of the teaching?
A) "I will need to use eye drops for the rest of my life to control my eye pressure."
B) "This condition will be cured after my cataract surgery."
C) "I should expect to see halos around lights, which is a normal symptom."
D) "My central vision will be the first thing to disappear."
E) "I can stop my medication once my vision returns to normal."
Correct Answer: A) "I will need to use eye drops for the rest of my life to control my eye
pressure."
Rationale: Open-angle glaucoma is a chronic condition characterized by increased
intraocular pressure (IOP) that damages the optic nerve. It cannot be cured, but it can be
controlled. The primary treatment is lifelong use of prescribed eye drops to lower IOP and
prevent further vision loss. Halos around lights are a sign of acute angle-closure glaucoma,
and glaucoma's hallmark is the loss of peripheral vision, not central vision.
Question 4
A client with Multiple Sclerosis (MS) is experiencing an acute exacerbation. The nurse should
anticipate the administration of which class of medication?
A) Anticholinergics
B) Dopamine agonists
C) Corticosteroids
D) Thrombolytics
E) Bisphosphonates
Correct Answer: C) Corticosteroids
Rationale: Acute exacerbations of MS are caused by inflammation and demyelination in
the central nervous system. High-dose corticosteroids (e.g., methylprednisolone) are the
mainstay of treatment for acute relapses because their powerful anti-inflammatory effects
can shorten the duration and severity of the attack.
,[Type here]
Question 5
When assessing a client with osteoarthritis (OA) of the knees, what is a classic symptom the
nurse would expect the client to report?
A) Severe morning stiffness that lasts for several hours.
B) Symmetrical swelling in all joints of the hands and feet.
C) Joint pain that worsens with activity and improves with rest.
D) A low-grade fever and fatigue.
E) A hot, red, and exquisitely tender great toe.
Correct Answer: C) Joint pain that worsens with activity and improves with rest.
Rationale: Osteoarthritis is a degenerative "wear-and-tear" disease. The hallmark
symptom is joint pain that is exacerbated by weight-bearing activities and movement, and
is relieved by rest. Prolonged morning stiffness (lasting >1 hour) and systemic symptoms
like fever and fatigue are characteristic of Rheumatoid Arthritis, an autoimmune disease. A
hot, tender great toe is the classic sign of gout.
Question 6
A nurse is caring for a client with late-stage Alzheimer's disease. Which of the following nursing
interventions is the highest priority?
A) Reorienting the client to person, place, and time every hour.
B) Encouraging the client to participate in group social activities.
C) Implementing aspiration precautions during meals.
D) Teaching the client coping skills for memory loss.
E) Providing a calendar and clock in the client's room.
Correct Answer: C) Implementing aspiration precautions during meals.
Rationale: In late-stage Alzheimer's disease, clients often lose the ability to chew and
swallow effectively, leading to severe dysphagia. This places them at a very high risk for
aspiration and subsequent pneumonia. Therefore, ensuring patient safety through
aspiration precautions (e.g., thickened liquids, pureed diet, upright positioning) is the
highest physiological priority, according to Maslow's hierarchy of needs.
Question 7
A client with a history of ulcerative colitis is admitted with severe diarrhea, abdominal
, [Type here]
distention, and a fever. The nurse recognizes these findings as potential signs of which life-
threatening complication?
A) Fistula formation
B) Intestinal obstruction
C) Toxic megacolon
D) Colon cancer
E) Pernicious anemia
Correct Answer: C) Toxic megacolon
Rationale: Toxic megacolon is a rare but lethal complication of ulcerative colitis. It is
characterized by acute, non-obstructive dilation of the colon with signs of systemic toxicity
(fever, tachycardia, severe pain, distention). It can lead to perforation and sepsis, requiring
immediate medical and often surgical intervention.
Question 8
Which diagnostic test is the definitive method for confirming a diagnosis of osteoporosis?
A) Serum calcium level
B) X-ray of the spine
C) Dual-energy x-ray absorptiometry (DEXA) scan
D) Bone biopsy
E) Serum alkaline phosphatase
Correct Answer: C) Dual-energy x-ray absorptiometry (DEXA) scan
Rationale: The DEXA scan is the gold standard for diagnosing osteoporosis. It is a non-
invasive test that measures bone mineral density (BMD) at specific sites, typically the hip
and spine, and compares the results to that of a healthy young adult (T-score). While an X-
ray can show fractures or thinning of bones, it is not sensitive enough to diagnose
osteoporosis until significant bone loss has already occurred.
Question 9
A nurse is providing dietary instructions to a client with chronic gout. Which of the following
food choices should the client be advised to avoid?
A) Brown rice and whole wheat bread
B) Organ meats, such as liver, and sardines
| 100% Correct - Galen College of Nursing
Question 1
A nurse is assessing a client with Parkinson's disease. Which of the following findings is a
cardinal manifestation of this condition?
A) Intention tremor
B) Flaccid paralysis
C) Bradykinesia
D) Spasticity
E) Nystagmus
Correct Answer: C) Bradykinesia
Rationale: Bradykinesia, or slowness in the initiation and execution of voluntary
movement, is one of the four cardinal signs of Parkinson's disease. The other cardinal signs
are resting tremor, muscle rigidity, and postural instability. An intention tremor (tremor
with purposeful movement) is more characteristic of cerebellar dysfunction, such as that
seen in Multiple Sclerosis. Flaccidity and spasticity are related to upper and lower motor
neuron damage, and nystagmus (involuntary eye movement) is not a cardinal sign of
Parkinson's.
Question 2
A client with chronic liver cirrhosis develops portal hypertension. The nurse should monitor the
client for which of the following potential complications?
A) Bacterial pneumonia
B) Esophageal varices
C) Deep vein thrombosis
D) Cholecystitis
E) Renal calculi
Correct Answer: B) Esophageal varices
Rationale: Portal hypertension is a primary complication of cirrhosis, where scarring of
the liver obstructs blood flow from the portal vein. This increased pressure causes blood to
be shunted to collateral vessels, including the fragile, thin-walled veins in the esophagus.
,[Type here]
These veins become distended (varices) and are at very high risk for life-threatening
rupture and hemorrhage.
Question 3
A nurse is educating a client newly diagnosed with open-angle glaucoma. Which statement by
the client indicates an understanding of the teaching?
A) "I will need to use eye drops for the rest of my life to control my eye pressure."
B) "This condition will be cured after my cataract surgery."
C) "I should expect to see halos around lights, which is a normal symptom."
D) "My central vision will be the first thing to disappear."
E) "I can stop my medication once my vision returns to normal."
Correct Answer: A) "I will need to use eye drops for the rest of my life to control my eye
pressure."
Rationale: Open-angle glaucoma is a chronic condition characterized by increased
intraocular pressure (IOP) that damages the optic nerve. It cannot be cured, but it can be
controlled. The primary treatment is lifelong use of prescribed eye drops to lower IOP and
prevent further vision loss. Halos around lights are a sign of acute angle-closure glaucoma,
and glaucoma's hallmark is the loss of peripheral vision, not central vision.
Question 4
A client with Multiple Sclerosis (MS) is experiencing an acute exacerbation. The nurse should
anticipate the administration of which class of medication?
A) Anticholinergics
B) Dopamine agonists
C) Corticosteroids
D) Thrombolytics
E) Bisphosphonates
Correct Answer: C) Corticosteroids
Rationale: Acute exacerbations of MS are caused by inflammation and demyelination in
the central nervous system. High-dose corticosteroids (e.g., methylprednisolone) are the
mainstay of treatment for acute relapses because their powerful anti-inflammatory effects
can shorten the duration and severity of the attack.
,[Type here]
Question 5
When assessing a client with osteoarthritis (OA) of the knees, what is a classic symptom the
nurse would expect the client to report?
A) Severe morning stiffness that lasts for several hours.
B) Symmetrical swelling in all joints of the hands and feet.
C) Joint pain that worsens with activity and improves with rest.
D) A low-grade fever and fatigue.
E) A hot, red, and exquisitely tender great toe.
Correct Answer: C) Joint pain that worsens with activity and improves with rest.
Rationale: Osteoarthritis is a degenerative "wear-and-tear" disease. The hallmark
symptom is joint pain that is exacerbated by weight-bearing activities and movement, and
is relieved by rest. Prolonged morning stiffness (lasting >1 hour) and systemic symptoms
like fever and fatigue are characteristic of Rheumatoid Arthritis, an autoimmune disease. A
hot, tender great toe is the classic sign of gout.
Question 6
A nurse is caring for a client with late-stage Alzheimer's disease. Which of the following nursing
interventions is the highest priority?
A) Reorienting the client to person, place, and time every hour.
B) Encouraging the client to participate in group social activities.
C) Implementing aspiration precautions during meals.
D) Teaching the client coping skills for memory loss.
E) Providing a calendar and clock in the client's room.
Correct Answer: C) Implementing aspiration precautions during meals.
Rationale: In late-stage Alzheimer's disease, clients often lose the ability to chew and
swallow effectively, leading to severe dysphagia. This places them at a very high risk for
aspiration and subsequent pneumonia. Therefore, ensuring patient safety through
aspiration precautions (e.g., thickened liquids, pureed diet, upright positioning) is the
highest physiological priority, according to Maslow's hierarchy of needs.
Question 7
A client with a history of ulcerative colitis is admitted with severe diarrhea, abdominal
, [Type here]
distention, and a fever. The nurse recognizes these findings as potential signs of which life-
threatening complication?
A) Fistula formation
B) Intestinal obstruction
C) Toxic megacolon
D) Colon cancer
E) Pernicious anemia
Correct Answer: C) Toxic megacolon
Rationale: Toxic megacolon is a rare but lethal complication of ulcerative colitis. It is
characterized by acute, non-obstructive dilation of the colon with signs of systemic toxicity
(fever, tachycardia, severe pain, distention). It can lead to perforation and sepsis, requiring
immediate medical and often surgical intervention.
Question 8
Which diagnostic test is the definitive method for confirming a diagnosis of osteoporosis?
A) Serum calcium level
B) X-ray of the spine
C) Dual-energy x-ray absorptiometry (DEXA) scan
D) Bone biopsy
E) Serum alkaline phosphatase
Correct Answer: C) Dual-energy x-ray absorptiometry (DEXA) scan
Rationale: The DEXA scan is the gold standard for diagnosing osteoporosis. It is a non-
invasive test that measures bone mineral density (BMD) at specific sites, typically the hip
and spine, and compares the results to that of a healthy young adult (T-score). While an X-
ray can show fractures or thinning of bones, it is not sensitive enough to diagnose
osteoporosis until significant bone loss has already occurred.
Question 9
A nurse is providing dietary instructions to a client with chronic gout. Which of the following
food choices should the client be advised to avoid?
A) Brown rice and whole wheat bread
B) Organ meats, such as liver, and sardines
