Galen College of Nursing | NUR 257 Chronic Conditions
NUR 257 Chronic Conditions Exam 4
Comprehensive Examination 2026/2027 |
Verified Questions
Galen College of Nursing | NUR 257 Chronic Conditions | University-Level Nursing Students
85 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
Galen College of Nursing | NUR 257 Chronic Conditions
Exam 4 Comprehensive Examination Actual Exam | Academic Year 2026/2027
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains exactly 85 verified questions designed to reinforce the official Galen
College of Nursing NUR 257 Chronic Conditions course objectives for actual exam readiness and clinical
proficiency, aligned to the 2026/2027 academic year. The questions are distributed across four core domains:
Domain 1 – Endocrine and Metabolic Chronic Conditions (22 questions); Domain 2 – Neurologic and
Musculoskeletal Chronic Conditions (21 questions); Domain 3 – Renal and Gastrointestinal Chronic Conditions
(21 questions); and Domain 4 – Oncology and Immunologic Chronic Conditions (21 questions). The content is
original and constructed to support university-level mastery of chronic disease management, nursing assessment,
and client education as presented in the NUR 257 curriculum and foundational medical-surgical nursing
resources.
ACTUAL QUESTIONS
Domain 1: Endocrine and Metabolic Chronic Conditions
Question 1. Which laboratory finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Low anion gap with metabolic alkalosis
B. High anion-gap metabolic acidosis with elevated serum ketones and hyperglycemia
C. Isolated hypernatremia without acidosis
D. Hypoglycemia with elevated insulin
Correct Answer: D
Rationale: DKA produces ketoacid accumulation, an elevated anion gap, and marked hyperglycemia.
Question 2. What is the priority nursing action for a client with hypoglycemia who is conscious
and able to swallow?
A. Administer intravenous 50% dextrose immediately
B. Provide 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes
C. Encourage the client to skip the next meal
D. Administer long-acting insulin
Correct Answer: C
Rationale: The 15-15 rule restores glucose safely in a conscious client while avoiding over-correction.
Question 3. Which of the following is a classic sign of hyperglycemia in a client with type 2
diabetes?
A. Cool, clammy skin and tremors
B. Polyuria, polydipsia, and blurred vision
C. Sudden loss of consciousness without warning
D. Bradycardia and constricted pupils
Correct Answer: A
Rationale: Osmotic diuresis from elevated glucose produces the classic polyuria–polydipsia presentation.
Question 4. What is the primary purpose of hemoglobin A1c monitoring in chronic diabetes
management?
A. To detect acute hypoglycemia only
B. To reflect average blood glucose over approximately the preceding 2–3 months
C. To measure daily fasting glucose exclusively
D. To diagnose diabetic nephropathy
Correct Answer: D
Rationale: A1c provides a longer-term indicator of glycemic control that guides therapy adjustments.
Question 5. Which nursing intervention is most important when administering insulin to a client
with chronic diabetes?
A. Always use the same injection site
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
, B. Rotate injection sites systematically to prevent lipohypertrophy
C. Mix all insulin types in one syringe without checking compatibility
D. Store opened insulin vials at room temperature indefinitely
Correct Answer: C
Rationale: Site rotation preserves tissue integrity and ensures consistent absorption.
Question 6. What is the primary pathophysiologic mechanism of type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Excess production of glucagon alone
D. Impaired incretin secretion only
Correct Answer: B
Rationale: Type 1 diabetes results from immune-mediated loss of insulin-producing beta cells.
Question 7. Which of the following is an appropriate teaching point for a client with
hypothyroidism starting levothyroxine?
A. Take the medication with a high-fiber meal for better absorption
B. Take the medication on an empty stomach, typically 30–60 minutes before breakfast, and report symptoms
of over- or under-replacement
C. Stop the medication when symptoms improve
D. Double the dose if a dose is missed
Correct Answer: A
Rationale: Consistent timing on an empty stomach optimizes absorption; dose titration is based on clinical and
laboratory response.
Question 8. What is the primary clinical concern in a client with long-standing uncontrolled
hyperthyroidism?
A. Weight gain and bradycardia
B. High-output cardiac strain, atrial fibrillation risk, and potential thyroid storm
C. Hypoglycemia and weight loss exclusively
D. Chronic constipation
Correct Answer: C
Rationale: Excess thyroid hormone increases metabolic demand and can precipitate cardiovascular
complications.
Question 9. Which of the following is a priority assessment for a client with Cushing syndrome?
A. Signs of hypotension and weight loss
B. Monitoring for hyperglycemia, hypertension, infection risk, and skin integrity changes
C. Assessment for hypoglycemia only
D. Assessment of urine output for diabetes insipidus exclusively
Correct Answer: B
Rationale: Cortisol excess produces the characteristic metabolic, cardiovascular, and immunosuppressive
effects.
Question 10. What is the primary nursing priority for a client with Addisonian (adrenal) crisis?
A. Fluid restriction and potassium supplementation
B. Immediate glucocorticoid replacement and volume resuscitation
C. Administration of insulin for hyperglycemia
D. High-dose thyroid hormone
Correct Answer: D
Rationale: Acute adrenal insufficiency is life-threatening; steroid and fluid replacement are the cornerstone of
initial care.
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
NUR 257 Chronic Conditions Exam 4
Comprehensive Examination 2026/2027 |
Verified Questions
Galen College of Nursing | NUR 257 Chronic Conditions | University-Level Nursing Students
85 Verified Questions | 4 Core Domains | Academic Year 2026/2027
Prepared by
Galen College of Nursing | NUR 257 Chronic Conditions
Exam 4 Comprehensive Examination Actual Exam | Academic Year 2026/2027
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
,INTRODUCTION
This comprehensive examination contains exactly 85 verified questions designed to reinforce the official Galen
College of Nursing NUR 257 Chronic Conditions course objectives for actual exam readiness and clinical
proficiency, aligned to the 2026/2027 academic year. The questions are distributed across four core domains:
Domain 1 – Endocrine and Metabolic Chronic Conditions (22 questions); Domain 2 – Neurologic and
Musculoskeletal Chronic Conditions (21 questions); Domain 3 – Renal and Gastrointestinal Chronic Conditions
(21 questions); and Domain 4 – Oncology and Immunologic Chronic Conditions (21 questions). The content is
original and constructed to support university-level mastery of chronic disease management, nursing assessment,
and client education as presented in the NUR 257 curriculum and foundational medical-surgical nursing
resources.
ACTUAL QUESTIONS
Domain 1: Endocrine and Metabolic Chronic Conditions
Question 1. Which laboratory finding is most characteristic of diabetic ketoacidosis (DKA)?
A. Low anion gap with metabolic alkalosis
B. High anion-gap metabolic acidosis with elevated serum ketones and hyperglycemia
C. Isolated hypernatremia without acidosis
D. Hypoglycemia with elevated insulin
Correct Answer: D
Rationale: DKA produces ketoacid accumulation, an elevated anion gap, and marked hyperglycemia.
Question 2. What is the priority nursing action for a client with hypoglycemia who is conscious
and able to swallow?
A. Administer intravenous 50% dextrose immediately
B. Provide 15 g of fast-acting carbohydrate and recheck glucose in 15 minutes
C. Encourage the client to skip the next meal
D. Administer long-acting insulin
Correct Answer: C
Rationale: The 15-15 rule restores glucose safely in a conscious client while avoiding over-correction.
Question 3. Which of the following is a classic sign of hyperglycemia in a client with type 2
diabetes?
A. Cool, clammy skin and tremors
B. Polyuria, polydipsia, and blurred vision
C. Sudden loss of consciousness without warning
D. Bradycardia and constricted pupils
Correct Answer: A
Rationale: Osmotic diuresis from elevated glucose produces the classic polyuria–polydipsia presentation.
Question 4. What is the primary purpose of hemoglobin A1c monitoring in chronic diabetes
management?
A. To detect acute hypoglycemia only
B. To reflect average blood glucose over approximately the preceding 2–3 months
C. To measure daily fasting glucose exclusively
D. To diagnose diabetic nephropathy
Correct Answer: D
Rationale: A1c provides a longer-term indicator of glycemic control that guides therapy adjustments.
Question 5. Which nursing intervention is most important when administering insulin to a client
with chronic diabetes?
A. Always use the same injection site
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
, B. Rotate injection sites systematically to prevent lipohypertrophy
C. Mix all insulin types in one syringe without checking compatibility
D. Store opened insulin vials at room temperature indefinitely
Correct Answer: C
Rationale: Site rotation preserves tissue integrity and ensures consistent absorption.
Question 6. What is the primary pathophysiologic mechanism of type 1 diabetes mellitus?
A. Insulin resistance in peripheral tissues
B. Autoimmune destruction of pancreatic beta cells leading to absolute insulin deficiency
C. Excess production of glucagon alone
D. Impaired incretin secretion only
Correct Answer: B
Rationale: Type 1 diabetes results from immune-mediated loss of insulin-producing beta cells.
Question 7. Which of the following is an appropriate teaching point for a client with
hypothyroidism starting levothyroxine?
A. Take the medication with a high-fiber meal for better absorption
B. Take the medication on an empty stomach, typically 30–60 minutes before breakfast, and report symptoms
of over- or under-replacement
C. Stop the medication when symptoms improve
D. Double the dose if a dose is missed
Correct Answer: A
Rationale: Consistent timing on an empty stomach optimizes absorption; dose titration is based on clinical and
laboratory response.
Question 8. What is the primary clinical concern in a client with long-standing uncontrolled
hyperthyroidism?
A. Weight gain and bradycardia
B. High-output cardiac strain, atrial fibrillation risk, and potential thyroid storm
C. Hypoglycemia and weight loss exclusively
D. Chronic constipation
Correct Answer: C
Rationale: Excess thyroid hormone increases metabolic demand and can precipitate cardiovascular
complications.
Question 9. Which of the following is a priority assessment for a client with Cushing syndrome?
A. Signs of hypotension and weight loss
B. Monitoring for hyperglycemia, hypertension, infection risk, and skin integrity changes
C. Assessment for hypoglycemia only
D. Assessment of urine output for diabetes insipidus exclusively
Correct Answer: B
Rationale: Cortisol excess produces the characteristic metabolic, cardiovascular, and immunosuppressive
effects.
Question 10. What is the primary nursing priority for a client with Addisonian (adrenal) crisis?
A. Fluid restriction and potassium supplementation
B. Immediate glucocorticoid replacement and volume resuscitation
C. Administration of insulin for hyperglycemia
D. High-dose thyroid hormone
Correct Answer: D
Rationale: Acute adrenal insufficiency is life-threatening; steroid and fluid replacement are the cornerstone of
initial care.
NUR 257 Chronic Conditions Exam 4 Comprehensive Examination 2026/2027 | Verified Questions
