NUR 257 CHRONIC EXAM 4 | FALL 2025/2026
Galen College of Nursing Chronic Conditions Exam with Complete Questions & 100% Correct
Answers | Latest Version
Overview
This Fall 2025/2026 updated resource contains the latest Galen College of Nursing NUR 257
Chronic Conditions Exam 4 with the exact 85 questions and 100% correct answers, following
current Galen College curriculum standards, evidence-based chronic disease management guidelines, and
nursing best practices for patients with long-term health conditions.
Key Features
● ✓ Actual Galen College exam format with the official 85 questions
● ✓ Comprehensive coverage of chronic disease management and nursing interventions
● ✓ Updated Fall 2025/2026 clinical practice guidelines and treatment protocols
● ✓ Practical patient care scenarios and nursing decision-making applications
● ✓ Patient education and health promotion strategies for chronic conditions
Core Content Areas (85 Total Questions)
● Chronic Cardiovascular Conditions (20 Qs)
● Endocrine & Metabolic Disorders (18 Qs)
● Chronic Respiratory Diseases (15 Qs)
● Neurological & Musculoskeletal Conditions (15 Qs)
● Chronic Renal & Gastrointestinal Disorders (12 Qs)
● Multimorbidity Management (5 Qs)
Detailed Content Breakdown
● Heart Failure & Chronic Coronary Artery Disease Management (10 Qs)
● Hypertension & Dyslipidemia Long-term Care (10 Qs)
● Diabetes Mellitus Type 2 & Metabolic Syndrome (12 Qs)
● Chronic Obstructive Pulmonary Disease & Asthma (10 Qs)
● Osteoarthritis & Rheumatoid Arthritis Management (8 Qs)
● Chronic Kidney Disease & Dialysis Care (8 Qs)
● Inflammatory Bowel Disease & Liver Cirrhosis (7 Qs)
● Multiple Sclerosis & Parkinson's Disease Care (8 Qs)
● Chronic Pain Management & Opioid Stewardship (7 Qs)
● Polypharmacy Management in Chronic Illness (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
● Galen College curriculum standard applications and learning outcomes
● Evidence-based chronic disease management guideline implementations
● Nursing intervention prioritization and clinical reasoning rationales
● Patient education strategy development for health literacy adaptation
● Medication adherence promotion and self-management support techniques
● Interprofessional collaboration and care coordination approaches
,Updates for Fall 2025/2026
●
●
🔹
🔹 Reflects Fall 2025/2026 Galen College NUR 257 curriculum revisions
Updated diabetes management guidelines and technology integration (CGMs,
● 🔹
pumps)
🔹 Enhanced telehealth applications for chronic disease monitoring
●
● 🔹
🔹
New health equity considerations in chronic disease management
Revised pain management and substance use disorder protocols
●
●
●
🔹 Updated heart failure and cardiac rehabilitation standards
🔹 New digital health tools for patient self-management
Revised cultural competence in chronic care delivery
NUR 257 CHRONIC EXAM 4 QUESTIONS (1–85)
1. A patient with heart failure (HF) reports increased shortness of breath and swelling in
the ankles. The nurse should first:
A. Administer PRN furosemide without assessment
B. Assess weight, lung sounds, oxygen saturation, and edema
C. Encourage increased fluid intake
D. Schedule a routine follow-up in 2 weeks
Rationale: Worsening HF symptoms require immediate assessment to determine if decompensation
is occurring. Daily weight, lung crackles, SpO₂, and edema are key indicators. Treatment (e.g.,
diuretics) follows assessment per Galen clinical judgment model (Galen NUR 257, 2025).
2. The nurse teaches a patient with type 2 diabetes that the primary goal of metformin
therapy is to:
A. Stimulate insulin secretion from the pancreas
B. Decrease hepatic glucose production and improve insulin sensitivity
C. Replace deficient insulin
D. Block carbohydrate absorption in the gut
Rationale: Metformin is a first-line agent for type 2 diabetes that reduces gluconeogenesis and
enhances peripheral glucose uptake without causing hypoglycemia (ADA Standards of Care, 2025).
, 3. A patient with COPD uses a short-acting bronchodilator (albuterol) more than twice
weekly for symptom relief. The nurse should:
A. Praise the patient for good adherence
B. Notify the provider—this indicates poor control and need for controller therapy
adjustment
C. Recommend switching to a long-acting anticholinergic only
D. Advise stopping all medications
Rationale: Frequent use of rescue inhalers (>2 days/week) signals uncontrolled COPD. Per GOLD
guidelines (2025), the regimen should be escalated to include LAMA/LABA combinations.
4. A patient with rheumatoid arthritis (RA) is prescribed methotrexate. The nurse
emphasizes the importance of:
A. Taking it on an empty stomach
B. Taking folic acid daily to reduce side effects and avoiding pregnancy
C. Increasing vitamin C intake
D. Stopping if joint pain improves
Rationale: Methotrexate is a disease-modifying antirheumatic drug (DMARD). Folic acid reduces
mucositis and hepatotoxicity. It is teratogenic—pregnancy must be avoided (ACR RA Guidelines,
2025).
5. A patient with chronic kidney disease (CKD) stage 4 has a potassium level of 5.8 mEq/L.
The nurse should:
A. Offer a banana as a snack
B. Hold potassium supplements and educate on low-potassium diet
C. Administer IV potassium
D. Encourage salt substitutes
Rationale: Hyperkalemia (K⁺ >5.0) is common in advanced CKD due to reduced excretion. Avoid
high-potassium foods (bananas, oranges) and salt substitutes (often potassium-based) (KDIGO CKD
Guidelines, 2025).
Galen College of Nursing Chronic Conditions Exam with Complete Questions & 100% Correct
Answers | Latest Version
Overview
This Fall 2025/2026 updated resource contains the latest Galen College of Nursing NUR 257
Chronic Conditions Exam 4 with the exact 85 questions and 100% correct answers, following
current Galen College curriculum standards, evidence-based chronic disease management guidelines, and
nursing best practices for patients with long-term health conditions.
Key Features
● ✓ Actual Galen College exam format with the official 85 questions
● ✓ Comprehensive coverage of chronic disease management and nursing interventions
● ✓ Updated Fall 2025/2026 clinical practice guidelines and treatment protocols
● ✓ Practical patient care scenarios and nursing decision-making applications
● ✓ Patient education and health promotion strategies for chronic conditions
Core Content Areas (85 Total Questions)
● Chronic Cardiovascular Conditions (20 Qs)
● Endocrine & Metabolic Disorders (18 Qs)
● Chronic Respiratory Diseases (15 Qs)
● Neurological & Musculoskeletal Conditions (15 Qs)
● Chronic Renal & Gastrointestinal Disorders (12 Qs)
● Multimorbidity Management (5 Qs)
Detailed Content Breakdown
● Heart Failure & Chronic Coronary Artery Disease Management (10 Qs)
● Hypertension & Dyslipidemia Long-term Care (10 Qs)
● Diabetes Mellitus Type 2 & Metabolic Syndrome (12 Qs)
● Chronic Obstructive Pulmonary Disease & Asthma (10 Qs)
● Osteoarthritis & Rheumatoid Arthritis Management (8 Qs)
● Chronic Kidney Disease & Dialysis Care (8 Qs)
● Inflammatory Bowel Disease & Liver Cirrhosis (7 Qs)
● Multiple Sclerosis & Parkinson's Disease Care (8 Qs)
● Chronic Pain Management & Opioid Stewardship (7 Qs)
● Polypharmacy Management in Chronic Illness (5 Qs)
Answer Format
Correct answers are marked in bold green and include:
● Galen College curriculum standard applications and learning outcomes
● Evidence-based chronic disease management guideline implementations
● Nursing intervention prioritization and clinical reasoning rationales
● Patient education strategy development for health literacy adaptation
● Medication adherence promotion and self-management support techniques
● Interprofessional collaboration and care coordination approaches
,Updates for Fall 2025/2026
●
●
🔹
🔹 Reflects Fall 2025/2026 Galen College NUR 257 curriculum revisions
Updated diabetes management guidelines and technology integration (CGMs,
● 🔹
pumps)
🔹 Enhanced telehealth applications for chronic disease monitoring
●
● 🔹
🔹
New health equity considerations in chronic disease management
Revised pain management and substance use disorder protocols
●
●
●
🔹 Updated heart failure and cardiac rehabilitation standards
🔹 New digital health tools for patient self-management
Revised cultural competence in chronic care delivery
NUR 257 CHRONIC EXAM 4 QUESTIONS (1–85)
1. A patient with heart failure (HF) reports increased shortness of breath and swelling in
the ankles. The nurse should first:
A. Administer PRN furosemide without assessment
B. Assess weight, lung sounds, oxygen saturation, and edema
C. Encourage increased fluid intake
D. Schedule a routine follow-up in 2 weeks
Rationale: Worsening HF symptoms require immediate assessment to determine if decompensation
is occurring. Daily weight, lung crackles, SpO₂, and edema are key indicators. Treatment (e.g.,
diuretics) follows assessment per Galen clinical judgment model (Galen NUR 257, 2025).
2. The nurse teaches a patient with type 2 diabetes that the primary goal of metformin
therapy is to:
A. Stimulate insulin secretion from the pancreas
B. Decrease hepatic glucose production and improve insulin sensitivity
C. Replace deficient insulin
D. Block carbohydrate absorption in the gut
Rationale: Metformin is a first-line agent for type 2 diabetes that reduces gluconeogenesis and
enhances peripheral glucose uptake without causing hypoglycemia (ADA Standards of Care, 2025).
, 3. A patient with COPD uses a short-acting bronchodilator (albuterol) more than twice
weekly for symptom relief. The nurse should:
A. Praise the patient for good adherence
B. Notify the provider—this indicates poor control and need for controller therapy
adjustment
C. Recommend switching to a long-acting anticholinergic only
D. Advise stopping all medications
Rationale: Frequent use of rescue inhalers (>2 days/week) signals uncontrolled COPD. Per GOLD
guidelines (2025), the regimen should be escalated to include LAMA/LABA combinations.
4. A patient with rheumatoid arthritis (RA) is prescribed methotrexate. The nurse
emphasizes the importance of:
A. Taking it on an empty stomach
B. Taking folic acid daily to reduce side effects and avoiding pregnancy
C. Increasing vitamin C intake
D. Stopping if joint pain improves
Rationale: Methotrexate is a disease-modifying antirheumatic drug (DMARD). Folic acid reduces
mucositis and hepatotoxicity. It is teratogenic—pregnancy must be avoided (ACR RA Guidelines,
2025).
5. A patient with chronic kidney disease (CKD) stage 4 has a potassium level of 5.8 mEq/L.
The nurse should:
A. Offer a banana as a snack
B. Hold potassium supplements and educate on low-potassium diet
C. Administer IV potassium
D. Encourage salt substitutes
Rationale: Hyperkalemia (K⁺ >5.0) is common in advanced CKD due to reduced excretion. Avoid
high-potassium foods (bananas, oranges) and salt substitutes (often potassium-based) (KDIGO CKD
Guidelines, 2025).
