NUR 257 CHRONIC EXAM 2 | V1 AND V2 |
ACTUAL QUESTIONS AND ANSWERS | 2026
UPDATED | 100% CORRECT - GALEN COLLEGE.
100 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 257 CHRONIC EXAM 2 | V1 AND V2 | ACTUAL QUESTIONS AND ANSWERS | 2026 UPDATED | 100%
CORRECT - GALEN COLLEGE.. It contains 100 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 100 Questions
Foundations - Application - NUR 257 Chronic 2 V1 AND V2 Actual AND 2026 Updated 100 Correct - Galen
College Chronic Illness Management IN Adult Health Nursing Undergraduate YEAR 3 Upper-division Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Chronic Neurological 1-17 Chronic, Disease, Kidney, Diabetes, Stage
Disorders
Chronic Respiratory 18-34 Chronic, Failure, Heart, Disease, Medication
Disorders
Chronic Cardiovascular 35-51 Chronic, Disease, Kidney, Intervention, Appropriate
Disorders
Chronic Renal AND Urinary 52-68 Chronic, Disease, Kidney, Failure, Prescribed
Disorders
Chronic Endocrine AND 69-85 Chronic, Failure, Heart, Disease, Therapy
Metabolic Disorders
Chronic Musculoskeletal 86-100 Chronic, Disease, Effect, Obstructive Pulmonary, Prescribed
AND Connective Tissue
Disorders
TOTAL 100 All questions include answers and detailed rationales
,Section A - Chronic Neurological Disorders
Q1.
A patient with type 2 diabetes and stage 3 chronic kidney disease (eGFR 35 mL/min) is
prescribed metformin. Which pharmacogenetic consideration should guide the nurse's
evaluation?
A. Metformin is contraindicated at this eGFR B. The dose should be reduced by 50% and
level due to risk of lactic acidosis. eGFR monitored every 3 months.
C. Metformin is safe with no dose D. Metformin should be avoided because it
adjustment until eGFR drops below 15 interacts with most antihypertensive
mL/min. medications.
Correct: A - Metformin is contraindicated at this eGFR level due to risk of lactic acidosis.
Rationale:Current guidelines (ADA, KDIGO) contraindicate metformin initiation when eGFR is
below 30 mL/min, and it should not be started at eGFR 30-45 mL/min without careful
risk-benefit assessment. At eGFR 35, metformin is not recommended due to increased lactic
acidosis risk, making option A correct. Options B and C are incorrect because they
underestimate the risk. Option D is a false statement; metformin does not have a significant
interaction with most antihypertensives.
Q2.
Which nursing intervention is most crucial during the first 24 hours after a patient
undergoes a permanent pacemaker insertion for symptomatic bradycardia?
A. Encourage early ambulation to prevent B. Monitor the incision site for hematoma
deep vein thrombosis. formation and assess for cardiac
tamponade.
C. Apply a shoulder immobilizer to restrict D. Administer prophylactic antibiotics as
movement on the operative side. prescribed for 7 days post-procedure.
Correct: B - Monitor the incision site for hematoma formation and assess for cardiac
tamponade.
Rationale:The critical complication after pacemaker insertion is cardiac tamponade due to
myocardial perforation or pocket hematoma, which requires early recognition. Monitoring the
incision site and assessing for tamponade (hypotension, muffled heart sounds, JVD) is the
most crucial intervention. While shoulder immobilization may be used, it is not the most
critical. Ambulation is encouraged but not the priority. Prophylactic antibiotics are typically
given perioperatively, not for 7 days.
Page 3
, Section A - Chronic Neurological Disorders
Q3.
For a patient with heart failure with reduced ejection fraction (HFrEF) who is on
sacubitril/valsartan, which lab value warrants immediate nursing intervention?
A. Potassium 5.6 mEq/L B. BUN 25 mg/dL
C. Hemoglobin 12.5 g/dL D. Sodium 138 mEq/L
Correct: A - Potassium 5.6 mEq/L
Rationale:Sacubitril/valsartan (ARNI) can cause hyperkalemia. A potassium of 5.6 mEq/L is
elevated and requires immediate intervention to prevent cardiac dysrhythmias. While BUN
elevation may be seen, it is not as immediately dangerous. Hemoglobin and sodium are
within normal limits.
Q4.
A clinic nurse is teaching a patient with chronic stable angina about a newly prescribed
antianginal medication. Which statement by the patient indicates a need for further
teaching?
A. I will place the tablet under my tongue B. I can take up to three tablets at 5-minute
when I feel chest pain. intervals if pain persists.
C. I should call 911 if the pain is not relieved D. I will store the tablets in the refrigerator to
after three tablets. keep them potent.
Correct: D - I will store the tablets in the refrigerator to keep them potent.
Rationale:Nitroglycerin tablets should be stored in a cool, dark place, but not in the
refrigerator, as cold can reduce potency. The other statements are correct: sublingual
administration, up to three doses at 5-minute intervals, and calling 911 if pain persists are
accurate.
Q5.
A patient with chronic kidney disease stage 5 on hemodialysis has a serum phosphorus of
7.2 mg/dL. Which medication should the nurse anticipate administering with meals?
A. Calcium carbonate B. Erythropoietin alfa
C. Ferrous sulfate D. Calcitonin
Correct: A - Calcium carbonate
Rationale:Hyperphosphatemia in CKD is managed with phosphate binders like calcium
carbonate taken with meals to bind dietary phosphate. Erythropoietin is for anemia, ferrous
sulfate is for iron deficiency, and calcitonin is not used for this purpose.
Page 4
ACTUAL QUESTIONS AND ANSWERS | 2026
UPDATED | 100% CORRECT - GALEN COLLEGE.
100 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 257 CHRONIC EXAM 2 | V1 AND V2 | ACTUAL QUESTIONS AND ANSWERS | 2026 UPDATED | 100%
CORRECT - GALEN COLLEGE.. It contains 100 carefully selected questions that reflect the most current exam
content and testing strategies. Each question is accompanied by a correct answer and a detailed rationale that
explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 100 Questions
Foundations - Application - NUR 257 Chronic 2 V1 AND V2 Actual AND 2026 Updated 100 Correct - Galen
College Chronic Illness Management IN Adult Health Nursing Undergraduate YEAR 3 Upper-division Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Chronic Neurological 1-17 Chronic, Disease, Kidney, Diabetes, Stage
Disorders
Chronic Respiratory 18-34 Chronic, Failure, Heart, Disease, Medication
Disorders
Chronic Cardiovascular 35-51 Chronic, Disease, Kidney, Intervention, Appropriate
Disorders
Chronic Renal AND Urinary 52-68 Chronic, Disease, Kidney, Failure, Prescribed
Disorders
Chronic Endocrine AND 69-85 Chronic, Failure, Heart, Disease, Therapy
Metabolic Disorders
Chronic Musculoskeletal 86-100 Chronic, Disease, Effect, Obstructive Pulmonary, Prescribed
AND Connective Tissue
Disorders
TOTAL 100 All questions include answers and detailed rationales
,Section A - Chronic Neurological Disorders
Q1.
A patient with type 2 diabetes and stage 3 chronic kidney disease (eGFR 35 mL/min) is
prescribed metformin. Which pharmacogenetic consideration should guide the nurse's
evaluation?
A. Metformin is contraindicated at this eGFR B. The dose should be reduced by 50% and
level due to risk of lactic acidosis. eGFR monitored every 3 months.
C. Metformin is safe with no dose D. Metformin should be avoided because it
adjustment until eGFR drops below 15 interacts with most antihypertensive
mL/min. medications.
Correct: A - Metformin is contraindicated at this eGFR level due to risk of lactic acidosis.
Rationale:Current guidelines (ADA, KDIGO) contraindicate metformin initiation when eGFR is
below 30 mL/min, and it should not be started at eGFR 30-45 mL/min without careful
risk-benefit assessment. At eGFR 35, metformin is not recommended due to increased lactic
acidosis risk, making option A correct. Options B and C are incorrect because they
underestimate the risk. Option D is a false statement; metformin does not have a significant
interaction with most antihypertensives.
Q2.
Which nursing intervention is most crucial during the first 24 hours after a patient
undergoes a permanent pacemaker insertion for symptomatic bradycardia?
A. Encourage early ambulation to prevent B. Monitor the incision site for hematoma
deep vein thrombosis. formation and assess for cardiac
tamponade.
C. Apply a shoulder immobilizer to restrict D. Administer prophylactic antibiotics as
movement on the operative side. prescribed for 7 days post-procedure.
Correct: B - Monitor the incision site for hematoma formation and assess for cardiac
tamponade.
Rationale:The critical complication after pacemaker insertion is cardiac tamponade due to
myocardial perforation or pocket hematoma, which requires early recognition. Monitoring the
incision site and assessing for tamponade (hypotension, muffled heart sounds, JVD) is the
most crucial intervention. While shoulder immobilization may be used, it is not the most
critical. Ambulation is encouraged but not the priority. Prophylactic antibiotics are typically
given perioperatively, not for 7 days.
Page 3
, Section A - Chronic Neurological Disorders
Q3.
For a patient with heart failure with reduced ejection fraction (HFrEF) who is on
sacubitril/valsartan, which lab value warrants immediate nursing intervention?
A. Potassium 5.6 mEq/L B. BUN 25 mg/dL
C. Hemoglobin 12.5 g/dL D. Sodium 138 mEq/L
Correct: A - Potassium 5.6 mEq/L
Rationale:Sacubitril/valsartan (ARNI) can cause hyperkalemia. A potassium of 5.6 mEq/L is
elevated and requires immediate intervention to prevent cardiac dysrhythmias. While BUN
elevation may be seen, it is not as immediately dangerous. Hemoglobin and sodium are
within normal limits.
Q4.
A clinic nurse is teaching a patient with chronic stable angina about a newly prescribed
antianginal medication. Which statement by the patient indicates a need for further
teaching?
A. I will place the tablet under my tongue B. I can take up to three tablets at 5-minute
when I feel chest pain. intervals if pain persists.
C. I should call 911 if the pain is not relieved D. I will store the tablets in the refrigerator to
after three tablets. keep them potent.
Correct: D - I will store the tablets in the refrigerator to keep them potent.
Rationale:Nitroglycerin tablets should be stored in a cool, dark place, but not in the
refrigerator, as cold can reduce potency. The other statements are correct: sublingual
administration, up to three doses at 5-minute intervals, and calling 911 if pain persists are
accurate.
Q5.
A patient with chronic kidney disease stage 5 on hemodialysis has a serum phosphorus of
7.2 mg/dL. Which medication should the nurse anticipate administering with meals?
A. Calcium carbonate B. Erythropoietin alfa
C. Ferrous sulfate D. Calcitonin
Correct: A - Calcium carbonate
Rationale:Hyperphosphatemia in CKD is managed with phosphate binders like calcium
carbonate taken with meals to bind dietary phosphate. Erythropoietin is for anemia, ferrous
sulfate is for iron deficiency, and calcitonin is not used for this purpose.
Page 4
