NUR 257 CHRONIC EXAM 4 - GALEN
COLLEGE COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT-GALEN.
1. A patient with chronic obstructive pulmonary disease (COPD) is prescribed oxygen at 2
L/min via nasal cannula. Which physiological mechanism explains why high-flow oxygen can
be dangerous for this patient?
A. High oxygen levels increase the work of breathing and metabolic rate.
B. Excessive oxygen causes pulmonary vasoconstriction and right-sided heart failure.
C. High flow oxygen leads to nitrogen washout and subsequent absorption atelectasis.
D. The patient’s respiratory drive is triggered by low oxygen levels rather than high carbon
dioxide levels.
Answer: D
Conceptual Explanation: In chronic CO2 retainers, the peripheral chemoreceptors
become the primary drive for breathing based on low oxygen levels (hypoxic drive).
Providing high-flow oxygen can suppress this drive, leading to respiratory arrest.
2. A client with Heart Failure (HF) is taking Digoxin 0.125 mg daily. Which assessment finding
should the nurse prioritize as an early sign of toxicity?
A. Tachycardia and hypertension
,B. Anorexia, nausea, and visual disturbances
C. Peripheral edema and weight gain
D. Increased urinary output and clear lung sounds
Answer: B
Conceptual Explanation: Early signs of digoxin toxicity include gastrointestinal symptoms
like anorexia, nausea, and vomiting, as well as neurological/visual changes like seeing
yellow-green halos.
3. When caring for a patient with Myasthenia Gravis (MG), which medication should the
nurse ensure is administered exactly on time?
A. Pyridostigmine
B. Prednisone
C. Azathioprine
D. Cyclosporine
Answer: A
Conceptual Explanation: Pyridostigmine (Mestinon) is an anticholinesterase medication
that must be given on time to maintain muscle strength, especially before meals to prevent
aspiration.
, 4. A patient is diagnosed with Multiple Sclerosis (MS). Which pathophysiology best describes
this chronic condition?
A. Degeneration of the dopamine-producing neurons in the substantia nigra.
B. Deficiency of acetylcholine at the neuromuscular junction.
C. Autoimmune destruction of the myelin sheath in the central nervous system.
D. Degeneration of lower motor neurons in the spinal cord.
Answer: C
Conceptual Explanation: Multiple Sclerosis is an autoimmune disease characterized by
demyelination and plaque formation within the brain and spinal cord.
5. Which dietary instruction is most critical for a patient in the oliguric phase of Chronic
Kidney Disease (CKD)?
A. Increase intake of potassium-rich foods like bananas.
B. Consume a high-phosphorus diet to support bone health.
C. Increase fluid intake to at least 3 liters per day.
D. Restrict protein, sodium, and potassium intake.
Answer: D
Conceptual Explanation: In CKD, the kidneys cannot effectively excrete metabolic waste
or electrolytes. Restricting protein (to limit urea), sodium (to control BP), and potassium
(to prevent arrhythmias) is vital.
COLLEGE COMPREHENSIVE REVIEW
QUESTIONS AND ANSWERS | 2026/2027
UPDATE | 100% CORRECT-GALEN.
1. A patient with chronic obstructive pulmonary disease (COPD) is prescribed oxygen at 2
L/min via nasal cannula. Which physiological mechanism explains why high-flow oxygen can
be dangerous for this patient?
A. High oxygen levels increase the work of breathing and metabolic rate.
B. Excessive oxygen causes pulmonary vasoconstriction and right-sided heart failure.
C. High flow oxygen leads to nitrogen washout and subsequent absorption atelectasis.
D. The patient’s respiratory drive is triggered by low oxygen levels rather than high carbon
dioxide levels.
Answer: D
Conceptual Explanation: In chronic CO2 retainers, the peripheral chemoreceptors
become the primary drive for breathing based on low oxygen levels (hypoxic drive).
Providing high-flow oxygen can suppress this drive, leading to respiratory arrest.
2. A client with Heart Failure (HF) is taking Digoxin 0.125 mg daily. Which assessment finding
should the nurse prioritize as an early sign of toxicity?
A. Tachycardia and hypertension
,B. Anorexia, nausea, and visual disturbances
C. Peripheral edema and weight gain
D. Increased urinary output and clear lung sounds
Answer: B
Conceptual Explanation: Early signs of digoxin toxicity include gastrointestinal symptoms
like anorexia, nausea, and vomiting, as well as neurological/visual changes like seeing
yellow-green halos.
3. When caring for a patient with Myasthenia Gravis (MG), which medication should the
nurse ensure is administered exactly on time?
A. Pyridostigmine
B. Prednisone
C. Azathioprine
D. Cyclosporine
Answer: A
Conceptual Explanation: Pyridostigmine (Mestinon) is an anticholinesterase medication
that must be given on time to maintain muscle strength, especially before meals to prevent
aspiration.
, 4. A patient is diagnosed with Multiple Sclerosis (MS). Which pathophysiology best describes
this chronic condition?
A. Degeneration of the dopamine-producing neurons in the substantia nigra.
B. Deficiency of acetylcholine at the neuromuscular junction.
C. Autoimmune destruction of the myelin sheath in the central nervous system.
D. Degeneration of lower motor neurons in the spinal cord.
Answer: C
Conceptual Explanation: Multiple Sclerosis is an autoimmune disease characterized by
demyelination and plaque formation within the brain and spinal cord.
5. Which dietary instruction is most critical for a patient in the oliguric phase of Chronic
Kidney Disease (CKD)?
A. Increase intake of potassium-rich foods like bananas.
B. Consume a high-phosphorus diet to support bone health.
C. Increase fluid intake to at least 3 liters per day.
D. Restrict protein, sodium, and potassium intake.
Answer: D
Conceptual Explanation: In CKD, the kidneys cannot effectively excrete metabolic waste
or electrolytes. Restricting protein (to limit urea), sodium (to control BP), and potassium
(to prevent arrhythmias) is vital.
