NUR 257 Chronic Conditions | Galen College of Nursing
Actual Exam 2026/2027 | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass Guaranteed –
A+ Graded
Cardiovascular & Hematologic Chronic Conditions
Q1: Which assessment finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Bilateral crackles in the lower lung fields [CORRECT]
D. Hepatomegaly
Correct Answer: C
Rationale: The best answer is bilateral crackles, because left-sided failure backs blood up into
the pulmonary circulation and produces congestion you can hear. JVD, peripheral edema, and
hepatomegaly all reflect right-sided congestion instead.
Q2: A client with newly diagnosed heart failure is learning about daily weight monitoring.
Which statement shows correct understanding?
A. "I'll weigh myself every morning after I urinate and before I eat breakfast." [CORRECT]
B. "I'll weigh myself at night so I can compare it to my dinner weight."
C. "I'll weigh once a week on whichever day works best."
D. "I'll use whichever scale is handy since small differences don't matter."
Correct Answer: A
Rationale: Weighing every morning after voiding, before eating, in similar clothing, on the
same scale gives the most accurate trend. This matches the principle that consistent technique
catches fluid retention early, such as a gain of 2 to 3 pounds in a day or 5 in a week.
,Q3: The nurse is preparing to give digoxin to a client with heart failure. The apical pulse is 58
and irregular. Which action should the nurse take?
A. Give the dose as scheduled
B. Give half the prescribed dose
C. Crush the tablet and give it with applesauce
D. Hold the dose and notify the provider [CORRECT]
Correct Answer: D
Rationale: Digoxin slows cardiac conduction, so it is withheld when the apical pulse falls
below 60 and the provider is notified. Giving any portion of the dose could drop the rate
further and push the client toward toxicity effects.
Q4: The nurse is reviewing a low-sodium diet with a client who has heart failure. Which food
choice indicates a need for further teaching?
A. Fresh apple slices
B. A bowl of canned chicken noodle soup [CORRECT]
C. Baked skinless chicken breast
D. Steamed green beans
Correct Answer: B
Rationale: Canned soups are loaded with sodium, which drives fluid retention and worsens
heart failure symptoms. Fresh fruit, lean poultry, and plain vegetables all fit the low-sodium
plan the client needs.
Q5: A newly diagnosed hypertensive client asks why treatment matters when he feels fine.
What is the nurse's best response?
A. "Hypertension damages the heart, brain, and kidneys over years without causing
symptoms." [CORRECT]
B. "Most people with high blood pressure get frequent headaches as an early warning."
C. "Feeling fine usually means your blood pressure is under control."
D. "Medication is only needed once dizziness and nosebleeds appear."
,Correct Answer: A
Rationale: Hypertension is called the silent killer because organ damage develops quietly
over time, which is exactly why treatment continues even when the client feels well.
Headaches, dizziness, and nosebleeds are not reliable warning signs and often appear only at
dangerously high levels.
Q6: A client has been taking lisinopril for three weeks. Which finding should the nurse
instruct the client to report immediately?
A. A dry, hacking cough
B. Mild dizziness when standing up quickly
C. Swelling of the lips or tongue [CORRECT]
D. A gradual drop in blood pressure readings
Correct Answer: C
Rationale: Lip or tongue swelling signals angioedema, a life-threatening ACE inhibitor
reaction that can obstruct the airway. A dry cough is common and bothersome but not
emergent, and a lower blood pressure is the intended effect.
Q7: A client with atrial fibrillation is starting warfarin. Which dietary instruction is most
important?
A. "Avoid all green leafy vegetables completely."
B. "Keep your intake of vitamin K foods consistent from day to day." [CORRECT]
C. "Eat extra citrus fruits to strengthen the medication's effect."
D. "Take your dose with an antacid to protect your stomach."
Correct Answer: B
Rationale: Warfarin works by opposing vitamin K, so the goal is a steady intake of leafy
greens rather than eliminating them, which causes INR swings. Remember, stability, not
avoidance, keeps anticoagulation therapeutic.
Q8: A client admitted with chronic heart failure suddenly becomes severely short of breath,
coughs up pink frothy sputum, and has crackles throughout all lung fields with an oxygen
saturation of 84%. What is the priority nursing action?
, A. Notify the provider of the change in condition
B. Begin strict intake and output monitoring
C. Obtain a stat weight
D. Position the client upright with legs dependent and apply oxygen [CORRECT]
Correct Answer: D
Rationale: The priority is always airway and breathing — sitting upright with legs dependent
reduces venous return to the overloaded heart while immediate oxygen improves saturation.
Provider notification follows, but interventions that restore oxygenation come first in acute
pulmonary edema.
Q9: Which description best characterizes stable angina?
A. Substernal pressure that occurs with exertion and eases with rest [CORRECT]
B. Sharp chest pain that worsens with deep breathing
C. Burning pain that improves after taking an antacid
D. Sudden tearing pain that radiates to the back
Correct Answer: A
Rationale: Stable angina is predictable exertional chest pressure relieved within minutes by
rest or nitroglycerin. Pain that changes with breathing points to a pleural cause, antacid relief
suggests reflux, and tearing back pain raises concern for dissection.
Q10: A client with coronary artery disease is reviewing lifestyle changes. Which statement
indicates a need for further teaching?
A. "I switched from butter to olive oil when I cook."
B. "My wife and I are reading food labels for saturated fat."
C. "As long as I walk every day, I don't need to quit smoking." [CORRECT]
D. "I'm working on losing ten pounds before summer."
Correct Answer: C
Rationale: Smoking directly injures coronary vessels and remains one of the strongest
modifiable risks, and exercise cannot offset it, so the client needs more teaching about
Actual Exam 2026/2027 | Complete Exam-Style Questions
with Detailed Rationales | 100% Verified – Pass Guaranteed –
A+ Graded
Cardiovascular & Hematologic Chronic Conditions
Q1: Which assessment finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Dependent peripheral edema
C. Bilateral crackles in the lower lung fields [CORRECT]
D. Hepatomegaly
Correct Answer: C
Rationale: The best answer is bilateral crackles, because left-sided failure backs blood up into
the pulmonary circulation and produces congestion you can hear. JVD, peripheral edema, and
hepatomegaly all reflect right-sided congestion instead.
Q2: A client with newly diagnosed heart failure is learning about daily weight monitoring.
Which statement shows correct understanding?
A. "I'll weigh myself every morning after I urinate and before I eat breakfast." [CORRECT]
B. "I'll weigh myself at night so I can compare it to my dinner weight."
C. "I'll weigh once a week on whichever day works best."
D. "I'll use whichever scale is handy since small differences don't matter."
Correct Answer: A
Rationale: Weighing every morning after voiding, before eating, in similar clothing, on the
same scale gives the most accurate trend. This matches the principle that consistent technique
catches fluid retention early, such as a gain of 2 to 3 pounds in a day or 5 in a week.
,Q3: The nurse is preparing to give digoxin to a client with heart failure. The apical pulse is 58
and irregular. Which action should the nurse take?
A. Give the dose as scheduled
B. Give half the prescribed dose
C. Crush the tablet and give it with applesauce
D. Hold the dose and notify the provider [CORRECT]
Correct Answer: D
Rationale: Digoxin slows cardiac conduction, so it is withheld when the apical pulse falls
below 60 and the provider is notified. Giving any portion of the dose could drop the rate
further and push the client toward toxicity effects.
Q4: The nurse is reviewing a low-sodium diet with a client who has heart failure. Which food
choice indicates a need for further teaching?
A. Fresh apple slices
B. A bowl of canned chicken noodle soup [CORRECT]
C. Baked skinless chicken breast
D. Steamed green beans
Correct Answer: B
Rationale: Canned soups are loaded with sodium, which drives fluid retention and worsens
heart failure symptoms. Fresh fruit, lean poultry, and plain vegetables all fit the low-sodium
plan the client needs.
Q5: A newly diagnosed hypertensive client asks why treatment matters when he feels fine.
What is the nurse's best response?
A. "Hypertension damages the heart, brain, and kidneys over years without causing
symptoms." [CORRECT]
B. "Most people with high blood pressure get frequent headaches as an early warning."
C. "Feeling fine usually means your blood pressure is under control."
D. "Medication is only needed once dizziness and nosebleeds appear."
,Correct Answer: A
Rationale: Hypertension is called the silent killer because organ damage develops quietly
over time, which is exactly why treatment continues even when the client feels well.
Headaches, dizziness, and nosebleeds are not reliable warning signs and often appear only at
dangerously high levels.
Q6: A client has been taking lisinopril for three weeks. Which finding should the nurse
instruct the client to report immediately?
A. A dry, hacking cough
B. Mild dizziness when standing up quickly
C. Swelling of the lips or tongue [CORRECT]
D. A gradual drop in blood pressure readings
Correct Answer: C
Rationale: Lip or tongue swelling signals angioedema, a life-threatening ACE inhibitor
reaction that can obstruct the airway. A dry cough is common and bothersome but not
emergent, and a lower blood pressure is the intended effect.
Q7: A client with atrial fibrillation is starting warfarin. Which dietary instruction is most
important?
A. "Avoid all green leafy vegetables completely."
B. "Keep your intake of vitamin K foods consistent from day to day." [CORRECT]
C. "Eat extra citrus fruits to strengthen the medication's effect."
D. "Take your dose with an antacid to protect your stomach."
Correct Answer: B
Rationale: Warfarin works by opposing vitamin K, so the goal is a steady intake of leafy
greens rather than eliminating them, which causes INR swings. Remember, stability, not
avoidance, keeps anticoagulation therapeutic.
Q8: A client admitted with chronic heart failure suddenly becomes severely short of breath,
coughs up pink frothy sputum, and has crackles throughout all lung fields with an oxygen
saturation of 84%. What is the priority nursing action?
, A. Notify the provider of the change in condition
B. Begin strict intake and output monitoring
C. Obtain a stat weight
D. Position the client upright with legs dependent and apply oxygen [CORRECT]
Correct Answer: D
Rationale: The priority is always airway and breathing — sitting upright with legs dependent
reduces venous return to the overloaded heart while immediate oxygen improves saturation.
Provider notification follows, but interventions that restore oxygenation come first in acute
pulmonary edema.
Q9: Which description best characterizes stable angina?
A. Substernal pressure that occurs with exertion and eases with rest [CORRECT]
B. Sharp chest pain that worsens with deep breathing
C. Burning pain that improves after taking an antacid
D. Sudden tearing pain that radiates to the back
Correct Answer: A
Rationale: Stable angina is predictable exertional chest pressure relieved within minutes by
rest or nitroglycerin. Pain that changes with breathing points to a pleural cause, antacid relief
suggests reflux, and tearing back pain raises concern for dissection.
Q10: A client with coronary artery disease is reviewing lifestyle changes. Which statement
indicates a need for further teaching?
A. "I switched from butter to olive oil when I cook."
B. "My wife and I are reading food labels for saturated fat."
C. "As long as I walk every day, I don't need to quit smoking." [CORRECT]
D. "I'm working on losing ten pounds before summer."
Correct Answer: C
Rationale: Smoking directly injures coronary vessels and remains one of the strongest
modifiable risks, and exercise cannot offset it, so the client needs more teaching about
