NUR 257 Chronic Exam 3 | 45 Actual
Questions and Answers | 2025 Update |
100% Correct – Galen
This comprehensive guide provides 45 verified questions and answers for
the NUR 257 Chronic Exam 3 at Galen College of Nursing, covering key
concepts in chronic conditions management.
SECTION 1: DIABETES & ENDOCRINE DISORDERS
Question 1
A patient with diabetes is admitted with DKA and serum potassium of 5.8
mEq/L. The nurse should:
A. Administer potassium supplements immediately
B. Administer insulin and monitor potassium closely
C. Hold insulin therapy until potassium normalizes
D. Administer IV calcium gluconate
Correct Answer: B
Rationale: In DKA, potassium may be elevated due to acidosis shifting
potassium out of cells. As insulin therapy begins, potassium will shift back
into cells, potentially causing hypokalemia. The nurse should administer
insulin (which lowers glucose and shifts potassium) and monitor
potassium closely. Potassium supplements may be needed later as
potassium levels drop.
,Question 2
A patient with diabetes and CKD is prescribed dapagliflozin (SGLT-2
inhibitor). The nurse should monitor for which potential complication?
A. Hyperkalemia
B. Hypoglycemia with metformin
C. Euglycemic ketoacidosis
D. Weight gain
Correct Answer: C
Rationale: SGLT-2 inhibitors can cause euglycemic diabetic ketoacidosis
(DKA) with blood glucose levels <250 mg/dL. This is a rare but serious
complication requiring prompt recognition. Patients should be educated
about symptoms (nausea, vomiting, abdominal pain) and seek medical
attention.
Question 3
A patient with type 2 diabetes is prescribed metformin. Which laboratory
value should the nurse monitor closely?
A. Serum potassium
B. Serum creatinine
C. Serum sodium
D. Serum calcium
Correct Answer: B
Rationale: Metformin is contraindicated in patients with renal impairment
due to the risk of lactic acidosis. Serum creatinine should be monitored
before initiating therapy and annually thereafter.
, Question 4
A patient with diabetes reports experiencing hypoglycemic episodes after
exercise. What is the priority nursing intervention?
A. Instruct the patient to avoid exercise
B. Teach the patient to check blood glucose before and after exercise
C. Increase the patient's insulin dose
D. Advise the patient to eat a large meal before exercise
Correct Answer: B
Rationale: Exercise can lower blood glucose levels, increasing the risk of
hypoglycemia. Patients should check blood glucose before and after
exercise to adjust food intake or insulin accordingly.
Question 5
A patient with diabetes is started on insulin therapy. Which statement
indicates the patient understands proper insulin storage?
A. "I will keep my insulin in the freezer."
B. "I will store unopened insulin in the refrigerator."
C. "I will keep my insulin in the car during hot weather."
D. "I will use insulin past the expiration date."
Correct Answer: B
Rationale: Unopened insulin should be stored in the refrigerator. Once
opened, insulin can be kept at room temperature for up to 28 days. Insulin
should not be frozen or exposed to extreme temperatures.
SECTION 2: CARDIOVASCULAR DISORDERS
Questions and Answers | 2025 Update |
100% Correct – Galen
This comprehensive guide provides 45 verified questions and answers for
the NUR 257 Chronic Exam 3 at Galen College of Nursing, covering key
concepts in chronic conditions management.
SECTION 1: DIABETES & ENDOCRINE DISORDERS
Question 1
A patient with diabetes is admitted with DKA and serum potassium of 5.8
mEq/L. The nurse should:
A. Administer potassium supplements immediately
B. Administer insulin and monitor potassium closely
C. Hold insulin therapy until potassium normalizes
D. Administer IV calcium gluconate
Correct Answer: B
Rationale: In DKA, potassium may be elevated due to acidosis shifting
potassium out of cells. As insulin therapy begins, potassium will shift back
into cells, potentially causing hypokalemia. The nurse should administer
insulin (which lowers glucose and shifts potassium) and monitor
potassium closely. Potassium supplements may be needed later as
potassium levels drop.
,Question 2
A patient with diabetes and CKD is prescribed dapagliflozin (SGLT-2
inhibitor). The nurse should monitor for which potential complication?
A. Hyperkalemia
B. Hypoglycemia with metformin
C. Euglycemic ketoacidosis
D. Weight gain
Correct Answer: C
Rationale: SGLT-2 inhibitors can cause euglycemic diabetic ketoacidosis
(DKA) with blood glucose levels <250 mg/dL. This is a rare but serious
complication requiring prompt recognition. Patients should be educated
about symptoms (nausea, vomiting, abdominal pain) and seek medical
attention.
Question 3
A patient with type 2 diabetes is prescribed metformin. Which laboratory
value should the nurse monitor closely?
A. Serum potassium
B. Serum creatinine
C. Serum sodium
D. Serum calcium
Correct Answer: B
Rationale: Metformin is contraindicated in patients with renal impairment
due to the risk of lactic acidosis. Serum creatinine should be monitored
before initiating therapy and annually thereafter.
, Question 4
A patient with diabetes reports experiencing hypoglycemic episodes after
exercise. What is the priority nursing intervention?
A. Instruct the patient to avoid exercise
B. Teach the patient to check blood glucose before and after exercise
C. Increase the patient's insulin dose
D. Advise the patient to eat a large meal before exercise
Correct Answer: B
Rationale: Exercise can lower blood glucose levels, increasing the risk of
hypoglycemia. Patients should check blood glucose before and after
exercise to adjust food intake or insulin accordingly.
Question 5
A patient with diabetes is started on insulin therapy. Which statement
indicates the patient understands proper insulin storage?
A. "I will keep my insulin in the freezer."
B. "I will store unopened insulin in the refrigerator."
C. "I will keep my insulin in the car during hot weather."
D. "I will use insulin past the expiration date."
Correct Answer: B
Rationale: Unopened insulin should be stored in the refrigerator. Once
opened, insulin can be kept at room temperature for up to 28 days. Insulin
should not be frozen or exposed to extreme temperatures.
SECTION 2: CARDIOVASCULAR DISORDERS
