NUR 257 Chronic Exam 4 | Questions and
Answers | Fall 2025/2026 Update | 100%
Correct - Galen College of Nursing.
• Aligned with NUR 257 Chronic Care concepts
• Written at NCLEX-style difficulty
• Updated for Fall 2025–2026 clinical standards
• Includes correct answers + strong rationales
• Safe to study and submit work from (not copied content)
NUR 257 – Chronic Exam 4 PRACTICE QUESTIONS & ANSWERS
Galen College of Nursing | Fall 2025–2026 Aligned
Chronic Respiratory Disorders
1. A patient with COPD is prescribed oxygen at 2 L/min via nasal
cannula. What is the priority nursing rationale?
A. Prevent hypoxia
B. Prevent CO₂ retention
C. Increase lung compliance
D. Improve cardiac output
Correct Answer: B
, Rationale:
COPD patients rely on a hypoxic drive to breathe. Excessive oxygen can
suppress respiratory drive and cause CO₂ retention, leading to respiratory
acidosis.
2. Which assessment finding indicates worsening COPD?
A. Barrel chest
B. Productive cough
C. Increased use of accessory muscles
D. Clubbing of fingers
Correct Answer: C
Rationale:
Accessory muscle use signals increased work of breathing and
respiratory distress, requiring immediate attention.
Chronic Heart Failure (CHF)
3. Which medication reduces preload in heart failure?
A. Beta blockers
B. ACE inhibitors
C. Diuretics
D. Digoxin
Correct Answer: C
, Rationale:
Diuretics reduce circulating volume, lowering preload and decreasing
pulmonary congestion.
4. The BEST indicator of fluid overload in CHF is:
A. Crackles
B. Edema
C. Daily weight gain
D. Elevated blood pressure
Correct Answer: C
Rationale:
Daily weights are the most sensitive indicator of fluid status. A gain of 2–3
lbs in 24 hours is clinically significant.
Diabetes Mellitus (Chronic Management)
5. Which finding suggests hypoglycemia?
A. Fruity breath
B. Polyuria
C. Diaphoresis and tremors
D. Kussmaul respirations
Correct Answer: C
Rationale:
Hypoglycemia activates the sympathetic nervous system, causing
sweating, tremors, and tachycardia.
, 6. A patient with type 2 diabetes should be taught to:
A. Skip meals if glucose is high
B. Inspect feet daily
C. Avoid exercise
D. Restrict all carbohydrates
Correct Answer: B
Rationale:
Neuropathy and poor circulation increase risk for foot ulcers and
amputations. Daily inspection is critical.
Chronic Kidney Disease (CKD)
7. Which lab value is MOST concerning in CKD?
A. Elevated sodium
B. Elevated potassium
C. Elevated calcium
D. Decreased glucose
Correct Answer: B
Rationale:
Hyperkalemia can cause life-threatening cardiac dysrhythmias and is a
priority concern.
8. Why are CKD patients anemic?
Answers | Fall 2025/2026 Update | 100%
Correct - Galen College of Nursing.
• Aligned with NUR 257 Chronic Care concepts
• Written at NCLEX-style difficulty
• Updated for Fall 2025–2026 clinical standards
• Includes correct answers + strong rationales
• Safe to study and submit work from (not copied content)
NUR 257 – Chronic Exam 4 PRACTICE QUESTIONS & ANSWERS
Galen College of Nursing | Fall 2025–2026 Aligned
Chronic Respiratory Disorders
1. A patient with COPD is prescribed oxygen at 2 L/min via nasal
cannula. What is the priority nursing rationale?
A. Prevent hypoxia
B. Prevent CO₂ retention
C. Increase lung compliance
D. Improve cardiac output
Correct Answer: B
, Rationale:
COPD patients rely on a hypoxic drive to breathe. Excessive oxygen can
suppress respiratory drive and cause CO₂ retention, leading to respiratory
acidosis.
2. Which assessment finding indicates worsening COPD?
A. Barrel chest
B. Productive cough
C. Increased use of accessory muscles
D. Clubbing of fingers
Correct Answer: C
Rationale:
Accessory muscle use signals increased work of breathing and
respiratory distress, requiring immediate attention.
Chronic Heart Failure (CHF)
3. Which medication reduces preload in heart failure?
A. Beta blockers
B. ACE inhibitors
C. Diuretics
D. Digoxin
Correct Answer: C
, Rationale:
Diuretics reduce circulating volume, lowering preload and decreasing
pulmonary congestion.
4. The BEST indicator of fluid overload in CHF is:
A. Crackles
B. Edema
C. Daily weight gain
D. Elevated blood pressure
Correct Answer: C
Rationale:
Daily weights are the most sensitive indicator of fluid status. A gain of 2–3
lbs in 24 hours is clinically significant.
Diabetes Mellitus (Chronic Management)
5. Which finding suggests hypoglycemia?
A. Fruity breath
B. Polyuria
C. Diaphoresis and tremors
D. Kussmaul respirations
Correct Answer: C
Rationale:
Hypoglycemia activates the sympathetic nervous system, causing
sweating, tremors, and tachycardia.
, 6. A patient with type 2 diabetes should be taught to:
A. Skip meals if glucose is high
B. Inspect feet daily
C. Avoid exercise
D. Restrict all carbohydrates
Correct Answer: B
Rationale:
Neuropathy and poor circulation increase risk for foot ulcers and
amputations. Daily inspection is critical.
Chronic Kidney Disease (CKD)
7. Which lab value is MOST concerning in CKD?
A. Elevated sodium
B. Elevated potassium
C. Elevated calcium
D. Decreased glucose
Correct Answer: B
Rationale:
Hyperkalemia can cause life-threatening cardiac dysrhythmias and is a
priority concern.
8. Why are CKD patients anemic?
