NUR 257 CHRONIC HEALTH EXAM
QUESTIONS AND ANSWERS
1. Which of the following assessments is a clinical manifestation of right-sided heart failure?
A. Crackles in the lung bases
B. Peripheral edema and jugular venous distension
C. Orthopnea and paroxysmal nocturnal dyspnea
D. Pink frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
peripheral edema, JVD, and hepatomegaly, whereas left-sided failure manifests as
pulmonary symptoms.
2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen therapy.
What is the primary concern when administering high concentrations of oxygen to this
patient?
A. Oxygen toxicity to the alveoli
B. Suppression of the hypoxic drive
C. Development of pulmonary embolism
,D. Increased risk of bacterial pneumonia
Answer: B
Conceptual Explanation: In some COPD patients with chronic CO2 retention, the
respiratory drive is triggered by low oxygen levels. High levels of O2 can suppress this
stimulus, leading to respiratory arrest.
3. Which lab value is the most critical to monitor for a patient diagnosed with Chronic Kidney
Disease (CKD) who is experiencing cardiac dysrhythmias?
A. Serum Sodium
B. Serum Potassium
C. Serum Creatinine
D. Blood Urea Nitrogen (BUN)
Answer: B
Conceptual Explanation: Hyperkalemia is a common and life-threatening complication of
CKD because the kidneys cannot excrete potassium effectively, leading to lethal cardiac
arrhythmias.
4. A patient with Type 2 Diabetes is prescribed Metformin. What is the most important
teaching point regarding this medication and diagnostic tests?
A. Take the medication only when blood glucose is above 200 mg/dL.
B. Stop the medication 48 hours before and after a CT scan with contrast.
, C. Metformin can cause significant weight gain.
D. It must be taken with a high-sugar beverage to prevent hypoglycemia.
Answer: B
Conceptual Explanation: Metformin must be withheld before and after contrast media
procedures to prevent lactic acidosis and acute renal failure.
5. In the management of Hypertension, which class of medication is often associated with the
side effect of a persistent dry cough?
A. Beta-Blockers
B. Calcium Channel Blockers
C. ACE Inhibitors
D. Thiazide Diuretics
Answer: C
Conceptual Explanation: ACE inhibitors (like Lisinopril) prevent the breakdown of
bradykinin, which can lead to a dry, hacking cough in many patients.
6. Which dietary instruction is most appropriate for a patient with Osteoporosis?
A. Decrease intake of Vitamin D to prevent stones.
B. Avoid weight-bearing exercises to prevent fractures.
C. Increase intake of calcium-rich foods like leafy greens and dairy.
QUESTIONS AND ANSWERS
1. Which of the following assessments is a clinical manifestation of right-sided heart failure?
A. Crackles in the lung bases
B. Peripheral edema and jugular venous distension
C. Orthopnea and paroxysmal nocturnal dyspnea
D. Pink frothy sputum
Answer: B
Conceptual Explanation: Right-sided heart failure causes systemic congestion, leading to
peripheral edema, JVD, and hepatomegaly, whereas left-sided failure manifests as
pulmonary symptoms.
2. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen therapy.
What is the primary concern when administering high concentrations of oxygen to this
patient?
A. Oxygen toxicity to the alveoli
B. Suppression of the hypoxic drive
C. Development of pulmonary embolism
,D. Increased risk of bacterial pneumonia
Answer: B
Conceptual Explanation: In some COPD patients with chronic CO2 retention, the
respiratory drive is triggered by low oxygen levels. High levels of O2 can suppress this
stimulus, leading to respiratory arrest.
3. Which lab value is the most critical to monitor for a patient diagnosed with Chronic Kidney
Disease (CKD) who is experiencing cardiac dysrhythmias?
A. Serum Sodium
B. Serum Potassium
C. Serum Creatinine
D. Blood Urea Nitrogen (BUN)
Answer: B
Conceptual Explanation: Hyperkalemia is a common and life-threatening complication of
CKD because the kidneys cannot excrete potassium effectively, leading to lethal cardiac
arrhythmias.
4. A patient with Type 2 Diabetes is prescribed Metformin. What is the most important
teaching point regarding this medication and diagnostic tests?
A. Take the medication only when blood glucose is above 200 mg/dL.
B. Stop the medication 48 hours before and after a CT scan with contrast.
, C. Metformin can cause significant weight gain.
D. It must be taken with a high-sugar beverage to prevent hypoglycemia.
Answer: B
Conceptual Explanation: Metformin must be withheld before and after contrast media
procedures to prevent lactic acidosis and acute renal failure.
5. In the management of Hypertension, which class of medication is often associated with the
side effect of a persistent dry cough?
A. Beta-Blockers
B. Calcium Channel Blockers
C. ACE Inhibitors
D. Thiazide Diuretics
Answer: C
Conceptual Explanation: ACE inhibitors (like Lisinopril) prevent the breakdown of
bradykinin, which can lead to a dry, hacking cough in many patients.
6. Which dietary instruction is most appropriate for a patient with Osteoporosis?
A. Decrease intake of Vitamin D to prevent stones.
B. Avoid weight-bearing exercises to prevent fractures.
C. Increase intake of calcium-rich foods like leafy greens and dairy.
