Galen NUR 257 Final Exam Practice Review:
Integrated Adult Health Concepts — exam
questions with correct answers
(verifiedanswers) plus rationales 2026 Q&A
instant download pdf
Question 1
A nurse is caring for an older adult with heart failure who
reports increasing shortness of breath and a 3-lb weight gain
over the past 2 days. Which action should the nurse take first?
A. Encourage the client to increase oral fluids.
B. Place the client in a supine position.
C. Assess the client's respiratory status and oxygen saturation.
D. Encourage the client to ambulate to improve circulation.
Correct answer: C. Assess the client's respiratory status and
oxygen saturation.
The combination of rapid weight gain and worsening dyspnea
suggests fluid retention and possible exacerbation of heart
failure. The nurse's immediate priority is assessment of
oxygenation and respiratory status because impaired gas
exchange can become life-threatening. Positioning the client
upright may subsequently improve ventilation, and prescribed
diuretics may be administered after appropriate assessment.
,Question 2
A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which finding requires the nurse's
immediate attention?
A. Oxygen saturation of 91%
B. Respiratory rate of 20/min
C. Increasing lethargy and difficulty arousing the client
D. Productive cough with clear sputum
Correct answer: C. Increasing lethargy and difficulty arousing
the client
Clients with COPD may have chronic carbon dioxide retention. A
significant change in level of consciousness can indicate
worsening hypercapnia and respiratory failure. Although oxygen
must be administered carefully in COPD, the nurse should not
withhold necessary oxygen. The client's airway, breathing,
oxygenation, and ventilation require immediate reassessment.
Question 3
A client with diabetes mellitus becomes shaky, diaphoretic, and
confused. The blood glucose level is 52 mg/dL. The client is
awake and able to swallow. What should the nurse do?
A. Administer the client's scheduled insulin.
B. Give the client a high-protein meal.
,C. Give approximately 15 g of rapid-acting carbohydrate.
D. Place the client on NPO status.
Correct answer: C. Give approximately 15 g of rapid-acting
carbohydrate.
The findings are characteristic of hypoglycemia. For an awake
client who can safely swallow, approximately 15 g of rapid-
acting carbohydrate should be given, followed by reassessment
of glucose in about 15 minutes and additional treatment if
needed. Insulin would worsen the hypoglycemia, while protein is
not the fastest treatment for an acute glucose deficit.
Question 4
Which finding is most concerning in a client with hyperglycemia
and suspected diabetic ketoacidosis (DKA)?
A. Increased thirst
B. Frequent urination
C. Blood glucose of 280 mg/dL
D. Deep, rapid respirations with fruity-smelling breath
Correct answer: D. Deep, rapid respirations with fruity-
smelling breath
Deep, rapid respirations are Kussmaul respirations and
represent the body's attempt to compensate for metabolic
acidosis. Fruity-smelling breath results from acetone produced
, during ketone metabolism. Together, these findings strongly
suggest significant ketoacidosis and require urgent intervention.
Question 5
A client with hypertension asks which lifestyle change can help
reduce blood pressure. Which response by the nurse is most
appropriate?
A. "Increase sodium intake when exercising."
B. "Avoid all physical activity."
C. "Follow a heart-healthy diet and participate in regular
physical activity."
D. "Stop antihypertensive medications once your blood
pressure improves."
Correct answer: C. "Follow a heart-healthy diet and participate
in regular physical activity."
Lifestyle measures such as a diet emphasizing fruits, vegetables,
whole grains, and appropriate sodium restriction, along with
regular physical activity, can reduce cardiovascular risk and help
control blood pressure. Lifestyle modifications complement
rather than automatically replace prescribed antihypertensive
therapy.
Question 6
Integrated Adult Health Concepts — exam
questions with correct answers
(verifiedanswers) plus rationales 2026 Q&A
instant download pdf
Question 1
A nurse is caring for an older adult with heart failure who
reports increasing shortness of breath and a 3-lb weight gain
over the past 2 days. Which action should the nurse take first?
A. Encourage the client to increase oral fluids.
B. Place the client in a supine position.
C. Assess the client's respiratory status and oxygen saturation.
D. Encourage the client to ambulate to improve circulation.
Correct answer: C. Assess the client's respiratory status and
oxygen saturation.
The combination of rapid weight gain and worsening dyspnea
suggests fluid retention and possible exacerbation of heart
failure. The nurse's immediate priority is assessment of
oxygenation and respiratory status because impaired gas
exchange can become life-threatening. Positioning the client
upright may subsequently improve ventilation, and prescribed
diuretics may be administered after appropriate assessment.
,Question 2
A client with chronic obstructive pulmonary disease (COPD) is
receiving oxygen therapy. Which finding requires the nurse's
immediate attention?
A. Oxygen saturation of 91%
B. Respiratory rate of 20/min
C. Increasing lethargy and difficulty arousing the client
D. Productive cough with clear sputum
Correct answer: C. Increasing lethargy and difficulty arousing
the client
Clients with COPD may have chronic carbon dioxide retention. A
significant change in level of consciousness can indicate
worsening hypercapnia and respiratory failure. Although oxygen
must be administered carefully in COPD, the nurse should not
withhold necessary oxygen. The client's airway, breathing,
oxygenation, and ventilation require immediate reassessment.
Question 3
A client with diabetes mellitus becomes shaky, diaphoretic, and
confused. The blood glucose level is 52 mg/dL. The client is
awake and able to swallow. What should the nurse do?
A. Administer the client's scheduled insulin.
B. Give the client a high-protein meal.
,C. Give approximately 15 g of rapid-acting carbohydrate.
D. Place the client on NPO status.
Correct answer: C. Give approximately 15 g of rapid-acting
carbohydrate.
The findings are characteristic of hypoglycemia. For an awake
client who can safely swallow, approximately 15 g of rapid-
acting carbohydrate should be given, followed by reassessment
of glucose in about 15 minutes and additional treatment if
needed. Insulin would worsen the hypoglycemia, while protein is
not the fastest treatment for an acute glucose deficit.
Question 4
Which finding is most concerning in a client with hyperglycemia
and suspected diabetic ketoacidosis (DKA)?
A. Increased thirst
B. Frequent urination
C. Blood glucose of 280 mg/dL
D. Deep, rapid respirations with fruity-smelling breath
Correct answer: D. Deep, rapid respirations with fruity-
smelling breath
Deep, rapid respirations are Kussmaul respirations and
represent the body's attempt to compensate for metabolic
acidosis. Fruity-smelling breath results from acetone produced
, during ketone metabolism. Together, these findings strongly
suggest significant ketoacidosis and require urgent intervention.
Question 5
A client with hypertension asks which lifestyle change can help
reduce blood pressure. Which response by the nurse is most
appropriate?
A. "Increase sodium intake when exercising."
B. "Avoid all physical activity."
C. "Follow a heart-healthy diet and participate in regular
physical activity."
D. "Stop antihypertensive medications once your blood
pressure improves."
Correct answer: C. "Follow a heart-healthy diet and participate
in regular physical activity."
Lifestyle measures such as a diet emphasizing fruits, vegetables,
whole grains, and appropriate sodium restriction, along with
regular physical activity, can reduce cardiovascular risk and help
control blood pressure. Lifestyle modifications complement
rather than automatically replace prescribed antihypertensive
therapy.
Question 6
