NUR 257 Chronic Exam 3 -Galen College of Nursing Practice Questions
with Verified Answers and Rationales 2026 Edition | 100% Correct | A+
Guaranteed
Excel on your third adult health nursing milestone with this definitive 2026 NUR 257
Chronic Exam 3 practice bank explicitly tailored for Galen College of Nursing. This
comprehensive preparation guide features high-yield questions paired with verified
correct answers and rigorous clinical rationales covering complex multi-system
disorders, progressive degenerative diseases, oncology care, and long-term
pharmacological management. It is an indispensable study tool for pre-licensure nursing
students looking to streamline their study time, master clinical judgment case studies,
and confidently secure an A+ grade.
SECTION 1: RESPIRATORY DISORDERS – COPD, ASTHMA,
PNEUMONIA (Questions 1-25)
Question 1:
A patient with COPD is prescribed home oxygen therapy at 2 L/min via nasal cannula.
Which assessment finding indicates the oxygen therapy is effective?
A) PaO2 of 55 mmHg
B) Respiratory rate of 24 breaths/min
C) SpO2 of 92% on 2 L/min
D) Use of accessory muscles
*Answer: * C) SpO2 of 92% on 2 L/min
*Rationale: * For patients with COPD, oxygen therapy is considered effective when SpO2
is maintained at 88-92%. Higher SpO2 can suppress the hypoxic drive, leading to
respiratory depression. An SpO2 of 92% indicates adequate oxygenation without excessive
oxygen delivery.
,Question 2:
A patient with COPD is admitted with pneumonia. Which laboratory value is most
concerning?
A) WBC 12,000/mm³
B) Serum sodium 135 mEq/L
C) PaO2 55 mmHg on room air
D) HCO3 26 mEq/L
*Answer: * C) PaO2 55 mmHg on room air
*Rationale: * A PaO2 of 55 mmHg indicates significant hypoxemia and requires
immediate intervention, including supplemental oxygen. This is critical for a COPD patient
with pneumonia.
Question 3:
Which medication is the primary treatment for acute exacerbation of COPD?
A) Long-acting beta-agonists
B) Inhaled corticosteroids
C) Short-acting bronchodilators
D) Leukotriene modifiers
*Answer: * C) Short-acting bronchodilators
*Rationale: * Short-acting bronchodilators (SABA) such as albuterol are the first-line
treatment for acute COPD exacerbations to relieve bronchospasm and improve airflow.
Question 4:
What teaching should the nurse provide to a patient with COPD regarding pursed-lip
breathing?
A) Inhale slowly through the mouth, exhale through pursed lips
B) Inhale through the nose, exhale slowly through pursed lips
C) Inhale and exhale rapidly through pursed lips
D) Hold breath for 10 seconds between breaths
,*Answer: * B) Inhale through the nose, exhale slowly through pursed lips
*Rationale: * Pursed-lip breathing involves inhaling through the nose and exhaling slowly
through pursed lips. This technique creates positive pressure that prevents airway collapse
and improves gas exchange.
Question 5:
A patient with asthma is prescribed a peak flow meter. What is the purpose of this
device?
A) To monitor lung function and detect early changes
B) To deliver medication to the lungs
C) To measure oxygen saturation
D) To assess respiratory rate
*Answer: * A) To monitor lung function and detect early changes
*Rationale: * A peak flow meter measures expiratory flow rate, helping patients monitor
lung function and detect early signs of asthma exacerbation before symptoms become
severe.
Question 6:
A patient with asthma is experiencing an exacerbation with a peak flow reading of 40%
of personal best. What is the appropriate action?
A) Continue with regular medications
B) Take rescue medication and repeat peak flow
C) Go to the emergency department immediately
D) Increase controller medications
*Answer: * C) Go to the emergency department immediately
*Rationale: * A peak flow reading of 40% of personal best indicates a severe exacerbation
requiring immediate emergency care. Patient should not wait; this is a medical emergency
requiring prompt treatment.
, Question 7:
Which finding indicates that a patient with pneumonia is not responding to antibiotic
therapy?
A) Decreased fever
B) Improved breath sounds
C) Persistent elevated WBC count
D) Decreased sputum production
*Answer: * C) Persistent elevated WBC count
*Rationale: * A persistent elevated WBC count indicates ongoing infection and suggests
the current antibiotic regimen may not be effective, requiring reassessment of the
treatment plan.
Question 8:
A patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which
intervention is most appropriate?
A) Administer oxygen at 4 L/min via nasal cannula
B) Encourage pursed-lip breathing
C) Place patient in supine position
D) Restrict fluid intake
*Answer: * B) Encourage pursed-lip breathing
*Rationale: * Pursed-lip breathing helps control the breathing pattern, prevents airway
collapse, and reduces dyspnea in COPD patients. Supine positioning worsens breathing
and should be avoided.
Question 9:
What is the primary nursing priority for a patient with status asthmaticus?
with Verified Answers and Rationales 2026 Edition | 100% Correct | A+
Guaranteed
Excel on your third adult health nursing milestone with this definitive 2026 NUR 257
Chronic Exam 3 practice bank explicitly tailored for Galen College of Nursing. This
comprehensive preparation guide features high-yield questions paired with verified
correct answers and rigorous clinical rationales covering complex multi-system
disorders, progressive degenerative diseases, oncology care, and long-term
pharmacological management. It is an indispensable study tool for pre-licensure nursing
students looking to streamline their study time, master clinical judgment case studies,
and confidently secure an A+ grade.
SECTION 1: RESPIRATORY DISORDERS – COPD, ASTHMA,
PNEUMONIA (Questions 1-25)
Question 1:
A patient with COPD is prescribed home oxygen therapy at 2 L/min via nasal cannula.
Which assessment finding indicates the oxygen therapy is effective?
A) PaO2 of 55 mmHg
B) Respiratory rate of 24 breaths/min
C) SpO2 of 92% on 2 L/min
D) Use of accessory muscles
*Answer: * C) SpO2 of 92% on 2 L/min
*Rationale: * For patients with COPD, oxygen therapy is considered effective when SpO2
is maintained at 88-92%. Higher SpO2 can suppress the hypoxic drive, leading to
respiratory depression. An SpO2 of 92% indicates adequate oxygenation without excessive
oxygen delivery.
,Question 2:
A patient with COPD is admitted with pneumonia. Which laboratory value is most
concerning?
A) WBC 12,000/mm³
B) Serum sodium 135 mEq/L
C) PaO2 55 mmHg on room air
D) HCO3 26 mEq/L
*Answer: * C) PaO2 55 mmHg on room air
*Rationale: * A PaO2 of 55 mmHg indicates significant hypoxemia and requires
immediate intervention, including supplemental oxygen. This is critical for a COPD patient
with pneumonia.
Question 3:
Which medication is the primary treatment for acute exacerbation of COPD?
A) Long-acting beta-agonists
B) Inhaled corticosteroids
C) Short-acting bronchodilators
D) Leukotriene modifiers
*Answer: * C) Short-acting bronchodilators
*Rationale: * Short-acting bronchodilators (SABA) such as albuterol are the first-line
treatment for acute COPD exacerbations to relieve bronchospasm and improve airflow.
Question 4:
What teaching should the nurse provide to a patient with COPD regarding pursed-lip
breathing?
A) Inhale slowly through the mouth, exhale through pursed lips
B) Inhale through the nose, exhale slowly through pursed lips
C) Inhale and exhale rapidly through pursed lips
D) Hold breath for 10 seconds between breaths
,*Answer: * B) Inhale through the nose, exhale slowly through pursed lips
*Rationale: * Pursed-lip breathing involves inhaling through the nose and exhaling slowly
through pursed lips. This technique creates positive pressure that prevents airway collapse
and improves gas exchange.
Question 5:
A patient with asthma is prescribed a peak flow meter. What is the purpose of this
device?
A) To monitor lung function and detect early changes
B) To deliver medication to the lungs
C) To measure oxygen saturation
D) To assess respiratory rate
*Answer: * A) To monitor lung function and detect early changes
*Rationale: * A peak flow meter measures expiratory flow rate, helping patients monitor
lung function and detect early signs of asthma exacerbation before symptoms become
severe.
Question 6:
A patient with asthma is experiencing an exacerbation with a peak flow reading of 40%
of personal best. What is the appropriate action?
A) Continue with regular medications
B) Take rescue medication and repeat peak flow
C) Go to the emergency department immediately
D) Increase controller medications
*Answer: * C) Go to the emergency department immediately
*Rationale: * A peak flow reading of 40% of personal best indicates a severe exacerbation
requiring immediate emergency care. Patient should not wait; this is a medical emergency
requiring prompt treatment.
, Question 7:
Which finding indicates that a patient with pneumonia is not responding to antibiotic
therapy?
A) Decreased fever
B) Improved breath sounds
C) Persistent elevated WBC count
D) Decreased sputum production
*Answer: * C) Persistent elevated WBC count
*Rationale: * A persistent elevated WBC count indicates ongoing infection and suggests
the current antibiotic regimen may not be effective, requiring reassessment of the
treatment plan.
Question 8:
A patient with COPD has a nursing diagnosis of Ineffective Breathing Pattern. Which
intervention is most appropriate?
A) Administer oxygen at 4 L/min via nasal cannula
B) Encourage pursed-lip breathing
C) Place patient in supine position
D) Restrict fluid intake
*Answer: * B) Encourage pursed-lip breathing
*Rationale: * Pursed-lip breathing helps control the breathing pattern, prevents airway
collapse, and reduces dyspnea in COPD patients. Supine positioning worsens breathing
and should be avoided.
Question 9:
What is the primary nursing priority for a patient with status asthmaticus?
