NUR 257 CHRONIC EXAM 3 -
ADVANCED CHRONIC CARE
MANAGEMENT QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100%
CORRECT-GALEN.
1. A patient with Stage 4 Chronic Kidney Disease (CKD) presents with a potassium level of 7.2
mEq/L and tall, peaked T-waves. Which medication should the nurse prioritize to stabilize the
cardiac membrane?
A. Sodium polystyrene sulfonate
B. Regular insulin and Dextrose 50%
C. Intravenous Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: In severe hyperkalemia with ECG changes, IV Calcium Gluconate
is administered first to stabilize the myocardium and prevent lethal arrhythmias, although
it does not lower the potassium level itself.
2. Which assessment finding in a patient with left-sided heart failure requires immediate
intervention by the nurse?
A. Pitting edema in both lower extremities
,B. Weight gain of 2 pounds in 24 hours
C. Jugular venous distension
D. Frothy, pink-tinged sputum
Answer: D
Conceptual Explanation: Frothy, pink-tinged sputum is a classic sign of acute pulmonary
edema, a life-threatening complication of left-sided heart failure requiring immediate
action.
3. A patient with COPD is receiving oxygen via a nasal cannula at 2L/min. The latest ABG
shows pH 7.32, PaCO2 55, and HCO3 28. How should the nurse interpret these results?
A. Compensated metabolic alkalosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Normal gas exchange for a COPD patient
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory), and the
HCO3 is elevated (compensatory mechanism), indicating partial compensation.
, 4. The nurse is caring for a patient with a T6 spinal cord injury. The patient reports a sudden
pounding headache and is found to be hypertensive (190/100) and bradycardic. What is the
nurse’s first action?
A. Administer prescribed hydralazine
B. Place the patient in a supine position
C. Check for bladder distension or fecal impaction
D. Notify the healthcare provider immediately
Answer: C
Conceptual Explanation: These are classic signs of autonomic dysreflexia. The priority is
to identify and remove the noxious stimulus, such as a distended bladder or impacted
bowel.
5. A patient with Type 1 Diabetes is found unconscious and diaphoretic. The fingerstick
glucose is 42 mg/dL. The patient does not have IV access. What is the priority nursing action?
A. Administer 1 mg of Glucagon intramuscularly
B. Establish a large-bore IV line for D50
C. Attempt to give the patient orange juice
D. Apply glucose gel to the buccal mucosa
Answer: A
ADVANCED CHRONIC CARE
MANAGEMENT QUESTIONS AND
ANSWERS | 2026/2027 UPDATE | 100%
CORRECT-GALEN.
1. A patient with Stage 4 Chronic Kidney Disease (CKD) presents with a potassium level of 7.2
mEq/L and tall, peaked T-waves. Which medication should the nurse prioritize to stabilize the
cardiac membrane?
A. Sodium polystyrene sulfonate
B. Regular insulin and Dextrose 50%
C. Intravenous Calcium Gluconate
D. Furosemide
Answer: C
Conceptual Explanation: In severe hyperkalemia with ECG changes, IV Calcium Gluconate
is administered first to stabilize the myocardium and prevent lethal arrhythmias, although
it does not lower the potassium level itself.
2. Which assessment finding in a patient with left-sided heart failure requires immediate
intervention by the nurse?
A. Pitting edema in both lower extremities
,B. Weight gain of 2 pounds in 24 hours
C. Jugular venous distension
D. Frothy, pink-tinged sputum
Answer: D
Conceptual Explanation: Frothy, pink-tinged sputum is a classic sign of acute pulmonary
edema, a life-threatening complication of left-sided heart failure requiring immediate
action.
3. A patient with COPD is receiving oxygen via a nasal cannula at 2L/min. The latest ABG
shows pH 7.32, PaCO2 55, and HCO3 28. How should the nurse interpret these results?
A. Compensated metabolic alkalosis
B. Partially compensated respiratory acidosis
C. Uncompensated respiratory acidosis
D. Normal gas exchange for a COPD patient
Answer: B
Conceptual Explanation: The pH is low (acidosis), the PaCO2 is high (respiratory), and the
HCO3 is elevated (compensatory mechanism), indicating partial compensation.
, 4. The nurse is caring for a patient with a T6 spinal cord injury. The patient reports a sudden
pounding headache and is found to be hypertensive (190/100) and bradycardic. What is the
nurse’s first action?
A. Administer prescribed hydralazine
B. Place the patient in a supine position
C. Check for bladder distension or fecal impaction
D. Notify the healthcare provider immediately
Answer: C
Conceptual Explanation: These are classic signs of autonomic dysreflexia. The priority is
to identify and remove the noxious stimulus, such as a distended bladder or impacted
bowel.
5. A patient with Type 1 Diabetes is found unconscious and diaphoretic. The fingerstick
glucose is 42 mg/dL. The patient does not have IV access. What is the priority nursing action?
A. Administer 1 mg of Glucagon intramuscularly
B. Establish a large-bore IV line for D50
C. Attempt to give the patient orange juice
D. Apply glucose gel to the buccal mucosa
Answer: A
