NUR 257 CHRONIC EXAM 2 QUESTIONS
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT-GALEN.
1. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen therapy
at 2L/min via nasal cannula. The nurse notes the patient’s respiratory rate has decreased to
10 breaths/min and they are becoming lethargic. Which physiological process is likely
occurring?
A. Hyperventilation causing respiratory alkalosis
B. Improved oxygenation of the brain tissues
C. Elimination of the hypoxic drive for respiration
D. Acute exacerbation of bacterial pneumonia
Answer: C
Conceptual Explanation: In patients with chronic CO2 retention (like some with COPD),
the stimulus to breathe shifts from high CO2 levels to low oxygen levels (hypoxic drive).
Providing too much oxygen can suppress this drive, leading to hypoventilation and carbon
dioxide narcosis.
,2. A client with Chronic Kidney Disease (CKD) Stage 4 has a serum potassium level of 6.2
mEq/L. Which electrocardiogram (ECG) change should the nurse expect to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves, prolonged PR intervals, and eventually a widened QRS
complex.
3. The nurse is teaching a patient with Heart Failure about their new prescription for
Spironolactone. Which statement by the patient indicates a need for further teaching?
A. I will avoid eating large amounts of bananas and spinach.
B. I should notify my doctor if I develop breast tenderness.
C. I need to have my blood drawn regularly to check my potassium.
D. I will use a salt substitute to reduce my sodium intake.
Answer: D
, Conceptual Explanation: Spironolactone is a potassium-sparing diuretic. Most salt
substitutes contain potassium chloride, which puts the patient at high risk for
hyperkalemia when taken with spironolactone.
4. A patient with Type 2 Diabetes is scheduled for an intravenous pyelogram (IVP) using
contrast media. Which medication must the nurse ensure is withheld for 48 hours after the
procedure?
A. Glipizide
B. Regular Insulin
C. Pioglitazone
D. Metformin
Answer: D
Conceptual Explanation: Metformin must be held before and for 48 hours after
procedures involving iodine-based contrast dye to prevent acute renal failure and lactic
acidosis.
5. A client is experiencing an acute exacerbation of Multiple Sclerosis (MS). Which
classification of medication does the nurse anticipate administering to reduce inflammation
and duration of the relapse?
A. Corticosteroids
B. Beta-interferons
C. Anticholinergics
AND ANSWERS | 2026/2027 UPDATE |
100% CORRECT-GALEN.
1. A patient with Chronic Obstructive Pulmonary Disease (COPD) is receiving oxygen therapy
at 2L/min via nasal cannula. The nurse notes the patient’s respiratory rate has decreased to
10 breaths/min and they are becoming lethargic. Which physiological process is likely
occurring?
A. Hyperventilation causing respiratory alkalosis
B. Improved oxygenation of the brain tissues
C. Elimination of the hypoxic drive for respiration
D. Acute exacerbation of bacterial pneumonia
Answer: C
Conceptual Explanation: In patients with chronic CO2 retention (like some with COPD),
the stimulus to breathe shifts from high CO2 levels to low oxygen levels (hypoxic drive).
Providing too much oxygen can suppress this drive, leading to hypoventilation and carbon
dioxide narcosis.
,2. A client with Chronic Kidney Disease (CKD) Stage 4 has a serum potassium level of 6.2
mEq/L. Which electrocardiogram (ECG) change should the nurse expect to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
D. Shortened PR interval
Answer: A
Conceptual Explanation: Hyperkalemia (potassium > 5.0 mEq/L) typically manifests on
an ECG as tall, peaked T waves, prolonged PR intervals, and eventually a widened QRS
complex.
3. The nurse is teaching a patient with Heart Failure about their new prescription for
Spironolactone. Which statement by the patient indicates a need for further teaching?
A. I will avoid eating large amounts of bananas and spinach.
B. I should notify my doctor if I develop breast tenderness.
C. I need to have my blood drawn regularly to check my potassium.
D. I will use a salt substitute to reduce my sodium intake.
Answer: D
, Conceptual Explanation: Spironolactone is a potassium-sparing diuretic. Most salt
substitutes contain potassium chloride, which puts the patient at high risk for
hyperkalemia when taken with spironolactone.
4. A patient with Type 2 Diabetes is scheduled for an intravenous pyelogram (IVP) using
contrast media. Which medication must the nurse ensure is withheld for 48 hours after the
procedure?
A. Glipizide
B. Regular Insulin
C. Pioglitazone
D. Metformin
Answer: D
Conceptual Explanation: Metformin must be held before and for 48 hours after
procedures involving iodine-based contrast dye to prevent acute renal failure and lactic
acidosis.
5. A client is experiencing an acute exacerbation of Multiple Sclerosis (MS). Which
classification of medication does the nurse anticipate administering to reduce inflammation
and duration of the relapse?
A. Corticosteroids
B. Beta-interferons
C. Anticholinergics
