NUR 257 CHRONIC EXAM 1 QUESTIONS
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE
1. A patient with Type 2 Diabetes is prescribed Metformin. Which diagnostic test result would
require the nurse to withhold the medication and notify the provider immediately?
A. Hemoglobin A1c of 8.2%
B. Serum Creatinine of 1.9 mg/dL
C. Blood Urea Nitrogen (BUN) of 22 mg/dL
D. Fasting Plasma Glucose of 145 mg/dL
Answer: B
Conceptual Explanation: Metformin is contraindicated in patients with renal impairment
(Creatinine > 1.5 in men or > 1.4 in women) due to the high risk of lactic acidosis.
2. A client with Chronic Obstructive Pulmonary Disease (COPD) is being discharged. Which
statement by the client indicates a need for further teaching regarding pursed-lip breathing?
A. ‘I should inhale through my nose for two counts.’
B. ‘I should exhale through my mouth for four counts.’
C. ‘I should puff my cheeks out while I am exhaling.’
D. ‘I should use this technique when I feel short of breath during activity.’
,Answer: C
Conceptual Explanation: Pursed-lip breathing involves exhaling through pressed-
together lips, not puffing out the cheeks, to maintain airway pressure and prevent airway
collapse.
3. The nurse is assessing a patient with Right-sided Heart Failure. Which clinical manifestation
should the nurse expect to find?
A. Jugular venous distension and peripheral edema
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Pulmonary crackles and wheezing
D. Frothy, pink-tinged sputum
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
manifesting as JVD, hepatomegaly, and peripheral edema.
4. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.2 mEq/L.
Which cardiac rhythm change is the nurse most likely to observe on the EKG?
A. Prominent U waves
B. Tall, peaked T waves
C. Shortened PR interval
D. ST-segment depression
, Answer: B
Conceptual Explanation: Hyperkalemia (Potassium > 5.0) causes characteristic EKG
changes including tall, peaked T waves, widened QRS, and prolonged PR intervals.
5. A patient with a history of Chronic Stable Angina is prescribed Nitroglycerin sublingual
tablets. What instruction is vital for the nurse to include?
A. ‘Swallow the tablet with a full glass of water.’
B. ‘Discard the tablets if they produce a tingling sensation under the tongue.’
C. ‘Store the medication in a clear plastic bottle in the refrigerator.’
D. ‘Take one tablet every 5 minutes for up to 3 doses if pain persists.’
Answer: D
Conceptual Explanation: Standard protocol for Nitroglycerin is 1 tablet every 5 minutes
for 3 doses; if pain persists, emergency services should be contacted.
6. Which assessment finding in a patient with Multiple Sclerosis (MS) would the nurse
categorize as Lhermitte’s sign?
A. An electric-shock sensation radiating down the spine with neck flexion
B. Double vision and nystagmus
C. Muscle spasticity in the lower extremities
D. Involuntary rhythmic oscillation of the eyes
Answer: A
AND ANSWERS WITH VERIFIED
SOLUTIONS 2026/2027 UPDATE
1. A patient with Type 2 Diabetes is prescribed Metformin. Which diagnostic test result would
require the nurse to withhold the medication and notify the provider immediately?
A. Hemoglobin A1c of 8.2%
B. Serum Creatinine of 1.9 mg/dL
C. Blood Urea Nitrogen (BUN) of 22 mg/dL
D. Fasting Plasma Glucose of 145 mg/dL
Answer: B
Conceptual Explanation: Metformin is contraindicated in patients with renal impairment
(Creatinine > 1.5 in men or > 1.4 in women) due to the high risk of lactic acidosis.
2. A client with Chronic Obstructive Pulmonary Disease (COPD) is being discharged. Which
statement by the client indicates a need for further teaching regarding pursed-lip breathing?
A. ‘I should inhale through my nose for two counts.’
B. ‘I should exhale through my mouth for four counts.’
C. ‘I should puff my cheeks out while I am exhaling.’
D. ‘I should use this technique when I feel short of breath during activity.’
,Answer: C
Conceptual Explanation: Pursed-lip breathing involves exhaling through pressed-
together lips, not puffing out the cheeks, to maintain airway pressure and prevent airway
collapse.
3. The nurse is assessing a patient with Right-sided Heart Failure. Which clinical manifestation
should the nurse expect to find?
A. Jugular venous distension and peripheral edema
B. Orthopnea and paroxysmal nocturnal dyspnea
C. Pulmonary crackles and wheezing
D. Frothy, pink-tinged sputum
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
manifesting as JVD, hepatomegaly, and peripheral edema.
4. A client with Chronic Kidney Disease (CKD) has a serum potassium level of 6.2 mEq/L.
Which cardiac rhythm change is the nurse most likely to observe on the EKG?
A. Prominent U waves
B. Tall, peaked T waves
C. Shortened PR interval
D. ST-segment depression
, Answer: B
Conceptual Explanation: Hyperkalemia (Potassium > 5.0) causes characteristic EKG
changes including tall, peaked T waves, widened QRS, and prolonged PR intervals.
5. A patient with a history of Chronic Stable Angina is prescribed Nitroglycerin sublingual
tablets. What instruction is vital for the nurse to include?
A. ‘Swallow the tablet with a full glass of water.’
B. ‘Discard the tablets if they produce a tingling sensation under the tongue.’
C. ‘Store the medication in a clear plastic bottle in the refrigerator.’
D. ‘Take one tablet every 5 minutes for up to 3 doses if pain persists.’
Answer: D
Conceptual Explanation: Standard protocol for Nitroglycerin is 1 tablet every 5 minutes
for 3 doses; if pain persists, emergency services should be contacted.
6. Which assessment finding in a patient with Multiple Sclerosis (MS) would the nurse
categorize as Lhermitte’s sign?
A. An electric-shock sensation radiating down the spine with neck flexion
B. Double vision and nystagmus
C. Muscle spasticity in the lower extremities
D. Involuntary rhythmic oscillation of the eyes
Answer: A
