1|Page
NUR 257 Exam 2: Concepts of
Aging & Chronic Illness| 2026
Latest Update | Galen College |
Verified Questions & Answers |
Grade A Study Guide
Exam Structure:
Subject: Nursing (Gerontology/Cardiology) - Concepts of Aging & Chronic Illness,
Exam 2
Source: Galen College of Nursing NUR 257 Exam 2 (2026)
Format: Multiple-Choice Q&A with Rationales
1. Which would the nurse stress as a periodic lifelong necessity for a
client managing infective endocarditis?
A. Exercise regimen
B. Antihypertensive medication
C. Potassium replacement
D. Antibiotic therapy
Correct Answer: D. Antibiotic therapy
Rationale:
1. Infective endocarditis is an infection of the heart valves or
endocardium.
2. Lifelong prophylactic or periodic antibiotic therapy is often required
to prevent recurrence, especially before dental or surgical procedures
that could cause bacteremia.
3. This is a key component of long-term management to prevent
complications and reinfection.
, 2|Page
2. The nurse is caring for a client who has been diagnosed with aortic
stenosis. The client is prescribed digoxin. What is the rationale for the
medication?
A. Angina
B. Dyspnea
C. Edema
D. Left ventricular dysfunction
Correct Answer: D. Left ventricular dysfunction
Rationale:
1. Aortic stenosis leads to increased pressure load on the left ventricle,
causing hypertrophy and eventual dysfunction.
2. Digoxin is a positive inotrope that increases myocardial contractility.
3. It is used to manage symptoms of heart failure resulting from left
ventricular dysfunction in conditions like aortic stenosis.
3. A client is admitted to the hospital with possible acute pericarditis
and pericardial effusion. The nurse knows to prepare the client for
which diagnostic test to confirm the client's diagnosis?
A. Computed tomography
B. Echocardiography
C. Chest x-ray
D. Cardiac catheterization
Correct Answer: B. Echocardiography
Rationale:
1. Echocardiography is the primary non-invasive test for visualizing the
pericardium and detecting effusion.
2. It can assess the size of the effusion, cardiac tamponade physiology,
and pericardial thickening.
3. It is more specific for pericardial pathology compared to a chest x-ray
or CT for this purpose.
4. A client comes to the clinic reporting fever, chills, and sore throat
and is diagnosed with streptococcal pharyngitis. A nurse knows that
early diagnosis and effective treatment is essential to avoid which
preventable disease?
A. Rheumatic fever
B. Cardiomyopathy
, 3|Page
C. Pericarditis
D. Mitral stenosis
Correct Answer: A. Rheumatic fever
Rationale:
1. Rheumatic fever is a preventable inflammatory sequela of untreated
Group A streptococcal pharyngitis.
2. Early antibiotic treatment of strep throat prevents the immune-
mediated response that damages heart valves.
3. This is a classic example of primary prevention for chronic valvular
heart disease.
5. The nurse is educating a client about the care related to a new
diagnosis of mitral valve prolapse. What statement made by the client
demonstrates understanding of the teaching?
A. "I will take antibiotics before getting my teeth cleaned."
B. "I can get my tongue pierced at a store in the shopping mall."
C. "I will avoid caffeine, alcohol, and smoking."
D. "I can get a tattoo at a local parlor."
Correct Answer: C. "I will avoid caffeine, alcohol, and smoking."
Rationale:
1. Caffeine, alcohol, and stimulants can exacerbate symptoms like
palpitations and tachycardia in mitral valve prolapse.
2. Lifestyle modification to avoid these substances is a standard part of
symptomatic management.
3. Prophylactic antibiotics are no longer routinely recommended for all
dental procedures in mitral valve prolapse per current guidelines.
6. A nurse is caring for a client with aortic stenosis whose
compensatory mechanisms of the heart have begun to fail. The nurse
will monitor the client carefully for which initial symptoms?
A. Dizziness, nausea, diarrhea
B. Exertional dyspnea, orthopnea, pulmonary edema
C. Syncope, fever, vomiting
D. Nausea, vomiting, exertional fatigue
Correct Answer: B. Exertional dyspnea, orthopnea, pulmonary edema
Rationale:
, 4|Page
1. When compensatory left ventricular hypertrophy fails in aortic
stenosis, left-sided heart failure develops.
2. The earliest signs are typically exertional dyspnea and orthopnea due
to pulmonary venous congestion.
3. Pulmonary edema indicates severe failure and is a late sign of
decompensation.
7. The nurse is assessing a client admitted with infective endocarditis.
Which manifestation would the nurse expect to find?
A. Bruising on the palms of the hands and soles of the feet
B. Raised red rash on the trunk and face
C. Involuntary muscle movements of the extremities
D. Small painful lesions on the pads of the fingers and toes
Correct Answer: D. Small painful lesions on the pads of the fingers and
toes
Rationale:
1. These lesions are called Osler's nodes.
2. They are tender, immunologic vascular phenomena characteristic of
infective endocarditis.
3. They differ from Janeway lesions (non-tender macules on
palms/soles) and other rashes.
8. During assessment of a client admitted for cardiomyopathy, the
nurse notes the following symptoms: dyspnea on exertion, fatigue,
fluid retention, and nausea. The initial appropriate nursing diagnosis
is which of the following?
A. Ineffective airway clearance
B. Disturbed sensory perception
C. Decreased cardiac output
D. Autonomic dysreflexia
Correct Answer: C. Decreased cardiac output
Rationale:
1. The symptoms described (dyspnea, fatigue, fluid retention) are
classic manifestations of heart failure due to reduced cardiac output.
2. Cardiomyopathy directly impairs the heart's pumping ability, leading
to decreased cardiac output.
NUR 257 Exam 2: Concepts of
Aging & Chronic Illness| 2026
Latest Update | Galen College |
Verified Questions & Answers |
Grade A Study Guide
Exam Structure:
Subject: Nursing (Gerontology/Cardiology) - Concepts of Aging & Chronic Illness,
Exam 2
Source: Galen College of Nursing NUR 257 Exam 2 (2026)
Format: Multiple-Choice Q&A with Rationales
1. Which would the nurse stress as a periodic lifelong necessity for a
client managing infective endocarditis?
A. Exercise regimen
B. Antihypertensive medication
C. Potassium replacement
D. Antibiotic therapy
Correct Answer: D. Antibiotic therapy
Rationale:
1. Infective endocarditis is an infection of the heart valves or
endocardium.
2. Lifelong prophylactic or periodic antibiotic therapy is often required
to prevent recurrence, especially before dental or surgical procedures
that could cause bacteremia.
3. This is a key component of long-term management to prevent
complications and reinfection.
, 2|Page
2. The nurse is caring for a client who has been diagnosed with aortic
stenosis. The client is prescribed digoxin. What is the rationale for the
medication?
A. Angina
B. Dyspnea
C. Edema
D. Left ventricular dysfunction
Correct Answer: D. Left ventricular dysfunction
Rationale:
1. Aortic stenosis leads to increased pressure load on the left ventricle,
causing hypertrophy and eventual dysfunction.
2. Digoxin is a positive inotrope that increases myocardial contractility.
3. It is used to manage symptoms of heart failure resulting from left
ventricular dysfunction in conditions like aortic stenosis.
3. A client is admitted to the hospital with possible acute pericarditis
and pericardial effusion. The nurse knows to prepare the client for
which diagnostic test to confirm the client's diagnosis?
A. Computed tomography
B. Echocardiography
C. Chest x-ray
D. Cardiac catheterization
Correct Answer: B. Echocardiography
Rationale:
1. Echocardiography is the primary non-invasive test for visualizing the
pericardium and detecting effusion.
2. It can assess the size of the effusion, cardiac tamponade physiology,
and pericardial thickening.
3. It is more specific for pericardial pathology compared to a chest x-ray
or CT for this purpose.
4. A client comes to the clinic reporting fever, chills, and sore throat
and is diagnosed with streptococcal pharyngitis. A nurse knows that
early diagnosis and effective treatment is essential to avoid which
preventable disease?
A. Rheumatic fever
B. Cardiomyopathy
, 3|Page
C. Pericarditis
D. Mitral stenosis
Correct Answer: A. Rheumatic fever
Rationale:
1. Rheumatic fever is a preventable inflammatory sequela of untreated
Group A streptococcal pharyngitis.
2. Early antibiotic treatment of strep throat prevents the immune-
mediated response that damages heart valves.
3. This is a classic example of primary prevention for chronic valvular
heart disease.
5. The nurse is educating a client about the care related to a new
diagnosis of mitral valve prolapse. What statement made by the client
demonstrates understanding of the teaching?
A. "I will take antibiotics before getting my teeth cleaned."
B. "I can get my tongue pierced at a store in the shopping mall."
C. "I will avoid caffeine, alcohol, and smoking."
D. "I can get a tattoo at a local parlor."
Correct Answer: C. "I will avoid caffeine, alcohol, and smoking."
Rationale:
1. Caffeine, alcohol, and stimulants can exacerbate symptoms like
palpitations and tachycardia in mitral valve prolapse.
2. Lifestyle modification to avoid these substances is a standard part of
symptomatic management.
3. Prophylactic antibiotics are no longer routinely recommended for all
dental procedures in mitral valve prolapse per current guidelines.
6. A nurse is caring for a client with aortic stenosis whose
compensatory mechanisms of the heart have begun to fail. The nurse
will monitor the client carefully for which initial symptoms?
A. Dizziness, nausea, diarrhea
B. Exertional dyspnea, orthopnea, pulmonary edema
C. Syncope, fever, vomiting
D. Nausea, vomiting, exertional fatigue
Correct Answer: B. Exertional dyspnea, orthopnea, pulmonary edema
Rationale:
, 4|Page
1. When compensatory left ventricular hypertrophy fails in aortic
stenosis, left-sided heart failure develops.
2. The earliest signs are typically exertional dyspnea and orthopnea due
to pulmonary venous congestion.
3. Pulmonary edema indicates severe failure and is a late sign of
decompensation.
7. The nurse is assessing a client admitted with infective endocarditis.
Which manifestation would the nurse expect to find?
A. Bruising on the palms of the hands and soles of the feet
B. Raised red rash on the trunk and face
C. Involuntary muscle movements of the extremities
D. Small painful lesions on the pads of the fingers and toes
Correct Answer: D. Small painful lesions on the pads of the fingers and
toes
Rationale:
1. These lesions are called Osler's nodes.
2. They are tender, immunologic vascular phenomena characteristic of
infective endocarditis.
3. They differ from Janeway lesions (non-tender macules on
palms/soles) and other rashes.
8. During assessment of a client admitted for cardiomyopathy, the
nurse notes the following symptoms: dyspnea on exertion, fatigue,
fluid retention, and nausea. The initial appropriate nursing diagnosis
is which of the following?
A. Ineffective airway clearance
B. Disturbed sensory perception
C. Decreased cardiac output
D. Autonomic dysreflexia
Correct Answer: C. Decreased cardiac output
Rationale:
1. The symptoms described (dyspnea, fatigue, fluid retention) are
classic manifestations of heart failure due to reduced cardiac output.
2. Cardiomyopathy directly impairs the heart's pumping ability, leading
to decreased cardiac output.
