NUR 257 Chronic Exam 3- 2026/2027 Edition –
Actual Questions with 100% Verified Correct
Answers -Galen
50 Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION :
This Nur 257 Chronic Exam 3- 2026/2027 review provides high-yield practice for
older adult care, covering heart failure, COPD, asthma, pneumonia, hypertension,
diabetes, stroke, Parkinson's, Alzheimer's, delirium, and depression. Designed to
strengthen clinical judgment, prioritization, and safe nursing interventions with
rationales supporting exam success and real-world patient-centered care for
comprehensive understanding and confident preparation throughout your nursing
journey today always succeeding
Answers are in bold Green, with rationales after.
1. Patient with stage 4 heart failure, what symptom will you see?
A. Chronic shortness of breath
B. Intermittent chest pain on exertion only
C. Occasional peripheral edema in the morning
D. Fatigue only after strenuous exercise
Rationale: Stage 4 HF is end-stage. Patients have symptoms at rest. Chronic
dyspnea/shortness of breath even at rest is classic, due to severely reduced cardiac
output and pulmonary congestion.
2. Patient with CAD (coronary artery disease) that is worsening, what
symptoms would you expect to see?
,A. Increased appetite and weight gain
B. Excessive fatigue, unusual defecation patterns, dizziness
C. Improved exercise tolerance
D. Bradycardia and hypertension at rest
Rationale: Worsening CAD reduces myocardial perfusion. Atypical symptoms in older
adults include excessive fatigue, GI changes from reduced perfusion, dizziness/syncope,
angina, dyspnea on exertion.
3. You are caring for a client diagnosed with asthma who is not responding to
medication. The client is concerned and asks the nurse "What's wrong with
me, why am I not getting better?" What is the nurse's best response?
A. You must not be taking your medication correctly
B. Asthma is incurable and will only get worse
C. There are many triggers for asthma that can make treatment difficult
D. Your asthma has probably turned into COPD
Rationale: Therapeutic, non-blaming response. Many environmental, allergic, stress,
infection triggers can exacerbate asthma and reduce medication effectiveness.
Requires further assessment of triggers and adherence.
4. You are caring for an older client diagnosed with pneumonia. They want to
know how this happened if they never had respiratory problems in the past.
What response by the nurse is appropriate?
A. Pneumonia only happens to people who smoked in the past
B. You must have caught it from being outside in cold air
C. Untreated dental caries or periodontal disease can make it easier for you to
develop pneumonia as a secondary infection.
D. Getting older automatically gives you pneumonia
, Rationale: In older adults, poor oral hygiene leads to aspiration of colonized
oropharyngeal secretions, a major risk factor for community-acquired and aspiration
pneumonia. Age-related immune changes also increase risk.
5. You are providing education for an older adult who has hypertension. What
statement should the nurse include in the teaching?
A. You should increase your sodium intake to raise blood volume
B. You can stop your medication once you feel better
C. You need to find a way to reduce stress and treat any underlying depression
- Low sodium diet, exercise
D. You should avoid all physical activity to keep BP low
Rationale: Non-pharmacologic management of HTN includes stress reduction,
depression screening/treatment, DASH/low sodium diet (<2g/day), regular moderate
exercise, weight control, and limiting alcohol.
6. You are caring for an older client. You are aware that the signs and
symptoms of heart failure in the older adult are:
A. Dyspnea and fatigue with exertion
B. Sharp chest pain and high fever
C. Sudden weight loss and increased appetite
D. Bradycardia and increased energy
Rationale: Older adults often present atypically. Classic early HF signs are dyspnea on
exertion, fatigue, weakness, confusion, nocturia, and edema, rather than classic chest
pain.
7. Older adult client with COPD, tachycardic dysrhythmia and is being
admitted for nebulizer treatments and IV steroids and antibiotics. Which
nursing diagnosis is the priority for this client?
A. Impaired gas exchange as evidenced by tachycardia and COPD
Actual Questions with 100% Verified Correct
Answers -Galen
50 Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION :
This Nur 257 Chronic Exam 3- 2026/2027 review provides high-yield practice for
older adult care, covering heart failure, COPD, asthma, pneumonia, hypertension,
diabetes, stroke, Parkinson's, Alzheimer's, delirium, and depression. Designed to
strengthen clinical judgment, prioritization, and safe nursing interventions with
rationales supporting exam success and real-world patient-centered care for
comprehensive understanding and confident preparation throughout your nursing
journey today always succeeding
Answers are in bold Green, with rationales after.
1. Patient with stage 4 heart failure, what symptom will you see?
A. Chronic shortness of breath
B. Intermittent chest pain on exertion only
C. Occasional peripheral edema in the morning
D. Fatigue only after strenuous exercise
Rationale: Stage 4 HF is end-stage. Patients have symptoms at rest. Chronic
dyspnea/shortness of breath even at rest is classic, due to severely reduced cardiac
output and pulmonary congestion.
2. Patient with CAD (coronary artery disease) that is worsening, what
symptoms would you expect to see?
,A. Increased appetite and weight gain
B. Excessive fatigue, unusual defecation patterns, dizziness
C. Improved exercise tolerance
D. Bradycardia and hypertension at rest
Rationale: Worsening CAD reduces myocardial perfusion. Atypical symptoms in older
adults include excessive fatigue, GI changes from reduced perfusion, dizziness/syncope,
angina, dyspnea on exertion.
3. You are caring for a client diagnosed with asthma who is not responding to
medication. The client is concerned and asks the nurse "What's wrong with
me, why am I not getting better?" What is the nurse's best response?
A. You must not be taking your medication correctly
B. Asthma is incurable and will only get worse
C. There are many triggers for asthma that can make treatment difficult
D. Your asthma has probably turned into COPD
Rationale: Therapeutic, non-blaming response. Many environmental, allergic, stress,
infection triggers can exacerbate asthma and reduce medication effectiveness.
Requires further assessment of triggers and adherence.
4. You are caring for an older client diagnosed with pneumonia. They want to
know how this happened if they never had respiratory problems in the past.
What response by the nurse is appropriate?
A. Pneumonia only happens to people who smoked in the past
B. You must have caught it from being outside in cold air
C. Untreated dental caries or periodontal disease can make it easier for you to
develop pneumonia as a secondary infection.
D. Getting older automatically gives you pneumonia
, Rationale: In older adults, poor oral hygiene leads to aspiration of colonized
oropharyngeal secretions, a major risk factor for community-acquired and aspiration
pneumonia. Age-related immune changes also increase risk.
5. You are providing education for an older adult who has hypertension. What
statement should the nurse include in the teaching?
A. You should increase your sodium intake to raise blood volume
B. You can stop your medication once you feel better
C. You need to find a way to reduce stress and treat any underlying depression
- Low sodium diet, exercise
D. You should avoid all physical activity to keep BP low
Rationale: Non-pharmacologic management of HTN includes stress reduction,
depression screening/treatment, DASH/low sodium diet (<2g/day), regular moderate
exercise, weight control, and limiting alcohol.
6. You are caring for an older client. You are aware that the signs and
symptoms of heart failure in the older adult are:
A. Dyspnea and fatigue with exertion
B. Sharp chest pain and high fever
C. Sudden weight loss and increased appetite
D. Bradycardia and increased energy
Rationale: Older adults often present atypically. Classic early HF signs are dyspnea on
exertion, fatigue, weakness, confusion, nocturia, and edema, rather than classic chest
pain.
7. Older adult client with COPD, tachycardic dysrhythmia and is being
admitted for nebulizer treatments and IV steroids and antibiotics. Which
nursing diagnosis is the priority for this client?
A. Impaired gas exchange as evidenced by tachycardia and COPD
