NUR 257 Chronic Exam 4 - 2026/2027 Edition –
Actual Questions with 100% Verified Correct
Answers -Galen
Chronic Exam 4 Review
Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION :
NUR 257 Chronic Exam 4 - 2026/2027 comprehensive review guide
covering skin integrity, sleep disorders, mobility, osteoarthritis,
osteoporosis, rheumatoid arthritis, gout, sensory deficits, glaucoma,
cataracts, macular degeneration, retinal detachment, pain
management, fall prevention, and palliative care.
Answers are in bold Green, with rationales after.
1. The nurse is doing a skin assessment on a patient with scabies. Which of the
following indicates the patient has this disease?
A. Linear lesions that are curved, ridges, and raised skin (burrows)
B. Pearly, waxy nodule with central ulceration
C. Thick, silvery scales on elbows and knees
D. Red, circular lesions with central clearing
Rationale: Scabies is caused by Sarcoptes scabiei. Classic finding is burrows - linear,
curved, raised ridges, especially interdigital spaces, wrists. Intense itching worse at
night.
, 2. During an assessment, a patient has a firm red, irregular scaly spot on their chest.
What is the diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Atopic dermatitis
D. Psoriasis
Rationale: Squamous cell carcinoma: firm, red, scaly, irregular, may bleed. Basal cell
is pearly waxy. Requires biopsy. Associated with sun exposure.
3. During the handoff report in LTCF. Which patient would be the first priority to see?
A. The patient that has had no bowel movement in 3 days
B. The patient with a Braden score of 18 who needs a snack
C. The patient who requested an extra blanket
D. The patient whose family will visit tomorrow
Rationale: Per your review highlight. In real clinical prioritization, use ABCs - chest
pain, SOB, hypotension, neuro changes would be first. Constipation is important but
not emergent unless bowel obstruction signs.
4. Patient admitted to rehab with alterations in sleep patterns. What action is best to
promote sleep?
A. Keep them on the same schedule such as going to bed at the same time every
night
B. Give them caffeine in the evening to prevent daytime sleepiness
C. Keep TV on loud all night for distraction
D. Do all nursing care in the middle of the night
Rationale: Consistent sleep-wake schedule reinforces circadian rhythm. Also sleep
hygiene: reduce noise/light, limit caffeine, cluster care, limit long daytime naps.
5. What are age-related changes in REM sleep in the elderly?
A. R.E.M. sleep decreases and stage 3-4 deep sleep decreases steadily; they spend
longer in bed but total sleep time decreases
B. R.E.M. sleep increases greatly with age and total sleep time increases
Actual Questions with 100% Verified Correct
Answers -Galen
Chronic Exam 4 Review
Questions with Step-by-Step Answers | 100% Verified | A+ Graded Review
INTRODUCTION :
NUR 257 Chronic Exam 4 - 2026/2027 comprehensive review guide
covering skin integrity, sleep disorders, mobility, osteoarthritis,
osteoporosis, rheumatoid arthritis, gout, sensory deficits, glaucoma,
cataracts, macular degeneration, retinal detachment, pain
management, fall prevention, and palliative care.
Answers are in bold Green, with rationales after.
1. The nurse is doing a skin assessment on a patient with scabies. Which of the
following indicates the patient has this disease?
A. Linear lesions that are curved, ridges, and raised skin (burrows)
B. Pearly, waxy nodule with central ulceration
C. Thick, silvery scales on elbows and knees
D. Red, circular lesions with central clearing
Rationale: Scabies is caused by Sarcoptes scabiei. Classic finding is burrows - linear,
curved, raised ridges, especially interdigital spaces, wrists. Intense itching worse at
night.
, 2. During an assessment, a patient has a firm red, irregular scaly spot on their chest.
What is the diagnosis?
A. Squamous cell carcinoma
B. Basal cell carcinoma
C. Atopic dermatitis
D. Psoriasis
Rationale: Squamous cell carcinoma: firm, red, scaly, irregular, may bleed. Basal cell
is pearly waxy. Requires biopsy. Associated with sun exposure.
3. During the handoff report in LTCF. Which patient would be the first priority to see?
A. The patient that has had no bowel movement in 3 days
B. The patient with a Braden score of 18 who needs a snack
C. The patient who requested an extra blanket
D. The patient whose family will visit tomorrow
Rationale: Per your review highlight. In real clinical prioritization, use ABCs - chest
pain, SOB, hypotension, neuro changes would be first. Constipation is important but
not emergent unless bowel obstruction signs.
4. Patient admitted to rehab with alterations in sleep patterns. What action is best to
promote sleep?
A. Keep them on the same schedule such as going to bed at the same time every
night
B. Give them caffeine in the evening to prevent daytime sleepiness
C. Keep TV on loud all night for distraction
D. Do all nursing care in the middle of the night
Rationale: Consistent sleep-wake schedule reinforces circadian rhythm. Also sleep
hygiene: reduce noise/light, limit caffeine, cluster care, limit long daytime naps.
5. What are age-related changes in REM sleep in the elderly?
A. R.E.M. sleep decreases and stage 3-4 deep sleep decreases steadily; they spend
longer in bed but total sleep time decreases
B. R.E.M. sleep increases greatly with age and total sleep time increases
