NUR 257 Chronic Exam 3
Chronic Exam 3 Practice Examination
Actual Exam Questions & Answers With Rationale
A+ GRADED
Welcome to NUR 257 Chronic Exam 3 Practice Examination. This comprehensive test bank
covers essential concepts in chronic disease management with a focus on diabetes mellitus,
thyroid disorders, cardiovascular comorbidities, and geriatric nursing considerations. The exam
consists of 250 multiple-choice questions designed to assess your understanding of
pathophysiology, clinical manifestations, nursing interventions, and patient education for older
adults with chronic conditions. Each question includes the correct answer and a brief rationale
to enhance your learning experience and prepare you for success on the actual examination.
Domains Covered:
1. Diabetes Mellitus - Diagnosis and Risk Factors (Questions 1-40)
2. Diabetes Management and Glucose Control (Questions 41-80)
3. Diabetes Complications and Neuropathy (Questions 81-115)
4. Hypothyroidism - Signs, Symptoms, and Management (Questions 116-150)
5. Cardiovascular Comorbidities and Risk Factors (Questions 151-180)
6. Medications and Hypoglycemia Recognition (Questions 181-210)
7. Nursing Interventions and Patient Education (Questions 211-240)
8. Comprehensive Review and Application (Questions 241-250)
QUESTION 1
An older adult who is a non-Hispanic Caucasian has a fasting blood sugar level above
130 mg/dL. Which client assessment does the nurse use to confirm a high risk for diabetes
mellitus in the client?
A) Family history of diabetes
B) 68 years of age
C) Body mass index above 30
D) History of hypertension
Answer: B) 68 years of age
Rationale: Age is a significant risk factor for diabetes mellitus. Older adults are at higher
risk for developing type 2 diabetes due to decreased beta-cell function and insulin
,sensitivity. A fasting blood sugar above 130 mg/dL indicates diabetes, and advanced
age confirms increased risk.
QUESTION 2
Which factor is commonly associated with the development of cardiovascular
comorbidities for those diagnosed with type 2 diabetes?
A) Alcohol use
B) Obesity
C) Physical inactivity
D) All of the above
Answer: D) All of the above
Rationale: Alcohol use, obesity, and physical inactivity are all commonly associated with
the development of cardiovascular comorbidities in patients with type 2 diabetes. These
factors contribute to hypertension, dyslipidemia, and vascular damage.
QUESTION 3
The nurse assists an older adult man who is diagnosed with type 2 diabetes mellitus to
improve his glucose control. Which of the following instructions does the nurse give to this
individual when he plans to walk more than usual in 1 day?
A) Increase carbohydrate intake before walking
B) Monitor blood glucose levels before and after walk
C) Skip insulin dose on days of increased activity
D) Walk only in the morning
Answer: B) Monitor blood glucose levels before and after walk
Rationale: When a patient with diabetes plans to exercise more than usual, they should
monitor blood glucose levels before and after the activity to prevent hypoglycemia or
hyperglycemia. Exercise increases glucose uptake and can lower blood sugar.
QUESTION 4
An older adult man diagnosed with diabetes mellitus complains to the nurse that his feet
feel like they are burning. Which of the following interventions should the nurse
recommend to this older adult to reduce his discomfort?
,A) Apply heat packs to the feet
B) Wear well-fitting shoes
C) Walk barefoot at home
D) Soak feet in hot water
Answer: B) Wear well-fitting shoes
Rationale: Burning feet in a diabetic patient suggests peripheral neuropathy. Wearing
well-fitting shoes can reduce pressure and trauma to the feet, preventing further nerve
damage. Avoid heat, hot water, and barefoot walking to prevent injury.
QUESTION 5
The nurse recognizes which of the following signs and symptoms as an indication of
hypothyroidism in an older adult? (Select all that apply.)
A) Decrease in thyroid-stimulating hormone (TSH) and thyroxine (T4)
B) Heat intolerance
C) Gait disturbances
D) Palpitations
E) Decline in cognitive function
Answer: C, D, E (Gait disturbances, Palpitations, Decline in cognitive function)
Rationale: Hypothyroidism in older adults presents with gait disturbances, palpitations,
decline in cognitive function, cold intolerance, weight gain, fatigue, and bradycardia.
Decrease in TSH and T4 is indicative of hyperthyroidism, not hypothyroidism.
QUESTION 6
When teaching a client about foods that do not increase blood glucose, which should the
nurse include?
A) White bread
B) Broccoli
C) Bananas
D) Orange juice
Answer: B) Broccoli
Rationale: Broccoli is a non-starchy vegetable that contains fiber and does not significantly
increase blood glucose levels. It has a low glycemic index and is an excellent choice for
diabetic patients.
, QUESTION 7
Which laboratory results are goals for reducing a person's risk for diabetes and heart
disease?
A) High-density lipoprotein (HDL) over 35 mg/dL
B) High-density lipoprotein (HDL) under 35 mg/dL
C) Low-density lipoprotein (LDL) over 130 mg/dL
D) Triglycerides over 150 mg/dL
Answer: A) High-density lipoprotein (HDL) over 35 mg/dL
Rationale: An HDL level over 35 mg/dL is a goal for reducing the risk of diabetes and
heart disease. Higher HDL levels are protective against cardiovascular disease. LDL should
be low, and triglycerides should be normal.
QUESTION 8
The nurse teaches an older adult diagnosed with diabetes mellitus and prescribed
metoprolol to recognize early clinical indicators of hypoglycemia. Which clinical indicators
of hypoglycemia does the nurse include in client teaching as the indicators this man is most
likely to detect? (Select all that apply.)
A) Confusion
B) Anxiety
C) Dizziness
D) Diaphoresis
E) Impaired vision
F) Tachycardia
Answer: B, D, F (Anxiety, Diaphoresis, Tachycardia)
Rationale: Patients on beta-blockers like metoprolol may not experience the typical
adrenergic symptoms of hypoglycemia (tachycardia, diaphoresis, anxiety). However,
these remain the most detectable indicators. Confusion and impaired vision are later signs
of hypoglycemia.
QUESTION 9
Which is the best goal when planning nursing care for an older client diagnosed with
diabetes mellitus?
A) Achieve perfect blood glucose control
Chronic Exam 3 Practice Examination
Actual Exam Questions & Answers With Rationale
A+ GRADED
Welcome to NUR 257 Chronic Exam 3 Practice Examination. This comprehensive test bank
covers essential concepts in chronic disease management with a focus on diabetes mellitus,
thyroid disorders, cardiovascular comorbidities, and geriatric nursing considerations. The exam
consists of 250 multiple-choice questions designed to assess your understanding of
pathophysiology, clinical manifestations, nursing interventions, and patient education for older
adults with chronic conditions. Each question includes the correct answer and a brief rationale
to enhance your learning experience and prepare you for success on the actual examination.
Domains Covered:
1. Diabetes Mellitus - Diagnosis and Risk Factors (Questions 1-40)
2. Diabetes Management and Glucose Control (Questions 41-80)
3. Diabetes Complications and Neuropathy (Questions 81-115)
4. Hypothyroidism - Signs, Symptoms, and Management (Questions 116-150)
5. Cardiovascular Comorbidities and Risk Factors (Questions 151-180)
6. Medications and Hypoglycemia Recognition (Questions 181-210)
7. Nursing Interventions and Patient Education (Questions 211-240)
8. Comprehensive Review and Application (Questions 241-250)
QUESTION 1
An older adult who is a non-Hispanic Caucasian has a fasting blood sugar level above
130 mg/dL. Which client assessment does the nurse use to confirm a high risk for diabetes
mellitus in the client?
A) Family history of diabetes
B) 68 years of age
C) Body mass index above 30
D) History of hypertension
Answer: B) 68 years of age
Rationale: Age is a significant risk factor for diabetes mellitus. Older adults are at higher
risk for developing type 2 diabetes due to decreased beta-cell function and insulin
,sensitivity. A fasting blood sugar above 130 mg/dL indicates diabetes, and advanced
age confirms increased risk.
QUESTION 2
Which factor is commonly associated with the development of cardiovascular
comorbidities for those diagnosed with type 2 diabetes?
A) Alcohol use
B) Obesity
C) Physical inactivity
D) All of the above
Answer: D) All of the above
Rationale: Alcohol use, obesity, and physical inactivity are all commonly associated with
the development of cardiovascular comorbidities in patients with type 2 diabetes. These
factors contribute to hypertension, dyslipidemia, and vascular damage.
QUESTION 3
The nurse assists an older adult man who is diagnosed with type 2 diabetes mellitus to
improve his glucose control. Which of the following instructions does the nurse give to this
individual when he plans to walk more than usual in 1 day?
A) Increase carbohydrate intake before walking
B) Monitor blood glucose levels before and after walk
C) Skip insulin dose on days of increased activity
D) Walk only in the morning
Answer: B) Monitor blood glucose levels before and after walk
Rationale: When a patient with diabetes plans to exercise more than usual, they should
monitor blood glucose levels before and after the activity to prevent hypoglycemia or
hyperglycemia. Exercise increases glucose uptake and can lower blood sugar.
QUESTION 4
An older adult man diagnosed with diabetes mellitus complains to the nurse that his feet
feel like they are burning. Which of the following interventions should the nurse
recommend to this older adult to reduce his discomfort?
,A) Apply heat packs to the feet
B) Wear well-fitting shoes
C) Walk barefoot at home
D) Soak feet in hot water
Answer: B) Wear well-fitting shoes
Rationale: Burning feet in a diabetic patient suggests peripheral neuropathy. Wearing
well-fitting shoes can reduce pressure and trauma to the feet, preventing further nerve
damage. Avoid heat, hot water, and barefoot walking to prevent injury.
QUESTION 5
The nurse recognizes which of the following signs and symptoms as an indication of
hypothyroidism in an older adult? (Select all that apply.)
A) Decrease in thyroid-stimulating hormone (TSH) and thyroxine (T4)
B) Heat intolerance
C) Gait disturbances
D) Palpitations
E) Decline in cognitive function
Answer: C, D, E (Gait disturbances, Palpitations, Decline in cognitive function)
Rationale: Hypothyroidism in older adults presents with gait disturbances, palpitations,
decline in cognitive function, cold intolerance, weight gain, fatigue, and bradycardia.
Decrease in TSH and T4 is indicative of hyperthyroidism, not hypothyroidism.
QUESTION 6
When teaching a client about foods that do not increase blood glucose, which should the
nurse include?
A) White bread
B) Broccoli
C) Bananas
D) Orange juice
Answer: B) Broccoli
Rationale: Broccoli is a non-starchy vegetable that contains fiber and does not significantly
increase blood glucose levels. It has a low glycemic index and is an excellent choice for
diabetic patients.
, QUESTION 7
Which laboratory results are goals for reducing a person's risk for diabetes and heart
disease?
A) High-density lipoprotein (HDL) over 35 mg/dL
B) High-density lipoprotein (HDL) under 35 mg/dL
C) Low-density lipoprotein (LDL) over 130 mg/dL
D) Triglycerides over 150 mg/dL
Answer: A) High-density lipoprotein (HDL) over 35 mg/dL
Rationale: An HDL level over 35 mg/dL is a goal for reducing the risk of diabetes and
heart disease. Higher HDL levels are protective against cardiovascular disease. LDL should
be low, and triglycerides should be normal.
QUESTION 8
The nurse teaches an older adult diagnosed with diabetes mellitus and prescribed
metoprolol to recognize early clinical indicators of hypoglycemia. Which clinical indicators
of hypoglycemia does the nurse include in client teaching as the indicators this man is most
likely to detect? (Select all that apply.)
A) Confusion
B) Anxiety
C) Dizziness
D) Diaphoresis
E) Impaired vision
F) Tachycardia
Answer: B, D, F (Anxiety, Diaphoresis, Tachycardia)
Rationale: Patients on beta-blockers like metoprolol may not experience the typical
adrenergic symptoms of hypoglycemia (tachycardia, diaphoresis, anxiety). However,
these remain the most detectable indicators. Confusion and impaired vision are later signs
of hypoglycemia.
QUESTION 9
Which is the best goal when planning nursing care for an older client diagnosed with
diabetes mellitus?
A) Achieve perfect blood glucose control
