NUR 257 CHRONIC EXAM/ ACTUAL NUR 257 CHRONIC EXAM 4 LATEST
2026/2027 EXAM PRACTICE QUESTIONS AND A NEW UPDATED STUDY
GUIDE ACCURATE EXAM
1. An older adult with several chronic conditions reports increasing fatigue,
reduced activity, and difficulty completing previously routine household
tasks. During assessment, the nurse notes decreased muscle strength,
slower gait, and unintentional weight loss. Which nursing interpretation
best reflects the relationship between chronic illness and frailty in this
patient?
A. Frailty represents a normal and unavoidable stage of aging that does not
require intervention
B. Frailty is synonymous with having multiple chronic diseases and resolves
when one disease is treated
C. Frailty reflects decreased physiologic reserve and increased vulnerability
to stressors and may coexist with chronic illness
D. Frailty occurs only when a patient has severe cognitive impairment
Answer: C
2. A 72-year-old patient with osteoarthritis reports persistent knee pain that
interferes with walking, sleeping, and participation in social activities. The
patient asks why the pain has continued despite several months of
conservative treatment. Which explanation by the nurse is most
appropriate?
A. Chronic pain may persist because long-standing changes in pain
processing can maintain symptoms even after the original tissue injury has
stabilized
B. Chronic pain always indicates that the underlying joint has become
acutely infected
C. Chronic pain occurs only when a patient has psychological illness
D. Chronic pain should disappear completely once an analgesic is
administered
Answer: A
pg. 1
, 3. A patient with chronic obstructive pulmonary disease has increasing
dyspnea while performing activities of daily living but remains stable at rest.
The patient states, “I have stopped doing things because I know I will
become short of breath.” Which nursing intervention is most appropriate to
help interrupt this cycle?
A. Encourage complete bed rest until the patient's breathing improves
permanently
B. Recommend avoiding all physical activity to prevent oxygen consumption
C. Encourage the patient to increase activity suddenly to build maximal
endurance
D. Teach energy-conservation techniques while gradually increasing
appropriately prescribed activity
Answer: D
4. A patient with long-standing heart failure tells the nurse that the disease
has affected employment, relationships, finances, and the ability to
participate in family activities. Which nursing response best demonstrates
an understanding of chronic illness management?
A. “The primary goal should be eliminating every symptom before
addressing these other concerns.”
B. “Chronic illness management includes addressing physical, psychological,
social, functional, and financial effects of the disease.”
C. “Those concerns are unrelated to the medical management of heart
failure.”
D. “You should focus exclusively on medication adherence because lifestyle
concerns are secondary.”
Answer: B
5. An 80-year-old patient with chronic kidney disease is prescribed several
medications by different providers. The nurse is reviewing the medication
list and discovers that two medications have similar therapeutic effects.
Which nursing action is most appropriate?
A. Tell the patient to discontinue both medications immediately
B. Instruct the patient to double the dose of whichever medication costs
pg. 2
, less
C. Reconcile the medication list and communicate the potential duplication
to the prescribing team
D. Advise the patient to continue both medications because multiple
providers prescribed them
Answer: C
6. A patient with osteoporosis asks why a diagnosis of osteopenia is important
even though no fracture has occurred. Which response by the nurse is most
accurate?
A. Osteopenia indicates reduced bone mineral density and can represent an
increased future risk for osteoporosis and fracture
B. Osteopenia means that a bone infection is already present
C. Osteopenia occurs only after a traumatic fracture
D. Osteopenia is synonymous with osteoarthritis and primarily affects
cartilage
Answer: A
7. A postmenopausal patient has several risk factors for osteoporosis and asks
which lifestyle measure can help preserve bone health. Which
recommendation should the nurse emphasize?
A. Avoiding all weight-bearing exercise
B. Maintaining prolonged bed rest to prevent skeletal stress
C. Eliminating dietary calcium because supplementation always causes
fractures
D. Participating in appropriate weight-bearing and muscle-strengthening
activity along with adequate calcium and vitamin D intake
Answer: D
8. A patient with chronic low back pain has been taking a prescribed opioid for
several months. The patient reports constipation, daytime drowsiness, and
increasing concern about medication dependence. Which nursing approach
is most appropriate?
A. Encourage the patient to abruptly stop the opioid without consulting the
pg. 3
, prescriber
B. Assess pain control, adverse effects, functional goals, and the overall
analgesic plan with the healthcare team
C. Recommend taking additional opioid doses whenever discomfort occurs
D. Explain that adverse effects are unavoidable and should not be discussed
Answer: B
9. A patient with rheumatoid arthritis reports morning stiffness that lasts
several hours and interferes with dressing and preparing breakfast. Which
finding most strongly supports an inflammatory rather than purely
degenerative joint process?
A. Pain occurring only after strenuous exercise
B. Brief stiffness lasting several minutes after sitting
C. Prolonged morning stiffness accompanied by swollen, tender joints
D. Isolated mechanical pain that improves with complete immobilization
Answer: C
10. An older adult with chronic illness states, “My family makes every
healthcare decision for me because they think I cannot manage anymore.”
Which nursing action best supports patient-centered chronic disease
management?
A. Assess the patient's decision-making preferences and involve family
members according to the patient's wishes
B. Allow the family to make all decisions because they provide
transportation
C. Exclude the family from all discussions regardless of the patient's
preference
D. Assume the patient lacks decision-making capacity because of age
Answer: A
11. A patient with chronic obstructive pulmonary disease is learning pursed-lip
breathing. Which explanation best describes the purpose of this technique?
A. It immediately eliminates all airway inflammation
B. It increases the patient's respiratory rate to improve oxygen consumption
pg. 4
2026/2027 EXAM PRACTICE QUESTIONS AND A NEW UPDATED STUDY
GUIDE ACCURATE EXAM
1. An older adult with several chronic conditions reports increasing fatigue,
reduced activity, and difficulty completing previously routine household
tasks. During assessment, the nurse notes decreased muscle strength,
slower gait, and unintentional weight loss. Which nursing interpretation
best reflects the relationship between chronic illness and frailty in this
patient?
A. Frailty represents a normal and unavoidable stage of aging that does not
require intervention
B. Frailty is synonymous with having multiple chronic diseases and resolves
when one disease is treated
C. Frailty reflects decreased physiologic reserve and increased vulnerability
to stressors and may coexist with chronic illness
D. Frailty occurs only when a patient has severe cognitive impairment
Answer: C
2. A 72-year-old patient with osteoarthritis reports persistent knee pain that
interferes with walking, sleeping, and participation in social activities. The
patient asks why the pain has continued despite several months of
conservative treatment. Which explanation by the nurse is most
appropriate?
A. Chronic pain may persist because long-standing changes in pain
processing can maintain symptoms even after the original tissue injury has
stabilized
B. Chronic pain always indicates that the underlying joint has become
acutely infected
C. Chronic pain occurs only when a patient has psychological illness
D. Chronic pain should disappear completely once an analgesic is
administered
Answer: A
pg. 1
, 3. A patient with chronic obstructive pulmonary disease has increasing
dyspnea while performing activities of daily living but remains stable at rest.
The patient states, “I have stopped doing things because I know I will
become short of breath.” Which nursing intervention is most appropriate to
help interrupt this cycle?
A. Encourage complete bed rest until the patient's breathing improves
permanently
B. Recommend avoiding all physical activity to prevent oxygen consumption
C. Encourage the patient to increase activity suddenly to build maximal
endurance
D. Teach energy-conservation techniques while gradually increasing
appropriately prescribed activity
Answer: D
4. A patient with long-standing heart failure tells the nurse that the disease
has affected employment, relationships, finances, and the ability to
participate in family activities. Which nursing response best demonstrates
an understanding of chronic illness management?
A. “The primary goal should be eliminating every symptom before
addressing these other concerns.”
B. “Chronic illness management includes addressing physical, psychological,
social, functional, and financial effects of the disease.”
C. “Those concerns are unrelated to the medical management of heart
failure.”
D. “You should focus exclusively on medication adherence because lifestyle
concerns are secondary.”
Answer: B
5. An 80-year-old patient with chronic kidney disease is prescribed several
medications by different providers. The nurse is reviewing the medication
list and discovers that two medications have similar therapeutic effects.
Which nursing action is most appropriate?
A. Tell the patient to discontinue both medications immediately
B. Instruct the patient to double the dose of whichever medication costs
pg. 2
, less
C. Reconcile the medication list and communicate the potential duplication
to the prescribing team
D. Advise the patient to continue both medications because multiple
providers prescribed them
Answer: C
6. A patient with osteoporosis asks why a diagnosis of osteopenia is important
even though no fracture has occurred. Which response by the nurse is most
accurate?
A. Osteopenia indicates reduced bone mineral density and can represent an
increased future risk for osteoporosis and fracture
B. Osteopenia means that a bone infection is already present
C. Osteopenia occurs only after a traumatic fracture
D. Osteopenia is synonymous with osteoarthritis and primarily affects
cartilage
Answer: A
7. A postmenopausal patient has several risk factors for osteoporosis and asks
which lifestyle measure can help preserve bone health. Which
recommendation should the nurse emphasize?
A. Avoiding all weight-bearing exercise
B. Maintaining prolonged bed rest to prevent skeletal stress
C. Eliminating dietary calcium because supplementation always causes
fractures
D. Participating in appropriate weight-bearing and muscle-strengthening
activity along with adequate calcium and vitamin D intake
Answer: D
8. A patient with chronic low back pain has been taking a prescribed opioid for
several months. The patient reports constipation, daytime drowsiness, and
increasing concern about medication dependence. Which nursing approach
is most appropriate?
A. Encourage the patient to abruptly stop the opioid without consulting the
pg. 3
, prescriber
B. Assess pain control, adverse effects, functional goals, and the overall
analgesic plan with the healthcare team
C. Recommend taking additional opioid doses whenever discomfort occurs
D. Explain that adverse effects are unavoidable and should not be discussed
Answer: B
9. A patient with rheumatoid arthritis reports morning stiffness that lasts
several hours and interferes with dressing and preparing breakfast. Which
finding most strongly supports an inflammatory rather than purely
degenerative joint process?
A. Pain occurring only after strenuous exercise
B. Brief stiffness lasting several minutes after sitting
C. Prolonged morning stiffness accompanied by swollen, tender joints
D. Isolated mechanical pain that improves with complete immobilization
Answer: C
10. An older adult with chronic illness states, “My family makes every
healthcare decision for me because they think I cannot manage anymore.”
Which nursing action best supports patient-centered chronic disease
management?
A. Assess the patient's decision-making preferences and involve family
members according to the patient's wishes
B. Allow the family to make all decisions because they provide
transportation
C. Exclude the family from all discussions regardless of the patient's
preference
D. Assume the patient lacks decision-making capacity because of age
Answer: A
11. A patient with chronic obstructive pulmonary disease is learning pursed-lip
breathing. Which explanation best describes the purpose of this technique?
A. It immediately eliminates all airway inflammation
B. It increases the patient's respiratory rate to improve oxygen consumption
pg. 4
