NUR 257 CHRONIC EXAM 4 / NUR257 (CHRONIC CARE MANAGEMENT)
ACTUAL EXAM 4 LATEST 2026 COMPLETE ACCURATE TEST REAL
QUESTIONS WITH WELL ELABORATED ANSWERS
1. A 78-year-old patient with hypertension, type 2 diabetes, osteoarthritis, and
chronic kidney disease tells the nurse that managing several medications,
dietary restrictions, appointments, and exercise recommendations has
become overwhelming. Which nursing intervention is most appropriate for
promoting successful long-term chronic disease management?
A. Encourage the patient to develop realistic goals collaboratively with the
healthcare team
B. Ask the patient's family to take complete responsibility for medication
administration
C. Tell the patient that strict adherence is more important than personal
preferences
D. Recommend addressing only the most symptomatic condition and postponing
the others
Answer: A
2. A 70-year-old patient with multiple chronic conditions repeatedly states, “I
understand everything,” but later cannot explain how or when medications
should be taken. Which nursing strategy is most effective for determining
whether the patient understands the treatment plan?
A. Provide another written pamphlet
B. Ask the family member whether the patient understands
C. Ask the patient to repeat the instructions in their own words
D. Assume understanding because the patient verbally agreed
Answer: C
3. A patient with chronic heart failure calls the clinic and reports a rapid 3-kg
weight gain over several days, increasing bilateral ankle edema, and new
pg. 1
, difficulty sleeping while lying flat. Which nursing action should receive
priority?
A. Encourage the patient to increase oral fluids
B. Recommend strenuous exercise to remove excess fluid
C. Tell the patient to discontinue the prescribed diuretic
D. Assess promptly for worsening fluid retention and heart failure
Answer: D
4. A 67-year-old patient with chronic obstructive pulmonary disease reports
that walking from the bedroom to the kitchen now causes severe shortness
of breath. The patient continues to smoke and uses prescribed inhalers
inconsistently. Which intervention is most important for improving long-
term disease management?
A. Encourage smoking cessation and review correct inhaler use
B. Recommend complete bed rest to prevent dyspnea
C. Encourage the patient to stop all bronchodilator therapy
D. Recommend drinking additional fluids instead of using inhalers
Answer: A
5. A patient with chronic illness states, “My disease controls my entire life, and
there is nothing I can do about it.” Which response by the nurse best
supports adaptation and self-management?
A. “You should simply follow your provider's instructions exactly.”
B. “Your family can make the decisions for you.”
C. “Let's identify which parts of your daily care you feel you can control.”
D. “Chronic illnesses generally become worse regardless of what patients do.”
Answer: C
6. An older adult taking 11 prescription medications, several over-the-counter
medications, and multiple herbal products reports dizziness and two recent
falls. Which nursing intervention is the priority?
pg. 2
,A. Encourage the patient to increase physical activity immediately
B. Complete a comprehensive medication reconciliation
C. Tell the patient to stop every medication until symptoms disappear
D. Focus only on the medications prescribed by the primary care provider
Answer: B
7. A patient with chronic illness repeatedly misses appointments because
transportation is unreliable and lives alone with limited financial resources.
Which nursing intervention best addresses the underlying barrier to care?
A. Document the missed appointments as noncompliance
B. Tell the patient that attendance is the patient's responsibility
C. Arrange appropriate community and transportation resources
D. Discontinue chronic disease follow-up
Answer: C
8. A patient with a newly diagnosed chronic illness appears withdrawn and
states, “I cannot believe this is happening to me.” Which nursing response is
most therapeutic?
A. “You need to accept the diagnosis immediately.”
B. “Many people adapt over time; tell me what concerns you most right now.”
C. “Try not to think about the diagnosis.”
D. “Your symptoms are probably not as serious as you think.”
Answer: B
9. A patient with chronic disease has limited health literacy and appears
embarrassed when asked about medication instructions. Which approach is
most appropriate?
A. Use plain language, limit information to essential points, and use teach-back
B. Provide a highly technical written explanation
C. Ask a family member to make all healthcare decisions
D. Avoid discussing the medication regimen until the next visit
pg. 3
, Answer: A
10. A patient with chronic illness says, “I keep forgetting to take my medications
because every day is different.” Which intervention is most likely to improve
adherence?
A. Increase the number of daily medication doses
B. Tell the patient to rely entirely on memory
C. Develop a routine linked to an established daily activity and use reminders
D. Encourage the patient to take medications only when symptoms occur
Answer: C
11. A 76-year-old patient with chronic hypertension asks why blood pressure
monitoring remains important even when there are no symptoms. Which
response is most accurate?
A. Hypertension causes symptoms every time it becomes elevated
B. Blood pressure is relevant only when chest pain occurs
C. Medication is unnecessary when the patient feels well
D. Persistent hypertension can cause target-organ damage even without
symptoms
Answer: D
12. A patient with hypertension has several elevated readings in the clinic but
consistently reports lower readings at home using a validated device. Which
phenomenon should the nurse recognize?
A. White-coat hypertension
B. Malignant hypertension
C. Resistant hypertension
D. Orthostatic hypotension
Answer: A
13. A patient with hypertension remains above the individualized blood-
pressure goal despite taking three appropriate medications, including a
pg. 4
ACTUAL EXAM 4 LATEST 2026 COMPLETE ACCURATE TEST REAL
QUESTIONS WITH WELL ELABORATED ANSWERS
1. A 78-year-old patient with hypertension, type 2 diabetes, osteoarthritis, and
chronic kidney disease tells the nurse that managing several medications,
dietary restrictions, appointments, and exercise recommendations has
become overwhelming. Which nursing intervention is most appropriate for
promoting successful long-term chronic disease management?
A. Encourage the patient to develop realistic goals collaboratively with the
healthcare team
B. Ask the patient's family to take complete responsibility for medication
administration
C. Tell the patient that strict adherence is more important than personal
preferences
D. Recommend addressing only the most symptomatic condition and postponing
the others
Answer: A
2. A 70-year-old patient with multiple chronic conditions repeatedly states, “I
understand everything,” but later cannot explain how or when medications
should be taken. Which nursing strategy is most effective for determining
whether the patient understands the treatment plan?
A. Provide another written pamphlet
B. Ask the family member whether the patient understands
C. Ask the patient to repeat the instructions in their own words
D. Assume understanding because the patient verbally agreed
Answer: C
3. A patient with chronic heart failure calls the clinic and reports a rapid 3-kg
weight gain over several days, increasing bilateral ankle edema, and new
pg. 1
, difficulty sleeping while lying flat. Which nursing action should receive
priority?
A. Encourage the patient to increase oral fluids
B. Recommend strenuous exercise to remove excess fluid
C. Tell the patient to discontinue the prescribed diuretic
D. Assess promptly for worsening fluid retention and heart failure
Answer: D
4. A 67-year-old patient with chronic obstructive pulmonary disease reports
that walking from the bedroom to the kitchen now causes severe shortness
of breath. The patient continues to smoke and uses prescribed inhalers
inconsistently. Which intervention is most important for improving long-
term disease management?
A. Encourage smoking cessation and review correct inhaler use
B. Recommend complete bed rest to prevent dyspnea
C. Encourage the patient to stop all bronchodilator therapy
D. Recommend drinking additional fluids instead of using inhalers
Answer: A
5. A patient with chronic illness states, “My disease controls my entire life, and
there is nothing I can do about it.” Which response by the nurse best
supports adaptation and self-management?
A. “You should simply follow your provider's instructions exactly.”
B. “Your family can make the decisions for you.”
C. “Let's identify which parts of your daily care you feel you can control.”
D. “Chronic illnesses generally become worse regardless of what patients do.”
Answer: C
6. An older adult taking 11 prescription medications, several over-the-counter
medications, and multiple herbal products reports dizziness and two recent
falls. Which nursing intervention is the priority?
pg. 2
,A. Encourage the patient to increase physical activity immediately
B. Complete a comprehensive medication reconciliation
C. Tell the patient to stop every medication until symptoms disappear
D. Focus only on the medications prescribed by the primary care provider
Answer: B
7. A patient with chronic illness repeatedly misses appointments because
transportation is unreliable and lives alone with limited financial resources.
Which nursing intervention best addresses the underlying barrier to care?
A. Document the missed appointments as noncompliance
B. Tell the patient that attendance is the patient's responsibility
C. Arrange appropriate community and transportation resources
D. Discontinue chronic disease follow-up
Answer: C
8. A patient with a newly diagnosed chronic illness appears withdrawn and
states, “I cannot believe this is happening to me.” Which nursing response is
most therapeutic?
A. “You need to accept the diagnosis immediately.”
B. “Many people adapt over time; tell me what concerns you most right now.”
C. “Try not to think about the diagnosis.”
D. “Your symptoms are probably not as serious as you think.”
Answer: B
9. A patient with chronic disease has limited health literacy and appears
embarrassed when asked about medication instructions. Which approach is
most appropriate?
A. Use plain language, limit information to essential points, and use teach-back
B. Provide a highly technical written explanation
C. Ask a family member to make all healthcare decisions
D. Avoid discussing the medication regimen until the next visit
pg. 3
, Answer: A
10. A patient with chronic illness says, “I keep forgetting to take my medications
because every day is different.” Which intervention is most likely to improve
adherence?
A. Increase the number of daily medication doses
B. Tell the patient to rely entirely on memory
C. Develop a routine linked to an established daily activity and use reminders
D. Encourage the patient to take medications only when symptoms occur
Answer: C
11. A 76-year-old patient with chronic hypertension asks why blood pressure
monitoring remains important even when there are no symptoms. Which
response is most accurate?
A. Hypertension causes symptoms every time it becomes elevated
B. Blood pressure is relevant only when chest pain occurs
C. Medication is unnecessary when the patient feels well
D. Persistent hypertension can cause target-organ damage even without
symptoms
Answer: D
12. A patient with hypertension has several elevated readings in the clinic but
consistently reports lower readings at home using a validated device. Which
phenomenon should the nurse recognize?
A. White-coat hypertension
B. Malignant hypertension
C. Resistant hypertension
D. Orthostatic hypotension
Answer: A
13. A patient with hypertension remains above the individualized blood-
pressure goal despite taking three appropriate medications, including a
pg. 4
