NUR 257 Chronic Exam 2 Actual Exam
Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
1. A client with chronic heart failure reports a sudden weight gain
of 2.5 kg (5.5 lbs) in 2 days. What is the nurse’s priority action?
o A. Increase the diuretic dose.
o B. Restrict fluids immediately.
o C. Notify the healthcare provider.
o D. Encourage increased activity.
Rationale: Rapid weight gain is a key indicator of fluid retention and
worsening heart failure. This finding requires prompt medical evaluation, as
it may signal the need for a change in the treatment plan.
2. Which symptom is most indicative of left-sided heart failure?
o A. Peripheral edema.
o B. Jugular vein distention.
o C. Crackles in the lungs.
o D. Ascites.
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion. This results in
classic signs such as crackles (rales) heard in the lung bases, dyspnea, and
orthopnea.
3. A client with COPD should be placed in which position for
optimal breathing?
o A. Supine.
o B. Trendelenburg.
, o C. High Fowler’s.
o D. Prone.
Rationale: The High Fowler’s position (sitting upright at a 90-degree angle)
allows for maximum lung expansion by using gravity to help the diaphragm
descend. This is the best position to improve oxygenation and reduce the
work of breathing for clients with COPD.
4. A client has a mechanical valve replacement. The nurse should
teach the client that the therapeutic international normalized
ratio (INR) range for a mechanical heart valve is typically:
o A. 1.5–2.0.
o B. 2.0–3.0.
o C. 2.5–3.5.
o D. 3.0–4.0.
Rationale: Mechanical heart valves are highly thrombogenic and require
lifelong anticoagulation. The therapeutic INR target is generally higher than
for other conditions, typically between 2.5 and 3.5, to prevent clot
formation while minimizing bleeding risk.
5. A priority intervention for chronic heart failure is:
o A. High sodium diet.
o B. Daily weight monitoring.
o C. Fluid restriction removal.
o D. Increased activity immediately.
Rationale: Daily weight monitoring is crucial for early detection of fluid
volume overload. A rapid increase in weight (e.g., 2-3 lbs in a day or 5 lbs in
a week) can indicate worsening heart failure and the need for intervention
before more severe symptoms develop.
6. ACE inhibitors primarily work to:
o A. Increase blood pressure.
o B. Lower blood pressure.
o C. Increase heart rate.
, o D. Cause hypoxia.
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, a potent vasoconstrictor. This action leads to vasodilation,
reduced blood volume, and ultimately a decrease in blood pressure,
making them a cornerstone of treatment for hypertension and heart failure.
7. A client with COPD has an oxygen saturation of 88% on room air.
Which of the following supplemental oxygen delivery methods is
most appropriate?
o A. Non-rebreather mask at 15 L/min.
o B. Nasal cannula at 2 L/min.
o C. Simple face mask at 10 L/min.
o D. Partial rebreather mask at 6 L/min.
Rationale: Clients with COPD often rely on a hypoxic drive to breathe. High
concentrations of oxygen can cause them to stop breathing. Low-flow
oxygen via nasal cannula (1-3 L/min) is preferred to safely raise oxygen
saturation to an acceptable level (typically 88-92%) without suppressing
their respiratory drive.
Endocrine
8. A diabetic patient reports blurred vision and frequent urination.
What is the priority nursing action?
o A. Check the blood glucose level.
o B. Administer insulin.
o C. Encourage fluids.
o D. Assess foot sensation.
Rationale: The symptoms of blurred vision and frequent urination (polyuria)
are classic signs of hyperglycemia. The priority action is to assess the
patient's current blood glucose level to confirm the suspected elevation
and guide further treatment.
9. Type 2 diabetes is characterized by:
, o A. An absolute lack of insulin production.
o B. Insulin resistance.
o C. Hypoglycemia only.
o D. The immediate need for exogenous insulin.
Rationale: In Type 2 diabetes, the pancreas usually produces insulin, but the
body’s cells become resistant to its effects. Over time, the pancreas may
also produce less insulin, but the defining characteristic is cellular
resistance.
Renal & Genitourinary
10. A client with chronic renal failure should limit which of the
following nutrients to prevent the buildup of toxic waste
products?
o A. Calcium.
o B. Protein.
o C. Vitamin C.
o D. Fiber.
Rationale: The kidneys are responsible for excreting the byproducts of
protein metabolism, such as urea. In chronic renal failure, protein intake is
restricted to slow the accumulation of these waste products, reducing the
workload on the failing kidneys.
11. When caring for a patient with urge incontinence, the nurse
understands that this is most directly caused by:
o A. A neurological lesion below the sacral level.
o B. Involuntary bladder contractions.
o C. A chronic bladder outlet obstruction.
o D. A lack of sensation to void.
Rationale: Urge incontinence, also known as "overactive bladder," is caused
by involuntary, spasmodic contractions of the detrusor muscle in the
bladder wall. This creates a sudden, intense need to urinate, often leading
to leakage before reaching a toilet.
Questions And Answers Practice
Questions with Solutions Newest |
Already Graded A+
1. A client with chronic heart failure reports a sudden weight gain
of 2.5 kg (5.5 lbs) in 2 days. What is the nurse’s priority action?
o A. Increase the diuretic dose.
o B. Restrict fluids immediately.
o C. Notify the healthcare provider.
o D. Encourage increased activity.
Rationale: Rapid weight gain is a key indicator of fluid retention and
worsening heart failure. This finding requires prompt medical evaluation, as
it may signal the need for a change in the treatment plan.
2. Which symptom is most indicative of left-sided heart failure?
o A. Peripheral edema.
o B. Jugular vein distention.
o C. Crackles in the lungs.
o D. Ascites.
Rationale: Left-sided heart failure causes blood to back up into the
pulmonary circulation, leading to pulmonary congestion. This results in
classic signs such as crackles (rales) heard in the lung bases, dyspnea, and
orthopnea.
3. A client with COPD should be placed in which position for
optimal breathing?
o A. Supine.
o B. Trendelenburg.
, o C. High Fowler’s.
o D. Prone.
Rationale: The High Fowler’s position (sitting upright at a 90-degree angle)
allows for maximum lung expansion by using gravity to help the diaphragm
descend. This is the best position to improve oxygenation and reduce the
work of breathing for clients with COPD.
4. A client has a mechanical valve replacement. The nurse should
teach the client that the therapeutic international normalized
ratio (INR) range for a mechanical heart valve is typically:
o A. 1.5–2.0.
o B. 2.0–3.0.
o C. 2.5–3.5.
o D. 3.0–4.0.
Rationale: Mechanical heart valves are highly thrombogenic and require
lifelong anticoagulation. The therapeutic INR target is generally higher than
for other conditions, typically between 2.5 and 3.5, to prevent clot
formation while minimizing bleeding risk.
5. A priority intervention for chronic heart failure is:
o A. High sodium diet.
o B. Daily weight monitoring.
o C. Fluid restriction removal.
o D. Increased activity immediately.
Rationale: Daily weight monitoring is crucial for early detection of fluid
volume overload. A rapid increase in weight (e.g., 2-3 lbs in a day or 5 lbs in
a week) can indicate worsening heart failure and the need for intervention
before more severe symptoms develop.
6. ACE inhibitors primarily work to:
o A. Increase blood pressure.
o B. Lower blood pressure.
o C. Increase heart rate.
, o D. Cause hypoxia.
Rationale: ACE inhibitors block the conversion of angiotensin I to
angiotensin II, a potent vasoconstrictor. This action leads to vasodilation,
reduced blood volume, and ultimately a decrease in blood pressure,
making them a cornerstone of treatment for hypertension and heart failure.
7. A client with COPD has an oxygen saturation of 88% on room air.
Which of the following supplemental oxygen delivery methods is
most appropriate?
o A. Non-rebreather mask at 15 L/min.
o B. Nasal cannula at 2 L/min.
o C. Simple face mask at 10 L/min.
o D. Partial rebreather mask at 6 L/min.
Rationale: Clients with COPD often rely on a hypoxic drive to breathe. High
concentrations of oxygen can cause them to stop breathing. Low-flow
oxygen via nasal cannula (1-3 L/min) is preferred to safely raise oxygen
saturation to an acceptable level (typically 88-92%) without suppressing
their respiratory drive.
Endocrine
8. A diabetic patient reports blurred vision and frequent urination.
What is the priority nursing action?
o A. Check the blood glucose level.
o B. Administer insulin.
o C. Encourage fluids.
o D. Assess foot sensation.
Rationale: The symptoms of blurred vision and frequent urination (polyuria)
are classic signs of hyperglycemia. The priority action is to assess the
patient's current blood glucose level to confirm the suspected elevation
and guide further treatment.
9. Type 2 diabetes is characterized by:
, o A. An absolute lack of insulin production.
o B. Insulin resistance.
o C. Hypoglycemia only.
o D. The immediate need for exogenous insulin.
Rationale: In Type 2 diabetes, the pancreas usually produces insulin, but the
body’s cells become resistant to its effects. Over time, the pancreas may
also produce less insulin, but the defining characteristic is cellular
resistance.
Renal & Genitourinary
10. A client with chronic renal failure should limit which of the
following nutrients to prevent the buildup of toxic waste
products?
o A. Calcium.
o B. Protein.
o C. Vitamin C.
o D. Fiber.
Rationale: The kidneys are responsible for excreting the byproducts of
protein metabolism, such as urea. In chronic renal failure, protein intake is
restricted to slow the accumulation of these waste products, reducing the
workload on the failing kidneys.
11. When caring for a patient with urge incontinence, the nurse
understands that this is most directly caused by:
o A. A neurological lesion below the sacral level.
o B. Involuntary bladder contractions.
o C. A chronic bladder outlet obstruction.
o D. A lack of sensation to void.
Rationale: Urge incontinence, also known as "overactive bladder," is caused
by involuntary, spasmodic contractions of the detrusor muscle in the
bladder wall. This creates a sudden, intense need to urinate, often leading
to leakage before reaching a toilet.
