NUR 257 CHRONIC EXAM 4 PRACTICE QUESTIONS AND
ANSWERS ENHANCED WITH RATIONALES-2026 LATEST
RELEASE IN THE MARKET-SUCCESS ALREADY ASSURED!!
1. A patient with COPD is prescribed oxygen at 2 L/min via nasal cannula. What is the priority
nursing rationale?
• A. Prevent hypoxia.
• B. Prevent CO₂ retention.
• C. Increase lung compliance.
• D. Improve cardiac output.
• Answer: B. Rationale: COPD patients often rely on a "hypoxic drive" to breathe.
Excessive oxygen can suppress this drive, causing CO₂ retention and respiratory acidosis.
2. Which assessment finding is the most sensitive indicator of fluid volume status in a patient
with heart failure?
• A. Peripheral edema.
• B. Crackles on lung auscultation.
• C. Daily body weight.
• D. Blood pressure readings.
• Answer: C. Rationale: Daily weights are the most accurate, objective measurement of
fluid retention. A gain of 2–3 lbs in 24 hours is clinically significant.
3. A patient with Chronic Kidney Disease (CKD) asks why they are anemic. The nurse’s best
response is:
• A. "You are losing blood through your urine."
• B. "Your kidneys are not producing enough erythropoietin."
• C. "You are not eating enough iron-rich foods."
• D. "The dialysis treatment destroys your red blood cells."
• Answer: B. Rationale: The kidneys produce erythropoietin, which stimulates the bone
marrow to produce RBCs. In CKD, this production is impaired.
4. Which electrolyte imbalance is the most life-threatening concern in a patient with CKD?
• A. Hyperkalemia.
• B. Hyponatremia.
, • C. Hypocalcemia.
• D. Hyperphosphatemia.
• Answer: A. Rationale: Hyperkalemia can lead to fatal cardiac dysrhythmias and requires
immediate intervention.
5. A patient with liver cirrhosis has an ammonia level of 85 mcg/dL. Which finding would the
nurse expect?
• A. Jaundice.
• B. Ascites.
• C. Asterixis (flapping tremor).
• D. Spider angiomas.
• Answer: C. Rationale: Elevated ammonia levels cross the blood-brain barrier, causing
hepatic encephalopathy, often characterized by asterixis.
6. What is the purpose of administering Lactulose to a patient with cirrhosis?
• A. To increase albumin levels.
• B. To treat jaundice.
• C. To reduce ammonia levels by promoting stool excretion.
• D. To decrease portal hypertension.
• Answer: C. Rationale: Lactulose draws ammonia into the bowel, where it is excreted,
lowering serum levels and preventing encephalopathy.
7. A patient with Parkinson’s disease is at high risk for falls. Which intervention is the highest
priority?
• A. Restricting fluids to prevent nocturia.
• B. Teaching the patient to take small, shuffling steps.
• C. Keeping the environment free of clutter and providing assistive devices.
• D. Limiting protein intake during the day.
• Answer: C. Rationale: Parkinson’s causes gait disturbances and postural instability,
making environment safety the priority.
8. Which of the following is a classic symptom of hypoglycemia?
• A. Fruity breath odor.
• B. Diaphoresis and tremors.
ANSWERS ENHANCED WITH RATIONALES-2026 LATEST
RELEASE IN THE MARKET-SUCCESS ALREADY ASSURED!!
1. A patient with COPD is prescribed oxygen at 2 L/min via nasal cannula. What is the priority
nursing rationale?
• A. Prevent hypoxia.
• B. Prevent CO₂ retention.
• C. Increase lung compliance.
• D. Improve cardiac output.
• Answer: B. Rationale: COPD patients often rely on a "hypoxic drive" to breathe.
Excessive oxygen can suppress this drive, causing CO₂ retention and respiratory acidosis.
2. Which assessment finding is the most sensitive indicator of fluid volume status in a patient
with heart failure?
• A. Peripheral edema.
• B. Crackles on lung auscultation.
• C. Daily body weight.
• D. Blood pressure readings.
• Answer: C. Rationale: Daily weights are the most accurate, objective measurement of
fluid retention. A gain of 2–3 lbs in 24 hours is clinically significant.
3. A patient with Chronic Kidney Disease (CKD) asks why they are anemic. The nurse’s best
response is:
• A. "You are losing blood through your urine."
• B. "Your kidneys are not producing enough erythropoietin."
• C. "You are not eating enough iron-rich foods."
• D. "The dialysis treatment destroys your red blood cells."
• Answer: B. Rationale: The kidneys produce erythropoietin, which stimulates the bone
marrow to produce RBCs. In CKD, this production is impaired.
4. Which electrolyte imbalance is the most life-threatening concern in a patient with CKD?
• A. Hyperkalemia.
• B. Hyponatremia.
, • C. Hypocalcemia.
• D. Hyperphosphatemia.
• Answer: A. Rationale: Hyperkalemia can lead to fatal cardiac dysrhythmias and requires
immediate intervention.
5. A patient with liver cirrhosis has an ammonia level of 85 mcg/dL. Which finding would the
nurse expect?
• A. Jaundice.
• B. Ascites.
• C. Asterixis (flapping tremor).
• D. Spider angiomas.
• Answer: C. Rationale: Elevated ammonia levels cross the blood-brain barrier, causing
hepatic encephalopathy, often characterized by asterixis.
6. What is the purpose of administering Lactulose to a patient with cirrhosis?
• A. To increase albumin levels.
• B. To treat jaundice.
• C. To reduce ammonia levels by promoting stool excretion.
• D. To decrease portal hypertension.
• Answer: C. Rationale: Lactulose draws ammonia into the bowel, where it is excreted,
lowering serum levels and preventing encephalopathy.
7. A patient with Parkinson’s disease is at high risk for falls. Which intervention is the highest
priority?
• A. Restricting fluids to prevent nocturia.
• B. Teaching the patient to take small, shuffling steps.
• C. Keeping the environment free of clutter and providing assistive devices.
• D. Limiting protein intake during the day.
• Answer: C. Rationale: Parkinson’s causes gait disturbances and postural instability,
making environment safety the priority.
8. Which of the following is a classic symptom of hypoglycemia?
• A. Fruity breath odor.
• B. Diaphoresis and tremors.
