NUR 265 EXAM 1 | ACTUAL QUESTIONS AND
ANSWERS LATEST UPDATED 2026/2027 (GRADED
A+)- GALEN COLLEGE OF NURSING
EXAM 1
Question 1
The nurse is caring for a client who has chronic kidney disease
(CKD) and has developed uremia. Which of the following findings
are consistent with this condition?
Options:
A. Flank pain
B. Cloudy urine
C. Hypotension
D. Muscle cramps
Correct Answer: D. Muscle cramps
Rationale: Uremia results from accumulation of nitrogenous wastes in the
blood due to CKD. Key manifestations include muscle cramps, metallic taste
in the mouth, uremic frost on the skin, pruritus, anorexia, and
nausea/vomiting. Flank pain and cloudy urine are not typical of uremia, and
hypotension is not a defining feature.
Reference: Page 157
Question 2
The nurse working on the telemetry unit is reviewing the laboratory
results of a client with CKD and notes a serum potassium level of
6.1 mEq/L. Which action should the nurse take first?
Options:
A. Administer prescribed lactulose
B. Review the client’s electrocardiogram (EKG)
C. Withhold the next scheduled dose of spironolactone
D. Notify the primary health care provider (PHCP)
Correct Answer: B. Review the client’s electrocardiogram (EKG)
Rationale: A potassium level of 6.1 mEq/L is hyperkalemia, which can lead
to life-threatening dysrhythmias. The priority action is to assess cardiac
function via EKG before any medication administration or notification.
, Withholding potassium-sparing drugs and notifying the PHCP come after
assessing cardiac risk.
Reference: Page 157
Question 3
The nurse is assessing clients for their risk of developing heparin-
induced thrombocytopenia (HIT). Which client is at greatest risk?
Options:
A. 72-year-old female with anaphylactic reaction after PRBC transfusion
B. 59-year-old female receiving heparin 5,000 units SQ BID for 10 days
C. 27-year-old male receiving cryoprecipitate for hemophilia
D. 45-year-old male taking prescribed enoxaparin for DVT
Correct Answer: B. 59-year-old female receiving heparin 5,000 units SQ
BID for 10 days
Rationale: HIT occurs more frequently in patients receiving unfractionated
heparin for more than 10 days and is more common in females.
Thrombocytopenia is the hallmark sign and may result in DVT or pulmonary
embolism. Other clients are at lower risk.
Reference: Page 897
Question 4
The nurse is teaching a client recently diagnosed with
thrombocytopenia. Which instructions should be included in
discharge teaching?
Options:
A. Avoid blowing your nose
B. Use a soft-bristled toothbrush
C. Drink at least 3 liters of fluid per day
D. Use only aspirin for pain
Correct Answer: A. Avoid blowing your nose & B. Use a soft-bristled
toothbrush
Rationale: Patients with thrombocytopenia are at risk for bleeding and
should avoid mouth and nasal trauma. Aspirin should be avoided, and
excessive fluid intake is not specifically indicated for thrombocytopenia.
Reference: Page 889
ANSWERS LATEST UPDATED 2026/2027 (GRADED
A+)- GALEN COLLEGE OF NURSING
EXAM 1
Question 1
The nurse is caring for a client who has chronic kidney disease
(CKD) and has developed uremia. Which of the following findings
are consistent with this condition?
Options:
A. Flank pain
B. Cloudy urine
C. Hypotension
D. Muscle cramps
Correct Answer: D. Muscle cramps
Rationale: Uremia results from accumulation of nitrogenous wastes in the
blood due to CKD. Key manifestations include muscle cramps, metallic taste
in the mouth, uremic frost on the skin, pruritus, anorexia, and
nausea/vomiting. Flank pain and cloudy urine are not typical of uremia, and
hypotension is not a defining feature.
Reference: Page 157
Question 2
The nurse working on the telemetry unit is reviewing the laboratory
results of a client with CKD and notes a serum potassium level of
6.1 mEq/L. Which action should the nurse take first?
Options:
A. Administer prescribed lactulose
B. Review the client’s electrocardiogram (EKG)
C. Withhold the next scheduled dose of spironolactone
D. Notify the primary health care provider (PHCP)
Correct Answer: B. Review the client’s electrocardiogram (EKG)
Rationale: A potassium level of 6.1 mEq/L is hyperkalemia, which can lead
to life-threatening dysrhythmias. The priority action is to assess cardiac
function via EKG before any medication administration or notification.
, Withholding potassium-sparing drugs and notifying the PHCP come after
assessing cardiac risk.
Reference: Page 157
Question 3
The nurse is assessing clients for their risk of developing heparin-
induced thrombocytopenia (HIT). Which client is at greatest risk?
Options:
A. 72-year-old female with anaphylactic reaction after PRBC transfusion
B. 59-year-old female receiving heparin 5,000 units SQ BID for 10 days
C. 27-year-old male receiving cryoprecipitate for hemophilia
D. 45-year-old male taking prescribed enoxaparin for DVT
Correct Answer: B. 59-year-old female receiving heparin 5,000 units SQ
BID for 10 days
Rationale: HIT occurs more frequently in patients receiving unfractionated
heparin for more than 10 days and is more common in females.
Thrombocytopenia is the hallmark sign and may result in DVT or pulmonary
embolism. Other clients are at lower risk.
Reference: Page 897
Question 4
The nurse is teaching a client recently diagnosed with
thrombocytopenia. Which instructions should be included in
discharge teaching?
Options:
A. Avoid blowing your nose
B. Use a soft-bristled toothbrush
C. Drink at least 3 liters of fluid per day
D. Use only aspirin for pain
Correct Answer: A. Avoid blowing your nose & B. Use a soft-bristled
toothbrush
Rationale: Patients with thrombocytopenia are at risk for bleeding and
should avoid mouth and nasal trauma. Aspirin should be avoided, and
excessive fluid intake is not specifically indicated for thrombocytopenia.
Reference: Page 889
