Galen NUR 265 Exam 1
Med-Surg (2026) – 150
Actual Questions &
Verified Answers
THIS DOCUMENT CONTAINS:
➢ GUARANTEE PASSING SCORE
➢ QUESTIONS AND ANSWERS
➢ EXPERT VERIFIED EXPLANATIONS
➢ FORMAT SET OF MULTIPLE-CHOICE
,Here is a comprehensive practice exam for NUR 265 Advanced
Concepts of Medical-Surgical Nursing Exam 1 at Galen College of
Nursing. This test bank contains 150 verified questions with detailed
rationales, covering all major topics typically tested on Exam 1
based on actual course content .
TABLE OF CONTENTS
Section Topic Area Questions
Section 1 Renal Disorders (CKD, AKI, Nephrotic Syndrome) 1-25
Section 2 Dialysis and Renal Replacement 26-40
Section 3 Fluid, Electrolyte, and Acid-Base Balance 41-55
Section 4 Gastrointestinal Disorders (Pancreatitis, Cirrhosis) 56-75
Section 5 Cardiac Disorders 76-95
Section 6 Respiratory Disorders (PE, ARDS, Chest Tubes) 96-115
Section 7 Immunologic and Infectious Disorders 116-130
Section 8 Endocrine Disorders 131-140
Section 9 Hematologic Disorders 141-150
,SECTION 1: Renal Disorders (CKD, AKI, Nephrotic
Syndrome)
Question 1
The nurse caring for a client who has nephrotic syndrome with severe proteinuria
should take which of the following actions?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: B) Administer lisinopril
Rationale: ACE inhibitors like lisinopril reduce proteinuria by lowering
intraglomerular pressure, which slows kidney damage progression. They are standard
therapy in nephrotic syndrome to decrease urinary protein loss. Furosemide may be
used for edema but does not address proteinuria directly .
Question 2
The nurse is reviewing labs of assigned clients. Which client requires priority follow-
up with the primary health care provider?
A) Client 2 days post-abdominal aortic aneurysm (AAA) repair with creatinine
increasing from 0.9 to 2.5 mg/dL
B) Client with creatinine stable at 1.1 mg/dL
C) Client with potassium 4.0 mEq/L
D) Client with mild hyponatremia
Correct Answer: A) Client 2 days post-AAA repair with creatinine increasing
from 0.9 to 2.5 mg/dL
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury (AKI), requiring urgent evaluation to prevent further renal damage. The
other values are within normal ranges .
, Question 3
A client receiving gentamicin has a trough level of 3.2 mcg/mL. Based on this finding,
what should the nurse do first?
A) Collect a specimen for gentamicin peak and trough levels
B) Administer the next dose as scheduled
C) Administer antihypertensive medication
D) Notify the dietitian
Correct Answer: A) Collect a specimen for gentamicin peak and trough levels
Rationale: Monitoring gentamicin peak and trough levels assesses potential
nephrotoxicity and guides dose adjustments to prevent further renal damage. An
elevated trough level indicates drug accumulation and risk of toxicity .
Question 4
The nurse is caring for a client with chronic kidney disease who is experiencing
increased rate and depth of respirations. After raising the head of the bed, what
should the nurse do next?
A) Order a chest x-ray
B) Obtain a blood specimen for arterial blood gases (ABGs)
C) Administer oxygen therapy
D) Encourage deep breathing exercises
Correct Answer: B) Obtain a blood specimen for arterial blood gases (ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations) indicate metabolic
acidosis, which is common in CKD. ABGs will confirm acidosis and guide treatment .
Question 5
Which client statement about dietary sodium needs further teaching for a client with
CKD on hemodialysis 3 times weekly?
A) "I try and limit my intake of dietary sodium to 5 grams per day."
B) "I avoid adding salt to my food."
C) "I read labels on processed foods for sodium content."
D) "I avoid salt substitutes containing potassium."
Med-Surg (2026) – 150
Actual Questions &
Verified Answers
THIS DOCUMENT CONTAINS:
➢ GUARANTEE PASSING SCORE
➢ QUESTIONS AND ANSWERS
➢ EXPERT VERIFIED EXPLANATIONS
➢ FORMAT SET OF MULTIPLE-CHOICE
,Here is a comprehensive practice exam for NUR 265 Advanced
Concepts of Medical-Surgical Nursing Exam 1 at Galen College of
Nursing. This test bank contains 150 verified questions with detailed
rationales, covering all major topics typically tested on Exam 1
based on actual course content .
TABLE OF CONTENTS
Section Topic Area Questions
Section 1 Renal Disorders (CKD, AKI, Nephrotic Syndrome) 1-25
Section 2 Dialysis and Renal Replacement 26-40
Section 3 Fluid, Electrolyte, and Acid-Base Balance 41-55
Section 4 Gastrointestinal Disorders (Pancreatitis, Cirrhosis) 56-75
Section 5 Cardiac Disorders 76-95
Section 6 Respiratory Disorders (PE, ARDS, Chest Tubes) 96-115
Section 7 Immunologic and Infectious Disorders 116-130
Section 8 Endocrine Disorders 131-140
Section 9 Hematologic Disorders 141-150
,SECTION 1: Renal Disorders (CKD, AKI, Nephrotic
Syndrome)
Question 1
The nurse caring for a client who has nephrotic syndrome with severe proteinuria
should take which of the following actions?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: B) Administer lisinopril
Rationale: ACE inhibitors like lisinopril reduce proteinuria by lowering
intraglomerular pressure, which slows kidney damage progression. They are standard
therapy in nephrotic syndrome to decrease urinary protein loss. Furosemide may be
used for edema but does not address proteinuria directly .
Question 2
The nurse is reviewing labs of assigned clients. Which client requires priority follow-
up with the primary health care provider?
A) Client 2 days post-abdominal aortic aneurysm (AAA) repair with creatinine
increasing from 0.9 to 2.5 mg/dL
B) Client with creatinine stable at 1.1 mg/dL
C) Client with potassium 4.0 mEq/L
D) Client with mild hyponatremia
Correct Answer: A) Client 2 days post-AAA repair with creatinine increasing
from 0.9 to 2.5 mg/dL
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury (AKI), requiring urgent evaluation to prevent further renal damage. The
other values are within normal ranges .
, Question 3
A client receiving gentamicin has a trough level of 3.2 mcg/mL. Based on this finding,
what should the nurse do first?
A) Collect a specimen for gentamicin peak and trough levels
B) Administer the next dose as scheduled
C) Administer antihypertensive medication
D) Notify the dietitian
Correct Answer: A) Collect a specimen for gentamicin peak and trough levels
Rationale: Monitoring gentamicin peak and trough levels assesses potential
nephrotoxicity and guides dose adjustments to prevent further renal damage. An
elevated trough level indicates drug accumulation and risk of toxicity .
Question 4
The nurse is caring for a client with chronic kidney disease who is experiencing
increased rate and depth of respirations. After raising the head of the bed, what
should the nurse do next?
A) Order a chest x-ray
B) Obtain a blood specimen for arterial blood gases (ABGs)
C) Administer oxygen therapy
D) Encourage deep breathing exercises
Correct Answer: B) Obtain a blood specimen for arterial blood gases (ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations) indicate metabolic
acidosis, which is common in CKD. ABGs will confirm acidosis and guide treatment .
Question 5
Which client statement about dietary sodium needs further teaching for a client with
CKD on hemodialysis 3 times weekly?
A) "I try and limit my intake of dietary sodium to 5 grams per day."
B) "I avoid adding salt to my food."
C) "I read labels on processed foods for sodium content."
D) "I avoid salt substitutes containing potassium."
