NUR 265 Exam 1 Medical-Surgical Nursing (2026) PDF | Galen
College of Nursing Graded A+(100 +QUESTIONS WITH ANSWERS
AND RATIONALES)
Section Questions Topic Focus
1 1–10 Renal System & Kidney Function
2 11–25 Acute Kidney Injury (AKI)
3 26–35 Chronic Kidney Disease (CKD)
4 36–45 Pancreatitis
5 46–55 Cirrhosis & Hepatic Disorders
6 56–70 Transplant & Immunology (SLE, AIDS, Kidney/Liver Transplant)
7 71–80 Preoperative Care
8 81–85 Postoperative Care (Hemorrhage, Malignant Hyperthermia, Urinary Retention)
9 86–90 Liver Biopsy & Paracentesis
10 91–93 TIPS Procedure & Portal Hypertension
11 94–96 Hepatitis (A, B, C)
12 97–98 Bariatric Surgery
13 99–100 Postoperative Complications (PE, Surgical Site Infection)
,Section 1: Renal System & Kidney Function (Questions 1–10)
Question 1: The nurse is explaining kidney functions to a group of nursing
students. Which of the following statements about kidney function is
correct? (Select all that apply)
A) Kidneys receive 5-10% of cardiac output under resting conditions
B) Kidneys secrete erythropoietin to increase RBC synthesis in bone marrow
C) Kidneys convert Vitamin D into its active form
D) The Loop of Henle concentrates urine and allows water reabsorption
E) Kidneys are primarily responsible for digesting proteins
Correct Answer: B, C, D
Rationale: Kidneys receive 20-25% (not 5-10%) of cardiac output . Key functions
include: erythropoietin production for RBC synthesis, Vitamin D activation, and
urine concentration via the Loop of Henle. Protein digestion occurs in the GI tract,
not the kidneys.
Question 2: A client with nephrotic syndrome has severe proteinuria. Which of
the following actions should the nurse take?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: B
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 .
Question 3: 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
stable at 1.1 mg/dL
B) Client 2 days post-AAA repair with creatinine increasing from 0.9 to 2.5 mg/dL
C) Client with potassium 4.0 mEq/L
D) Client with mild hyponatremia
Correct Answer: B
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury, requiring urgent evaluation. This is a priority over stable findings or
mild electrolyte abnormalities .
Question 4: A client with CKD asks why they need to limit phosphorus in their
diet. The nurse's best response is:
A) "Phosphorus causes fluid retention in your body."
B) "High phosphorus levels increase your risk of bleeding."
C) "High phosphorus levels can lead to bone disease and calcium deposits in
your tissues."
D) "Phosphorus interferes with your blood pressure medications."
Correct Answer: C
Rationale: In CKD, the kidneys cannot excrete phosphorus, leading to
hyperphosphatemia. This causes calcium to be pulled from bones (renal
osteodystrophy) and calcium-phosphate deposits in soft tissues.
Question 5: A client with CKD is prescribed epoetin alfa (Epogen). The nurse
knows this medication is given to treat:
A) Hyperkalemia
B) Metabolic acidosis
C) Anemia
D) Hypertension
, Correct Answer: C
Rationale: Epoetin alfa is synthetic erythropoietin, which stimulates RBC
production. CKD patients have decreased erythropoietin production, leading to
anemia .
Question 6: The nurse is assessing a client with CKD. Which finding is most
concerning for uremia?
A) Blood pressure 138/88 mm Hg
B) Uremic frost on the skin
C) Mild peripheral edema
D) Hemoglobin 10.5 g/dL
Correct Answer: B
Rationale: Uremic frost (crystallized urea on the skin) indicates severe, advanced
uremia and requires immediate intervention. It occurs when BUN is extremely
elevated .
Question 7: A client with stage 4 CKD reports muscle cramps and tingling in the
fingers. Which lab value should the nurse check first?
A) Hemoglobin
B) Calcium
C) Sodium
D) Phosphate
Correct Answer: B
Rationale: Muscle cramps and tingling suggest hypocalcemia, common in CKD due
to decreased Vitamin D activation and hyperphosphatemia. Hypocalcemia can
cause tetany and seizures.
College of Nursing Graded A+(100 +QUESTIONS WITH ANSWERS
AND RATIONALES)
Section Questions Topic Focus
1 1–10 Renal System & Kidney Function
2 11–25 Acute Kidney Injury (AKI)
3 26–35 Chronic Kidney Disease (CKD)
4 36–45 Pancreatitis
5 46–55 Cirrhosis & Hepatic Disorders
6 56–70 Transplant & Immunology (SLE, AIDS, Kidney/Liver Transplant)
7 71–80 Preoperative Care
8 81–85 Postoperative Care (Hemorrhage, Malignant Hyperthermia, Urinary Retention)
9 86–90 Liver Biopsy & Paracentesis
10 91–93 TIPS Procedure & Portal Hypertension
11 94–96 Hepatitis (A, B, C)
12 97–98 Bariatric Surgery
13 99–100 Postoperative Complications (PE, Surgical Site Infection)
,Section 1: Renal System & Kidney Function (Questions 1–10)
Question 1: The nurse is explaining kidney functions to a group of nursing
students. Which of the following statements about kidney function is
correct? (Select all that apply)
A) Kidneys receive 5-10% of cardiac output under resting conditions
B) Kidneys secrete erythropoietin to increase RBC synthesis in bone marrow
C) Kidneys convert Vitamin D into its active form
D) The Loop of Henle concentrates urine and allows water reabsorption
E) Kidneys are primarily responsible for digesting proteins
Correct Answer: B, C, D
Rationale: Kidneys receive 20-25% (not 5-10%) of cardiac output . Key functions
include: erythropoietin production for RBC synthesis, Vitamin D activation, and
urine concentration via the Loop of Henle. Protein digestion occurs in the GI tract,
not the kidneys.
Question 2: A client with nephrotic syndrome has severe proteinuria. Which of
the following actions should the nurse take?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: B
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 .
Question 3: 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
stable at 1.1 mg/dL
B) Client 2 days post-AAA repair with creatinine increasing from 0.9 to 2.5 mg/dL
C) Client with potassium 4.0 mEq/L
D) Client with mild hyponatremia
Correct Answer: B
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury, requiring urgent evaluation. This is a priority over stable findings or
mild electrolyte abnormalities .
Question 4: A client with CKD asks why they need to limit phosphorus in their
diet. The nurse's best response is:
A) "Phosphorus causes fluid retention in your body."
B) "High phosphorus levels increase your risk of bleeding."
C) "High phosphorus levels can lead to bone disease and calcium deposits in
your tissues."
D) "Phosphorus interferes with your blood pressure medications."
Correct Answer: C
Rationale: In CKD, the kidneys cannot excrete phosphorus, leading to
hyperphosphatemia. This causes calcium to be pulled from bones (renal
osteodystrophy) and calcium-phosphate deposits in soft tissues.
Question 5: A client with CKD is prescribed epoetin alfa (Epogen). The nurse
knows this medication is given to treat:
A) Hyperkalemia
B) Metabolic acidosis
C) Anemia
D) Hypertension
, Correct Answer: C
Rationale: Epoetin alfa is synthetic erythropoietin, which stimulates RBC
production. CKD patients have decreased erythropoietin production, leading to
anemia .
Question 6: The nurse is assessing a client with CKD. Which finding is most
concerning for uremia?
A) Blood pressure 138/88 mm Hg
B) Uremic frost on the skin
C) Mild peripheral edema
D) Hemoglobin 10.5 g/dL
Correct Answer: B
Rationale: Uremic frost (crystallized urea on the skin) indicates severe, advanced
uremia and requires immediate intervention. It occurs when BUN is extremely
elevated .
Question 7: A client with stage 4 CKD reports muscle cramps and tingling in the
fingers. Which lab value should the nurse check first?
A) Hemoglobin
B) Calcium
C) Sodium
D) Phosphate
Correct Answer: B
Rationale: Muscle cramps and tingling suggest hypocalcemia, common in CKD due
to decreased Vitamin D activation and hyperphosphatemia. Hypocalcemia can
cause tetany and seizures.
