NUR 265 Medical-Surgical Nursing Exam
1 – Versions 1, 2, & 3 – 300 Questions
with Answers & Rationales - Galen
College of Nursing.
Exam Blueprint
Version Topics Covered Questions
Version 1 Renal, Endocrine, Diabetes 1–100
Version 2 Cardiac, Respiratory, Periop, Gastrointestinal 101–200
Version 3 Critical Care, IV Therapy, Infectious Disease, Hematology 201–300
NUR 265 Exam 1 – Version 1: Renal, Endocrine, & Diabetes (Questions 1–100)
1. The nurse caring for a client with 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 in
nephrotic syndrome .
,2. The nurse is reviewing labs of assigned clients. Which client requires
priority follow-up with the primary healthcare provider?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
✅ Correct Answer: B) Temperature of 101.4°F
*Rationale: Fever above 101°F post-dialysis indicates possible infection and
requires prompt assessment and intervention .*
3. Which finding in a client who had hemodialysis yesterday requires
immediate follow-up?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
✅ Correct Answer: B) Temperature of 101.4°F
Rationale: Fever post-hemodialysis is a red flag for sepsis or access-related
infection. The nurse should assess for other signs of infection and notify the
provider immediately .
4. 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."
✅ Correct Answer: A) "I try and limit my intake of dietary sodium to 5 grams
per day."
*Rationale: Sodium intake should be restricted to 2-4 grams per day in
hemodialysis to help manage hypertension and fluid balance. Five grams
exceeds the recommended limit .*
,5. Which client statement suggests correct understanding of teaching for a
client in late-stage CKD?
A) "If I develop any muscle weakness or tremors, I should report it to my
doctor."
B) "I can skip dialysis if I feel well."
C) "I do not need to worry about my potassium intake."
D) "I should increase my protein intake significantly."
✅ Correct Answer: A) "If I develop any muscle weakness or tremors, I should
report it to my doctor."
Rationale: Muscle weakness and tremors may indicate electrolyte imbalances
such as hypokalemia or hypocalcemia, requiring medical evaluation .
6. A client with type 1 diabetes mellitus has a blood glucose of 45 mg/dL and
is unconscious. Which intervention should the nurse implement first?
A) Administer glucagon 1 mg IM
B) Give orange juice orally
C) Start an IV of D5W
D) Recheck blood glucose in 15 minutes
✅ Correct Answer: A) Administer glucagon 1 mg IM
Rationale: An unconscious client cannot safely swallow. Glucagon IM raises
blood glucose rapidly by stimulating glycogenolysis in the liver. IV dextrose is
also appropriate but requires IV access, which takes longer .
7. A patient with type 1 diabetes has received diet instruction. The nurse
determines a need for additional instruction when the patient says:
A) "I may have an occasional alcoholic drink if I include it in my meal plan."
B) "I will need a bedtime snack because I take an evening dose of NPH
insulin."
C) "I will eat meals as scheduled, even if I am not hungry, to prevent
hypoglycemia."
D) "I may eat whatever I want, as long as I use enough insulin to cover the
calories."
, ✅ Correct Answer: D) "I may eat whatever I want, as long as I use enough
insulin to cover the calories."
Rationale: Patients with type 1 diabetes need to plan diet choices carefully.
While intensified insulin therapy provides flexibility, dietary intake of fat,
protein, and alcohol must still be restricted. Simply covering calories with
insulin promotes poor glucose control and weight gain .
8. Which action should the nurse take when a client is receiving peritoneal
dialysis and the dialysate outflow is less than inflow?
A) Turn the client from side to side
B) Increase the flow rate of the dialysate
C) Notify the healthcare provider immediately
D) Document the finding as normal
✅ Correct Answer: A) Turn the client from side to side
Rationale: Repositioning the client can improve the gravity-dependent flow of
dialysate and relieve outflow obstruction. If outflow remains low after
repositioning, further assessment is needed .
9. Which of the following infection control actions is appropriate when
changing a peritoneal dialysis catheter dressing?
A) Use sterile gloves only
B) Place a mask on the client
C) Use clean gloves only
D) No protective equipment needed
✅ Correct Answer: B) Place a mask on the client
Rationale: Masks reduce infection risk by minimizing airborne pathogens
during catheter dressing changes in clients receiving peritoneal dialysis. Both
the nurse and the client should wear masks .
10. The nurse preceptor observes a newly hired nurse caring for a client
receiving peritoneal dialysis. Which action indicates correct technique?
A) Using a microwave to warm dialysate
B) Repositioning the client during dialysis to improve dialysate flow
1 – Versions 1, 2, & 3 – 300 Questions
with Answers & Rationales - Galen
College of Nursing.
Exam Blueprint
Version Topics Covered Questions
Version 1 Renal, Endocrine, Diabetes 1–100
Version 2 Cardiac, Respiratory, Periop, Gastrointestinal 101–200
Version 3 Critical Care, IV Therapy, Infectious Disease, Hematology 201–300
NUR 265 Exam 1 – Version 1: Renal, Endocrine, & Diabetes (Questions 1–100)
1. The nurse caring for a client with 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 in
nephrotic syndrome .
,2. The nurse is reviewing labs of assigned clients. Which client requires
priority follow-up with the primary healthcare provider?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
✅ Correct Answer: B) Temperature of 101.4°F
*Rationale: Fever above 101°F post-dialysis indicates possible infection and
requires prompt assessment and intervention .*
3. Which finding in a client who had hemodialysis yesterday requires
immediate follow-up?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
✅ Correct Answer: B) Temperature of 101.4°F
Rationale: Fever post-hemodialysis is a red flag for sepsis or access-related
infection. The nurse should assess for other signs of infection and notify the
provider immediately .
4. 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."
✅ Correct Answer: A) "I try and limit my intake of dietary sodium to 5 grams
per day."
*Rationale: Sodium intake should be restricted to 2-4 grams per day in
hemodialysis to help manage hypertension and fluid balance. Five grams
exceeds the recommended limit .*
,5. Which client statement suggests correct understanding of teaching for a
client in late-stage CKD?
A) "If I develop any muscle weakness or tremors, I should report it to my
doctor."
B) "I can skip dialysis if I feel well."
C) "I do not need to worry about my potassium intake."
D) "I should increase my protein intake significantly."
✅ Correct Answer: A) "If I develop any muscle weakness or tremors, I should
report it to my doctor."
Rationale: Muscle weakness and tremors may indicate electrolyte imbalances
such as hypokalemia or hypocalcemia, requiring medical evaluation .
6. A client with type 1 diabetes mellitus has a blood glucose of 45 mg/dL and
is unconscious. Which intervention should the nurse implement first?
A) Administer glucagon 1 mg IM
B) Give orange juice orally
C) Start an IV of D5W
D) Recheck blood glucose in 15 minutes
✅ Correct Answer: A) Administer glucagon 1 mg IM
Rationale: An unconscious client cannot safely swallow. Glucagon IM raises
blood glucose rapidly by stimulating glycogenolysis in the liver. IV dextrose is
also appropriate but requires IV access, which takes longer .
7. A patient with type 1 diabetes has received diet instruction. The nurse
determines a need for additional instruction when the patient says:
A) "I may have an occasional alcoholic drink if I include it in my meal plan."
B) "I will need a bedtime snack because I take an evening dose of NPH
insulin."
C) "I will eat meals as scheduled, even if I am not hungry, to prevent
hypoglycemia."
D) "I may eat whatever I want, as long as I use enough insulin to cover the
calories."
, ✅ Correct Answer: D) "I may eat whatever I want, as long as I use enough
insulin to cover the calories."
Rationale: Patients with type 1 diabetes need to plan diet choices carefully.
While intensified insulin therapy provides flexibility, dietary intake of fat,
protein, and alcohol must still be restricted. Simply covering calories with
insulin promotes poor glucose control and weight gain .
8. Which action should the nurse take when a client is receiving peritoneal
dialysis and the dialysate outflow is less than inflow?
A) Turn the client from side to side
B) Increase the flow rate of the dialysate
C) Notify the healthcare provider immediately
D) Document the finding as normal
✅ Correct Answer: A) Turn the client from side to side
Rationale: Repositioning the client can improve the gravity-dependent flow of
dialysate and relieve outflow obstruction. If outflow remains low after
repositioning, further assessment is needed .
9. Which of the following infection control actions is appropriate when
changing a peritoneal dialysis catheter dressing?
A) Use sterile gloves only
B) Place a mask on the client
C) Use clean gloves only
D) No protective equipment needed
✅ Correct Answer: B) Place a mask on the client
Rationale: Masks reduce infection risk by minimizing airborne pathogens
during catheter dressing changes in clients receiving peritoneal dialysis. Both
the nurse and the client should wear masks .
10. The nurse preceptor observes a newly hired nurse caring for a client
receiving peritoneal dialysis. Which action indicates correct technique?
A) Using a microwave to warm dialysate
B) Repositioning the client during dialysis to improve dialysate flow
