NSG 4100/ NSG4100 Exams 1,2,3 & 4 (New 2026/
2027 Updates BUNDLED TOGETHER PACKAGE)
Questions & Answers | Grade A| 100% Correct
(Verified Solutions)- Galen
How to Use This Study Guide
This comprehensive document contains 200 exam-style questions and
,,,ANSWER,,,s covering all four NSG 4100 (Nursing Practice: Adult Health III) exams
for Galen College of Nursing, updated for the 2026/2027 curriculum. Each question
includes the correct ,,,ANSWER,,, and a detailed rationale explaining the clinical
reasoning. Use this guide to reinforce key concepts, test your knowledge, and
prepare for success on your exams.
NSG 4100 EXAM 1 – Renal, Respiratory, Endocrine, & Cardiac Disorders
(Questions 1-50)
Q1. More than 90% of the nephrons are unable to function properly. What is this
condition?
A) Acute Kidney Injury (AKI)
B) Chronic Kidney Disease (CKD) Stage 3
C) End Stage Renal Disease (ESRD)
D) Nephrotic Syndrome
Correct ,,,ANSWER,,,: C
,Rationale: ESRD is defined by the irreversible loss of kidney function, typically when
GFR falls below 15 mL/min, representing the loss of over 90% of nephron function.
At this stage, renal replacement therapy (dialysis or transplant) is required for
survival.
Q2. A patient with ESRD has a GFR of 12 mL/min. Which lab finding is expected
due to the loss of glomerular filtration?
A) Decreased BUN and Creatinine
B) Elevated BUN and Creatinine
C) Elevated Hemoglobin
D) Decreased Potassium
Correct ,,,ANSWER,,,: B
Rationale: BUN and creatinine are waste products normally filtered by the kidneys.
As GFR decreases, these levels accumulate in the blood. Elevated BUN (azotemia)
and creatinine are hallmark findings in kidney failure.
Q3. Why does metabolic acidosis commonly occur in patients with ESRD?
A) The kidneys produce excess bicarbonate
B) The lungs cannot excrete enough CO2
C) The kidneys cannot excrete acids or reabsorb bicarbonate
D) The liver produces excess metabolic acids
Correct ,,,ANSWER,,,: C
Rationale: Healthy kidneys excrete hydrogen ions and regenerate bicarbonate. In
ESRD, the loss of this function leads to a buildup of metabolic acids, causing
metabolic acidosis (low pH, low HCO3).
Q4. A patient with ESRD has a hemoglobin of 8.5 g/dL. What is the primary
pathophysiological reason for this anemia?
,A) Iron deficiency from poor diet
B) Blood loss during dialysis
C) Lack of Erythropoietin (EPO) production
D) Vitamin B12 deficiency
Correct ,,,ANSWER,,,: C
Rationale: The kidneys produce EPO to stimulate RBC production in the bone
marrow. Diseased kidneys cannot produce enough EPO, leading to anemia.
Treatment includes supplemental EPO (epoetin alfa) and iron supplementation.
Q5. Which complication of uremia is life-threatening and requires immediate
intervention due to friction rub on auscultation?
A) Pleural effusion
B) Pericarditis
C) Gastroenteritis
D) Pneumonia
Correct ,,,ANSWER,,,: B
Rationale: Uremic toxins irritate the pericardium, causing inflammation
(pericarditis). A pericardial friction rub is heard on auscultation. If untreated,
pericarditis can lead to cardiac tamponade, a life-threatening emergency.
Q6. A nurse reviews a diet tray for a patient with ESRD. Which item must be
removed because it is high in potassium?
A) White rice
B) Baked potato
C) Apple slices
D) White bread
Correct ,,,ANSWER,,,: B
, Rationale: Potatoes, oranges, bananas, tomatoes, and avocados are high in
potassium. Damaged kidneys cannot excrete potassium, leading to life-threatening
hyperkalemia (cardiac dysrhythmias).
Q7. A patient with ESRD has a potassium level of 6.1 mEq/L. What is the priority
nursing action?
A) Encourage high-potassium foods
B) Review the patient's telemetry strip for cardiac changes
C) Prepare for dialysis in the morning
D) Administer oral potassium supplements
Correct ,,,ANSWER,,,: B
Rationale: Hyperkalemia (K+ >5.0 mEq/L) can cause life-threatening cardiac
dysrhythmias, including peaked T waves, widened QRS, and cardiac arrest. The
priority is to assess cardiac status immediately.
Q8. A patient with COPD has an oxygen saturation of 88%. What is the safest
oxygen delivery goal for this patient?
A) Maintain O2 saturation at 100%
B) Maintain O2 saturation between 88-92%
C) Maintain O2 saturation above 95%
D) Do not give oxygen at all
Correct ,,,ANSWER,,,: B
Rationale: COPD patients often retain CO2 (chronic hypercapnia). Their respiratory
drive may depend on hypoxic drive rather than CO2 levels. High oxygen delivery can
remove their hypoxic drive, leading to respiratory depression and CO2 narcosis.
Titration to 88-92% is standard.
2027 Updates BUNDLED TOGETHER PACKAGE)
Questions & Answers | Grade A| 100% Correct
(Verified Solutions)- Galen
How to Use This Study Guide
This comprehensive document contains 200 exam-style questions and
,,,ANSWER,,,s covering all four NSG 4100 (Nursing Practice: Adult Health III) exams
for Galen College of Nursing, updated for the 2026/2027 curriculum. Each question
includes the correct ,,,ANSWER,,, and a detailed rationale explaining the clinical
reasoning. Use this guide to reinforce key concepts, test your knowledge, and
prepare for success on your exams.
NSG 4100 EXAM 1 – Renal, Respiratory, Endocrine, & Cardiac Disorders
(Questions 1-50)
Q1. More than 90% of the nephrons are unable to function properly. What is this
condition?
A) Acute Kidney Injury (AKI)
B) Chronic Kidney Disease (CKD) Stage 3
C) End Stage Renal Disease (ESRD)
D) Nephrotic Syndrome
Correct ,,,ANSWER,,,: C
,Rationale: ESRD is defined by the irreversible loss of kidney function, typically when
GFR falls below 15 mL/min, representing the loss of over 90% of nephron function.
At this stage, renal replacement therapy (dialysis or transplant) is required for
survival.
Q2. A patient with ESRD has a GFR of 12 mL/min. Which lab finding is expected
due to the loss of glomerular filtration?
A) Decreased BUN and Creatinine
B) Elevated BUN and Creatinine
C) Elevated Hemoglobin
D) Decreased Potassium
Correct ,,,ANSWER,,,: B
Rationale: BUN and creatinine are waste products normally filtered by the kidneys.
As GFR decreases, these levels accumulate in the blood. Elevated BUN (azotemia)
and creatinine are hallmark findings in kidney failure.
Q3. Why does metabolic acidosis commonly occur in patients with ESRD?
A) The kidneys produce excess bicarbonate
B) The lungs cannot excrete enough CO2
C) The kidneys cannot excrete acids or reabsorb bicarbonate
D) The liver produces excess metabolic acids
Correct ,,,ANSWER,,,: C
Rationale: Healthy kidneys excrete hydrogen ions and regenerate bicarbonate. In
ESRD, the loss of this function leads to a buildup of metabolic acids, causing
metabolic acidosis (low pH, low HCO3).
Q4. A patient with ESRD has a hemoglobin of 8.5 g/dL. What is the primary
pathophysiological reason for this anemia?
,A) Iron deficiency from poor diet
B) Blood loss during dialysis
C) Lack of Erythropoietin (EPO) production
D) Vitamin B12 deficiency
Correct ,,,ANSWER,,,: C
Rationale: The kidneys produce EPO to stimulate RBC production in the bone
marrow. Diseased kidneys cannot produce enough EPO, leading to anemia.
Treatment includes supplemental EPO (epoetin alfa) and iron supplementation.
Q5. Which complication of uremia is life-threatening and requires immediate
intervention due to friction rub on auscultation?
A) Pleural effusion
B) Pericarditis
C) Gastroenteritis
D) Pneumonia
Correct ,,,ANSWER,,,: B
Rationale: Uremic toxins irritate the pericardium, causing inflammation
(pericarditis). A pericardial friction rub is heard on auscultation. If untreated,
pericarditis can lead to cardiac tamponade, a life-threatening emergency.
Q6. A nurse reviews a diet tray for a patient with ESRD. Which item must be
removed because it is high in potassium?
A) White rice
B) Baked potato
C) Apple slices
D) White bread
Correct ,,,ANSWER,,,: B
, Rationale: Potatoes, oranges, bananas, tomatoes, and avocados are high in
potassium. Damaged kidneys cannot excrete potassium, leading to life-threatening
hyperkalemia (cardiac dysrhythmias).
Q7. A patient with ESRD has a potassium level of 6.1 mEq/L. What is the priority
nursing action?
A) Encourage high-potassium foods
B) Review the patient's telemetry strip for cardiac changes
C) Prepare for dialysis in the morning
D) Administer oral potassium supplements
Correct ,,,ANSWER,,,: B
Rationale: Hyperkalemia (K+ >5.0 mEq/L) can cause life-threatening cardiac
dysrhythmias, including peaked T waves, widened QRS, and cardiac arrest. The
priority is to assess cardiac status immediately.
Q8. A patient with COPD has an oxygen saturation of 88%. What is the safest
oxygen delivery goal for this patient?
A) Maintain O2 saturation at 100%
B) Maintain O2 saturation between 88-92%
C) Maintain O2 saturation above 95%
D) Do not give oxygen at all
Correct ,,,ANSWER,,,: B
Rationale: COPD patients often retain CO2 (chronic hypercapnia). Their respiratory
drive may depend on hypoxic drive rather than CO2 levels. High oxygen delivery can
remove their hypoxic drive, leading to respiratory depression and CO2 narcosis.
Titration to 88-92% is standard.
