NUR 265 NUR265 Exam 1 – Advanced Concepts of Medical-Surgical Nursing
Galen (Latest 2026 2027 Updates
NUR 265 Exam 1 Practice Question Bank (200 Q&A)
Course: Advanced Concepts of Medical-Surgical Nursing | Institution: Galen
College of Nursing
Academic Year: 2026/2027 | Format: Multiple Choice with Rationales
BLOCK 1: COMPLEX RENAL DISORDERS (Questions 1-40)
1. The nurse is caring for a client with nephrotic syndrome who has severe
proteinuria. Which action should the nurse take?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Answer: B
Rationale: ACE inhibitors like lisinopril reduce intraglomerular pressure, which
decreases urinary protein loss and slows the progression of kidney damage. This is
first-line therapy for nephrotic syndrome .
,2. The nurse is reviewing lab results. Which client requires priority follow-up with
the provider?
A) Client 2 days post-AAA repair with creatinine increase 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
Answer: A
Rationale: A rapid rise in serum creatinine (0.9 to 2.5) indicates Acute Kidney
Injury (AKI) requiring urgent evaluation. Post-surgical patients are at high risk for
prerenal azotemia or ischemic injury .
3. A client with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L.
What is the priority intervention?
A) Administer sodium polystyrene sulfonate (Kayexalate) orally
B) Prepare the client for emergent hemodialysis
C) Administer IV calcium gluconate
D) Restrict dietary potassium intake
Answer: C
,Rationale: IV calcium gluconate is given emergently to stabilize cardiac
membranes and prevent life-threatening arrhythmias in severe hyperkalemia
(>6.5). It does NOT lower potassium but protects the heart while other
treatments take effect .
4. A client with chronic kidney disease (CKD) is prescribed epoetin alfa (Epogen).
The nurse understands this treats which complication?
A) Hyperkalemia
B) Anemia
C) Metabolic acidosis
D) Hyperphosphatemia
Answer: B
Rationale: Damaged kidneys do not produce enough erythropoietin (EPO), which
stimulates red blood cell production, resulting in anemia. Epoetin alfa is synthetic
EPO used to treat anemia of CKD.
5. A client with AKI in the oliguric phase has which finding requiring immediate
intervention?
A) Urine output of 350 mL in 24 hours
B) Blood pressure 138/88 mm Hg
, C) Crackles auscultated in lung bases
D) Serum potassium 5.2 mEq/L
Answer: C
Rationale: Crackles indicate pulmonary edema from fluid overload, a life-
threatening complication of the oliguric phase requiring immediate intervention
(diuretics, possibly dialysis). Oliguria is expected in this phase.
6. The nurse is teaching a client with CKD about dietary restrictions. Which food
should the client avoid?
A) Apples
B) Rice
C) Bananas
D) Cabbage
Answer: C
Rationale: Bananas are high in potassium, which can accumulate to dangerous
levels in CKD due to reduced renal excretion.
Galen (Latest 2026 2027 Updates
NUR 265 Exam 1 Practice Question Bank (200 Q&A)
Course: Advanced Concepts of Medical-Surgical Nursing | Institution: Galen
College of Nursing
Academic Year: 2026/2027 | Format: Multiple Choice with Rationales
BLOCK 1: COMPLEX RENAL DISORDERS (Questions 1-40)
1. The nurse is caring for a client with nephrotic syndrome who has severe
proteinuria. Which action should the nurse take?
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Answer: B
Rationale: ACE inhibitors like lisinopril reduce intraglomerular pressure, which
decreases urinary protein loss and slows the progression of kidney damage. This is
first-line therapy for nephrotic syndrome .
,2. The nurse is reviewing lab results. Which client requires priority follow-up with
the provider?
A) Client 2 days post-AAA repair with creatinine increase 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
Answer: A
Rationale: A rapid rise in serum creatinine (0.9 to 2.5) indicates Acute Kidney
Injury (AKI) requiring urgent evaluation. Post-surgical patients are at high risk for
prerenal azotemia or ischemic injury .
3. A client with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L.
What is the priority intervention?
A) Administer sodium polystyrene sulfonate (Kayexalate) orally
B) Prepare the client for emergent hemodialysis
C) Administer IV calcium gluconate
D) Restrict dietary potassium intake
Answer: C
,Rationale: IV calcium gluconate is given emergently to stabilize cardiac
membranes and prevent life-threatening arrhythmias in severe hyperkalemia
(>6.5). It does NOT lower potassium but protects the heart while other
treatments take effect .
4. A client with chronic kidney disease (CKD) is prescribed epoetin alfa (Epogen).
The nurse understands this treats which complication?
A) Hyperkalemia
B) Anemia
C) Metabolic acidosis
D) Hyperphosphatemia
Answer: B
Rationale: Damaged kidneys do not produce enough erythropoietin (EPO), which
stimulates red blood cell production, resulting in anemia. Epoetin alfa is synthetic
EPO used to treat anemia of CKD.
5. A client with AKI in the oliguric phase has which finding requiring immediate
intervention?
A) Urine output of 350 mL in 24 hours
B) Blood pressure 138/88 mm Hg
, C) Crackles auscultated in lung bases
D) Serum potassium 5.2 mEq/L
Answer: C
Rationale: Crackles indicate pulmonary edema from fluid overload, a life-
threatening complication of the oliguric phase requiring immediate intervention
(diuretics, possibly dialysis). Oliguria is expected in this phase.
6. The nurse is teaching a client with CKD about dietary restrictions. Which food
should the client avoid?
A) Apples
B) Rice
C) Bananas
D) Cabbage
Answer: C
Rationale: Bananas are high in potassium, which can accumulate to dangerous
levels in CKD due to reduced renal excretion.
