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Galen NUR 265 Advanced Concepts of Medical-Surgical Nursing – Test 1

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This test covers foundational advanced concepts in medical-surgical nursing for NUR 265 at Galen College of Nursing. Test 1 typically focuses on critical and complex patient care topics including fluid and electrolyte imbalances, acid-base disturbances, intravenous (IV) therapy, blood transfusion reactions, shock pathophysiology and management (including early recognition and nursing interventions), sepsis, systemic inflammatory response syndrome (SIRS), and basic hemodynamic monitoring. Emphasis is placed on clinical reasoning, prioritization, pharmacology relevant to these conditions, and application of the nursing process to acutely ill adult patients across the care continuum.

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Test 1

1. The nurse has provided discharge instructions to a client who is newly
diagnosed with nephrotic syndrome. Which of the following client statements
indicates a correct understanding of the teaching?

a. I must decrease my intake of foods high in potassium.
b. I should take all prescribed antibiotics until they are gone
c. I must protect myself from developing an infection.
d. I should avoid using any type of salt substitute on my food.

2. The nurse is reviewing the lab results of an assigned clients. It is priority
for the nurse to follow up with primary health care provider if a client who.

a. Had a mitral (mechanical) valve replacement and taking prescribed
warfarin has an international normalized ratio (INR) that is 3.2.
b. Is receiving prescribed enoxaparin postoperatively from cardiac surgery
and has a platelet count that is decreased from 200,000 to 175,000 over the
past 2 days.
c. Had an abdominal aortic aneurysm (AAA) repair 2 days ago has a
creatinine level that has increased from 0.9 to 2.5.
d. Is receiving prescribed digoxin and has a blood urea nitrogen level that
has increased from 15 to 19 over the past 3 days.

3. The nurse is caring for a client who has been hospitalized for 8 days with
acute kidney injury caused by dehydration. Which of the following should the
nurse report immediately to the primary health care provider (PCHP)?

a. A rhythm strip reading that has tall, peaked T waves.
b. A creatinine level of 3 mg/dl
c. A blood urea nitrogen (BUN) level of 67 mg/dl
d. A decreased glomerular filtration rate

4. The nurse is caring for a client who is receiving gentamicin intravenously
for an infection and has development oliguria and an increased blood
pressure. Which of the following actions should the nurse take first.

a. Insert a prescribed urethral urinary catheter.
b. Raise the head of the bed (HOB) to a 45 degree angle.
c. Collect a urine sample to check the specific gravity.
d. Obtain a prescription for gentamicin peak and trough levels.

, 5. The nurse is caring for a client who has chronic kidney disease (CKD). The
client is reporting muscle weakness, diarrhea, and tingling in the hands.
Which action should the nurse take first?

a. Notify the primary health care provider (PCP)
b. Determine if the client is scheduled to receive hemodialysis
c. Check the clients most recent serum electrolyte levels.
d. Evaluate the clients urine output for the past 4 hours.

6. The nurse is talking with a client who has chronic kidney disease (CKD)
and is receiving hemodialysis 3 times per week. Which of the following client
statements is priority for follow up by the nurse?

a. I have noticed that my breath has developed a very unpleasant odor.
b. I have noticed that my skin looks like it has a layer of frost on it.
c. I try and limit my intake of dietary sodium to 5 grams per day.
d. I will make sure that I consume at least 50 grams of protein every day.

7. The nurse is teaching a client who is in the late stage of chronic kidney
disease (CKD). Which of the following client statements indicates a correct
understanding of the teaching.

a. I can expect to have an increase in my energy level after a dialysis
treatment
b. I should obtain much of my protein from dairy products and eggs.
c. If I develop any fatigue or weakness, I should report to my doctor.
d. Hemodialysis will be performed 2 times per week in an outpatient center.

8. The nurse is caring for a client who has just returned from receiving a
hemodialysis treatment. It requires immediate follow up by the nurse if the
client has

a. developed a blood pressure of 90/58 mm Hg.
b. a potassium level that decreased from 6.1 to 5.1 mEq/L
c. reports of feeling tired and no desire to eat
d. developed a temperature of 99.4 Degrees F

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Uploaded on
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Written in
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