NUR 265/ NUR265 Exam 1 –
(New 2026/ 2027 Update)
Advanced Concepts of Medical-
Surgical Nursing Guide|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
1. The nurse caring for a client who has 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
,,,answer,,,,: B. Administer lisinopril
Rationale: Nephrotic syndrome is characterized by increased
glomerular permeability, leading to massive proteinuria (>3.5
g/24hrs). ACE inhibitors like lisinopril are first-line therapy because
they reduce intraglomerular pressure, which decreases urinary
protein loss and slows the progression of kidney damage .
,2. The nurse is reviewing labs of assigned clients. Which of the
following clients requires priority follow-up with the primary health
care provider?
A. Client 2 days post-abdominal aortic aneurysm (AAA) repair with
creatinine increasing 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. Client 2 days post-AAA repair with creatinine
increasing from 0.9 to 2.5 mg/dL
Rationale: A rapid rise in serum creatinine (0.9 to 2.5 mg/dL)
indicates Acute Kidney Injury (AKI). Post-surgical patients are at
high risk for prerenal azotemia or ischemic injury. This change
requires urgent evaluation to prevent permanent damage .
3. A client with chronic kidney disease (CKD) has a potassium level
of 6.8 mEq/L. Which intervention should the nurse anticipate first?
A. Prepare the client for hemodialysis
B. Administer oral sodium polystyrene sulfonate (Kayexalate)
C. Administer intravenous calcium gluconate
D. Restrict dietary potassium
,,,answer,,,,: C. Administer intravenous calcium gluconate
,Rationale: Severe hyperkalemia (>6.5 mEq/L) is life-threatening
due to the risk of cardiac arrest. IV Calcium Gluconate is the priority
because it stabilizes the cardiac membrane immediately, preventing
dysrhythmias. Other treatments remove potassium but take longer
to work .
4. A client on hemodialysis has an arteriovenous (AV) fistula in the
left arm. Which action by the nurse is appropriate?
A. Take blood pressure in the left arm
B. Palpate for a thrill over the fistula
C. Draw blood from the fistula site
D. Apply a tight tourniquet above the fistula
,,,answer,,,,: B. Palpate for a thrill over the fistula
Rationale: A palpable thrill and audible bruit indicate patency of the
AV fistula. Blood pressure, venipuncture, and tight tourniquets
should never be done on the fistula arm as they can damage the
fistula .
5. The nurse is caring for a client with chronic kidney disease who is
experiencing increased rate and depth of respirations. After raising
the head of the bed, what should the nurse do next?
A. Order a chest x-ray
B. Obtain a blood specimen for arterial blood gases (ABGs)
, C. Administer oxygen therapy
D. Encourage deep breathing exercises
,,,answer,,,,: B. Obtain a blood specimen for arterial blood gases
(ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations)
indicate metabolic acidosis, a common complication of CKD due to
the kidney's inability to excrete acids. ABGs are required to confirm
acidosis and guide bicarbonate therapy .
6. Which of the following client statements 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."
,,,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. 5
grams is too high .
(New 2026/ 2027 Update)
Advanced Concepts of Medical-
Surgical Nursing Guide|
Questions & Answers | Grade A|
100% Correct (Verified
Solutions)- Galen
1. The nurse caring for a client who has 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
,,,answer,,,,: B. Administer lisinopril
Rationale: Nephrotic syndrome is characterized by increased
glomerular permeability, leading to massive proteinuria (>3.5
g/24hrs). ACE inhibitors like lisinopril are first-line therapy because
they reduce intraglomerular pressure, which decreases urinary
protein loss and slows the progression of kidney damage .
,2. The nurse is reviewing labs of assigned clients. Which of the
following clients requires priority follow-up with the primary health
care provider?
A. Client 2 days post-abdominal aortic aneurysm (AAA) repair with
creatinine increasing 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. Client 2 days post-AAA repair with creatinine
increasing from 0.9 to 2.5 mg/dL
Rationale: A rapid rise in serum creatinine (0.9 to 2.5 mg/dL)
indicates Acute Kidney Injury (AKI). Post-surgical patients are at
high risk for prerenal azotemia or ischemic injury. This change
requires urgent evaluation to prevent permanent damage .
3. A client with chronic kidney disease (CKD) has a potassium level
of 6.8 mEq/L. Which intervention should the nurse anticipate first?
A. Prepare the client for hemodialysis
B. Administer oral sodium polystyrene sulfonate (Kayexalate)
C. Administer intravenous calcium gluconate
D. Restrict dietary potassium
,,,answer,,,,: C. Administer intravenous calcium gluconate
,Rationale: Severe hyperkalemia (>6.5 mEq/L) is life-threatening
due to the risk of cardiac arrest. IV Calcium Gluconate is the priority
because it stabilizes the cardiac membrane immediately, preventing
dysrhythmias. Other treatments remove potassium but take longer
to work .
4. A client on hemodialysis has an arteriovenous (AV) fistula in the
left arm. Which action by the nurse is appropriate?
A. Take blood pressure in the left arm
B. Palpate for a thrill over the fistula
C. Draw blood from the fistula site
D. Apply a tight tourniquet above the fistula
,,,answer,,,,: B. Palpate for a thrill over the fistula
Rationale: A palpable thrill and audible bruit indicate patency of the
AV fistula. Blood pressure, venipuncture, and tight tourniquets
should never be done on the fistula arm as they can damage the
fistula .
5. The nurse is caring for a client with chronic kidney disease who is
experiencing increased rate and depth of respirations. After raising
the head of the bed, what should the nurse do next?
A. Order a chest x-ray
B. Obtain a blood specimen for arterial blood gases (ABGs)
, C. Administer oxygen therapy
D. Encourage deep breathing exercises
,,,answer,,,,: B. Obtain a blood specimen for arterial blood gases
(ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations)
indicate metabolic acidosis, a common complication of CKD due to
the kidney's inability to excrete acids. ABGs are required to confirm
acidosis and guide bicarbonate therapy .
6. Which of the following client statements 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."
,,,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. 5
grams is too high .
