NUR 265 Exam 1 V1, V2 and V3|
Questions and Answers | 2026 Update |
100% Correct - Galen College of Nursing.
1. A client with acute kidney injury (AKI) has a serum potassium of 6.8
mEq/L and peaked T-waves on the EKG. Which intervention should the
nurse implement FIRST?
• A. Restrict oral potassium intake
• B. Administer calcium gluconate IV
• C. Prepare the client for emergent hemodialysis
• D. Administer sodium polystyrene sulfonate (Kayexalate)
Correct ,,,,answer,,,,: B
Rationale: Calcium gluconate is the priority intervention for hyperkalemia with
EKG changes because it stabilizes the cardiac membrane and prevents life-
threatening dysrhythmias. It does not lower potassium but buys time for other
treatments. Dialysis and Kayexalate remove potassium but are not the immediate
priority when EKG changes are present.
2. A client in the oliguric phase of AKI has a 24-hour urine output of 280 mL.
Which assessment finding is most concerning?
• A. Serum creatinine of 2.8 mg/dL
• B. Serum potassium of 6.5 mEq/L
, • C. BUN of 48 mg/dL
• D. Serum sodium of 135 mEq/L
Correct ,,,,answer,,,,: B
Rationale: A potassium of 6.5 mEq/L is critically elevated and can cause fatal
cardiac dysrhythmias. While elevated BUN and creatinine are expected in the
oliguric phase, hyperkalemia poses the most immediate life threat.
3. The nurse is assessing a client's newly created AV fistula for hemodialysis.
Which finding indicates adequate maturation?
• A. Absence of a bruit
• B. A palpable thrill and audible bruit
• C. Coolness and pallor of the extremity
• D. Capillary refill greater than 3 seconds
Correct ,,,,answer,,,,: B
Rationale: A palpable thrill (vibration) and audible bruit (whooshing sound)
indicate good blood flow through the AV fistula and adequate maturation. Absence
of these findings suggests stenosis or thrombosis.
4. A client with CKD is being discharged. Which statement indicates a need
for further teaching about dietary restrictions?
• A. "I should limit foods high in potassium like bananas and oranges."
• B. "I will increase my intake of dairy products for calcium."
• C. "I need to limit my sodium intake to help control fluid retention."
• D. "I should avoid processed meats that are high in phosphorus."
,Correct ,,,,answer,,,,: B
Rationale: In CKD, the kidneys cannot excrete phosphorus effectively, leading to
hyperphosphatemia. Dairy products are high in phosphorus and should be limited,
not increased. The other statements are correct for CKD dietary management.
5. A client on hemodialysis develops confusion, headache, and nausea toward
the end of the dialysis session. The nurse suspects:
• A. Hyperglycemia
• B. Dialysis disequilibrium syndrome
• C. Anaphylactic reaction
• D. Air embolism
Correct ,,,,answer,,,,: B
Rationale: Dialysis disequilibrium syndrome is caused by rapid removal of urea
and fluid, leading to cerebral edema and increased intracranial pressure. Symptoms
include confusion, headache, nausea, and seizures. Prevention includes slower
dialysis rates and shorter sessions for new patients.
6. Which laboratory finding is most consistent with prerenal AKI?
• A. Urine sodium > 40 mEq/L
• B. Fractional excretion of sodium (FENa) < 1%
• C. Urine osmolality < 350 mOsm/kg
• D. BUN-to-creatinine ratio < 10:1
Correct ,,,,answer,,,,: B
Rationale: In prerenal AKI, the kidneys are hypoperfused but structurally intact,
, so they retain sodium and water. A FENa < 1% indicates the kidneys are trying to
conserve sodium, consistent with prerenal causes. FENa > 2% is seen in intrarenal
AKI.
7. A client with CKD is receiving erythropoietin (Epogen) therapy. The nurse
should monitor for which therapeutic response?
• A. Decreased serum potassium
• B. Increased hemoglobin and hematocrit
• C. Decreased blood pressure
• D. Increased urine output
Correct ,,,,answer,,,,: B
Rationale: Erythropoietin stimulates red blood cell production in the bone
marrow. The therapeutic response is an increase in hemoglobin and hematocrit,
which treats the anemia of CKD.
8. The nurse is caring for a client with peritoneal dialysis. Which finding
should be reported to the healthcare provider immediately?
• A. Cloudy peritoneal effluent
• B. Mild abdominal discomfort
• C. Weight gain of 0.5 kg
• D. Clear yellow effluent
Correct ,,,,answer,,,,: A
Rationale: Cloudy peritoneal effluent is the classic sign of peritonitis, a serious
Questions and Answers | 2026 Update |
100% Correct - Galen College of Nursing.
1. A client with acute kidney injury (AKI) has a serum potassium of 6.8
mEq/L and peaked T-waves on the EKG. Which intervention should the
nurse implement FIRST?
• A. Restrict oral potassium intake
• B. Administer calcium gluconate IV
• C. Prepare the client for emergent hemodialysis
• D. Administer sodium polystyrene sulfonate (Kayexalate)
Correct ,,,,answer,,,,: B
Rationale: Calcium gluconate is the priority intervention for hyperkalemia with
EKG changes because it stabilizes the cardiac membrane and prevents life-
threatening dysrhythmias. It does not lower potassium but buys time for other
treatments. Dialysis and Kayexalate remove potassium but are not the immediate
priority when EKG changes are present.
2. A client in the oliguric phase of AKI has a 24-hour urine output of 280 mL.
Which assessment finding is most concerning?
• A. Serum creatinine of 2.8 mg/dL
• B. Serum potassium of 6.5 mEq/L
, • C. BUN of 48 mg/dL
• D. Serum sodium of 135 mEq/L
Correct ,,,,answer,,,,: B
Rationale: A potassium of 6.5 mEq/L is critically elevated and can cause fatal
cardiac dysrhythmias. While elevated BUN and creatinine are expected in the
oliguric phase, hyperkalemia poses the most immediate life threat.
3. The nurse is assessing a client's newly created AV fistula for hemodialysis.
Which finding indicates adequate maturation?
• A. Absence of a bruit
• B. A palpable thrill and audible bruit
• C. Coolness and pallor of the extremity
• D. Capillary refill greater than 3 seconds
Correct ,,,,answer,,,,: B
Rationale: A palpable thrill (vibration) and audible bruit (whooshing sound)
indicate good blood flow through the AV fistula and adequate maturation. Absence
of these findings suggests stenosis or thrombosis.
4. A client with CKD is being discharged. Which statement indicates a need
for further teaching about dietary restrictions?
• A. "I should limit foods high in potassium like bananas and oranges."
• B. "I will increase my intake of dairy products for calcium."
• C. "I need to limit my sodium intake to help control fluid retention."
• D. "I should avoid processed meats that are high in phosphorus."
,Correct ,,,,answer,,,,: B
Rationale: In CKD, the kidneys cannot excrete phosphorus effectively, leading to
hyperphosphatemia. Dairy products are high in phosphorus and should be limited,
not increased. The other statements are correct for CKD dietary management.
5. A client on hemodialysis develops confusion, headache, and nausea toward
the end of the dialysis session. The nurse suspects:
• A. Hyperglycemia
• B. Dialysis disequilibrium syndrome
• C. Anaphylactic reaction
• D. Air embolism
Correct ,,,,answer,,,,: B
Rationale: Dialysis disequilibrium syndrome is caused by rapid removal of urea
and fluid, leading to cerebral edema and increased intracranial pressure. Symptoms
include confusion, headache, nausea, and seizures. Prevention includes slower
dialysis rates and shorter sessions for new patients.
6. Which laboratory finding is most consistent with prerenal AKI?
• A. Urine sodium > 40 mEq/L
• B. Fractional excretion of sodium (FENa) < 1%
• C. Urine osmolality < 350 mOsm/kg
• D. BUN-to-creatinine ratio < 10:1
Correct ,,,,answer,,,,: B
Rationale: In prerenal AKI, the kidneys are hypoperfused but structurally intact,
, so they retain sodium and water. A FENa < 1% indicates the kidneys are trying to
conserve sodium, consistent with prerenal causes. FENa > 2% is seen in intrarenal
AKI.
7. A client with CKD is receiving erythropoietin (Epogen) therapy. The nurse
should monitor for which therapeutic response?
• A. Decreased serum potassium
• B. Increased hemoglobin and hematocrit
• C. Decreased blood pressure
• D. Increased urine output
Correct ,,,,answer,,,,: B
Rationale: Erythropoietin stimulates red blood cell production in the bone
marrow. The therapeutic response is an increase in hemoglobin and hematocrit,
which treats the anemia of CKD.
8. The nurse is caring for a client with peritoneal dialysis. Which finding
should be reported to the healthcare provider immediately?
• A. Cloudy peritoneal effluent
• B. Mild abdominal discomfort
• C. Weight gain of 0.5 kg
• D. Clear yellow effluent
Correct ,,,,answer,,,,: A
Rationale: Cloudy peritoneal effluent is the classic sign of peritonitis, a serious
