ACTUAL 2026/2027 | Galen College of Nursing
Practice Test | Graded A+ | Pass Guaranteed - A+
Graded
Section 1: Nutrition & Hydration (Questions 1-12)
Q1. A nurse is preparing to administer a tube feeding to a patient with a newly
placed small-bore nasogastric (NG) tube. Before initiating the feeding, the nurse
aspirates fluid and tests the pH, which reads 6.5. What is the nurse's priority action?
A. Flush the tube with 30 mL of water and proceed with the feeding
B. Obtain a chest X-ray to confirm tube placement before administering the feeding
C. Auscultate the epigastrium while instilling 20 mL of air to verify placement
D. Administer the feeding slowly at half the ordered rate to test tolerance
B. Obtain a chest X-ray to confirm tube placement before administering the feeding
[CORRECT]
Rationale: A gastric pH of 6.5 is above the accepted cutoff of 5.0, suggesting the tube
may be in the respiratory tract or small intestine rather than the stomach. The gold
standard for confirming NG tube placement is a chest X-ray (CXR). Auscultation is
unreliable and can produce false positives, while proceeding with the feeding risks
aspiration if the tube is misplaced.
Q2. A patient on continuous enteral nutrition via nasogastric tube develops diarrhea.
Which nursing intervention is the priority?
A. Switch to bolus feedings to reduce intestinal stimulation
B. Check the feeding formula for contamination and verify osmolality
C. Immediately discontinue the feeding and notify the provider
D. Administer an antidiarrheal medication per standing orders
B. Check the feeding formula for contamination and verify osmolality [CORRECT]
Rationale: Diarrhea in enteral feeding is often caused by formula contamination, high
osmolality, or rapid infusion rates. The nurse should first assess the formula and
,delivery system before making changes. Discontinuing the feeding (C) is premature
without assessment, and antidiarrheals (D) may mask the underlying cause.
Q3. A patient with chronic kidney disease (CKD) Stage 4 is prescribed a therapeutic
diet. Which dietary instruction is most appropriate for the nurse to provide?
A. "Increase your intake of lean red meats to maintain protein stores."
B. "Limit potassium-rich foods such as bananas, oranges, and tomatoes."
C. "Drink at least 3 liters of fluid daily to flush your kidneys."
D. "Use salt substitutes to reduce your sodium intake."
B. "Limit potassium-rich foods such as bananas, oranges, and tomatoes." [CORRECT]
Rationale: CKD Stage 4 patients have impaired potassium excretion and are at high
risk for hyperkalemia. Protein is moderately restricted (not increased), fluid is
restricted (not increased), and salt substitutes often contain potassium chloride,
which is dangerous for these patients.
Q4. A nurse is caring for a patient with heart failure who is prescribed the DASH diet.
Which patient statement indicates understanding of the dietary recommendations?
A. "I will avoid all carbohydrates and focus on high-protein foods."
B. "I can have canned soups as long as they are labeled low-fat."
C. "I will increase my intake of fresh fruits, vegetables, and whole grains while limiting
sodium."
D. "I should drink 2% milk instead of whole milk to reduce my fat intake."
C. "I will increase my intake of fresh fruits, vegetables, and whole grains while limiting
sodium." [CORRECT]
Rationale: The DASH diet emphasizes fruits, vegetables, whole grains, lean proteins,
and low-fat dairy while significantly restricting sodium. Option A misrepresents the
diet (it does not restrict carbs), B is incorrect because canned soups are typically high
in sodium, and D focuses only on fat rather than the comprehensive DASH approach.
Q5. A patient with type 1 diabetes is placed on a clear liquid diet pre-operatively.
Which item is appropriate for the nurse to offer?
A. Orange juice with pulp
B. Vanilla pudding
, C. Chicken broth
D. Milkshake
C. Chicken broth [CORRECT]
Rationale: A clear liquid diet includes transparent liquids that leave minimal residue.
Chicken broth is appropriate. Orange juice with pulp (A) and pudding (B) are not
clear liquids, and a milkshake (D) is a full liquid and contains high carbohydrates
inappropriate for pre-op clearance.
Q6. A nurse is verifying NG tube placement using a CO2 detector. The detector
changes color, indicating CO2 is present. What is the nurse's interpretation?
A. The tube is correctly placed in the stomach
B. The tube is in the esophagus and should be advanced 5 cm
C. The tube is likely in the respiratory tract and must be removed immediately
D. The detector is malfunctioning and should be replaced
C. The tube is likely in the respiratory tract and must be removed immediately
[CORRECT]
Rationale: CO2 detection indicates the tube tip is in the respiratory tract (trachea or
bronchus) rather than the stomach. The presence of CO2 is a critical safety indicator
of misplacement, requiring immediate removal and reinsertion to prevent aspiration.
Q7. A patient receiving total parenteral nutrition (TPN) through a central line
develops a fever of 38.5°C (101.3°F) and chills. What is the nurse's priority action?
A. Increase the TPN infusion rate to provide more calories
B. Obtain blood cultures from the central line and a peripheral site, then notify the
provider
C. Administer acetaminophen and monitor the temperature every 4 hours
D. Discontinue the TPN and flush the line with heparin
B. Obtain blood cultures from the central line and a peripheral site, then notify the
provider [CORRECT]
Rationale: Fever and chills in a patient receiving TPN strongly suggest catheter-
related bloodstream infection (CRBSI). The priority is to obtain paired blood cultures
(central and peripheral) before starting antibiotics. Simply discontinuing the TPN (D)
without cultures may delay diagnosis.