NUR 265 Exam 1 Medical-Surgical Nursing (2026)
PDF | Galen College of Nursing
Renal & Urinary Disorders
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
→ B) Administer lisinopril
Rationale: ACE inhibitors like lisinopril reduce proteinuria by lowering
intraglomerular pressure, which slows kidney damage progression. They are
standard therapy in nephrotic syndrome to decrease urinary protein loss.
2. The nurse is reviewing labs of assigned clients. Which client 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
→ A) Client 2 days post-AAA repair with creatinine increasing from 0.9 to 2.5
mg/dL
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury (AKI), requiring urgent evaluation.
,3. The nurse is caring for a client with chronic kidney disease (CKD) 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
→ B) Obtain a blood specimen for arterial blood gases (ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations) indicate metabolic
acidosis, common in CKD. ABGs will confirm acidosis and guide treatment.
4. 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."
→ 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 exceeds the
recommended limit.
5. Which client statement suggests correct understanding of teaching for a client
in late-stage CKD?
A) "If I develop any muscle weakness or tremors, I should report it to my doctor."
B) "I can skip dialysis if I feel well."
C) "I do not need to worry about my potassium intake."
D) "I should increase my protein intake significantly."
, → A) "If I develop any muscle weakness or tremors, I should report it to my
doctor."
Rationale: Muscle weakness and tremors may indicate electrolyte imbalances,
such as hypokalemia post-dialysis, needing medical evaluation.
6. It requires immediate follow-up if a client who had hemodialysis yesterday
develops which of the following?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
→ B) Temperature of 101.4°F
Rationale: Fever above 101°F post-dialysis indicates possible infection (sepsis or
access-related infection) and requires prompt assessment.
7. Which of the following infection control actions is appropriate when changing
a peritoneal dialysis catheter dressing?
A) Use sterile gloves only
B) Place a mask on the client
C) Use clean gloves only
D) No protective equipment needed
→ B) Place a mask on the client
Rationale: Masks reduce infection risk by minimizing airborne pathogens during
catheter dressing changes in clients receiving peritoneal dialysis. Both the nurse
and the client should wear masks.
8. The RN is caring for a pt who is in the pre-renal stage of AKI. The RN should
recognize that a cause of this condition is...?
PDF | Galen College of Nursing
Renal & Urinary Disorders
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
→ B) Administer lisinopril
Rationale: ACE inhibitors like lisinopril reduce proteinuria by lowering
intraglomerular pressure, which slows kidney damage progression. They are
standard therapy in nephrotic syndrome to decrease urinary protein loss.
2. The nurse is reviewing labs of assigned clients. Which client 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
→ A) Client 2 days post-AAA repair with creatinine increasing from 0.9 to 2.5
mg/dL
Rationale: A significant increase in creatinine post-surgery indicates possible acute
kidney injury (AKI), requiring urgent evaluation.
,3. The nurse is caring for a client with chronic kidney disease (CKD) 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
→ B) Obtain a blood specimen for arterial blood gases (ABGs)
Rationale: Deep and rapid respirations (Kussmaul respirations) indicate metabolic
acidosis, common in CKD. ABGs will confirm acidosis and guide treatment.
4. 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."
→ 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 exceeds the
recommended limit.
5. Which client statement suggests correct understanding of teaching for a client
in late-stage CKD?
A) "If I develop any muscle weakness or tremors, I should report it to my doctor."
B) "I can skip dialysis if I feel well."
C) "I do not need to worry about my potassium intake."
D) "I should increase my protein intake significantly."
, → A) "If I develop any muscle weakness or tremors, I should report it to my
doctor."
Rationale: Muscle weakness and tremors may indicate electrolyte imbalances,
such as hypokalemia post-dialysis, needing medical evaluation.
6. It requires immediate follow-up if a client who had hemodialysis yesterday
develops which of the following?
A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
→ B) Temperature of 101.4°F
Rationale: Fever above 101°F post-dialysis indicates possible infection (sepsis or
access-related infection) and requires prompt assessment.
7. Which of the following infection control actions is appropriate when changing
a peritoneal dialysis catheter dressing?
A) Use sterile gloves only
B) Place a mask on the client
C) Use clean gloves only
D) No protective equipment needed
→ B) Place a mask on the client
Rationale: Masks reduce infection risk by minimizing airborne pathogens during
catheter dressing changes in clients receiving peritoneal dialysis. Both the nurse
and the client should wear masks.
8. The RN is caring for a pt who is in the pre-renal stage of AKI. The RN should
recognize that a cause of this condition is...?
