NU 185 Exam 3: Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to observe?
A. Urine output of 2 liters per day
B. Metabolic alkalosis
C. Serum creatinine level of 0.6 mg/dL
D. Fluid volume excess and edema
Answer: D
Rationale: During the oliguric phase of AKI, urine output drops significantly (usually less
than 400 mL/day), leading to fluid retention, edema, and hypertension.
2. Which laboratory value is the most sensitive indicator of renal function in a
patient with Chronic Kidney Disease (CKD)?
A. Glomerular Filtration Rate (GFR)
B. Serum Sodium
C. Blood Urea Nitrogen (BUN)
D. Urine Specific Gravity
Answer: A
Rationale: GFR is the best overall indicator of kidney function as it measures the rate at
which blood is filtered by the glomeruli.
,3. A patient is diagnosed with hyperkalemia. Which medication should the
nurse expect to administer to help shift potassium into the cells?
A. Spironolactone
B. Regular insulin and Dextrose 50%
C. Furosemide
D. Calcium Gluconate
Answer: B
Rationale: Regular insulin moves potassium from the extracellular fluid into the cells;
dextrose is given concurrently to prevent hypoglycemia.
4. What is a priority nursing assessment for a patient immediately following a
renal biopsy?
A. Checking the patient’s temperature
B. Assessing for bowel sounds
C. Encouraging the patient to walk immediately
D. Monitoring for signs of bleeding at the site
Answer: D
Rationale: The kidney is highly vascular; therefore, the priority post-biopsy is monitoring
for hemorrhage through vital signs and site assessment.
5. A patient with CKD has a low hemoglobin level. Which medication will likely
be prescribed to address this?
A. Warfarin
B. Epoetin alfa
C. Metoprolol
D. Simvastatin
Answer: B
Rationale: Epoetin alfa is a synthetic form of erythropoietin, which the kidneys normally
produce to stimulate red blood cell production.
, 6. While assessing a patient with hypocalcemia, the nurse inflates a blood
pressure cuff and observes carpal spasms. This is known as:
A. Chvostek’s sign
B. Trousseau’s sign
C. Babinski reflex
D. Homans’ sign
Answer: B
Rationale: Trousseau’s sign is a classic indicator of hypocalcemia or hypomagnesemia
characterized by carpal spasms when blood flow is occluded.
7. A patient’s ABG results are: pH 7.30, PaCO2 55, HCO3 24. How should the
nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 indicates a
respiratory cause.
8. Which dietary instruction is most appropriate for a patient receiving
hemodialysis?
A. Increase intake of bananas and spinach
B. Limit protein intake to 0.2g/kg/day
C. Restrict sodium, potassium, and fluid intake
D. Drink at least 3 liters of water daily
Answer: C
Rationale: Dialysis patients must restrict fluid and electrolytes because the kidneys cannot
effectively filter them between treatments.
College
1. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to observe?
A. Urine output of 2 liters per day
B. Metabolic alkalosis
C. Serum creatinine level of 0.6 mg/dL
D. Fluid volume excess and edema
Answer: D
Rationale: During the oliguric phase of AKI, urine output drops significantly (usually less
than 400 mL/day), leading to fluid retention, edema, and hypertension.
2. Which laboratory value is the most sensitive indicator of renal function in a
patient with Chronic Kidney Disease (CKD)?
A. Glomerular Filtration Rate (GFR)
B. Serum Sodium
C. Blood Urea Nitrogen (BUN)
D. Urine Specific Gravity
Answer: A
Rationale: GFR is the best overall indicator of kidney function as it measures the rate at
which blood is filtered by the glomeruli.
,3. A patient is diagnosed with hyperkalemia. Which medication should the
nurse expect to administer to help shift potassium into the cells?
A. Spironolactone
B. Regular insulin and Dextrose 50%
C. Furosemide
D. Calcium Gluconate
Answer: B
Rationale: Regular insulin moves potassium from the extracellular fluid into the cells;
dextrose is given concurrently to prevent hypoglycemia.
4. What is a priority nursing assessment for a patient immediately following a
renal biopsy?
A. Checking the patient’s temperature
B. Assessing for bowel sounds
C. Encouraging the patient to walk immediately
D. Monitoring for signs of bleeding at the site
Answer: D
Rationale: The kidney is highly vascular; therefore, the priority post-biopsy is monitoring
for hemorrhage through vital signs and site assessment.
5. A patient with CKD has a low hemoglobin level. Which medication will likely
be prescribed to address this?
A. Warfarin
B. Epoetin alfa
C. Metoprolol
D. Simvastatin
Answer: B
Rationale: Epoetin alfa is a synthetic form of erythropoietin, which the kidneys normally
produce to stimulate red blood cell production.
, 6. While assessing a patient with hypocalcemia, the nurse inflates a blood
pressure cuff and observes carpal spasms. This is known as:
A. Chvostek’s sign
B. Trousseau’s sign
C. Babinski reflex
D. Homans’ sign
Answer: B
Rationale: Trousseau’s sign is a classic indicator of hypocalcemia or hypomagnesemia
characterized by carpal spasms when blood flow is occluded.
7. A patient’s ABG results are: pH 7.30, PaCO2 55, HCO3 24. How should the
nurse interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Metabolic Alkalosis
D. Respiratory Acidosis
Answer: D
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 indicates a
respiratory cause.
8. Which dietary instruction is most appropriate for a patient receiving
hemodialysis?
A. Increase intake of bananas and spinach
B. Limit protein intake to 0.2g/kg/day
C. Restrict sodium, potassium, and fluid intake
D. Drink at least 3 liters of water daily
Answer: C
Rationale: Dialysis patients must restrict fluid and electrolytes because the kidneys cannot
effectively filter them between treatments.
