,NUR265/NUR 265 Exam 1 | Medical-Surgical
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. The nurse is caring for a client with nephrotic syndrome and severe proteinuria. Which action
should the nurse anticipate?**
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: 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. A client 2 days post-abdominal aortic aneurysm (AAA) repair has a creatinine level that increased
from 0.9 to 2.5 mg/dL. Which action should the nurse take?**
A) Continue routine monitoring
B) Notify the healthcare provider immediately
C) Increase IV fluids
D) Administer furosemide
Correct Answer: B) Notify the healthcare provider immediately
Rationale: A significant increase in creatinine post-surgery indicates possible acute kidney injury (AKI),
requiring urgent evaluation. The provider must be notified immediately.
**3. A client with cirrhosis develops increasing abdominal girth and discomfort. Which medication
should the nurse expect to be ordered?**
,A) Furosemide
B) Spironolactone
C) Beta-blockers
D) Albumin
Correct Answer: B) Spironolactone
Rationale: Ascites from cirrhosis often requires potassium-sparing diuretics like spironolactone to
manage fluid retention by antagonizing aldosterone. This choice considers electrolyte balance and renal
function, critical in Med-Surg care.
**4. A client receiving vancomycin for sepsis develops oliguria, elevated creatinine, and elevated BUN.
What is the priority nursing action?**
A) Collect a blood specimen for antibiotic peak and trough levels
B) Stop vancomycin immediately
C) Increase IV fluids aggressively
D) Change antibiotic to another class
Correct Answer: A) Collect a blood specimen for antibiotic peak and trough levels
Rationale: Vancomycin is nephrotoxic; monitoring peak and trough levels is crucial to avoid toxicity and
ensure therapeutic dosing. Oliguria and renal labs indicate possible toxicity requiring urgent
intervention.
**5. Which infection control action 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 is needed
, Correct Answer: 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.
**6. A client who had hemodialysis yesterday develops a temperature of 101.4°F. What is the priority
nursing action?**
A) Administer acetaminophen
B) Document the finding
C) Notify the healthcare provider immediately
D) Apply a cooling blanket
Correct Answer: C) Notify the healthcare provider immediately
Rationale: Fever above 101°F post-dialysis indicates possible infection and requires prompt assessment.
The healthcare provider must be notified immediately.
**7. The nurse preceptor observes a newly hired nurse caring for a client receiving peritoneal dialysis.
Which action indicates correct technique?**
A) Using a microwave to warm dialysate
B) Repositioning the client during dialysis to improve dialysate flow
C) Placing the client flat in bed during dialysis
D) Ignoring air bubbles in tubing
Correct Answer: B) Repositioning the client during dialysis to improve dialysate flow
Rationale: Repositioning the client during peritoneal dialysis helps improve dialysate flow and drainage.
Warming dialysate should be done with a warmer, not a microwave. The client should be positioned
with the head of bed elevated, and air bubbles must be removed from tubing.
Nursing | Galen College | Q & A | 2026/2027
Edition (PDF)
**1. The nurse is caring for a client with nephrotic syndrome and severe proteinuria. Which action
should the nurse anticipate?**
A) Administer furosemide
B) Administer lisinopril
C) Restrict fluids
D) Increase protein intake
Correct Answer: 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. A client 2 days post-abdominal aortic aneurysm (AAA) repair has a creatinine level that increased
from 0.9 to 2.5 mg/dL. Which action should the nurse take?**
A) Continue routine monitoring
B) Notify the healthcare provider immediately
C) Increase IV fluids
D) Administer furosemide
Correct Answer: B) Notify the healthcare provider immediately
Rationale: A significant increase in creatinine post-surgery indicates possible acute kidney injury (AKI),
requiring urgent evaluation. The provider must be notified immediately.
**3. A client with cirrhosis develops increasing abdominal girth and discomfort. Which medication
should the nurse expect to be ordered?**
,A) Furosemide
B) Spironolactone
C) Beta-blockers
D) Albumin
Correct Answer: B) Spironolactone
Rationale: Ascites from cirrhosis often requires potassium-sparing diuretics like spironolactone to
manage fluid retention by antagonizing aldosterone. This choice considers electrolyte balance and renal
function, critical in Med-Surg care.
**4. A client receiving vancomycin for sepsis develops oliguria, elevated creatinine, and elevated BUN.
What is the priority nursing action?**
A) Collect a blood specimen for antibiotic peak and trough levels
B) Stop vancomycin immediately
C) Increase IV fluids aggressively
D) Change antibiotic to another class
Correct Answer: A) Collect a blood specimen for antibiotic peak and trough levels
Rationale: Vancomycin is nephrotoxic; monitoring peak and trough levels is crucial to avoid toxicity and
ensure therapeutic dosing. Oliguria and renal labs indicate possible toxicity requiring urgent
intervention.
**5. Which infection control action 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 is needed
, Correct Answer: 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.
**6. A client who had hemodialysis yesterday develops a temperature of 101.4°F. What is the priority
nursing action?**
A) Administer acetaminophen
B) Document the finding
C) Notify the healthcare provider immediately
D) Apply a cooling blanket
Correct Answer: C) Notify the healthcare provider immediately
Rationale: Fever above 101°F post-dialysis indicates possible infection and requires prompt assessment.
The healthcare provider must be notified immediately.
**7. The nurse preceptor observes a newly hired nurse caring for a client receiving peritoneal dialysis.
Which action indicates correct technique?**
A) Using a microwave to warm dialysate
B) Repositioning the client during dialysis to improve dialysate flow
C) Placing the client flat in bed during dialysis
D) Ignoring air bubbles in tubing
Correct Answer: B) Repositioning the client during dialysis to improve dialysate flow
Rationale: Repositioning the client during peritoneal dialysis helps improve dialysate flow and drainage.
Warming dialysate should be done with a warmer, not a microwave. The client should be positioned
with the head of bed elevated, and air bubbles must be removed from tubing.
