NUR 265 / NUR265 EXAM 1-3 ADVANCED
CONCEPTS IN MEDICAL-SURGICAL NURSING
EXAM 1-3 | QUESTIONS AND ANSWERS RATED
A+ | 2026/2027
Exam 1 (Questions 1-200)
Exam 2 (Questions 201-365)
Exam 3 (Questions 366-530)
EXAM 1 (Questions 1-200)
SECTION 1: RENAL DISORDERS (Questions 1-45)
1. What is nephrotic syndrome?
A. Inflammation of the glomeruli
B. A condition of increased glomerular permeability that allows larger molecules to pass
through the membrane into the urine
C. Obstruction of the urinary tract after the kidney
D. Decreased perfusion to the kidneys
Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability
resulting from damage to the glomerular filtration barrier, leading to the excretion of
large proteins, such as albumin, in the urine. This pathophysiological change disrupts
normal protein balance, contributing to edema and hypoalbuminemia .
2. What are examples of nephrotoxic drugs?
,A. NSAIDs, metformin, diuretics, antibiotics (-mycin), and contrast dye
B. ACE inhibitors, ARBs, and beta-blockers
C. Insulin, metformin, and sulfonylureas
D. Corticosteroids and immunosuppressants
Answer: A
Rationale: Nephrotoxic drugs directly damage renal tissue or alter renal hemodynamics.
NSAIDs inhibit prostaglandin synthesis, diuretics can cause volume depletion, certain
antibiotics are nephrotoxic, and contrast dye can induce acute kidney injury .
3. Describe Prerenal AKI. Give examples.
A. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis
B. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis, MI/HF
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: B
Rationale: Prerenal acute kidney injury occurs due to decreased perfusion to the
kidneys, where insufficient blood flow compromises renal function. Causes include
NSAID use, severe dehydration, conditions like MI or HF that reduce cardiac output,
blood/fluid loss, renal artery stenosis, and atherosclerosis .
4. Describe Intrarenal AKI. Give examples.
A. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis
B. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis, intrarenal
bleeding, pyelonephritis
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: B
Rationale: Intrarenal acute kidney injury occurs due to direct damage to renal
parenchyma. Causes include glomerulonephritis (inflammation of the glomeruli), sepsis,
,intrarenal bleeding, and pyelonephritis (kidney infection). This damage impairs renal
function by disrupting filtration and homeostasis .
5. Describe Postrenal AKI. Give examples.
A. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis
B. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: C
Rationale: Postrenal acute kidney injury arises from obstruction in the urinary tract after
the kidneys. Common causes include benign prostatic hyperplasia, bladder tumors, and
nephrolithiasis (kidney stones), all of which impede urine flow and can precipitate renal
dysfunction .
6. How do you determine the mean arterial pressure (MAP)?
A. Systolic + Diastolic / 2
B. Systolic + (Diastolic × 2) / 3
C. Systolic × Diastolic / 2
D. Systolic - Diastolic / 2
Answer: B
Rationale: MAP = (Systolic + 2 × Diastolic) / 3. This formula accounts for the time the
heart spends in diastole (which is longer than systole) by doubling the diastolic pressure.
Normal MAP is 70-100 mmHg .
7. What is the MAP needed to perfuse the kidneys?
A. 50 mmHg
B. 65 mmHg
C. 80 mmHg
D. 100 mmHg
, Answer: B
Rationale: A MAP of 65 mmHg is necessary to maintain adequate renal perfusion and
glomerular filtration. Below this threshold, renal ischemia can occur, leading to potential
acute kidney injury .
8. What are the dietary restrictions for an AKI patient?
A. High protein, high sodium, fluid restriction 1000-1500 mL/day
B. Low protein, low sodium, fluid restriction 1000-1500 mL/day
C. High protein, low sodium, fluid restriction 2000-2500 mL/day
D. Low protein, high sodium, fluid restriction 500-1000 mL/day
Answer: B
Rationale: Restricting protein minimizes nitrogenous waste accumulation in AKI.
Limiting sodium and fluid intake helps prevent hypertension and fluid overload. Fluid
restriction is typically 1000-1500 mL/day .
9. What is the priority intervention for a patient with acute kidney injury and a
serum potassium of 6.8 mEq/L?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally
B. Prepare the client for emergent hemodialysis
C. Administer IV calcium gluconate
D. Restrict dietary potassium intake
Answer: C
Rationale: IV calcium gluconate is given emergently to stabilize cardiac membranes and
prevent life-threatening arrhythmias in severe hyperkalemia. It does not lower
potassium but protects the heart while other treatments take effect .
10. A client with chronic kidney disease is prescribed epoetin alfa (Epogen). The
nurse understands that this medication is given to treat which complication?
A. Hyperkalemia
B. Anemia
CONCEPTS IN MEDICAL-SURGICAL NURSING
EXAM 1-3 | QUESTIONS AND ANSWERS RATED
A+ | 2026/2027
Exam 1 (Questions 1-200)
Exam 2 (Questions 201-365)
Exam 3 (Questions 366-530)
EXAM 1 (Questions 1-200)
SECTION 1: RENAL DISORDERS (Questions 1-45)
1. What is nephrotic syndrome?
A. Inflammation of the glomeruli
B. A condition of increased glomerular permeability that allows larger molecules to pass
through the membrane into the urine
C. Obstruction of the urinary tract after the kidney
D. Decreased perfusion to the kidneys
Answer: B
Rationale: Nephrotic syndrome is characterized by increased glomerular permeability
resulting from damage to the glomerular filtration barrier, leading to the excretion of
large proteins, such as albumin, in the urine. This pathophysiological change disrupts
normal protein balance, contributing to edema and hypoalbuminemia .
2. What are examples of nephrotoxic drugs?
,A. NSAIDs, metformin, diuretics, antibiotics (-mycin), and contrast dye
B. ACE inhibitors, ARBs, and beta-blockers
C. Insulin, metformin, and sulfonylureas
D. Corticosteroids and immunosuppressants
Answer: A
Rationale: Nephrotoxic drugs directly damage renal tissue or alter renal hemodynamics.
NSAIDs inhibit prostaglandin synthesis, diuretics can cause volume depletion, certain
antibiotics are nephrotoxic, and contrast dye can induce acute kidney injury .
3. Describe Prerenal AKI. Give examples.
A. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis
B. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis, MI/HF
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: B
Rationale: Prerenal acute kidney injury occurs due to decreased perfusion to the
kidneys, where insufficient blood flow compromises renal function. Causes include
NSAID use, severe dehydration, conditions like MI or HF that reduce cardiac output,
blood/fluid loss, renal artery stenosis, and atherosclerosis .
4. Describe Intrarenal AKI. Give examples.
A. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis
B. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis, intrarenal
bleeding, pyelonephritis
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: B
Rationale: Intrarenal acute kidney injury occurs due to direct damage to renal
parenchyma. Causes include glomerulonephritis (inflammation of the glomeruli), sepsis,
,intrarenal bleeding, and pyelonephritis (kidney infection). This damage impairs renal
function by disrupting filtration and homeostasis .
5. Describe Postrenal AKI. Give examples.
A. Decreased perfusion to kidneys; examples: NSAIDs, severe dehydration, renal artery
stenosis
B. Tissue damage to the actual kidneys; examples: glomerulonephritis, sepsis
C. Obstruction after the kidney; examples: BPH, bladder cancer, kidney stones
D. Autoimmune attack on the kidneys; examples: lupus, Goodpasture syndrome
Answer: C
Rationale: Postrenal acute kidney injury arises from obstruction in the urinary tract after
the kidneys. Common causes include benign prostatic hyperplasia, bladder tumors, and
nephrolithiasis (kidney stones), all of which impede urine flow and can precipitate renal
dysfunction .
6. How do you determine the mean arterial pressure (MAP)?
A. Systolic + Diastolic / 2
B. Systolic + (Diastolic × 2) / 3
C. Systolic × Diastolic / 2
D. Systolic - Diastolic / 2
Answer: B
Rationale: MAP = (Systolic + 2 × Diastolic) / 3. This formula accounts for the time the
heart spends in diastole (which is longer than systole) by doubling the diastolic pressure.
Normal MAP is 70-100 mmHg .
7. What is the MAP needed to perfuse the kidneys?
A. 50 mmHg
B. 65 mmHg
C. 80 mmHg
D. 100 mmHg
, Answer: B
Rationale: A MAP of 65 mmHg is necessary to maintain adequate renal perfusion and
glomerular filtration. Below this threshold, renal ischemia can occur, leading to potential
acute kidney injury .
8. What are the dietary restrictions for an AKI patient?
A. High protein, high sodium, fluid restriction 1000-1500 mL/day
B. Low protein, low sodium, fluid restriction 1000-1500 mL/day
C. High protein, low sodium, fluid restriction 2000-2500 mL/day
D. Low protein, high sodium, fluid restriction 500-1000 mL/day
Answer: B
Rationale: Restricting protein minimizes nitrogenous waste accumulation in AKI.
Limiting sodium and fluid intake helps prevent hypertension and fluid overload. Fluid
restriction is typically 1000-1500 mL/day .
9. What is the priority intervention for a patient with acute kidney injury and a
serum potassium of 6.8 mEq/L?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally
B. Prepare the client for emergent hemodialysis
C. Administer IV calcium gluconate
D. Restrict dietary potassium intake
Answer: C
Rationale: IV calcium gluconate is given emergently to stabilize cardiac membranes and
prevent life-threatening arrhythmias in severe hyperkalemia. It does not lower
potassium but protects the heart while other treatments take effect .
10. A client with chronic kidney disease is prescribed epoetin alfa (Epogen). The
nurse understands that this medication is given to treat which complication?
A. Hyperkalemia
B. Anemia
