,NSG4100/NSG 4100 Exam 1 | Nursing Practice – Adult
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is caring for a client with End-Stage Renal Disease (ESRD). The client's laboratory results show
a GFR of 12 mL/min. Which finding is most consistent with this level of renal function?
A) The client's kidneys are functioning at approximately 50% of normal capacity
B) The client is experiencing end-stage renal failure and will likely require renal replacement therapy
C) The client's kidneys are functioning normally
D) The client is in the early stages of chronic kidney disease
Correct Answer: The client is experiencing end-stage renal failure and will likely require renal
replacement therapy
Rationale: A GFR of less than 15 mL/min indicates end-stage renal disease (ESRD), requiring renal
replacement therapy such as hemodialysis or transplantation. Normal GFR is approximately 90-120
mL/min.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L. Which nursing
action is the priority?
A) Encourage potassium-rich foods in the diet
B) Administer potassium supplements as prescribed
C) Assess the cardiac rhythm and notify the provider
D) Instruct the client to increase fluid intake
Correct Answer: Assess the cardiac rhythm and notify the provider
Rationale: Hyperkalemia (potassium >5.0 mEq/L) can cause life-threatening cardiac dysrhythmias. The
priority is to assess the cardiac rhythm and notify the healthcare provider immediately.
,3. A client with ESRD is prescribed a low-potassium diet. Which food choice by the client indicates a
correct understanding of the dietary restriction?
A) Baked potato
B) Banana
C) Apple
D) Orange juice
Correct Answer: Apple
Rationale: Apples are low in potassium, while baked potatoes, bananas, and orange juice are high-
potassium foods that should be avoided by clients with ESRD.
4. A nurse is providing education to a client with newly diagnosed Type 1 Diabetes Mellitus. Which
instruction is most important to prevent diabetic ketoacidosis (DKA)?
A) Refer the client to the American Diabetes Association
B) Take prescribed insulin even when unable to eat due to illness
C) Avoid taking any over-the-counter medications
D) Explain the need for annual flu and pneumonia vaccines
Correct Answer: Take prescribed insulin even when unable to eat due to illness
Rationale: Clients with Type 1 DM should take insulin even when ill and unable to eat to prevent DKA.
Illness increases the body's stress response, which can raise blood glucose levels.
5. A client with Diabetes Insipidus (DI) is being admitted to the unit. Which assessment finding is most
characteristic of this condition?
A) Hypertension and bradycardia
B) Polyuria and polydipsia
C) Weight gain and peripheral edema
D) Decreased urine output and hypernatremia
, Correct Answer: Polyuria and polydipsia
Rationale: Diabetes Insipidus is characterized by excessive thirst (polydipsia) and large volumes of dilute
urine (polyuria) due to a deficiency of ADH. These findings help differentiate DI from other conditions
like SIADH.
6. The nurse is caring for a client with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). The
client's serum sodium level is 118 mEq/L. Which prescription should the nurse anticipate? Select all that
apply.
A) Initiate infusion of 3% NaCl
B) Administer IV furosemide
C) Restrict fluids to 800 mL over 24 hours
D) Elevate the head of the bed to High-Fowler's
E) Administer a vasopressin antagonist as prescribed
Correct Answer: Initiate infusion of 3% NaCl, Restrict fluids to 800 mL over 24 hours, Administer a
vasopressin antagonist as prescribed
Rationale: SIADH causes water retention and dilutional hyponatremia. Treatment includes hypertonic
saline (3% NaCl) for severe hyponatremia, fluid restriction, and vasopressin antagonists to block the
effects of ADH.
7. A client is admitted with Hyperosmolar Hyperglycemic State (HHS). The client's blood glucose is 680
mg/dL. Which question should the nurse ask to determine the cause of this acute complication?
A) "When was the last time you took your insulin?"
B) "When did you have your last meal?"
C) "Have you had some type of infection lately?"
D) "How long have you had diabetes?"
Correct Answer: "Have you had some type of infection lately?"
Health III | Galen College | Q & A | 2026/2027 Edition
(PDF)
1. A nurse is caring for a client with End-Stage Renal Disease (ESRD). The client's laboratory results show
a GFR of 12 mL/min. Which finding is most consistent with this level of renal function?
A) The client's kidneys are functioning at approximately 50% of normal capacity
B) The client is experiencing end-stage renal failure and will likely require renal replacement therapy
C) The client's kidneys are functioning normally
D) The client is in the early stages of chronic kidney disease
Correct Answer: The client is experiencing end-stage renal failure and will likely require renal
replacement therapy
Rationale: A GFR of less than 15 mL/min indicates end-stage renal disease (ESRD), requiring renal
replacement therapy such as hemodialysis or transplantation. Normal GFR is approximately 90-120
mL/min.
2. A client with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L. Which nursing
action is the priority?
A) Encourage potassium-rich foods in the diet
B) Administer potassium supplements as prescribed
C) Assess the cardiac rhythm and notify the provider
D) Instruct the client to increase fluid intake
Correct Answer: Assess the cardiac rhythm and notify the provider
Rationale: Hyperkalemia (potassium >5.0 mEq/L) can cause life-threatening cardiac dysrhythmias. The
priority is to assess the cardiac rhythm and notify the healthcare provider immediately.
,3. A client with ESRD is prescribed a low-potassium diet. Which food choice by the client indicates a
correct understanding of the dietary restriction?
A) Baked potato
B) Banana
C) Apple
D) Orange juice
Correct Answer: Apple
Rationale: Apples are low in potassium, while baked potatoes, bananas, and orange juice are high-
potassium foods that should be avoided by clients with ESRD.
4. A nurse is providing education to a client with newly diagnosed Type 1 Diabetes Mellitus. Which
instruction is most important to prevent diabetic ketoacidosis (DKA)?
A) Refer the client to the American Diabetes Association
B) Take prescribed insulin even when unable to eat due to illness
C) Avoid taking any over-the-counter medications
D) Explain the need for annual flu and pneumonia vaccines
Correct Answer: Take prescribed insulin even when unable to eat due to illness
Rationale: Clients with Type 1 DM should take insulin even when ill and unable to eat to prevent DKA.
Illness increases the body's stress response, which can raise blood glucose levels.
5. A client with Diabetes Insipidus (DI) is being admitted to the unit. Which assessment finding is most
characteristic of this condition?
A) Hypertension and bradycardia
B) Polyuria and polydipsia
C) Weight gain and peripheral edema
D) Decreased urine output and hypernatremia
, Correct Answer: Polyuria and polydipsia
Rationale: Diabetes Insipidus is characterized by excessive thirst (polydipsia) and large volumes of dilute
urine (polyuria) due to a deficiency of ADH. These findings help differentiate DI from other conditions
like SIADH.
6. The nurse is caring for a client with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). The
client's serum sodium level is 118 mEq/L. Which prescription should the nurse anticipate? Select all that
apply.
A) Initiate infusion of 3% NaCl
B) Administer IV furosemide
C) Restrict fluids to 800 mL over 24 hours
D) Elevate the head of the bed to High-Fowler's
E) Administer a vasopressin antagonist as prescribed
Correct Answer: Initiate infusion of 3% NaCl, Restrict fluids to 800 mL over 24 hours, Administer a
vasopressin antagonist as prescribed
Rationale: SIADH causes water retention and dilutional hyponatremia. Treatment includes hypertonic
saline (3% NaCl) for severe hyponatremia, fluid restriction, and vasopressin antagonists to block the
effects of ADH.
7. A client is admitted with Hyperosmolar Hyperglycemic State (HHS). The client's blood glucose is 680
mg/dL. Which question should the nurse ask to determine the cause of this acute complication?
A) "When was the last time you took your insulin?"
B) "When did you have your last meal?"
C) "Have you had some type of infection lately?"
D) "How long have you had diabetes?"
Correct Answer: "Have you had some type of infection lately?"
