NUR 265 Exam 1 Review 300+ Questions and100%
Correct Answers Latest 2026 Update - Galen College of
Nursing.
Question 1
A nurse is caring for a client with chronic kidney disease (CKD) who is receiving
hemodialysis. The client asks why the diet restricts phosphorus. Which of the following is
the best response by the nurse?
A) "Phosphorus builds up in your blood and can cause bone disease"
B) "Phosphorus causes fluid retention and swelling"
C) "Phosphorus increases your risk of bleeding"
D) "Phosphorus raises your blood sugar levels"
Answer: A) "Phosphorus builds up in your blood and can cause bone disease"
Rationale: In CKD, the kidneys cannot excrete phosphorus, leading to hyperphosphatemia.
This causes calcium to be pulled from bones, leading to renal osteodystrophy. Fluid
retention, bleeding, and elevated blood sugar are not directly related to phosphorus
restriction.
Question 2
A client with heart failure is prescribed carvedilol. The nurse should instruct the client to
monitor for which of the following adverse effects?
A) Bradycardia and hypotension
B) Tachycardia and hypertension
,C) Hyperglycemia and weight loss
D) Tachypnea and fever
Answer: A) Bradycardia and hypotension
Rationale: Carvedilol is a beta-blocker that decreases heart rate and blood pressure.
Clients should monitor for bradycardia (heart rate < 60) and hypotension (dizziness,
lightheadedness). Tachycardia, hyperglycemia, and tachypnea are not typical adverse
effects.
Question 3
A nurse is assessing a client with cirrhosis who has ascites. Which of the following
findings would the nurse expect?
A) Shifting dullness on percussion
B) Hyperresonance on percussion
C) Decreased abdominal girth
D) Increased bowel sounds
Answer: A) Shifting dullness on percussion
Rationale: Ascites causes fluid accumulation in the abdominal cavity, which produces
shifting dullness on percussion. Hyperresonance is associated with air; decreased girth
would indicate improvement; bowel sounds may be decreased, not increased.
Question 4
A client with diabetes mellitus type 1 is prescribed insulin lispro. The nurse should
instruct the client to administer this insulin:
A) 5 to 15 minutes before meals
B) 30 to 60 minutes before meals
C) At bedtime only
D) Once daily in the morning
,Answer: A) 5 to 15 minutes before meals
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 5–15 minutes. It should
be given immediately before meals (within 15 minutes). Regular insulin is given 30
minutes before meals; long-acting insulin is given once daily.
Question 5
A client with acute pancreatitis reports severe abdominal pain. Which of the following
laboratory values is most specific for acute pancreatitis?
A) Elevated serum lipase
B) Elevated serum amylase
C) Elevated serum glucose
D) Elevated serum calcium
Answer: A) Elevated serum lipase
Rationale: Serum lipase is more specific for acute pancreatitis than amylase. Amylase can
be elevated in other conditions (e.g., salivary gland disorders). Glucose may be elevated,
and calcium is often low, not elevated.
Question 6
A nurse is caring for a client with end-stage renal disease who is receiving peritoneal
dialysis. Which of the following findings indicates peritonitis?
A) Cloudy dialysate effluent
B) Clear dialysate effluent
C) Weight loss
D) Decreased blood pressure
Answer: A) Cloudy dialysate effluent
Rationale: Cloudy dialysate effluent is the hallmark sign of peritonitis in peritoneal
dialysis. Clear effluent is normal. Weight loss and decreased blood pressure are not specific
signs of peritonitis.
, Question 7
A client with cirrhosis has a serum ammonia level of 85 mcg/dL. Which of the following
medications should the nurse anticipate?
A) Lactulose
B) Spironolactone
C) Furosemide
D) Metoprolol
Answer: A) Lactulose
Rationale: An elevated ammonia level indicates hepatic encephalopathy. Lactulose is the
first-line treatment to reduce ammonia. Spironolactone and furosemide treat ascites;
metoprolol is for hypertension.
Question 8
A client with heart failure is receiving furosemide. The nurse notes that the client's urine
output has increased significantly. Which of the following is a potential complication of
this medication?
A) Hypokalemia
B) Hyperkalemia
C) Hypernatremia
D) Hypercalcemia
Answer: A) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia. Hypokalemia can cause cardiac arrhythmias. Hyperkalemia is associated
with potassium-sparing diuretics; hypernatremia and hypercalcemia are not typical.
Question 9
Correct Answers Latest 2026 Update - Galen College of
Nursing.
Question 1
A nurse is caring for a client with chronic kidney disease (CKD) who is receiving
hemodialysis. The client asks why the diet restricts phosphorus. Which of the following is
the best response by the nurse?
A) "Phosphorus builds up in your blood and can cause bone disease"
B) "Phosphorus causes fluid retention and swelling"
C) "Phosphorus increases your risk of bleeding"
D) "Phosphorus raises your blood sugar levels"
Answer: A) "Phosphorus builds up in your blood and can cause bone disease"
Rationale: In CKD, the kidneys cannot excrete phosphorus, leading to hyperphosphatemia.
This causes calcium to be pulled from bones, leading to renal osteodystrophy. Fluid
retention, bleeding, and elevated blood sugar are not directly related to phosphorus
restriction.
Question 2
A client with heart failure is prescribed carvedilol. The nurse should instruct the client to
monitor for which of the following adverse effects?
A) Bradycardia and hypotension
B) Tachycardia and hypertension
,C) Hyperglycemia and weight loss
D) Tachypnea and fever
Answer: A) Bradycardia and hypotension
Rationale: Carvedilol is a beta-blocker that decreases heart rate and blood pressure.
Clients should monitor for bradycardia (heart rate < 60) and hypotension (dizziness,
lightheadedness). Tachycardia, hyperglycemia, and tachypnea are not typical adverse
effects.
Question 3
A nurse is assessing a client with cirrhosis who has ascites. Which of the following
findings would the nurse expect?
A) Shifting dullness on percussion
B) Hyperresonance on percussion
C) Decreased abdominal girth
D) Increased bowel sounds
Answer: A) Shifting dullness on percussion
Rationale: Ascites causes fluid accumulation in the abdominal cavity, which produces
shifting dullness on percussion. Hyperresonance is associated with air; decreased girth
would indicate improvement; bowel sounds may be decreased, not increased.
Question 4
A client with diabetes mellitus type 1 is prescribed insulin lispro. The nurse should
instruct the client to administer this insulin:
A) 5 to 15 minutes before meals
B) 30 to 60 minutes before meals
C) At bedtime only
D) Once daily in the morning
,Answer: A) 5 to 15 minutes before meals
Rationale: Insulin lispro is a rapid-acting insulin with an onset of 5–15 minutes. It should
be given immediately before meals (within 15 minutes). Regular insulin is given 30
minutes before meals; long-acting insulin is given once daily.
Question 5
A client with acute pancreatitis reports severe abdominal pain. Which of the following
laboratory values is most specific for acute pancreatitis?
A) Elevated serum lipase
B) Elevated serum amylase
C) Elevated serum glucose
D) Elevated serum calcium
Answer: A) Elevated serum lipase
Rationale: Serum lipase is more specific for acute pancreatitis than amylase. Amylase can
be elevated in other conditions (e.g., salivary gland disorders). Glucose may be elevated,
and calcium is often low, not elevated.
Question 6
A nurse is caring for a client with end-stage renal disease who is receiving peritoneal
dialysis. Which of the following findings indicates peritonitis?
A) Cloudy dialysate effluent
B) Clear dialysate effluent
C) Weight loss
D) Decreased blood pressure
Answer: A) Cloudy dialysate effluent
Rationale: Cloudy dialysate effluent is the hallmark sign of peritonitis in peritoneal
dialysis. Clear effluent is normal. Weight loss and decreased blood pressure are not specific
signs of peritonitis.
, Question 7
A client with cirrhosis has a serum ammonia level of 85 mcg/dL. Which of the following
medications should the nurse anticipate?
A) Lactulose
B) Spironolactone
C) Furosemide
D) Metoprolol
Answer: A) Lactulose
Rationale: An elevated ammonia level indicates hepatic encephalopathy. Lactulose is the
first-line treatment to reduce ammonia. Spironolactone and furosemide treat ascites;
metoprolol is for hypertension.
Question 8
A client with heart failure is receiving furosemide. The nurse notes that the client's urine
output has increased significantly. Which of the following is a potential complication of
this medication?
A) Hypokalemia
B) Hyperkalemia
C) Hypernatremia
D) Hypercalcemia
Answer: A) Hypokalemia
Rationale: Furosemide is a loop diuretic that causes potassium wasting, leading to
hypokalemia. Hypokalemia can cause cardiac arrhythmias. Hyperkalemia is associated
with potassium-sparing diuretics; hypernatremia and hypercalcemia are not typical.
Question 9
