NUR 265 Exam 1 Review 250 Questions and100%
Correct Answers Latest 2026 Update - Galen College of
Nursing.
Question 1
A nurse is caring for a client with end-stage renal disease (ESRD) who is
receiving hemodialysis. Which of the following laboratory values should the
nurse monitor most closely before dialysis?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Potassium levels can rise to dangerous levels between dialysis
sessions, causing life-threatening cardiac arrhythmias. Pre-dialysis potassium
must be monitored closely. Sodium, calcium, and magnesium are important
but potassium is the most critical for safety.
Question 2
A client with cirrhosis is prescribed lactulose. The nurse understands that
this medication is given to:
A) Reduce serum ammonia levels
B) Increase serum bilirubin excretion
C) Decrease portal hypertension
D) Prevent gastrointestinal bleeding
,Answer: A) Reduce serum ammonia levels
Rationale: Lactulose is used to treat hepatic encephalopathy by reducing
serum ammonia levels. It works by acidifying the colon and promoting
ammonia excretion. It does not affect bilirubin, portal hypertension, or
bleeding directly.
Question 3
A nurse is assessing a client with heart failure who is receiving furosemide.
Which of the following findings indicates the medication is effective?
A) Weight loss of 2 pounds in 24 hours
B) Blood pressure of 90/60 mmHg
C) Crackles in the lung bases
D) Peripheral edema worsening
Answer: A) Weight loss of 2 pounds in 24 hours
Rationale: Effective diuresis results in weight loss and reduction of edema and
crackles. Hypotension may indicate over-diuresis. Crackles and worsening
edema indicate worsening heart failure.
Question 4
A client with acute kidney injury (AKI) is in the oliguric phase. Which of the
following is the priority nursing intervention?
A) Restrict dietary potassium
B) Administer erythropoietin
C) Encourage high-protein intake
D) Increase fluid intake
,Answer: A) Restrict dietary potassium
Rationale: In the oliguric phase, urine output is decreased, leading to
potassium retention. Hyperkalemia is a life-threatening complication. Dietary
potassium must be restricted. Erythropoietin is for anemia; protein is limited;
fluids are restricted, not increased.
Question 5
A client with diabetes mellitus type 1 is experiencing diabetic ketoacidosis
(DKA). Which of the following is the priority assessment?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Potassium levels can fluctuate dangerously during DKA treatment.
Insulin shifts potassium into cells, causing hypokalemia. Blood glucose is also
important, but potassium is a priority for safety due to cardiac risks.
Question 6
A client with chronic kidney disease (CKD) is prescribed calcium acetate.
The nurse understands that the purpose of this medication is to:
A) Bind phosphate in the gastrointestinal tract
B) Increase serum calcium levels
C) Decrease serum potassium levels
D) Increase vitamin D absorption
, Answer: A) Bind phosphate in the gastrointestinal tract
Rationale: Calcium acetate is a phosphate binder used to lower serum
phosphate levels in CKD. It binds dietary phosphate in the GI tract, preventing
absorption. It is not primarily used to increase calcium, decrease potassium,
or increase vitamin D.
Question 7
A client with heart failure is prescribed an ACE inhibitor. Which of the
following adverse effects should the nurse monitor?
A) Dry cough
B) Hyperkalemia
C) Hypotension
D) All of the above
Answer: D) All of the above
Rationale: ACE inhibitors can cause a dry cough, hyperkalemia, and
hypotension. All are important adverse effects to monitor. Angioedema is also
a rare but serious adverse effect.
Question 8
A nurse is caring for a client with acute pancreatitis. Which of the following
positions would best reduce the client's pain?
A) Supine with legs extended
B) Side-lying with knees flexed
C) Prone
D) Trendelenburg
Correct Answers Latest 2026 Update - Galen College of
Nursing.
Question 1
A nurse is caring for a client with end-stage renal disease (ESRD) who is
receiving hemodialysis. Which of the following laboratory values should the
nurse monitor most closely before dialysis?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Potassium levels can rise to dangerous levels between dialysis
sessions, causing life-threatening cardiac arrhythmias. Pre-dialysis potassium
must be monitored closely. Sodium, calcium, and magnesium are important
but potassium is the most critical for safety.
Question 2
A client with cirrhosis is prescribed lactulose. The nurse understands that
this medication is given to:
A) Reduce serum ammonia levels
B) Increase serum bilirubin excretion
C) Decrease portal hypertension
D) Prevent gastrointestinal bleeding
,Answer: A) Reduce serum ammonia levels
Rationale: Lactulose is used to treat hepatic encephalopathy by reducing
serum ammonia levels. It works by acidifying the colon and promoting
ammonia excretion. It does not affect bilirubin, portal hypertension, or
bleeding directly.
Question 3
A nurse is assessing a client with heart failure who is receiving furosemide.
Which of the following findings indicates the medication is effective?
A) Weight loss of 2 pounds in 24 hours
B) Blood pressure of 90/60 mmHg
C) Crackles in the lung bases
D) Peripheral edema worsening
Answer: A) Weight loss of 2 pounds in 24 hours
Rationale: Effective diuresis results in weight loss and reduction of edema and
crackles. Hypotension may indicate over-diuresis. Crackles and worsening
edema indicate worsening heart failure.
Question 4
A client with acute kidney injury (AKI) is in the oliguric phase. Which of the
following is the priority nursing intervention?
A) Restrict dietary potassium
B) Administer erythropoietin
C) Encourage high-protein intake
D) Increase fluid intake
,Answer: A) Restrict dietary potassium
Rationale: In the oliguric phase, urine output is decreased, leading to
potassium retention. Hyperkalemia is a life-threatening complication. Dietary
potassium must be restricted. Erythropoietin is for anemia; protein is limited;
fluids are restricted, not increased.
Question 5
A client with diabetes mellitus type 1 is experiencing diabetic ketoacidosis
(DKA). Which of the following is the priority assessment?
A) Serum potassium
B) Serum sodium
C) Serum calcium
D) Serum magnesium
Answer: A) Serum potassium
Rationale: Potassium levels can fluctuate dangerously during DKA treatment.
Insulin shifts potassium into cells, causing hypokalemia. Blood glucose is also
important, but potassium is a priority for safety due to cardiac risks.
Question 6
A client with chronic kidney disease (CKD) is prescribed calcium acetate.
The nurse understands that the purpose of this medication is to:
A) Bind phosphate in the gastrointestinal tract
B) Increase serum calcium levels
C) Decrease serum potassium levels
D) Increase vitamin D absorption
, Answer: A) Bind phosphate in the gastrointestinal tract
Rationale: Calcium acetate is a phosphate binder used to lower serum
phosphate levels in CKD. It binds dietary phosphate in the GI tract, preventing
absorption. It is not primarily used to increase calcium, decrease potassium,
or increase vitamin D.
Question 7
A client with heart failure is prescribed an ACE inhibitor. Which of the
following adverse effects should the nurse monitor?
A) Dry cough
B) Hyperkalemia
C) Hypotension
D) All of the above
Answer: D) All of the above
Rationale: ACE inhibitors can cause a dry cough, hyperkalemia, and
hypotension. All are important adverse effects to monitor. Angioedema is also
a rare but serious adverse effect.
Question 8
A nurse is caring for a client with acute pancreatitis. Which of the following
positions would best reduce the client's pain?
A) Supine with legs extended
B) Side-lying with knees flexed
C) Prone
D) Trendelenburg
