Galen College NUR 170 Exam 3 (pdf) | 2026/2027 | Med-Surg Q&A |
Medical-Surgical Nursing
1. A patient with chronic kidney disease has a hemoglobin of 7.8 g/dL. The
nurse anticipates administering which medication?
A) Ferrous sulfate
B) Erythropoietin stimulating agent
C) Vitamin B12 injection
D) Folic acid
Correct Answer: Erythropoietin stimulating agent
Rationale: In chronic kidney disease (CKD), the kidneys produce less
erythropoietin, leading to anemia. Erythropoietin stimulating agents (e.g.,
epoetin alfa) replace this hormone and stimulate red blood cell production.
Iron supplements may be given if iron stores are low, but ESA is the primary
treatment for CKD anemia.
2. The nurse is providing discharge teaching to a client with type 2 diabetes
and peripheral neuropathy. Which statement by the client indicates a need
for further teaching?
A) "I will inspect my feet daily for blisters or redness."
B) "I can break in my shoes by wearing them all day."
C) "I will wear white cotton socks."
D) "I will avoid crossing my legs."
Correct Answer: "I can break in my shoes by wearing them all day."
Rationale: Clients with peripheral neuropathy have decreased sensation in
their feet and should not break in shoes by wearing them all day, as this can
,cause blisters or ulcers that may go unnoticed. Clients should wear well-
fitting shoes from the start and inspect their feet daily.
3. A patient with type 1 diabetes mellitus received regular insulin at 7:00
a.m. When is the nurse most likely to assess for hypoglycemia?
A) 8:00 a.m.
B) 9:00 a.m.
C) 11:00 a.m.
D) 1:00 p.m.
Correct Answer: 9:00 a.m.
Rationale: Regular insulin has an onset of 30-60 minutes, a peak of 2-4
hours, and a duration of 5-8 hours. The peak action time is when
hypoglycemia is most likely to occur. If administered at 7:00 a.m., the peak
would be approximately between 9:00 a.m. and 11:00 a.m.
4. A patient with type 2 diabetes who is taking metformin is seen in the
diabetic clinic. The fasting blood glucose is 108 mg/dL, and the glycosylated
hemoglobin (HbA1C) is 8.2%. Which action will the nurse take next?
A) Increase the metformin dose.
B) Ask the client about current dietary intake and medication use.
C) Instruct the client to start insulin therapy.
D) Reassure the client that the values are within target range.
Correct Answer: Ask the client about current dietary intake and medication
use.
Rationale: An HbA1C of 8.2% indicates poor glycemic control over the past 2-
3 months. The nurse should first assess the client's dietary intake,
,medication adherence, and lifestyle factors before recommending any
changes to the treatment plan.
5. An intensive care client with diabetic ketoacidosis (DKA) is receiving an
insulin infusion. When the cardiac monitor shows ventricular ectopy, which
assessment will the nurse make?
A) Serum glucose level
B) Potassium level
C) Calcium level
D) Magnesium level
Correct Answer: Potassium level
Rationale: In DKA, insulin therapy drives potassium back into the cells, which
can lead to a rapid drop in serum potassium levels (hypokalemia).
Hypokalemia can cause ventricular ectopy and other cardiac dysrhythmias.
The nurse should assess the potassium level immediately.
6. What is the classic triad of symptoms for diabetes mellitus?
A) Polyuria, polydipsia, polyphagia
B) Polyuria, polydipsia, polycythemia
C) Polyphagia, polydipsia, polycythemia
D) Polyuria, polyphagia, polycythemia
Correct Answer: Polyuria, polydipsia, polyphagia
Rationale: The classic "Three P's" of diabetes are polyuria (frequent
urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
These symptoms occur due to hyperglycemia causing osmotic diuresis,
dehydration, and cellular starvation.
, 7. The nurse is caring for a patient who has just returned from hemodialysis.
Which assessment finding requires immediate follow-up?
A) Blood pressure 110/70 mmHg
B) Heart rate 88 beats/min
C) Temperature 101.2°F (38.4°C)
D) Mild headache
Correct Answer: Temperature 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F (38.4°C) may indicate an infection,
which could be related to the dialysis access site or a systemic infection. This
finding requires immediate follow-up. A mild headache may be related to
disequilibrium syndrome, but fever is more concerning.
8. A patient with chronic kidney disease is prescribed a phosphate binder.
The nurse should instruct the client to take this medication:
A) With meals
B) On an empty stomach
C) At bedtime
D) With a full glass of water
Correct Answer: With meals
Rationale: Phosphate binders should be taken with meals to bind dietary
phosphate in the gastrointestinal tract, preventing its absorption and
lowering serum phosphate levels. This is a key intervention in managing
hyperphosphatemia in CKD.
Medical-Surgical Nursing
1. A patient with chronic kidney disease has a hemoglobin of 7.8 g/dL. The
nurse anticipates administering which medication?
A) Ferrous sulfate
B) Erythropoietin stimulating agent
C) Vitamin B12 injection
D) Folic acid
Correct Answer: Erythropoietin stimulating agent
Rationale: In chronic kidney disease (CKD), the kidneys produce less
erythropoietin, leading to anemia. Erythropoietin stimulating agents (e.g.,
epoetin alfa) replace this hormone and stimulate red blood cell production.
Iron supplements may be given if iron stores are low, but ESA is the primary
treatment for CKD anemia.
2. The nurse is providing discharge teaching to a client with type 2 diabetes
and peripheral neuropathy. Which statement by the client indicates a need
for further teaching?
A) "I will inspect my feet daily for blisters or redness."
B) "I can break in my shoes by wearing them all day."
C) "I will wear white cotton socks."
D) "I will avoid crossing my legs."
Correct Answer: "I can break in my shoes by wearing them all day."
Rationale: Clients with peripheral neuropathy have decreased sensation in
their feet and should not break in shoes by wearing them all day, as this can
,cause blisters or ulcers that may go unnoticed. Clients should wear well-
fitting shoes from the start and inspect their feet daily.
3. A patient with type 1 diabetes mellitus received regular insulin at 7:00
a.m. When is the nurse most likely to assess for hypoglycemia?
A) 8:00 a.m.
B) 9:00 a.m.
C) 11:00 a.m.
D) 1:00 p.m.
Correct Answer: 9:00 a.m.
Rationale: Regular insulin has an onset of 30-60 minutes, a peak of 2-4
hours, and a duration of 5-8 hours. The peak action time is when
hypoglycemia is most likely to occur. If administered at 7:00 a.m., the peak
would be approximately between 9:00 a.m. and 11:00 a.m.
4. A patient with type 2 diabetes who is taking metformin is seen in the
diabetic clinic. The fasting blood glucose is 108 mg/dL, and the glycosylated
hemoglobin (HbA1C) is 8.2%. Which action will the nurse take next?
A) Increase the metformin dose.
B) Ask the client about current dietary intake and medication use.
C) Instruct the client to start insulin therapy.
D) Reassure the client that the values are within target range.
Correct Answer: Ask the client about current dietary intake and medication
use.
Rationale: An HbA1C of 8.2% indicates poor glycemic control over the past 2-
3 months. The nurse should first assess the client's dietary intake,
,medication adherence, and lifestyle factors before recommending any
changes to the treatment plan.
5. An intensive care client with diabetic ketoacidosis (DKA) is receiving an
insulin infusion. When the cardiac monitor shows ventricular ectopy, which
assessment will the nurse make?
A) Serum glucose level
B) Potassium level
C) Calcium level
D) Magnesium level
Correct Answer: Potassium level
Rationale: In DKA, insulin therapy drives potassium back into the cells, which
can lead to a rapid drop in serum potassium levels (hypokalemia).
Hypokalemia can cause ventricular ectopy and other cardiac dysrhythmias.
The nurse should assess the potassium level immediately.
6. What is the classic triad of symptoms for diabetes mellitus?
A) Polyuria, polydipsia, polyphagia
B) Polyuria, polydipsia, polycythemia
C) Polyphagia, polydipsia, polycythemia
D) Polyuria, polyphagia, polycythemia
Correct Answer: Polyuria, polydipsia, polyphagia
Rationale: The classic "Three P's" of diabetes are polyuria (frequent
urination), polydipsia (excessive thirst), and polyphagia (excessive hunger).
These symptoms occur due to hyperglycemia causing osmotic diuresis,
dehydration, and cellular starvation.
, 7. The nurse is caring for a patient who has just returned from hemodialysis.
Which assessment finding requires immediate follow-up?
A) Blood pressure 110/70 mmHg
B) Heart rate 88 beats/min
C) Temperature 101.2°F (38.4°C)
D) Mild headache
Correct Answer: Temperature 101.2°F (38.4°C)
Rationale: A temperature of 101.2°F (38.4°C) may indicate an infection,
which could be related to the dialysis access site or a systemic infection. This
finding requires immediate follow-up. A mild headache may be related to
disequilibrium syndrome, but fever is more concerning.
8. A patient with chronic kidney disease is prescribed a phosphate binder.
The nurse should instruct the client to take this medication:
A) With meals
B) On an empty stomach
C) At bedtime
D) With a full glass of water
Correct Answer: With meals
Rationale: Phosphate binders should be taken with meals to bind dietary
phosphate in the gastrointestinal tract, preventing its absorption and
lowering serum phosphate levels. This is a key intervention in managing
hyperphosphatemia in CKD.
