Galen College NSG 3130 Exam 2 (pdf) | 2026/2027 | Fundamental
Concepts & Skills for Nursing Practice II Q&A | Nursing
1. A client with diabetes complicated by kidney disease is receiving multiple
medications. The nurse should make a detailed assessment when
administering medications because this client may have problems with which
pharmacokinetic phase?
A) Absorption
B) Distribution
C) Biotransformation
D) Excretion
Correct Answer: Biotransformation
Rationale: Biotransformation (metabolism) occurs primarily in the liver.
However, in clients with kidney disease, the excretion of medications and
their metabolites is impaired, leading to drug accumulation. For this client,
excretion is the primary concern. Absorption and distribution are less directly
affected by kidney disease.
2. A nurse is preparing to document the administration of a PRN pain
medication. When should this documentation occur?
A) Before administering the medication
B) Immediately after administering the medication
C) At the end of the shift
D) Only if the patient reports pain relief
Correct Answer: Immediately after administering the medication
,Rationale: Documentation of medication administration must occur
immediately after giving the medication. This confirms the medication was
actually administered and prevents duplicate dosing.
3. A client is prescribed a medication that has a narrow therapeutic index.
Which nursing action is most important?
A) Administering the medication with food
B) Monitoring serum drug levels
C) Teaching the client about side effects
D) Documenting the administration
Correct Answer: Monitoring serum drug levels
Rationale: A narrow therapeutic index means there is a small margin
between the therapeutic and toxic doses. Regular monitoring of serum drug
levels is essential to ensure the dose is within the therapeutic range and to
prevent toxicity.
4. The nurse is calculating the intake and output for a client. The client has
consumed 240 mL of ice chips. How should this be documented as fluid
intake?
A) 240 mL
B) 120 mL
C) 60 mL
D) 0 mL
Correct Answer: 120 mL
,Rationale: When calculating intake, ice chips are typically documented as
half their volume, as they melt to approximately half the volume. Therefore,
240 mL of ice chips would be documented as 120 mL of fluid intake.
5. A client is prescribed an enteric-coated medication. The nurse should
instruct the client to:
A) Crush the medication for easier swallowing
B) Chew the medication thoroughly
C) Swallow the medication whole
D) Dissolve the medication in water
Correct Answer: Swallow the medication whole
Rationale: Enteric-coated medications are designed to dissolve in the small
intestine, not the stomach, to protect the stomach from irritation or to
protect the drug from stomach acid. Crushing or chewing the tablet would
destroy the enteric coating.
6. A client is receiving an intermittent enteral feeding via a nasogastric tube.
Which client position is most appropriate to reduce the risk of aspiration?
A) Supine
B) High-Fowler's (head of bed 30-45 degrees)
C) Trendelenburg
D) Right side-lying
Correct Answer: High-Fowler's (head of bed 30-45 degrees)
Rationale: Elevating the head of the bed to 30-45 degrees reduces the risk of
aspiration during enteral feedings. Supine and Trendelenburg positions
increase the risk of regurgitation and aspiration.
, 7. The nurse is preparing to administer an enteral feeding. Which action
should the nurse take to verify nasogastric tube placement?
A) Auscultate for a whooshing sound over the stomach
B) Check the pH of the aspirate
C) Measure the length of the exposed tube
D) Observe the color of the aspirate
Correct Answer: Check the pH of the aspirate
Rationale: Checking the pH of the aspirate is a reliable method for verifying
NG tube placement. Gastric aspirate typically has a pH of 4 or less, while
respiratory or intestinal aspirate has a higher pH. Auscultation is no longer
considered a reliable method.
8. A client with a nasogastric tube has a gastric residual of 250 mL. The
nurse's best action is to:
A) Reinstill the residual and continue the feeding
B) Discard the residual and continue the feeding
C) Hold the feeding and notify the healthcare provider
D) Increase the feeding rate to compensate
Correct Answer: Hold the feeding and notify the healthcare provider
Rationale: A gastric residual volume greater than the prescribed limit
(typically 200-250 mL) may indicate delayed gastric emptying and increase
the risk of aspiration. The nurse should hold the feeding, reassess, and notify
the provider.
Concepts & Skills for Nursing Practice II Q&A | Nursing
1. A client with diabetes complicated by kidney disease is receiving multiple
medications. The nurse should make a detailed assessment when
administering medications because this client may have problems with which
pharmacokinetic phase?
A) Absorption
B) Distribution
C) Biotransformation
D) Excretion
Correct Answer: Biotransformation
Rationale: Biotransformation (metabolism) occurs primarily in the liver.
However, in clients with kidney disease, the excretion of medications and
their metabolites is impaired, leading to drug accumulation. For this client,
excretion is the primary concern. Absorption and distribution are less directly
affected by kidney disease.
2. A nurse is preparing to document the administration of a PRN pain
medication. When should this documentation occur?
A) Before administering the medication
B) Immediately after administering the medication
C) At the end of the shift
D) Only if the patient reports pain relief
Correct Answer: Immediately after administering the medication
,Rationale: Documentation of medication administration must occur
immediately after giving the medication. This confirms the medication was
actually administered and prevents duplicate dosing.
3. A client is prescribed a medication that has a narrow therapeutic index.
Which nursing action is most important?
A) Administering the medication with food
B) Monitoring serum drug levels
C) Teaching the client about side effects
D) Documenting the administration
Correct Answer: Monitoring serum drug levels
Rationale: A narrow therapeutic index means there is a small margin
between the therapeutic and toxic doses. Regular monitoring of serum drug
levels is essential to ensure the dose is within the therapeutic range and to
prevent toxicity.
4. The nurse is calculating the intake and output for a client. The client has
consumed 240 mL of ice chips. How should this be documented as fluid
intake?
A) 240 mL
B) 120 mL
C) 60 mL
D) 0 mL
Correct Answer: 120 mL
,Rationale: When calculating intake, ice chips are typically documented as
half their volume, as they melt to approximately half the volume. Therefore,
240 mL of ice chips would be documented as 120 mL of fluid intake.
5. A client is prescribed an enteric-coated medication. The nurse should
instruct the client to:
A) Crush the medication for easier swallowing
B) Chew the medication thoroughly
C) Swallow the medication whole
D) Dissolve the medication in water
Correct Answer: Swallow the medication whole
Rationale: Enteric-coated medications are designed to dissolve in the small
intestine, not the stomach, to protect the stomach from irritation or to
protect the drug from stomach acid. Crushing or chewing the tablet would
destroy the enteric coating.
6. A client is receiving an intermittent enteral feeding via a nasogastric tube.
Which client position is most appropriate to reduce the risk of aspiration?
A) Supine
B) High-Fowler's (head of bed 30-45 degrees)
C) Trendelenburg
D) Right side-lying
Correct Answer: High-Fowler's (head of bed 30-45 degrees)
Rationale: Elevating the head of the bed to 30-45 degrees reduces the risk of
aspiration during enteral feedings. Supine and Trendelenburg positions
increase the risk of regurgitation and aspiration.
, 7. The nurse is preparing to administer an enteral feeding. Which action
should the nurse take to verify nasogastric tube placement?
A) Auscultate for a whooshing sound over the stomach
B) Check the pH of the aspirate
C) Measure the length of the exposed tube
D) Observe the color of the aspirate
Correct Answer: Check the pH of the aspirate
Rationale: Checking the pH of the aspirate is a reliable method for verifying
NG tube placement. Gastric aspirate typically has a pH of 4 or less, while
respiratory or intestinal aspirate has a higher pH. Auscultation is no longer
considered a reliable method.
8. A client with a nasogastric tube has a gastric residual of 250 mL. The
nurse's best action is to:
A) Reinstill the residual and continue the feeding
B) Discard the residual and continue the feeding
C) Hold the feeding and notify the healthcare provider
D) Increase the feeding rate to compensate
Correct Answer: Hold the feeding and notify the healthcare provider
Rationale: A gastric residual volume greater than the prescribed limit
(typically 200-250 mL) may indicate delayed gastric emptying and increase
the risk of aspiration. The nurse should hold the feeding, reassess, and notify
the provider.
