NUR 265 Exam 1 Medical-
Surgical Nursing (2026) PDF |
Galen College of Nursing
EXAM PRACTICE 250
QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS
|DETAILED RATIONALES
|HINTED COMPLETE EXAM
PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A client with acute kidney injury has a urine output of 15
mL/hr for the past 4 hours. Which action should the nurse
take first?
A. Encourage oral fluids
B. Document the finding as expected
C. Assess the client's hemodynamic status
D. Administer potassium
Answer: C. Assess the client's hemodynamic status
,Rationale: Oliguria may indicate worsening renal perfusion or
acute kidney injury. The nurse should first assess blood
pressure, heart rate, perfusion, and fluid status before
selecting an intervention.
2. Which laboratory value is most useful for evaluating renal
filtration?
A. ALT
B. Serum creatinine
C. Hemoglobin
D. Amylase
Answer: B. Serum creatinine
Rationale: Serum creatinine is a key indicator of kidney
filtration and generally rises when glomerular filtration
decreases.
3. Which finding is most consistent with prerenal acute
kidney injury?
A. Renal calculi
B. Acute tubular necrosis
C. Severe dehydration
D. Glomerulonephritis
Answer: C. Severe dehydration
Rationale: Prerenal AKI results from decreased renal
perfusion. Dehydration, hemorrhage, and reduced cardiac
output are common causes.
,4. Which condition is classified as postrenal acute kidney
injury?
A. Sepsis
B. Severe hemorrhage
C. Nephrotoxic medication exposure
D. Ureteral obstruction
Answer: D. Ureteral obstruction
Rationale: Postrenal AKI occurs when urine outflow is
obstructed, such as from stones, tumors, or urinary tract
obstruction.
5. A client with AKI has potassium of 6.4 mEq/L. Which
assessment is the priority?
A. Bowel sounds
B. Cardiac rhythm
C. Skin turgor
D. Visual acuity
Answer: B. Cardiac rhythm
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias. Continuous ECG monitoring is a
priority.
6. Which ECG finding is associated with hyperkalemia?
, A. Peaked T waves
B. U waves
C. Prolonged QT interval only
D. ST elevation in every lead
Answer: A. Peaked T waves
Rationale: Hyperkalemia classically produces tall, peaked T
waves and may progress to PR prolongation, QRS widening,
and fatal dysrhythmias.
7. Which medication should the nurse question for a client
with significant renal impairment?
A. Acetaminophen
B. Nephrotoxic aminoglycoside
C. Calcium carbonate
D. Stool softener
Answer: B. Nephrotoxic aminoglycoside
Rationale: Aminoglycosides can cause nephrotoxicity and
require careful dosing and monitoring in patients with
impaired renal function.
8. Which finding is expected in fluid volume excess
associated with AKI?
A. Flat neck veins
B. Crackles
C. Dry mucous membranes
D. Orthostatic hypotension
Surgical Nursing (2026) PDF |
Galen College of Nursing
EXAM PRACTICE 250
QUESTIONS |ORIGINAL
QUESTIONS & ANSWERS
|DETAILED RATIONALES
|HINTED COMPLETE EXAM
PREP GRADED A+*INSTANT
DOWNLOAD PDF
1. A client with acute kidney injury has a urine output of 15
mL/hr for the past 4 hours. Which action should the nurse
take first?
A. Encourage oral fluids
B. Document the finding as expected
C. Assess the client's hemodynamic status
D. Administer potassium
Answer: C. Assess the client's hemodynamic status
,Rationale: Oliguria may indicate worsening renal perfusion or
acute kidney injury. The nurse should first assess blood
pressure, heart rate, perfusion, and fluid status before
selecting an intervention.
2. Which laboratory value is most useful for evaluating renal
filtration?
A. ALT
B. Serum creatinine
C. Hemoglobin
D. Amylase
Answer: B. Serum creatinine
Rationale: Serum creatinine is a key indicator of kidney
filtration and generally rises when glomerular filtration
decreases.
3. Which finding is most consistent with prerenal acute
kidney injury?
A. Renal calculi
B. Acute tubular necrosis
C. Severe dehydration
D. Glomerulonephritis
Answer: C. Severe dehydration
Rationale: Prerenal AKI results from decreased renal
perfusion. Dehydration, hemorrhage, and reduced cardiac
output are common causes.
,4. Which condition is classified as postrenal acute kidney
injury?
A. Sepsis
B. Severe hemorrhage
C. Nephrotoxic medication exposure
D. Ureteral obstruction
Answer: D. Ureteral obstruction
Rationale: Postrenal AKI occurs when urine outflow is
obstructed, such as from stones, tumors, or urinary tract
obstruction.
5. A client with AKI has potassium of 6.4 mEq/L. Which
assessment is the priority?
A. Bowel sounds
B. Cardiac rhythm
C. Skin turgor
D. Visual acuity
Answer: B. Cardiac rhythm
Rationale: Severe hyperkalemia can cause life-threatening
cardiac dysrhythmias. Continuous ECG monitoring is a
priority.
6. Which ECG finding is associated with hyperkalemia?
, A. Peaked T waves
B. U waves
C. Prolonged QT interval only
D. ST elevation in every lead
Answer: A. Peaked T waves
Rationale: Hyperkalemia classically produces tall, peaked T
waves and may progress to PR prolongation, QRS widening,
and fatal dysrhythmias.
7. Which medication should the nurse question for a client
with significant renal impairment?
A. Acetaminophen
B. Nephrotoxic aminoglycoside
C. Calcium carbonate
D. Stool softener
Answer: B. Nephrotoxic aminoglycoside
Rationale: Aminoglycosides can cause nephrotoxicity and
require careful dosing and monitoring in patients with
impaired renal function.
8. Which finding is expected in fluid volume excess
associated with AKI?
A. Flat neck veins
B. Crackles
C. Dry mucous membranes
D. Orthostatic hypotension
