NU 185 Exam 3 Medical-Surgical Nursing II Preparation 2026 Galen
College
1. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to observe?
A. Daily urine output of 3 liters
B. Decreased serum creatinine levels
C. Hypernatremia and dehydration
D. Urine output of less than 400 mL per day
Answer: D
Rationale: The oliguric phase is characterized by a significant decrease in urine output,
typically less than 400 mL/day, leading to fluid retention and azotemia.
2. A client is diagnosed with acute glomerulonephritis. Which finding in the
patient’s history is most likely associated with this diagnosis?
A. Recent deep vein thrombosis
B. Recent streptococcal throat infection
C. History of kidney stones
D. Long-term use of NSAIDs
Answer: B
Rationale: Acute glomerulonephritis is often a post-infectious complication, most
commonly following a group A beta-hemolytic streptococcal infection.
,3. The nurse is assessing a patient’s arteriovenous (AV) fistula for hemodialysis.
Which assessment finding indicates the fistula is patent?
A. Presence of a radial pulse distal to the site
B. Palpation of a thrill over the site
C. Absence of a bruit upon auscultation
D. Coolness of the extremity below the fistula
Answer: B
Rationale: A palpable thrill and an audible bruit are normal findings indicating that the AV
fistula is patent and has adequate blood flow.
4. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering to protect
the heart from dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Insulin with Dextrose
Answer: B
Rationale: While other medications help lower potassium, calcium gluconate is
administered to stabilize the myocardium and prevent life-threatening dysrhythmias.
5. Which dietary instruction is most appropriate for a patient with Nephrotic
Syndrome?
A. High protein, high sodium diet
B. Fluid restriction of 500 mL per day
C. Low carbohydrate, high fat diet
D. Moderate protein, low sodium diet
Answer: D
, Rationale: Nephrotic syndrome requires a low sodium diet to manage edema and
moderate protein intake to replace losses without overtaxing the kidneys.
6. A nurse is caring for a patient with left-sided heart failure. Which respiratory
assessment finding is most characteristic of this condition?
A. Productive cough with green sputum
B. Crackles heard upon auscultation
C. Wheezing during expiration only
D. Stridor during inspiration
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, which manifests as
crackles (rales) due to fluid in the alveoli.
7. A patient is admitted with right-sided heart failure. What is the nurse most
likely to find during the physical assessment?
A. Cheyne-Stokes respirations
B. Pulmonary edema and orthopnea
C. Weak peripheral pulses and cool skin
D. Jugular venous distension (JVD)
Answer: D
Rationale: Right-sided heart failure causes systemic venous congestion, leading to JVD,
peripheral edema, and hepatomegaly.
8. A client taking Digoxin reports blurred vision and seeing yellow-green halos.
What is the nurse’s priority action?
A. Check the patient’s blood pressure
B. Document the finding as a normal side effect
C. Assess for signs of digoxin toxicity and check serum levels
D. Administer the next scheduled dose
Answer: C
College
1. A patient with Acute Kidney Injury (AKI) is in the oliguric phase. Which clinical
manifestation should the nurse expect to observe?
A. Daily urine output of 3 liters
B. Decreased serum creatinine levels
C. Hypernatremia and dehydration
D. Urine output of less than 400 mL per day
Answer: D
Rationale: The oliguric phase is characterized by a significant decrease in urine output,
typically less than 400 mL/day, leading to fluid retention and azotemia.
2. A client is diagnosed with acute glomerulonephritis. Which finding in the
patient’s history is most likely associated with this diagnosis?
A. Recent deep vein thrombosis
B. Recent streptococcal throat infection
C. History of kidney stones
D. Long-term use of NSAIDs
Answer: B
Rationale: Acute glomerulonephritis is often a post-infectious complication, most
commonly following a group A beta-hemolytic streptococcal infection.
,3. The nurse is assessing a patient’s arteriovenous (AV) fistula for hemodialysis.
Which assessment finding indicates the fistula is patent?
A. Presence of a radial pulse distal to the site
B. Palpation of a thrill over the site
C. Absence of a bruit upon auscultation
D. Coolness of the extremity below the fistula
Answer: B
Rationale: A palpable thrill and an audible bruit are normal findings indicating that the AV
fistula is patent and has adequate blood flow.
4. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse anticipate administering to protect
the heart from dysrhythmias?
A. Sodium polystyrene sulfonate
B. Calcium gluconate
C. Furosemide
D. Insulin with Dextrose
Answer: B
Rationale: While other medications help lower potassium, calcium gluconate is
administered to stabilize the myocardium and prevent life-threatening dysrhythmias.
5. Which dietary instruction is most appropriate for a patient with Nephrotic
Syndrome?
A. High protein, high sodium diet
B. Fluid restriction of 500 mL per day
C. Low carbohydrate, high fat diet
D. Moderate protein, low sodium diet
Answer: D
, Rationale: Nephrotic syndrome requires a low sodium diet to manage edema and
moderate protein intake to replace losses without overtaxing the kidneys.
6. A nurse is caring for a patient with left-sided heart failure. Which respiratory
assessment finding is most characteristic of this condition?
A. Productive cough with green sputum
B. Crackles heard upon auscultation
C. Wheezing during expiration only
D. Stridor during inspiration
Answer: B
Rationale: Left-sided heart failure causes pulmonary congestion, which manifests as
crackles (rales) due to fluid in the alveoli.
7. A patient is admitted with right-sided heart failure. What is the nurse most
likely to find during the physical assessment?
A. Cheyne-Stokes respirations
B. Pulmonary edema and orthopnea
C. Weak peripheral pulses and cool skin
D. Jugular venous distension (JVD)
Answer: D
Rationale: Right-sided heart failure causes systemic venous congestion, leading to JVD,
peripheral edema, and hepatomegaly.
8. A client taking Digoxin reports blurred vision and seeing yellow-green halos.
What is the nurse’s priority action?
A. Check the patient’s blood pressure
B. Document the finding as a normal side effect
C. Assess for signs of digoxin toxicity and check serum levels
D. Administer the next scheduled dose
Answer: C
