2026/2027
Galen College NUR 265 Medical
Surgical Nursing Final Exam
Preparation Workbook with
NCLEX-Style Questions and
Detailed Rationales 2026/2027
Question 1
A nurse is teaching a patient about nephrotic syndrome. Which statement best
describes the condition?
A. Inflammation of the renal pelvis causing infection
B. Increased glomerular permeability allowing protein loss into urine
C. Obstruction of urine flow in the urethra
D. Decreased hormone production by the kidneys
Correct Answer: B. Increased glomerular permeability allowing protein loss into
urine
Rationale: Nephrotic syndrome is caused by damage to the glomerular filtration
barrier, leading to excessive protein leakage into urine. This results in
hypoalbuminemia, edema, and hyperlipidemia. The other options describe unrelated
renal or urinary conditions.
Question 2
Which finding is a key clinical feature of nephrotic syndrome?
A. Hematuria and flank pain
B. Massive proteinuria and edema
C. Hypercalcemia and hypertension
D. Polyuria and dehydration
Correct Answer: B. Massive proteinuria and edema
Rationale: Nephrotic syndrome is characterized by heavy protein loss in urine (>3.5
g/24 hours), leading to low albumin levels and generalized edema. Hematuria is more
typical of nephritic syndrome, while the other options are not defining features.
Question 3
,2026/2027
A urine protein loss diagnostic for nephrotic syndrome is greater than:
A. 150 mg/24 hours
B. 1 g/24 hours
C. 3.5 g/24 hours
D. 5 g/24 hours
Correct Answer: C. 3.5 g/24 hours
Rationale: Nephrotic syndrome is defined by proteinuria exceeding 3.5 g/day due to
severe glomerular damage. Lower values may indicate mild kidney disease but are not
diagnostic of nephrotic syndrome.
Question 4
Which medication is commonly prescribed to reduce protein loss in nephrotic
syndrome?
A. ACE inhibitors
B. Opioids
C. Antacids
D. Bronchodilators
Correct Answer: A. ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure, thereby decreasing protein
filtration into urine. They are commonly used to slow kidney damage progression.
The other medications are unrelated to renal protein management.
Question 5
Which medication class helps manage hyperlipidemia in nephrotic syndrome?
A. Statins
B. Antibiotics
C. Anticoagulants
D. Diuretics
Correct Answer: A. Statins
Rationale: Statins reduce elevated lipid levels caused by hepatic compensation for
protein loss in nephrotic syndrome. The other options address infection, clotting, or
fluid overload but do not treat hyperlipidemia.
Question 6
, 2026/2027
Which complication is associated with nephrotic syndrome due to loss of
anticoagulant proteins?
A. Hypokalemia
B. Increased clotting risk
C. Severe anemia
D. Respiratory alkalosis
Correct Answer: B. Increased clotting risk
Rationale: Loss of antithrombin III and other proteins increases the risk of thrombosis.
Patients with nephrotic syndrome are therefore at higher risk of clot formation.
Question 7
What is the hallmark laboratory finding in nephrotic syndrome?
A. Low serum albumin
B. High serum calcium
C. Elevated white blood cells
D. Increased hemoglobin
Correct Answer: A. Low serum albumin
Rationale: Hypoalbuminemia occurs due to massive urinary protein loss, leading to
decreased plasma oncotic pressure and edema formation.
Question 8
Which stage of AKI is characterized by creatinine three times normal and 75% GFR
reduction?
A. Risk
B. Injury
C. Failure
D. Recovery
Correct Answer: C. Failure
Rationale: The failure stage represents severe kidney dysfunction with marked
elevation in creatinine and major GFR decline. This stage often requires dialysis.
Question 9
Which AKI stage shows creatinine x1.5 and 25% GFR reduction?
Galen College NUR 265 Medical
Surgical Nursing Final Exam
Preparation Workbook with
NCLEX-Style Questions and
Detailed Rationales 2026/2027
Question 1
A nurse is teaching a patient about nephrotic syndrome. Which statement best
describes the condition?
A. Inflammation of the renal pelvis causing infection
B. Increased glomerular permeability allowing protein loss into urine
C. Obstruction of urine flow in the urethra
D. Decreased hormone production by the kidneys
Correct Answer: B. Increased glomerular permeability allowing protein loss into
urine
Rationale: Nephrotic syndrome is caused by damage to the glomerular filtration
barrier, leading to excessive protein leakage into urine. This results in
hypoalbuminemia, edema, and hyperlipidemia. The other options describe unrelated
renal or urinary conditions.
Question 2
Which finding is a key clinical feature of nephrotic syndrome?
A. Hematuria and flank pain
B. Massive proteinuria and edema
C. Hypercalcemia and hypertension
D. Polyuria and dehydration
Correct Answer: B. Massive proteinuria and edema
Rationale: Nephrotic syndrome is characterized by heavy protein loss in urine (>3.5
g/24 hours), leading to low albumin levels and generalized edema. Hematuria is more
typical of nephritic syndrome, while the other options are not defining features.
Question 3
,2026/2027
A urine protein loss diagnostic for nephrotic syndrome is greater than:
A. 150 mg/24 hours
B. 1 g/24 hours
C. 3.5 g/24 hours
D. 5 g/24 hours
Correct Answer: C. 3.5 g/24 hours
Rationale: Nephrotic syndrome is defined by proteinuria exceeding 3.5 g/day due to
severe glomerular damage. Lower values may indicate mild kidney disease but are not
diagnostic of nephrotic syndrome.
Question 4
Which medication is commonly prescribed to reduce protein loss in nephrotic
syndrome?
A. ACE inhibitors
B. Opioids
C. Antacids
D. Bronchodilators
Correct Answer: A. ACE inhibitors
Rationale: ACE inhibitors reduce intraglomerular pressure, thereby decreasing protein
filtration into urine. They are commonly used to slow kidney damage progression.
The other medications are unrelated to renal protein management.
Question 5
Which medication class helps manage hyperlipidemia in nephrotic syndrome?
A. Statins
B. Antibiotics
C. Anticoagulants
D. Diuretics
Correct Answer: A. Statins
Rationale: Statins reduce elevated lipid levels caused by hepatic compensation for
protein loss in nephrotic syndrome. The other options address infection, clotting, or
fluid overload but do not treat hyperlipidemia.
Question 6
, 2026/2027
Which complication is associated with nephrotic syndrome due to loss of
anticoagulant proteins?
A. Hypokalemia
B. Increased clotting risk
C. Severe anemia
D. Respiratory alkalosis
Correct Answer: B. Increased clotting risk
Rationale: Loss of antithrombin III and other proteins increases the risk of thrombosis.
Patients with nephrotic syndrome are therefore at higher risk of clot formation.
Question 7
What is the hallmark laboratory finding in nephrotic syndrome?
A. Low serum albumin
B. High serum calcium
C. Elevated white blood cells
D. Increased hemoglobin
Correct Answer: A. Low serum albumin
Rationale: Hypoalbuminemia occurs due to massive urinary protein loss, leading to
decreased plasma oncotic pressure and edema formation.
Question 8
Which stage of AKI is characterized by creatinine three times normal and 75% GFR
reduction?
A. Risk
B. Injury
C. Failure
D. Recovery
Correct Answer: C. Failure
Rationale: The failure stage represents severe kidney dysfunction with marked
elevation in creatinine and major GFR decline. This stage often requires dialysis.
Question 9
Which AKI stage shows creatinine x1.5 and 25% GFR reduction?
