2026/2027
NUR 253 Exam 3 Galen College
Comprehensive Review and Practice
Questions Study Guide for Success
(2026/2027 New Version)
Question 1:
A 78-year-old male client is scheduled to complete a 24-hour urine collection. Which
nursing action is most essential for ensuring proper specimen collection?
A. Instruct the client to discard the first voided urine at the start of collection
B. Provide the client with multiple sterile urine containers
C. Post a visible sign in the bathroom stating “Save All Urine”
D. Encourage increased fluid intake throughout the collection period
Correct Answer: C. Post a visible sign in the bathroom stating “Save All Urine”
Rationale:
Posting a visible reminder is the most important intervention because it ensures all
staff and visitors are aware that urine must be collected for 24 hours, preventing
accidental disposal. Option A is partially correct in concept, but the priority is system-
wide communication rather than verbal instruction alone. Option B is incorrect
because urine is collected in one clean container, not multiple sterile ones. Option D
may affect test accuracy depending on provider instructions and is not the priority
nursing intervention.
Question 2:
Which laboratory result requires immediate notification of the primary healthcare
provider?
A. Hemoglobin 16 g/dL in a male client
B. Hematocrit 22% in a female client
C. White blood cell count 9 × 10³/mm³
D. Platelet count 300 × 10³/mm³
Correct Answer: B. Hematocrit 22% in a female client
Rationale:
A hematocrit of 22% is critically low and indicates severe anemia, which can impair
oxygen delivery to tissues and may be life-threatening. Option A is within normal
male range. Option C represents a normal white blood cell count, indicating no acute
,2026/2027
infection or leukopenia. Option D is also within normal limits, indicating adequate
clotting potential.
Question 3:
Which diagnostic procedure provides indirect visualization of the urinary system?
A. Intravenous pyelography (IVP)
B. Kidney, ureter, bladder (KUB) X-ray
C. Retrograde pyelography
D. Cystoscopy
Correct Answer: B. Kidney, ureter, bladder (KUB) X-ray
Rationale:
A KUB is a noninvasive radiographic study that provides indirect visualization of
urinary structures without contrast injection or instrumentation. IVP and retrograde
pyelography involve contrast media, making them invasive imaging studies.
Cystoscopy provides direct visualization using an inserted scope, making it an
invasive endoscopic procedure.
Question 4:
Which diagnostic test evaluates organ function rather than structure?
A. Angiography
B. CT scan
C. MRI
D. Positron emission tomography (PET) scan
Correct Answer: D. Positron emission tomography (PET) scan
Rationale:
A PET scan evaluates metabolic activity and organ function by measuring cellular
activity, making it functional rather than structural imaging. Angiography evaluates
blood vessels invasively. CT and MRI provide structural detail based on tissue density
and anatomy rather than physiological function.
Question 5:
During care of a client after a bone marrow biopsy, which nursing intervention is
most important?
A. Place the client in a side-lying position
B. Monitor for respiratory distress
C. Assess for bleeding and hematoma formation
D. Maintain the neck in a flexed position
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Correct Answer: C. Assess for bleeding and hematoma formation
Rationale:
Bone marrow biopsy involves puncturing bone and marrow, creating a significant risk
of bleeding. Monitoring for hematoma formation is critical. Option A is appropriate
for other procedures such as liver biopsy. Option B is relevant for thoracentesis
complications. Option D is unrelated and more appropriate for spinal procedures.
Question 6:
Which laboratory findings are commonly associated with liver dysfunction? (Select
all that apply)
A. Alanine aminotransferase (ALT) elevation
B. Myoglobin elevation
C. Increased cholesterol
D. Elevated ammonia level
E. Elevated BNP
Correct Answer: A and D. ALT elevation and Elevated ammonia level
Rationale:
ALT elevation indicates hepatocellular injury, as it is released when liver cells are
damaged. Elevated ammonia occurs due to impaired hepatic metabolism of protein
waste. Myoglobin and BNP are cardiac-related markers, while cholesterol is more
associated with lipid metabolism and cardiovascular risk rather than acute liver injury.
Question 7:
Which laboratory test reflects average blood glucose control over the past 2–3 months?
A. Fasting blood glucose
B. Random capillary glucose
C. Glycosylated hemoglobin (HbA1c)
D. Gamma-glutamyl transferase (GGT)
Correct Answer: C. Glycosylated hemoglobin (HbA1c)
Rationale:
HbA1c reflects long-term glucose control over approximately 8–12 weeks. Fasting
and capillary glucose provide only immediate or short-term values. GGT is a liver
enzyme and does not assess glycemic control.
Question 8:
Which actions are appropriate when performing a fecal occult blood (Hemoccult) test?
(Select all that apply)
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A. Collect stool from two different areas of the specimen
B. Observe for a blue color change
C. Mix stool with reagent before applying to card
D. Verify positive results with a second nurse
E. Assess recent vitamin C intake
Correct Answer: A, B, and E
Rationale:
Sampling from different stool areas improves detection accuracy. A blue color change
indicates a positive result. Vitamin C intake must be assessed because it can cause
false-negative results. The reagent is applied after stool placement, not before mixing,
and verification by another nurse is not required for color interpretation.
Question 9:
Which positioning is appropriate for a client undergoing thoracentesis?
A. Supine with head elevated
B. Trendelenburg position
C. Sitting upright with arms supported on a table
D. Prone position
Correct Answer: C. Sitting upright with arms supported on a table
Rationale:
This position allows lung expansion and widens intercostal spaces for safe needle
insertion. Trendelenburg and supine positions reduce access and increase risk. Prone
positioning is not used for thoracentesis.
Question 10:
Which actions are appropriate when collecting sputum for tuberculosis testing?
(Select all that apply)
A. Collect specimen in the morning
B. Send specimen immediately to laboratory
C. Collect saliva sample
D. Provide oral hygiene before and after collection
E. Collect samples for 3 consecutive days
Correct Answer: A, B, and E
Rationale:
Morning specimens contain the highest concentration of organisms. Immediate
transport prevents contamination. Three consecutive samples improve diagnostic
accuracy. Saliva is not acceptable because it does not contain lower respiratory
secretions.
NUR 253 Exam 3 Galen College
Comprehensive Review and Practice
Questions Study Guide for Success
(2026/2027 New Version)
Question 1:
A 78-year-old male client is scheduled to complete a 24-hour urine collection. Which
nursing action is most essential for ensuring proper specimen collection?
A. Instruct the client to discard the first voided urine at the start of collection
B. Provide the client with multiple sterile urine containers
C. Post a visible sign in the bathroom stating “Save All Urine”
D. Encourage increased fluid intake throughout the collection period
Correct Answer: C. Post a visible sign in the bathroom stating “Save All Urine”
Rationale:
Posting a visible reminder is the most important intervention because it ensures all
staff and visitors are aware that urine must be collected for 24 hours, preventing
accidental disposal. Option A is partially correct in concept, but the priority is system-
wide communication rather than verbal instruction alone. Option B is incorrect
because urine is collected in one clean container, not multiple sterile ones. Option D
may affect test accuracy depending on provider instructions and is not the priority
nursing intervention.
Question 2:
Which laboratory result requires immediate notification of the primary healthcare
provider?
A. Hemoglobin 16 g/dL in a male client
B. Hematocrit 22% in a female client
C. White blood cell count 9 × 10³/mm³
D. Platelet count 300 × 10³/mm³
Correct Answer: B. Hematocrit 22% in a female client
Rationale:
A hematocrit of 22% is critically low and indicates severe anemia, which can impair
oxygen delivery to tissues and may be life-threatening. Option A is within normal
male range. Option C represents a normal white blood cell count, indicating no acute
,2026/2027
infection or leukopenia. Option D is also within normal limits, indicating adequate
clotting potential.
Question 3:
Which diagnostic procedure provides indirect visualization of the urinary system?
A. Intravenous pyelography (IVP)
B. Kidney, ureter, bladder (KUB) X-ray
C. Retrograde pyelography
D. Cystoscopy
Correct Answer: B. Kidney, ureter, bladder (KUB) X-ray
Rationale:
A KUB is a noninvasive radiographic study that provides indirect visualization of
urinary structures without contrast injection or instrumentation. IVP and retrograde
pyelography involve contrast media, making them invasive imaging studies.
Cystoscopy provides direct visualization using an inserted scope, making it an
invasive endoscopic procedure.
Question 4:
Which diagnostic test evaluates organ function rather than structure?
A. Angiography
B. CT scan
C. MRI
D. Positron emission tomography (PET) scan
Correct Answer: D. Positron emission tomography (PET) scan
Rationale:
A PET scan evaluates metabolic activity and organ function by measuring cellular
activity, making it functional rather than structural imaging. Angiography evaluates
blood vessels invasively. CT and MRI provide structural detail based on tissue density
and anatomy rather than physiological function.
Question 5:
During care of a client after a bone marrow biopsy, which nursing intervention is
most important?
A. Place the client in a side-lying position
B. Monitor for respiratory distress
C. Assess for bleeding and hematoma formation
D. Maintain the neck in a flexed position
,2026/2027
Correct Answer: C. Assess for bleeding and hematoma formation
Rationale:
Bone marrow biopsy involves puncturing bone and marrow, creating a significant risk
of bleeding. Monitoring for hematoma formation is critical. Option A is appropriate
for other procedures such as liver biopsy. Option B is relevant for thoracentesis
complications. Option D is unrelated and more appropriate for spinal procedures.
Question 6:
Which laboratory findings are commonly associated with liver dysfunction? (Select
all that apply)
A. Alanine aminotransferase (ALT) elevation
B. Myoglobin elevation
C. Increased cholesterol
D. Elevated ammonia level
E. Elevated BNP
Correct Answer: A and D. ALT elevation and Elevated ammonia level
Rationale:
ALT elevation indicates hepatocellular injury, as it is released when liver cells are
damaged. Elevated ammonia occurs due to impaired hepatic metabolism of protein
waste. Myoglobin and BNP are cardiac-related markers, while cholesterol is more
associated with lipid metabolism and cardiovascular risk rather than acute liver injury.
Question 7:
Which laboratory test reflects average blood glucose control over the past 2–3 months?
A. Fasting blood glucose
B. Random capillary glucose
C. Glycosylated hemoglobin (HbA1c)
D. Gamma-glutamyl transferase (GGT)
Correct Answer: C. Glycosylated hemoglobin (HbA1c)
Rationale:
HbA1c reflects long-term glucose control over approximately 8–12 weeks. Fasting
and capillary glucose provide only immediate or short-term values. GGT is a liver
enzyme and does not assess glycemic control.
Question 8:
Which actions are appropriate when performing a fecal occult blood (Hemoccult) test?
(Select all that apply)
, 2026/2027
A. Collect stool from two different areas of the specimen
B. Observe for a blue color change
C. Mix stool with reagent before applying to card
D. Verify positive results with a second nurse
E. Assess recent vitamin C intake
Correct Answer: A, B, and E
Rationale:
Sampling from different stool areas improves detection accuracy. A blue color change
indicates a positive result. Vitamin C intake must be assessed because it can cause
false-negative results. The reagent is applied after stool placement, not before mixing,
and verification by another nurse is not required for color interpretation.
Question 9:
Which positioning is appropriate for a client undergoing thoracentesis?
A. Supine with head elevated
B. Trendelenburg position
C. Sitting upright with arms supported on a table
D. Prone position
Correct Answer: C. Sitting upright with arms supported on a table
Rationale:
This position allows lung expansion and widens intercostal spaces for safe needle
insertion. Trendelenburg and supine positions reduce access and increase risk. Prone
positioning is not used for thoracentesis.
Question 10:
Which actions are appropriate when collecting sputum for tuberculosis testing?
(Select all that apply)
A. Collect specimen in the morning
B. Send specimen immediately to laboratory
C. Collect saliva sample
D. Provide oral hygiene before and after collection
E. Collect samples for 3 consecutive days
Correct Answer: A, B, and E
Rationale:
Morning specimens contain the highest concentration of organisms. Immediate
transport prevents contamination. Three consecutive samples improve diagnostic
accuracy. Saliva is not acceptable because it does not contain lower respiratory
secretions.
