NUR 254 Exam 3 – Galen College of Nursing Study Guide, Notes &
Practice Questions (2026 Updated)
NUR 254 Exam 3 (Galen College of Nursing) - correct answer ✔✔EXAM COVERAGE - NUR 254
Exam 3 (Galen College of Nursing)
The NUR 254 Exam 3 at Galen College of Nursing assesses knowledge and clinical competencies
in medical-surgical nursing, pharmacology, and patient care management. Key topics include
assessment and management of adult patients with complex conditions, understanding
pathophysiology, interpreting laboratory and diagnostic data, and implementing evidence-based
nursing interventions. Candidates are tested on medication administration, dosage calculations,
and monitoring for therapeutic and adverse effects, as well as safety, infection control, and
patient education. Additional areas include care planning, prioritization of nursing actions,
delegation, and interdisciplinary collaboration. The exam emphasizes clinical reasoning, critical
thinking, and application of best practices to ensure safe and effective patient outcomes in
acute and chronic care settings.
1. A 78-year-old male client needs to complete a 24-hour urine specimen. In planning his care,
the nurse realizes that which measure is most important? 1. Instruct the client to empty his
bladder and save this voiding to start the collection.
2. Instruct the client to use sterile individual containers to collect the urine.
3. Post a sign stating "Save All Urine" in the bathroom.
4. Keep the urine specimen in the refrigerator. - correct answer ✔✔Answer: 3. Rationale:
Option 3 is the most important nursing measure. This will inform the staff that the client is on a
24-hour urine collection. Option 1 is not appropriate since the first voided specimen is to be
discarded. Option 2 is not an appropriate nursing measure since the specimen container is clean
not sterile, and one container is needed—not individual containers. Option 4 is inappropriate
because some 24-hour urine collections do not require refrigeration.
2. The nurse would call the primary care provider immediately for which laboratory result?
1. Hgb = 16 g/dL for a male client
2. Hct = 22% for a female client
,3. WBC = 9 × 103 /mL3
4. Platelets = 300 × 103 /mL3 - correct answer ✔✔Answer: 2. Rationale: Option 2 is very low
and can lead to death. The client's red blood cells participate in oxygenation. Options 1, 3, and 4
are within normal range and should not be reported to the primary care provider.
3. The client has a urinary health problem. Which procedure is performed using indirect
visualization? 1. Intravenous pyelography (IVP)
2. Kidneys, ureter, bladder (KUB)
3. Retrograde pyelography
4. Cystoscopy - correct answer ✔✔Answer: 2. Rationale: A KUB is an x-ray of the kidneys,
ureters, and bladder. This does not require direct visualization. Option 1 is an IVP, an
intravenous pyelogram, which requires the injection of a contrast media. Option 3 is a
retrograde pyelography, which requires the injection of a contrast media. Option 4 is a
cystoscopy, which uses a lighted instrument (cystoscope) inserted through the urethra, resulting
in direct visualization.
4. Which noninvasive procedure provides information about the physiology or function of an
organ?
1. Angiography
2. Computerized tomography (CT)
3. Magnetic resonance imaging (MRI)
4. Positron emission tomography (PET) - correct answer ✔✔Answer: 4. Rationale: This type of
nuclear scan demonstrates the ability of tissues to absorb the chemical to indicate the
physiology and function of an organ. Option 1 is an invasive procedure that focuses on blood
flow through an organ. Options 2 and 3 provide information about density of tissue to help
distinguish between normal and abnormal tissue of an organ.
5. When assisting with a bone marrow biopsy, the nurse should take which action?
1. Assist the client to a right side-lying position after the procedure.
2. Observe for signs of dyspnea, pallor, and coughing.
, 3. Assess for bleeding and hematoma formation for several days after the procedure.
4. Stand in front of the client and support the back of the neck and knees. - correct answer
✔✔Answer: 3. Rationale: Bone marrow aspiration includes deep penetration into soft tissue
and large bones such as the sternum and iliac crest. This penetration can result in bleeding. The
client should be observed for bleeding in the days following the procedure. Option 1 is a nursing
action during a liver biopsy. Option 2 is a nursing action for a thoracentesis, and Option 4 is a
nursing action for a lumbar puncture.
6. During an assessment, the nurse learns that the client has a history of liver disease. Which
diagnostic tests might be indicated for this client? Select all that apply.
1. Alanine aminotransferase (ALT)
2. Myoglobin
3. Cholesterol
4. Ammonia
5. Brain natriuretic peptide or B-type natriuretic peptide (BNP) - correct answer ✔✔Answer: 1
and 4. Rationale: ALT is an enzyme that contributes to protein and carbohydrate metabolism. An
increase in the enzyme indicates damage to the liver. The liver contributes to the metabolism of
protein, which results in the production of ammonia. If the liver is damaged, the ammonia level
is increased. Options 2, 3, and 5 (myoglobin, cholesterol, and BNP) are relevant for heart
disease.
7. The nurse practitioner requests a laboratory blood test to determine how well a client has
controlled her diabetes during the past 3 months. Which blood test will provide this
information?
1. Fasting blood glucose
2. Capillary blood specimen
3. Glycosylated hemoglobin
4. GGT (gamma-glutamyl transferase) - correct answer ✔✔Answer: 3. Rationale: A glycosylated
hemoglobin will indicate the glucose levels for a period of time, which is indicated by the nurse
practitioner. Options 1 and 2 will provide information about the current blood glucose, not the
past history. Option 4 is used to assess for liver disease. Cognitive Level: Remembering. Client
Need: Physiological Integrity. Nursing Process: Planning. Learning Outcome: 34-2. 8.
Practice Questions (2026 Updated)
NUR 254 Exam 3 (Galen College of Nursing) - correct answer ✔✔EXAM COVERAGE - NUR 254
Exam 3 (Galen College of Nursing)
The NUR 254 Exam 3 at Galen College of Nursing assesses knowledge and clinical competencies
in medical-surgical nursing, pharmacology, and patient care management. Key topics include
assessment and management of adult patients with complex conditions, understanding
pathophysiology, interpreting laboratory and diagnostic data, and implementing evidence-based
nursing interventions. Candidates are tested on medication administration, dosage calculations,
and monitoring for therapeutic and adverse effects, as well as safety, infection control, and
patient education. Additional areas include care planning, prioritization of nursing actions,
delegation, and interdisciplinary collaboration. The exam emphasizes clinical reasoning, critical
thinking, and application of best practices to ensure safe and effective patient outcomes in
acute and chronic care settings.
1. A 78-year-old male client needs to complete a 24-hour urine specimen. In planning his care,
the nurse realizes that which measure is most important? 1. Instruct the client to empty his
bladder and save this voiding to start the collection.
2. Instruct the client to use sterile individual containers to collect the urine.
3. Post a sign stating "Save All Urine" in the bathroom.
4. Keep the urine specimen in the refrigerator. - correct answer ✔✔Answer: 3. Rationale:
Option 3 is the most important nursing measure. This will inform the staff that the client is on a
24-hour urine collection. Option 1 is not appropriate since the first voided specimen is to be
discarded. Option 2 is not an appropriate nursing measure since the specimen container is clean
not sterile, and one container is needed—not individual containers. Option 4 is inappropriate
because some 24-hour urine collections do not require refrigeration.
2. The nurse would call the primary care provider immediately for which laboratory result?
1. Hgb = 16 g/dL for a male client
2. Hct = 22% for a female client
,3. WBC = 9 × 103 /mL3
4. Platelets = 300 × 103 /mL3 - correct answer ✔✔Answer: 2. Rationale: Option 2 is very low
and can lead to death. The client's red blood cells participate in oxygenation. Options 1, 3, and 4
are within normal range and should not be reported to the primary care provider.
3. The client has a urinary health problem. Which procedure is performed using indirect
visualization? 1. Intravenous pyelography (IVP)
2. Kidneys, ureter, bladder (KUB)
3. Retrograde pyelography
4. Cystoscopy - correct answer ✔✔Answer: 2. Rationale: A KUB is an x-ray of the kidneys,
ureters, and bladder. This does not require direct visualization. Option 1 is an IVP, an
intravenous pyelogram, which requires the injection of a contrast media. Option 3 is a
retrograde pyelography, which requires the injection of a contrast media. Option 4 is a
cystoscopy, which uses a lighted instrument (cystoscope) inserted through the urethra, resulting
in direct visualization.
4. Which noninvasive procedure provides information about the physiology or function of an
organ?
1. Angiography
2. Computerized tomography (CT)
3. Magnetic resonance imaging (MRI)
4. Positron emission tomography (PET) - correct answer ✔✔Answer: 4. Rationale: This type of
nuclear scan demonstrates the ability of tissues to absorb the chemical to indicate the
physiology and function of an organ. Option 1 is an invasive procedure that focuses on blood
flow through an organ. Options 2 and 3 provide information about density of tissue to help
distinguish between normal and abnormal tissue of an organ.
5. When assisting with a bone marrow biopsy, the nurse should take which action?
1. Assist the client to a right side-lying position after the procedure.
2. Observe for signs of dyspnea, pallor, and coughing.
, 3. Assess for bleeding and hematoma formation for several days after the procedure.
4. Stand in front of the client and support the back of the neck and knees. - correct answer
✔✔Answer: 3. Rationale: Bone marrow aspiration includes deep penetration into soft tissue
and large bones such as the sternum and iliac crest. This penetration can result in bleeding. The
client should be observed for bleeding in the days following the procedure. Option 1 is a nursing
action during a liver biopsy. Option 2 is a nursing action for a thoracentesis, and Option 4 is a
nursing action for a lumbar puncture.
6. During an assessment, the nurse learns that the client has a history of liver disease. Which
diagnostic tests might be indicated for this client? Select all that apply.
1. Alanine aminotransferase (ALT)
2. Myoglobin
3. Cholesterol
4. Ammonia
5. Brain natriuretic peptide or B-type natriuretic peptide (BNP) - correct answer ✔✔Answer: 1
and 4. Rationale: ALT is an enzyme that contributes to protein and carbohydrate metabolism. An
increase in the enzyme indicates damage to the liver. The liver contributes to the metabolism of
protein, which results in the production of ammonia. If the liver is damaged, the ammonia level
is increased. Options 2, 3, and 5 (myoglobin, cholesterol, and BNP) are relevant for heart
disease.
7. The nurse practitioner requests a laboratory blood test to determine how well a client has
controlled her diabetes during the past 3 months. Which blood test will provide this
information?
1. Fasting blood glucose
2. Capillary blood specimen
3. Glycosylated hemoglobin
4. GGT (gamma-glutamyl transferase) - correct answer ✔✔Answer: 3. Rationale: A glycosylated
hemoglobin will indicate the glucose levels for a period of time, which is indicated by the nurse
practitioner. Options 1 and 2 will provide information about the current blood glucose, not the
past history. Option 4 is used to assess for liver disease. Cognitive Level: Remembering. Client
Need: Physiological Integrity. Nursing Process: Planning. Learning Outcome: 34-2. 8.
