(2026) Q&A | Galen College
1. A patient's serum sodium is 128 mEq/L. The nurse expects which clinical
manifestation?
A) Increased thirst and dry mucous membranes
B) Muscle twitching and hyperreflexia
C) Lethargy, confusion, and seizures
D) Polyuria and polydipsia
Correct Answer: Lethargy, confusion, and seizures
Rationale: Hyponatremia causes water to shift into brain cells, producing
cerebral edema. Early neurological symptoms include lethargy and confusion,
progressing to seizures in severe cases. Thirst and dry mucous membranes are
more typical of hypernatremia.
2. The kidneys release erythropoietin in response to which stimulus?
A) High blood pressure
B) Low oxygen levels
C) Elevated blood glucose
D) Increased sodium intake
Correct Answer: Low oxygen levels
Rationale: Peritubular interstitial cells in the kidneys detect hypoxia and secrete
erythropoietin, which stimulates bone marrow to produce red blood cells. This
,helps restore oxygen-carrying capacity. Other options do not trigger EPO
release.
3. Arterial blood gas results show pH 7.30, PaCO₂ 50 mm Hg, HCO₃⁻ 24 mEq/L.
This indicates:
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory acidosis
D) Respiratory alkalosis
Correct Answer: Respiratory acidosis
Rationale: The low pH indicates acidosis. Elevated PaCO₂ (>45 mm Hg) signals a
respiratory origin, while a normal HCO₃⁻ (24) means no metabolic compensation
has yet occurred. This is classic acute respiratory acidosis from hypoventilation.
4. Kussmaul respirations are most characteristic of which acid–base
disturbance?
A) Respiratory acidosis
B) Respiratory alkalosis
C) Metabolic acidosis
D) Metabolic alkalosis
Correct Answer: Metabolic acidosis
, Rationale: Deep, rapid (Kussmaul) breathing is a compensatory mechanism for
metabolic acidosis, such as in diabetic ketoacidosis. The lungs blow off CO₂ to
raise pH. This respiratory compensation helps offset the metabolic acid load.
5. A patient receiving a blood transfusion develops chills, fever, and back pain.
What is the priority nursing action?
A) Slow the transfusion rate
B) Stop the transfusion immediately
C) Administer an antihistamine
D) Notify the provider
Correct Answer: Stop the transfusion immediately
Rationale: These are signs of a hemolytic transfusion reaction. The infusion
must be stopped at once to prevent further exposure. After stopping the blood,
the nurse maintains IV access with normal saline and notifies the provider.
6. Which is an example of physiological hypertrophy?
A) Enlargement of the heart muscle due to hypertension
B) Enlargement of the uterus during pregnancy
C) Enlargement of the prostate gland in benign prostatic hyperplasia
D) Enlargement of the liver due to fatty infiltration
Correct Answer: Enlargement of the uterus during pregnancy