NUR 265 Exam 1 – Medical-Surgical Nursing –
(2026) Actual Questions & Answers (Galen
College of Nursing)
EXAM 1 – VERSION 1: RENAL, ENDOCRINE, &
DIABETES (Questions)
QUESTION 1
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which
laboratory value should the nurse report to the provider immediately prior to the
procedure?
A. Serum potassium 5.2 mEq/L
B. Serum potassium 6.8 mEq/L
C. BUN 45 mg/dL
D. Serum creatinine 3.5 mg/dL
Correct Answer: B. Serum potassium 6.8 mEq/L
*Rationale: * A serum potassium level of 6.8 mEq/L is dangerously high and can cause
life-threatening cardiac arrhythmias. This requires immediate intervention, possibly
including emergency hemodialysis. The provider must be notified immediately. A
potassium of 5.2 is elevated but less emergent. BUN and creatinine elevations are
expected in CKD but are not immediately life-threatening.
QUESTION 2
,The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an
insulin infusion. Which laboratory value requires the most frequent monitoring?
A. Blood glucose
B. Serum potassium
C. Serum sodium
D. Serum calcium
Correct Answer: B. Serum potassium
*Rationale: * During DKA treatment, insulin drives potassium into cells, which can cause
severe hypokalemia. This can lead to cardiac arrhythmias and respiratory muscle
weakness. Potassium levels must be monitored frequently (every 1-2 hours) during
insulin therapy. Blood glucose is also important but potassium is the most critical for
safety.
QUESTION 3
A client with hyperthyroidism is prescribed propylthiouracil (PTU). The nurse should
instruct the client to report which adverse effect immediately?
A. Weight gain
B. Sore throat and fever
C. Bradycardia
D. Drowsiness
*Correct Answer: B. Sore throat and fever
*Rationale: * PTU can cause agranulocytosis, a severe drop in white blood cells that
increases infection risk. Sore throat and fever are early signs of agranulocytosis and
should be reported immediately. Weight gain, bradycardia, and drowsiness are not
typical adverse effects of PTU.
,QUESTION 4
The nurse is caring for a client with acute renal failure who is in the oliguric phase.
Which assessment finding is expected?
A. Urine output of 1,500 mL/day
B. Urine output of 200 mL/day
C. Urine output of 2,500 mL/day
D. Urine output of 3,000 mL/day
*Correct Answer: B. Urine output of 200 mL/day
*Rationale: * The oliguric phase of acute renal failure is characterized by urine output
less than 400 mL/day. This indicates decreased renal perfusion and impaired kidney
function. Polyuria (>2,500 mL/day) is seen in the diuretic phase, not the oliguric phase.
QUESTION 5
A client with type 1 diabetes is experiencing hypoglycemia. The client is conscious but
confused. Which intervention should the nurse implement first?
A. Administer glucagon IM
B. Administer 50% dextrose IV
C. Check blood glucose
D. Provide 15 grams of oral glucose
*Correct Answer: C. Check blood glucose
*Rationale: * The first step in suspected hypoglycemia is to check the blood glucose
level to confirm the diagnosis. Once confirmed, treatment can be initiated based on the
, level and the client's ability to swallow. Oral glucose is not appropriate if the client is
confused. Glucagon and IV dextrose are for unconscious clients.
QUESTION 6
The nurse is teaching a client with chronic kidney disease about dietary restrictions.
Which instruction is most important?
A. "Increase your protein intake."
B. "Limit foods high in potassium."
C. "Increase your fluid intake."
D. "Eat a diet high in sodium."
*Correct Answer: B. "Limit foods high in potassium."
*Rationale: * Clients with CKD must limit potassium to prevent hyperkalemia, which can
cause fatal arrhythmias. Protein, fluids, and sodium are also restricted, but potassium
restriction is a priority due to the immediate risk of cardiac arrest.
QUESTION 7
A client with diabetes insipidus is prescribed desmopressin. The nurse should monitor
for which therapeutic effect?
A. Decreased urine output
B. Increased urine output
C. Decreased blood glucose
D. Increased blood glucose
(2026) Actual Questions & Answers (Galen
College of Nursing)
EXAM 1 – VERSION 1: RENAL, ENDOCRINE, &
DIABETES (Questions)
QUESTION 1
A client with chronic kidney disease (CKD) is scheduled for hemodialysis. Which
laboratory value should the nurse report to the provider immediately prior to the
procedure?
A. Serum potassium 5.2 mEq/L
B. Serum potassium 6.8 mEq/L
C. BUN 45 mg/dL
D. Serum creatinine 3.5 mg/dL
Correct Answer: B. Serum potassium 6.8 mEq/L
*Rationale: * A serum potassium level of 6.8 mEq/L is dangerously high and can cause
life-threatening cardiac arrhythmias. This requires immediate intervention, possibly
including emergency hemodialysis. The provider must be notified immediately. A
potassium of 5.2 is elevated but less emergent. BUN and creatinine elevations are
expected in CKD but are not immediately life-threatening.
QUESTION 2
,The nurse is caring for a client with diabetic ketoacidosis (DKA) who is receiving an
insulin infusion. Which laboratory value requires the most frequent monitoring?
A. Blood glucose
B. Serum potassium
C. Serum sodium
D. Serum calcium
Correct Answer: B. Serum potassium
*Rationale: * During DKA treatment, insulin drives potassium into cells, which can cause
severe hypokalemia. This can lead to cardiac arrhythmias and respiratory muscle
weakness. Potassium levels must be monitored frequently (every 1-2 hours) during
insulin therapy. Blood glucose is also important but potassium is the most critical for
safety.
QUESTION 3
A client with hyperthyroidism is prescribed propylthiouracil (PTU). The nurse should
instruct the client to report which adverse effect immediately?
A. Weight gain
B. Sore throat and fever
C. Bradycardia
D. Drowsiness
*Correct Answer: B. Sore throat and fever
*Rationale: * PTU can cause agranulocytosis, a severe drop in white blood cells that
increases infection risk. Sore throat and fever are early signs of agranulocytosis and
should be reported immediately. Weight gain, bradycardia, and drowsiness are not
typical adverse effects of PTU.
,QUESTION 4
The nurse is caring for a client with acute renal failure who is in the oliguric phase.
Which assessment finding is expected?
A. Urine output of 1,500 mL/day
B. Urine output of 200 mL/day
C. Urine output of 2,500 mL/day
D. Urine output of 3,000 mL/day
*Correct Answer: B. Urine output of 200 mL/day
*Rationale: * The oliguric phase of acute renal failure is characterized by urine output
less than 400 mL/day. This indicates decreased renal perfusion and impaired kidney
function. Polyuria (>2,500 mL/day) is seen in the diuretic phase, not the oliguric phase.
QUESTION 5
A client with type 1 diabetes is experiencing hypoglycemia. The client is conscious but
confused. Which intervention should the nurse implement first?
A. Administer glucagon IM
B. Administer 50% dextrose IV
C. Check blood glucose
D. Provide 15 grams of oral glucose
*Correct Answer: C. Check blood glucose
*Rationale: * The first step in suspected hypoglycemia is to check the blood glucose
level to confirm the diagnosis. Once confirmed, treatment can be initiated based on the
, level and the client's ability to swallow. Oral glucose is not appropriate if the client is
confused. Glucagon and IV dextrose are for unconscious clients.
QUESTION 6
The nurse is teaching a client with chronic kidney disease about dietary restrictions.
Which instruction is most important?
A. "Increase your protein intake."
B. "Limit foods high in potassium."
C. "Increase your fluid intake."
D. "Eat a diet high in sodium."
*Correct Answer: B. "Limit foods high in potassium."
*Rationale: * Clients with CKD must limit potassium to prevent hyperkalemia, which can
cause fatal arrhythmias. Protein, fluids, and sodium are also restricted, but potassium
restriction is a priority due to the immediate risk of cardiac arrest.
QUESTION 7
A client with diabetes insipidus is prescribed desmopressin. The nurse should monitor
for which therapeutic effect?
A. Decreased urine output
B. Increased urine output
C. Decreased blood glucose
D. Increased blood glucose
