Exams 1-4 Enrichment) for NUR 265 Complete
Exam Bundle | Galen Med-Surg Nursing (PDF)
1. A client with nephrotic syndrome has severe proteinuria.
Which medication does the nurse anticipate administering
to reduce protein loss?
A) Furosemide
B) Lisinopril
C) Spironolactone
D) Metoprolol
Correct Answer: B) Lisinopril
Rationale: ACE inhibitors (lisinopril) lower intraglomerular
pressure, which reduces proteinuria and slows the
progression of kidney damage in nephrotic syndrome.
Furosemide manages edema but does not reduce protein
loss .
2. The nurse is reviewing morning labs. Which client
requires priority follow-up?
1
,A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
Correct Answer: B) Temperature of 101.4°F
Rationale: A fever over 101°F in a client, particularly one
on dialysis or immunocompromised, indicates possible
infection and requires immediate assessment and
intervention .
3. A client on hemodialysis reports eating “lots of
sandwiches and chips.” Which statement indicates a need
for further teaching?
A) “I limit my sodium to 5 grams per day.”
B) “I avoid adding salt to my food.”
C) “I read labels on processed foods.”
D) “I avoid potassium-based salt substitutes.”
Correct Answer: A) “I limit my sodium to 5 grams per day.”
*Rationale: Clients on hemodialysis should restrict sodium
2
,to 2-4 grams per day to manage hypertension and fluid
balance. Five grams exceeds the recommended limit .*
4. A client with type 2 diabetes has an HbA1c of 10.2%.
What is the priority discharge goal?
A) HbA1c below 7%
B) Fasting glucose below 200 mg/dL
C) Daily glucose monitoring
D) Correct insulin injection technique
Correct Answer: A) HbA1c below 7%
*Rationale: HbA1c reflects average blood glucose over
2-3 months. The target for most adults is <7% to reduce
the risk of long-term complications .*
5. A client with type 1 diabetes rides a bicycle daily.
Where should the nurse teach the client to administer
morning insulin?
A) Thigh
B) Buttock
3
, C) Abdomen
D) Arm
Correct Answer: C) Abdomen
Rationale: The abdomen provides the fastest and most
consistent insulin absorption. Extremities used during
exercise (thighs, arms) may absorb insulin faster during
activity, increasing the risk of hypoglycemia .
6. A client presents with atrial fibrillation, heat intolerance,
and weight loss. Which condition does the nurse suspect?
A) Hypothyroidism
B) Hyperthyroidism
C) Adrenal crisis
D) SIADH
Correct Answer: B) Hyperthyroidism
Rationale: Hyperthyroidism causes increased metabolic
rate, leading to weight loss, heat intolerance, tachycardia,
and atrial fibrillation. Hypothyroidism presents with
weight gain and cold intolerance .
4
Exam Bundle | Galen Med-Surg Nursing (PDF)
1. A client with nephrotic syndrome has severe proteinuria.
Which medication does the nurse anticipate administering
to reduce protein loss?
A) Furosemide
B) Lisinopril
C) Spironolactone
D) Metoprolol
Correct Answer: B) Lisinopril
Rationale: ACE inhibitors (lisinopril) lower intraglomerular
pressure, which reduces proteinuria and slows the
progression of kidney damage in nephrotic syndrome.
Furosemide manages edema but does not reduce protein
loss .
2. The nurse is reviewing morning labs. Which client
requires priority follow-up?
1
,A) Temperature of 99.8°F
B) Temperature of 101.4°F
C) Mild fatigue
D) Slight nausea
Correct Answer: B) Temperature of 101.4°F
Rationale: A fever over 101°F in a client, particularly one
on dialysis or immunocompromised, indicates possible
infection and requires immediate assessment and
intervention .
3. A client on hemodialysis reports eating “lots of
sandwiches and chips.” Which statement indicates a need
for further teaching?
A) “I limit my sodium to 5 grams per day.”
B) “I avoid adding salt to my food.”
C) “I read labels on processed foods.”
D) “I avoid potassium-based salt substitutes.”
Correct Answer: A) “I limit my sodium to 5 grams per day.”
*Rationale: Clients on hemodialysis should restrict sodium
2
,to 2-4 grams per day to manage hypertension and fluid
balance. Five grams exceeds the recommended limit .*
4. A client with type 2 diabetes has an HbA1c of 10.2%.
What is the priority discharge goal?
A) HbA1c below 7%
B) Fasting glucose below 200 mg/dL
C) Daily glucose monitoring
D) Correct insulin injection technique
Correct Answer: A) HbA1c below 7%
*Rationale: HbA1c reflects average blood glucose over
2-3 months. The target for most adults is <7% to reduce
the risk of long-term complications .*
5. A client with type 1 diabetes rides a bicycle daily.
Where should the nurse teach the client to administer
morning insulin?
A) Thigh
B) Buttock
3
, C) Abdomen
D) Arm
Correct Answer: C) Abdomen
Rationale: The abdomen provides the fastest and most
consistent insulin absorption. Extremities used during
exercise (thighs, arms) may absorb insulin faster during
activity, increasing the risk of hypoglycemia .
6. A client presents with atrial fibrillation, heat intolerance,
and weight loss. Which condition does the nurse suspect?
A) Hypothyroidism
B) Hyperthyroidism
C) Adrenal crisis
D) SIADH
Correct Answer: B) Hyperthyroidism
Rationale: Hyperthyroidism causes increased metabolic
rate, leading to weight loss, heat intolerance, tachycardia,
and atrial fibrillation. Hypothyroidism presents with
weight gain and cold intolerance .
4
