GALEN NUR 242 MED-SURG EXAM 3: GI,
RENAL, AND HEPATIC SYSTEMS. EXAM
QUESTIONS AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) enters the diuretic phase. Which of the following is
the nurse’s priority assessment?
A. Monitoring for signs of hypervolemia
B. Monitoring for an increase in Serum Creatinine
C. Evaluating the patient for metabolic acidosis
D. Assessing for hypokalemia and dehydration
Answer: D
Conceptual Explanation: During the diuretic phase of AKI, the kidneys begin to excrete
large volumes of urine, but cannot yet concentrate it, leading to significant fluid and
electrolyte loss, specifically potassium and sodium.
2. Which clinical manifestation would a nurse expect to find in a patient diagnosed with
Chronic Kidney Disease (CKD) experiencing uremia?
A. Pruritus and uremic frost
B. Hypotension
,C. Increased hemoglobin levels
D. Respiratory alkalosis
Answer: A
Conceptual Explanation: Uremia leads to the accumulation of waste products in the
blood, which can manifest as crystallized urea on the skin (uremic frost) and intense
itching (pruritus).
3. A patient is receiving Hemodialysis. The nurse notes the patient is experiencing a
headache, nausea, and restlessness. Which complication is most likely occurring?
A. Air embolism
B. Hypovolemic shock
C. Disequilibrium syndrome
D. Peritonitis
Answer: C
Conceptual Explanation: Disequilibrium syndrome occurs due to a rapid shift of solutes
and fluids from the blood into the brain cells during dialysis, causing cerebral edema.
4. Which dietary instruction is most appropriate for a patient with Stage 4 Chronic Kidney
Disease?
A. Restrict phosphorus-rich foods like dairy and nuts
B. Increase protein intake to 1.5 g/kg/day
, C. Use salt substitutes containing potassium
D. Maintain a high-sodium diet to prevent hypotension
Answer: A
Conceptual Explanation: In advanced CKD, the kidneys cannot excrete phosphorus,
leading to hyperphosphatemia. Salt substitutes often contain potassium and should be
avoided.
5. A patient with Nephrotic Syndrome presents with severe generalized edema. What is the
primary physiological cause of this edema?
A. Increased hydrostatic pressure in the capillaries
B. Decreased serum albumin causing low oncotic pressure
C. Retention of glucose in the interstitial space
D. Increased secretion of ADH
Answer: B
Conceptual Explanation: Nephrotic syndrome involves massive proteinuria, which
reduces serum albumin levels. This lowers the colloid oncotic pressure, allowing fluid to
leak into the tissues.
RENAL, AND HEPATIC SYSTEMS. EXAM
QUESTIONS AND ANSWERS
1. A patient with Acute Kidney Injury (AKI) enters the diuretic phase. Which of the following is
the nurse’s priority assessment?
A. Monitoring for signs of hypervolemia
B. Monitoring for an increase in Serum Creatinine
C. Evaluating the patient for metabolic acidosis
D. Assessing for hypokalemia and dehydration
Answer: D
Conceptual Explanation: During the diuretic phase of AKI, the kidneys begin to excrete
large volumes of urine, but cannot yet concentrate it, leading to significant fluid and
electrolyte loss, specifically potassium and sodium.
2. Which clinical manifestation would a nurse expect to find in a patient diagnosed with
Chronic Kidney Disease (CKD) experiencing uremia?
A. Pruritus and uremic frost
B. Hypotension
,C. Increased hemoglobin levels
D. Respiratory alkalosis
Answer: A
Conceptual Explanation: Uremia leads to the accumulation of waste products in the
blood, which can manifest as crystallized urea on the skin (uremic frost) and intense
itching (pruritus).
3. A patient is receiving Hemodialysis. The nurse notes the patient is experiencing a
headache, nausea, and restlessness. Which complication is most likely occurring?
A. Air embolism
B. Hypovolemic shock
C. Disequilibrium syndrome
D. Peritonitis
Answer: C
Conceptual Explanation: Disequilibrium syndrome occurs due to a rapid shift of solutes
and fluids from the blood into the brain cells during dialysis, causing cerebral edema.
4. Which dietary instruction is most appropriate for a patient with Stage 4 Chronic Kidney
Disease?
A. Restrict phosphorus-rich foods like dairy and nuts
B. Increase protein intake to 1.5 g/kg/day
, C. Use salt substitutes containing potassium
D. Maintain a high-sodium diet to prevent hypotension
Answer: A
Conceptual Explanation: In advanced CKD, the kidneys cannot excrete phosphorus,
leading to hyperphosphatemia. Salt substitutes often contain potassium and should be
avoided.
5. A patient with Nephrotic Syndrome presents with severe generalized edema. What is the
primary physiological cause of this edema?
A. Increased hydrostatic pressure in the capillaries
B. Decreased serum albumin causing low oncotic pressure
C. Retention of glucose in the interstitial space
D. Increased secretion of ADH
Answer: B
Conceptual Explanation: Nephrotic syndrome involves massive proteinuria, which
reduces serum albumin levels. This lowers the colloid oncotic pressure, allowing fluid to
leak into the tissues.
