NUR 265 Med-Surg Advanced Concepts Exam 3 2026/20… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Med-Surg Advanced Concepts Exam 3 2026/2027
UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 265 Med-Surg Advanced Concepts Exam 3 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally.
B. Instruct the patient to avoid high-potassium foods.
C. Check the patient’s morning BUN and creatinine levels.
D. Place the patient on a cardiac monitor.
Answer: D
Rationale: Hyperkalemia (K+ > 6.0) poses an immediate risk for lethal cardiac dysrhythmias. Placing
the patient on a cardiac monitor is the priority to detect life- threatening changes like peaked T-waves
or widened QRS complexes. This is important because the nurse must choose the action that keeps
the client safest while still meeting their basic needs. Always think about safety first when answering
these questions. Remembering this point will help you decide the best nursing action when similar
questions appear on the exam. Link the answer to the client’s current condition and risk level.
2. Which assessment finding in a patient with Chronic Kidney Disease (CKD) indicates the
need for immediate notification of the healthcare provider?
A. A serum calcium level of 8.2 mg/dL.
B. New-onset crackles at the lung bases and jugular venous distension.
C. A hemoglobin level of 9.5 g/dL.
D. indicates the need for immediate notification of the healthcare provider?
Answer: B
Rationale: Crackles and JVD indicate fluid volume overload and potential pulmonary edema, which
are life-threatening complications of CKD requiring urgent intervention. Knowing the reason behind the
correct answer makes it easier to rule out the wrong options quickly. Look for the choice that protects
the client and matches the priority need. Understanding this helps the nurse notice early warning signs
and act before the problem gets worse. Early action often prevents bigger complications for the client.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Med-Surg Advanced Concepts Exam 3 2026/20… 2026/2027 • Verified • Assured Grade A+
3. A patient is receiving peritoneal dialysis. The nurse notes that the dialysate drainage is
cloudy. What is the nurse’s priority action?
A. Notify the provider and obtain a sample for culture.
B. Reposition the patient to facilitate drainage.
C. Document the finding as a normal result of dialysis.
D. Irrigate the catheter with heparinized saline.
Answer: A
Rationale: Cloudy effluent is the earliest sign of peritonitis, a serious complication of peritoneal
dialysis. The provider must be notified, and a culture is required to guide antibiotic therapy.
Understanding this helps the nurse notice early warning signs and act before the problem gets worse.
Early action often prevents bigger complications for the client. Understanding this helps the nurse
notice early warning signs and act before the problem gets worse. Early action often prevents bigger
complications for the client.
4. The nurse is caring for a patient in the oliguric phase of AKI. Which finding is most
expected?
A. Hypokalemia and hypotension.
B. Hypophosphatemia and hypertension.
C. Hypernatremia and increased urine output.
D. Specific gravity of 1.010 and metabolic acidosis.
Answer: D
Rationale: During the oliguric phase, the kidneys cannot concentrate urine (fixed specific gravity
around 1.010) and cannot excrete hydrogen ions, leading to metabolic acidosis. In practice, this guides
the nurse to set priorities and protect the client from harm. Safety, nutrition, and clear communication
are frequent priorities. In practice, this guides the nurse to set priorities and protect the client from
harm. Safety, nutrition, and clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Med-Surg Advanced Concepts Exam 3 2026/2027
UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 265 Med-Surg Advanced Concepts Exam 3 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with Acute Kidney Injury (AKI) has a serum potassium level of 6.8 mEq/L. Which
intervention should the nurse implement first?
A. Administer sodium polystyrene sulfonate (Kayexalate) orally.
B. Instruct the patient to avoid high-potassium foods.
C. Check the patient’s morning BUN and creatinine levels.
D. Place the patient on a cardiac monitor.
Answer: D
Rationale: Hyperkalemia (K+ > 6.0) poses an immediate risk for lethal cardiac dysrhythmias. Placing
the patient on a cardiac monitor is the priority to detect life- threatening changes like peaked T-waves
or widened QRS complexes. This is important because the nurse must choose the action that keeps
the client safest while still meeting their basic needs. Always think about safety first when answering
these questions. Remembering this point will help you decide the best nursing action when similar
questions appear on the exam. Link the answer to the client’s current condition and risk level.
2. Which assessment finding in a patient with Chronic Kidney Disease (CKD) indicates the
need for immediate notification of the healthcare provider?
A. A serum calcium level of 8.2 mg/dL.
B. New-onset crackles at the lung bases and jugular venous distension.
C. A hemoglobin level of 9.5 g/dL.
D. indicates the need for immediate notification of the healthcare provider?
Answer: B
Rationale: Crackles and JVD indicate fluid volume overload and potential pulmonary edema, which
are life-threatening complications of CKD requiring urgent intervention. Knowing the reason behind the
correct answer makes it easier to rule out the wrong options quickly. Look for the choice that protects
the client and matches the priority need. Understanding this helps the nurse notice early warning signs
and act before the problem gets worse. Early action often prevents bigger complications for the client.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Med-Surg Advanced Concepts Exam 3 2026/20… 2026/2027 • Verified • Assured Grade A+
3. A patient is receiving peritoneal dialysis. The nurse notes that the dialysate drainage is
cloudy. What is the nurse’s priority action?
A. Notify the provider and obtain a sample for culture.
B. Reposition the patient to facilitate drainage.
C. Document the finding as a normal result of dialysis.
D. Irrigate the catheter with heparinized saline.
Answer: A
Rationale: Cloudy effluent is the earliest sign of peritonitis, a serious complication of peritoneal
dialysis. The provider must be notified, and a culture is required to guide antibiotic therapy.
Understanding this helps the nurse notice early warning signs and act before the problem gets worse.
Early action often prevents bigger complications for the client. Understanding this helps the nurse
notice early warning signs and act before the problem gets worse. Early action often prevents bigger
complications for the client.
4. The nurse is caring for a patient in the oliguric phase of AKI. Which finding is most
expected?
A. Hypokalemia and hypotension.
B. Hypophosphatemia and hypertension.
C. Hypernatremia and increased urine output.
D. Specific gravity of 1.010 and metabolic acidosis.
Answer: D
Rationale: During the oliguric phase, the kidneys cannot concentrate urine (fixed specific gravity
around 1.010) and cannot excrete hydrogen ions, leading to metabolic acidosis. In practice, this guides
the nurse to set priorities and protect the client from harm. Safety, nutrition, and clear communication
are frequent priorities. In practice, this guides the nurse to set priorities and protect the client from
harm. Safety, nutrition, and clear communication are frequent priorities.
Exam (Elaborations) • Detailed Rationales Page 3
