,Verified NUR 265 Exam 1 Test Bank & Guaranteed
Success Exam Prep Guide | Advanced Medical
Surgical Nursing | Galen College of Nursing | Q & A
| 2026/2027 Edition (PDF)
1. The nurse is caring for a client with nephrotic syndrome who has severe proteinuria. Which
assessment finding is most consistent with this condition?
A) Periorbital edema
B) Hypertension
C) Hyperlipidemia
D) All of the above
Correct Answer: D) All of the above
Rationale: Nephrotic syndrome is characterized by severe proteinuria, hypoalbuminemia,
edema (including periorbital edema), and hyperlipidemia. Hypertension is also common due to
fluid retention. The syndrome results from increased glomerular permeability to plasma
proteins.
2. A patient with end-stage renal disease is scheduled for hemodialysis. Which laboratory value
should the nurse report to the provider before dialysis?
A) Serum potassium of 5.8 mEq/L
B) Serum phosphorus of 6.0 mg/dL
,C) Hemoglobin of 10.5 g/dL
D) Serum calcium of 8.5 mg/dL
Correct Answer: A) Serum potassium of 5.8 mEq/L
Rationale: A serum potassium of 5.8 mEq/L is elevated and places the patient at risk for cardiac
arrhythmias. While this is an indication for dialysis, the provider should be notified to confirm
the dialysis prescription and ensure appropriate monitoring. The other values are commonly
seen in ESRD and are not immediate concerns.
3. A patient with acute kidney injury is in the oliguric phase. Which clinical manifestation should
the nurse anticipate?
A) Urine output of 1500 mL/day
B) Metabolic alkalosis
C) Hyperkalemia
D) Hypokalemia
Correct Answer: C) Hyperkalemia
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia. Urine output is <400 mL/day (not 1500 mL/day). Metabolic acidosis (not
alkalosis) and hyperkalemia are characteristic. Hyperkalemia can cause life-threatening cardiac
arrhythmias.
, 4. A patient with chronic kidney disease has a serum potassium of 6.0 mEq/L. Which medication
should the nurse anticipate administering?
A) Potassium supplements
B) Sodium polystyrene sulfonate (Kayexalate)
C) Calcium gluconate
D) IV potassium chloride
Correct Answer: B) Sodium polystyrene sulfonate (Kayexalate)
Rationale: Kayexalate is used to treat hyperkalemia by exchanging sodium for potassium in the
GI tract. Potassium supplements would worsen the condition; calcium gluconate stabilizes the
cardiac membrane but does not lower potassium. IV potassium chloride would be
contraindicated.
5. A patient receiving hemodialysis develops hypotension during the treatment. What is the
priority nursing action?
A) Increase the ultrafiltration rate
B) Administer IV fluids
C) Place the patient in Trendelenburg position
D) Stop the dialysis and notify the provider
Correct Answer: B) Administer IV fluids
Rationale: Hypotension during hemodialysis is a common complication caused by rapid fluid
removal. The priority is to administer IV fluids (normal saline) to restore intravascular volume.
The ultrafiltration rate should be decreased, not increased. Trendelenburg position is not
recommended.
Success Exam Prep Guide | Advanced Medical
Surgical Nursing | Galen College of Nursing | Q & A
| 2026/2027 Edition (PDF)
1. The nurse is caring for a client with nephrotic syndrome who has severe proteinuria. Which
assessment finding is most consistent with this condition?
A) Periorbital edema
B) Hypertension
C) Hyperlipidemia
D) All of the above
Correct Answer: D) All of the above
Rationale: Nephrotic syndrome is characterized by severe proteinuria, hypoalbuminemia,
edema (including periorbital edema), and hyperlipidemia. Hypertension is also common due to
fluid retention. The syndrome results from increased glomerular permeability to plasma
proteins.
2. A patient with end-stage renal disease is scheduled for hemodialysis. Which laboratory value
should the nurse report to the provider before dialysis?
A) Serum potassium of 5.8 mEq/L
B) Serum phosphorus of 6.0 mg/dL
,C) Hemoglobin of 10.5 g/dL
D) Serum calcium of 8.5 mg/dL
Correct Answer: A) Serum potassium of 5.8 mEq/L
Rationale: A serum potassium of 5.8 mEq/L is elevated and places the patient at risk for cardiac
arrhythmias. While this is an indication for dialysis, the provider should be notified to confirm
the dialysis prescription and ensure appropriate monitoring. The other values are commonly
seen in ESRD and are not immediate concerns.
3. A patient with acute kidney injury is in the oliguric phase. Which clinical manifestation should
the nurse anticipate?
A) Urine output of 1500 mL/day
B) Metabolic alkalosis
C) Hyperkalemia
D) Hypokalemia
Correct Answer: C) Hyperkalemia
Rationale: In the oliguric phase of AKI, the kidneys cannot excrete potassium, leading to
hyperkalemia. Urine output is <400 mL/day (not 1500 mL/day). Metabolic acidosis (not
alkalosis) and hyperkalemia are characteristic. Hyperkalemia can cause life-threatening cardiac
arrhythmias.
, 4. A patient with chronic kidney disease has a serum potassium of 6.0 mEq/L. Which medication
should the nurse anticipate administering?
A) Potassium supplements
B) Sodium polystyrene sulfonate (Kayexalate)
C) Calcium gluconate
D) IV potassium chloride
Correct Answer: B) Sodium polystyrene sulfonate (Kayexalate)
Rationale: Kayexalate is used to treat hyperkalemia by exchanging sodium for potassium in the
GI tract. Potassium supplements would worsen the condition; calcium gluconate stabilizes the
cardiac membrane but does not lower potassium. IV potassium chloride would be
contraindicated.
5. A patient receiving hemodialysis develops hypotension during the treatment. What is the
priority nursing action?
A) Increase the ultrafiltration rate
B) Administer IV fluids
C) Place the patient in Trendelenburg position
D) Stop the dialysis and notify the provider
Correct Answer: B) Administer IV fluids
Rationale: Hypotension during hemodialysis is a common complication caused by rapid fluid
removal. The priority is to administer IV fluids (normal saline) to restore intravascular volume.
The ultrafiltration rate should be decreased, not increased. Trendelenburg position is not
recommended.
