Galen NSG 3800 actual Exams 1–4 | Nursing Practice Adult
Health II | 2026/2027 Complete Practice Questions, Correct
Answers & Detailed Rationales
EXAM 1 — RENAL, FLUID/ELECTROLYTES, ENDOCRINE & NEUROLOGIC
1.
A client with chronic kidney disease has a serum potassium level of 6.4
mEq/L. Which finding requires the nurse's immediate attention?
A. Muscle fatigue
B. Peaked T waves
C. Increased thirst
D. Mild nausea
Correct Answer: B. Peaked T waves
Rationale: Hyperkalemia can produce life-threatening cardiac
dysrhythmias. Peaked T waves are an important ECG manifestation
requiring immediate intervention.
2.
A client with hypokalemia is receiving potassium replacement. Which
assessment is most important?
A. Bowel sounds
B. Cardiac rhythm
C. Skin turgor
D. Pupillary response
Correct Answer: B. Cardiac rhythm
,Rationale: Potassium abnormalities can significantly affect cardiac
conduction. Continuous or frequent cardiac monitoring is important
during significant potassium replacement.
3.
Which laboratory value best reflects renal filtration?
A. Serum creatinine
B. Serum sodium
C. Hemoglobin
D. Serum calcium
Correct Answer: A. Serum creatinine
Rationale: Creatinine is produced from muscle metabolism and is
primarily eliminated by the kidneys. Rising serum creatinine commonly
indicates declining renal function.
4.
A client with acute kidney injury has oliguria. Which finding should the
nurse anticipate?
A. Fluid retention
B. Severe polyuria
C. Low serum potassium
D. Decreased BUN
Correct Answer: A. Fluid retention
Rationale: Reduced urine output can lead to sodium and water
retention, resulting in edema, hypertension, and pulmonary congestion.
5.
,Which dietary instruction is appropriate for many clients with advanced
chronic kidney disease?
A. Increase sodium intake
B. Follow prescribed restrictions on sodium, potassium, phosphorus,
and fluids
C. Eat unlimited high-protein foods
D. Drink unlimited fluids
Correct Answer: B. Follow prescribed restrictions on sodium,
potassium, phosphorus, and fluids
Rationale: Dietary restrictions are individualized according to renal
function and laboratory results. Excess sodium, potassium, phosphorus,
or fluid may worsen complications.
6.
A client receiving hemodialysis develops headache, nausea, confusion,
and restlessness during treatment. Which complication should the
nurse suspect?
A. Disequilibrium syndrome
B. Hypoglycemia
C. Peritonitis
D. Nephrotic syndrome
Correct Answer: A. Disequilibrium syndrome
Rationale: Rapid removal of urea during dialysis can produce cerebral
edema and neurologic symptoms known as dialysis disequilibrium
syndrome.
7.
, Which assessment is essential before using an arteriovenous fistula?
A. Check for a bruit and thrill
B. Check bowel sounds
C. Measure abdominal girth
D. Assess pupillary response
Correct Answer: A. Check for a bruit and thrill
Rationale: A palpable thrill and audible bruit indicate blood flow
through the fistula. Absence may indicate thrombosis or vascular
compromise.
8.
Which action should be avoided in an extremity containing an AV
fistula?
A. Checking temperature
B. Assessing circulation
C. Obtaining blood pressure
D. Observing the skin
Correct Answer: C. Obtaining blood pressure
Rationale: Blood pressure cuffs can compress the access and impair
blood flow, potentially damaging the fistula.
9.
A client with nephrotic syndrome has severe edema. Which laboratory
finding is expected?
A. Hypoalbuminemia
B. Hypercalcemia
Health II | 2026/2027 Complete Practice Questions, Correct
Answers & Detailed Rationales
EXAM 1 — RENAL, FLUID/ELECTROLYTES, ENDOCRINE & NEUROLOGIC
1.
A client with chronic kidney disease has a serum potassium level of 6.4
mEq/L. Which finding requires the nurse's immediate attention?
A. Muscle fatigue
B. Peaked T waves
C. Increased thirst
D. Mild nausea
Correct Answer: B. Peaked T waves
Rationale: Hyperkalemia can produce life-threatening cardiac
dysrhythmias. Peaked T waves are an important ECG manifestation
requiring immediate intervention.
2.
A client with hypokalemia is receiving potassium replacement. Which
assessment is most important?
A. Bowel sounds
B. Cardiac rhythm
C. Skin turgor
D. Pupillary response
Correct Answer: B. Cardiac rhythm
,Rationale: Potassium abnormalities can significantly affect cardiac
conduction. Continuous or frequent cardiac monitoring is important
during significant potassium replacement.
3.
Which laboratory value best reflects renal filtration?
A. Serum creatinine
B. Serum sodium
C. Hemoglobin
D. Serum calcium
Correct Answer: A. Serum creatinine
Rationale: Creatinine is produced from muscle metabolism and is
primarily eliminated by the kidneys. Rising serum creatinine commonly
indicates declining renal function.
4.
A client with acute kidney injury has oliguria. Which finding should the
nurse anticipate?
A. Fluid retention
B. Severe polyuria
C. Low serum potassium
D. Decreased BUN
Correct Answer: A. Fluid retention
Rationale: Reduced urine output can lead to sodium and water
retention, resulting in edema, hypertension, and pulmonary congestion.
5.
,Which dietary instruction is appropriate for many clients with advanced
chronic kidney disease?
A. Increase sodium intake
B. Follow prescribed restrictions on sodium, potassium, phosphorus,
and fluids
C. Eat unlimited high-protein foods
D. Drink unlimited fluids
Correct Answer: B. Follow prescribed restrictions on sodium,
potassium, phosphorus, and fluids
Rationale: Dietary restrictions are individualized according to renal
function and laboratory results. Excess sodium, potassium, phosphorus,
or fluid may worsen complications.
6.
A client receiving hemodialysis develops headache, nausea, confusion,
and restlessness during treatment. Which complication should the
nurse suspect?
A. Disequilibrium syndrome
B. Hypoglycemia
C. Peritonitis
D. Nephrotic syndrome
Correct Answer: A. Disequilibrium syndrome
Rationale: Rapid removal of urea during dialysis can produce cerebral
edema and neurologic symptoms known as dialysis disequilibrium
syndrome.
7.
, Which assessment is essential before using an arteriovenous fistula?
A. Check for a bruit and thrill
B. Check bowel sounds
C. Measure abdominal girth
D. Assess pupillary response
Correct Answer: A. Check for a bruit and thrill
Rationale: A palpable thrill and audible bruit indicate blood flow
through the fistula. Absence may indicate thrombosis or vascular
compromise.
8.
Which action should be avoided in an extremity containing an AV
fistula?
A. Checking temperature
B. Assessing circulation
C. Obtaining blood pressure
D. Observing the skin
Correct Answer: C. Obtaining blood pressure
Rationale: Blood pressure cuffs can compress the access and impair
blood flow, potentially damaging the fistula.
9.
A client with nephrotic syndrome has severe edema. Which laboratory
finding is expected?
A. Hypoalbuminemia
B. Hypercalcemia
