,NUR 265 Exam 1 Advanced Concepts of Medical-Surgical Nursing
Questions And Answers 2026/2027 Galen College
Q1. A patient with acute kidney injury has a urine output of 15
mL/hr for the past 3 hours. Which action should the nurse take first?
A) Assess the patient's hemodynamic status and blood pressure.
B) Encourage the patient to drink additional fluids.
C) Administer the prescribed potassium supplement.
D) Restrict all oral and intravenous fluids.
Correct Answer: A) Assess the patient's hemodynamic status and blood
pressure.
Rationale: Reduced renal perfusion can cause or worsen acute kidney injury.
Assessing circulation and hemodynamic status helps identify a potentially
reversible cause.
Q2. Which laboratory value is most useful for evaluating a change in
renal filtration?
A) Sodium
B) Serum creatinine
C) Hemoglobin
D) Albumin
Correct Answer: B) Serum creatinine
Rationale: Serum creatinine rises when the kidneys lose their ability to
adequately filter and excrete metabolic waste.
Q3. Which condition is most likely to cause prerenal acute kidney
injury?
A) Ureteral obstruction
B) Acute glomerulonephritis
C) Severe hypovolemia
D) Renal tubular necrosis
Correct Answer: C) Severe hypovolemia
Rationale: Prerenal AKI results from inadequate blood flow to the kidneys.
Severe fluid loss can significantly reduce renal perfusion.
,Q4. A patient with acute kidney injury develops a potassium level of
6.7 mEq/L. Which assessment finding requires immediate attention?
A) Mild peripheral edema
B) Fatigue
C) Decreased appetite
D) Cardiac dysrhythmia
Correct Answer: D) Cardiac dysrhythmia
Rationale: Severe hyperkalemia can impair cardiac conduction and cause
life-threatening dysrhythmias.
Q5. Which finding is most consistent with chronic kidney disease
rather than an isolated acute kidney injury?
A) Long-term decline in kidney function
B) Sudden oliguria after hemorrhage
C) Abrupt increase in creatinine
D) Rapid onset after nephrotoxic exposure
Correct Answer: A) Long-term decline in kidney function
Rationale: CKD involves persistent, progressive loss of kidney function over
time, whereas AKI develops abruptly.
Q6. Which assessment is essential for a patient with an
arteriovenous fistula for hemodialysis?
A) Measure blood pressure in the access arm.
B) Palpate for a thrill and auscultate for a bruit.
C) Apply a tight dressing over the fistula.
D) Keep the access arm below heart level.
Correct Answer: B) Palpate for a thrill and auscultate for a bruit.
Rationale: A palpable thrill and audible bruit indicate blood flow through the
vascular access.
, Q7. Which action should the nurse avoid when caring for a patient
with an AV fistula?
A) Inspecting the access site
B) Assessing the thrill
C) Obtaining blood pressure on the access arm
D) Assessing for signs of infection
Correct Answer: C) Obtaining blood pressure on the access arm
Rationale: Pressure from blood-pressure measurement can compromise the
vascular access and should be avoided.
Q8. A patient receiving hemodialysis develops confusion, headache,
and nausea during treatment. Which complication should the nurse
suspect?
A) Peritonitis
B) Hypoglycemia
C) Hypercalcemia
D) Dialysis disequilibrium syndrome
Correct Answer: D) Dialysis disequilibrium syndrome
Rationale: Rapid changes in solute concentrations during dialysis can cause
cerebral edema and neurologic symptoms known as dialysis disequilibrium
syndrome.
Q9. Which diet is generally appropriate for a patient with advanced
chronic kidney disease?
A) Controlled sodium and potassium intake with individualized protein intake
B) Unlimited potassium and sodium
C) High-protein and high-sodium intake
D) Unlimited fluids regardless of urine output
Correct Answer: A) Controlled sodium and potassium intake with
individualized protein intake
Rationale: CKD can impair regulation of electrolytes and fluid. Dietary
restrictions are individualized according to kidney function and laboratory
findings.
Questions And Answers 2026/2027 Galen College
Q1. A patient with acute kidney injury has a urine output of 15
mL/hr for the past 3 hours. Which action should the nurse take first?
A) Assess the patient's hemodynamic status and blood pressure.
B) Encourage the patient to drink additional fluids.
C) Administer the prescribed potassium supplement.
D) Restrict all oral and intravenous fluids.
Correct Answer: A) Assess the patient's hemodynamic status and blood
pressure.
Rationale: Reduced renal perfusion can cause or worsen acute kidney injury.
Assessing circulation and hemodynamic status helps identify a potentially
reversible cause.
Q2. Which laboratory value is most useful for evaluating a change in
renal filtration?
A) Sodium
B) Serum creatinine
C) Hemoglobin
D) Albumin
Correct Answer: B) Serum creatinine
Rationale: Serum creatinine rises when the kidneys lose their ability to
adequately filter and excrete metabolic waste.
Q3. Which condition is most likely to cause prerenal acute kidney
injury?
A) Ureteral obstruction
B) Acute glomerulonephritis
C) Severe hypovolemia
D) Renal tubular necrosis
Correct Answer: C) Severe hypovolemia
Rationale: Prerenal AKI results from inadequate blood flow to the kidneys.
Severe fluid loss can significantly reduce renal perfusion.
,Q4. A patient with acute kidney injury develops a potassium level of
6.7 mEq/L. Which assessment finding requires immediate attention?
A) Mild peripheral edema
B) Fatigue
C) Decreased appetite
D) Cardiac dysrhythmia
Correct Answer: D) Cardiac dysrhythmia
Rationale: Severe hyperkalemia can impair cardiac conduction and cause
life-threatening dysrhythmias.
Q5. Which finding is most consistent with chronic kidney disease
rather than an isolated acute kidney injury?
A) Long-term decline in kidney function
B) Sudden oliguria after hemorrhage
C) Abrupt increase in creatinine
D) Rapid onset after nephrotoxic exposure
Correct Answer: A) Long-term decline in kidney function
Rationale: CKD involves persistent, progressive loss of kidney function over
time, whereas AKI develops abruptly.
Q6. Which assessment is essential for a patient with an
arteriovenous fistula for hemodialysis?
A) Measure blood pressure in the access arm.
B) Palpate for a thrill and auscultate for a bruit.
C) Apply a tight dressing over the fistula.
D) Keep the access arm below heart level.
Correct Answer: B) Palpate for a thrill and auscultate for a bruit.
Rationale: A palpable thrill and audible bruit indicate blood flow through the
vascular access.
, Q7. Which action should the nurse avoid when caring for a patient
with an AV fistula?
A) Inspecting the access site
B) Assessing the thrill
C) Obtaining blood pressure on the access arm
D) Assessing for signs of infection
Correct Answer: C) Obtaining blood pressure on the access arm
Rationale: Pressure from blood-pressure measurement can compromise the
vascular access and should be avoided.
Q8. A patient receiving hemodialysis develops confusion, headache,
and nausea during treatment. Which complication should the nurse
suspect?
A) Peritonitis
B) Hypoglycemia
C) Hypercalcemia
D) Dialysis disequilibrium syndrome
Correct Answer: D) Dialysis disequilibrium syndrome
Rationale: Rapid changes in solute concentrations during dialysis can cause
cerebral edema and neurologic symptoms known as dialysis disequilibrium
syndrome.
Q9. Which diet is generally appropriate for a patient with advanced
chronic kidney disease?
A) Controlled sodium and potassium intake with individualized protein intake
B) Unlimited potassium and sodium
C) High-protein and high-sodium intake
D) Unlimited fluids regardless of urine output
Correct Answer: A) Controlled sodium and potassium intake with
individualized protein intake
Rationale: CKD can impair regulation of electrolytes and fluid. Dietary
restrictions are individualized according to kidney function and laboratory
findings.
