NSG 4100 (AH III) Exam 1 | Questions and
Correct Answers plus Rationales | New Update
2026-2027 | Galen
1. Increased uremia results in metabolic toxins accumulating in the body. How
will this manifest in the patient?
Correct Answer: Pericardial friction rub
Rationale: Uremia can cause uremic pericarditis, which presents with a pericardial
friction rub. This is a late manifestation of severe renal failure.
2. Your patient's K+ level is reported at 5.9 mEq/L. What do you do next?
Correct Answer: Notify the MD
Rationale: A potassium level of 5.9 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias. The nurse should notify the provider
immediately, place the patient on a cardiac monitor, and prepare for interventions
such as calcium gluconate, insulin with glucose, or sodium bicarbonate.
3. Your patient with ESRD presents with anorexia, metallic taste in the mouth
and mental status changes. This may be indicative of:
Correct Answer: Uremia
Rationale: Uremia is the accumulation of metabolic toxins in the blood due to
renal failure. Classic manifestations include anorexia, metallic taste, nausea, and
mental status changes.
, 4. The nurse is caring for assigned clients who have end-stage renal disease
(ESRD). Which of the following arterial blood gas (ABG) results should the nurse
correlate to this condition?
a. pH 7.50, PaCO2 30 mm Hg, HCO3- 24 mEq/L
b. pH 7.20, PaO2 80 mm Hg, PaCO2 36 mm Hg, HCO3- 16 mEq/L
c. pH 7.35, PaCO2 45 mm Hg, HCO3- 26 mEq/L
d. pH 7.45, PaCO2 35 mm Hg, HCO3- 22 mEq/L
Correct Answer: b. pH 7.20, PaO2 80 mm Hg, PaCO2 36 mm Hg, HCO3- 16 mEq/L
Rationale: ESRD causes metabolic acidosis due to the kidneys' inability to excrete
hydrogen ions and reabsorb bicarbonate. This ABG shows a low pH and low HCO3-
, consistent with metabolic acidosis.
5. Which patient is priority for hemodialysis?
a. A patient with BP of 170/100 mm Hg
b. A patient with K+ of 5.0 mEq/L
c. A patient with BUN of 40 mg/dL
d. A patient with creatinine of 2.5 mg/dL
Correct Answer: a. A patient with BP of 170/100 mm Hg
Rationale: Severe hypertension unresponsive to medications may require urgent
dialysis. Other indications for emergent dialysis include severe hyperkalemia,
pulmonary edema, and severe metabolic acidosis.
6. ESRD increases the patient's risk for developing:
Correct Answer: PAD (Peripheral Arterial Disease)
Rationale: ESRD accelerates atherosclerosis and vascular calcification, increasing
the risk of peripheral arterial disease, coronary artery disease, and stroke.
7. Your client reports indigestion. Which OTC medication is appropriate for
them?
Correct Answers plus Rationales | New Update
2026-2027 | Galen
1. Increased uremia results in metabolic toxins accumulating in the body. How
will this manifest in the patient?
Correct Answer: Pericardial friction rub
Rationale: Uremia can cause uremic pericarditis, which presents with a pericardial
friction rub. This is a late manifestation of severe renal failure.
2. Your patient's K+ level is reported at 5.9 mEq/L. What do you do next?
Correct Answer: Notify the MD
Rationale: A potassium level of 5.9 mEq/L indicates hyperkalemia, which can
cause life-threatening cardiac dysrhythmias. The nurse should notify the provider
immediately, place the patient on a cardiac monitor, and prepare for interventions
such as calcium gluconate, insulin with glucose, or sodium bicarbonate.
3. Your patient with ESRD presents with anorexia, metallic taste in the mouth
and mental status changes. This may be indicative of:
Correct Answer: Uremia
Rationale: Uremia is the accumulation of metabolic toxins in the blood due to
renal failure. Classic manifestations include anorexia, metallic taste, nausea, and
mental status changes.
, 4. The nurse is caring for assigned clients who have end-stage renal disease
(ESRD). Which of the following arterial blood gas (ABG) results should the nurse
correlate to this condition?
a. pH 7.50, PaCO2 30 mm Hg, HCO3- 24 mEq/L
b. pH 7.20, PaO2 80 mm Hg, PaCO2 36 mm Hg, HCO3- 16 mEq/L
c. pH 7.35, PaCO2 45 mm Hg, HCO3- 26 mEq/L
d. pH 7.45, PaCO2 35 mm Hg, HCO3- 22 mEq/L
Correct Answer: b. pH 7.20, PaO2 80 mm Hg, PaCO2 36 mm Hg, HCO3- 16 mEq/L
Rationale: ESRD causes metabolic acidosis due to the kidneys' inability to excrete
hydrogen ions and reabsorb bicarbonate. This ABG shows a low pH and low HCO3-
, consistent with metabolic acidosis.
5. Which patient is priority for hemodialysis?
a. A patient with BP of 170/100 mm Hg
b. A patient with K+ of 5.0 mEq/L
c. A patient with BUN of 40 mg/dL
d. A patient with creatinine of 2.5 mg/dL
Correct Answer: a. A patient with BP of 170/100 mm Hg
Rationale: Severe hypertension unresponsive to medications may require urgent
dialysis. Other indications for emergent dialysis include severe hyperkalemia,
pulmonary edema, and severe metabolic acidosis.
6. ESRD increases the patient's risk for developing:
Correct Answer: PAD (Peripheral Arterial Disease)
Rationale: ESRD accelerates atherosclerosis and vascular calcification, increasing
the risk of peripheral arterial disease, coronary artery disease, and stroke.
7. Your client reports indigestion. Which OTC medication is appropriate for
them?
