GNRS 558 EXAM 3 2025 ACTUAL EXAM WITH CORRECT
ANSWERS/MULTIPLE CHOICE QUESTIONS (ALL 2025
SESSIONS)
A young adult contracts hepatitis from contaminated food. Which result would the nurse expect
serologic testing to reveal during the acute (icteric) phase of the patient's illness?
a. Antibody to hepatitis D (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
ANS: D Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM appears during
the acute phase of hepatitis A. The patient would not have antigen for hepatitis B or antibody for
hepatitis D. Anti-HAV IgG would indicate past infection and lifelong immunity
A client with chronic kidney disease (CKD) is refusing to take his medication and has missed
two hemodialysis appointments. What is the best initial action for the nurse?
a. Discuss what the treatment regimen means to the client.
b. Refer the client to a mental health nurse practitioner.
c. Reschedule the appointments to another date and time.
d. Discuss the option of peritoneal dialysis.
a. Discuss what the treatment regimen means to the client.
A client is taking furosemide 40 mg/day for management of early chronic kidney disease
(CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?
a. Obtain daily weights of the client.
b. Auscultate heart and breath sounds.
,c. Palpate the client's abdomen.
d. Assess the client's diet history.
a. Obtain daily weights of the client.
A 70-kg adult client with chronic kidney disease (CKD) is on a 40-g protein diet. The patient
has a reduced glomerular filtration rate and is not undergoing dialysis. Which result would be
of most concern to the nurse?
a. Albumin level of 2.5 g/dL (3.63 mcmol/L)
b. Phosphorus level of 5 mg/dL (1.62 mmol/L)
c. Sodium level of 135 mEq/L (135 mmol/L)
d. Potassium level of 5.5 mEq/L (5.5mmol/L)
a. Albumin level of 2.5 g/dL (3.63 mcmol/L)
The nurse is teaching a client with chronic kidney disease (CKD) about the sodium restriction
needed in the diet to prevent edema and hypertension. Which statement by the client indicates
that more teaching is needed?
a. "I will probably lose weight by cutting out potato chips."
b. "I will cut out bacon with my eggs every morning."
c. "My cooking style will change by not adding salt."
d. "I am thrilled that I can continue to eat fast food."
d. "I am thrilled that I can continue to eat fast food."
,A client is placed on fluid restriction because of chronic kidney disease (CKD). Which
assessment finding would alert the nurse that the client's fluid balance is stable at this time?
a. Decreased calcium levels
b. Increased phosphorus levels
c. No adventitious sounds in the lungs
d. Increased edema in the legs
c. No adventitious sounds in the lungs
The charge nurse is orienting a new nurse about care for an assigned client with an
arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse
would be considered unsafe?
a. Palpating the access site for a bruit or thrill
b. Using the right arm for a blood pressure reading
c. Administering intravenous fluids through the AV fistula
d. Checking distal pulses in the left arm
c. Administering intravenous fluids through the AV fistula
A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the
effluent. What is the priority action by the nurse?
a. Warm the dialysate solution in a microwave before instillation.
b. Obtain a sample of the effluent and send to the laboratory.
c. Flush the tubing with normal saline to maintain patency of the catheter.
d. Check the peritoneal catheter for kinking and curling
, b. Obtain a sample of the effluent and send to the laboratory.
The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity
during dialysis. Which statement by the client demonstrates a correct understanding of the
teaching?
a. "I should leave the drainage bag above the level of my abdomen."
b. "I could flush the tubing with normal saline if the flow stops."
c. "I should take a stool softener every morning to avoid constipation."
d. "My diet should have low fiber in it to prevent any irritation."
c. "I should take a stool softener every morning to avoid constipation."
A nurse reviews the laboratory values of a client who returned from kidney transplantation 12
hours ago:
Na+ 136 mEq/L (135 mmol/L)
K+ 5 mEq/L (5mmol/L)
BUN 44mg/dL (15.7 mmol/L)
Serum Creatine 2.5 mg/dL (221 mcmol/L)
What initial intervention would the nurse anticipate?
a. Start hemodialysis immediately.
b. Discuss the need for peritoneal dialysis.
c. Increase the dose of immunosuppression.
d. Return the client to surgery for exploration
c. Increase the dose of immunosuppression.
ANSWERS/MULTIPLE CHOICE QUESTIONS (ALL 2025
SESSIONS)
A young adult contracts hepatitis from contaminated food. Which result would the nurse expect
serologic testing to reveal during the acute (icteric) phase of the patient's illness?
a. Antibody to hepatitis D (anti-HDV)
b. Hepatitis B surface antigen (HBsAg)
c. Anti-hepatitis A virus immunoglobulin G (anti-HAV IgG)
d. Anti-hepatitis A virus immunoglobulin M (anti-HAV IgM)
ANS: D Hepatitis A is transmitted through the oral-fecal route, and antibody to HAV IgM appears during
the acute phase of hepatitis A. The patient would not have antigen for hepatitis B or antibody for
hepatitis D. Anti-HAV IgG would indicate past infection and lifelong immunity
A client with chronic kidney disease (CKD) is refusing to take his medication and has missed
two hemodialysis appointments. What is the best initial action for the nurse?
a. Discuss what the treatment regimen means to the client.
b. Refer the client to a mental health nurse practitioner.
c. Reschedule the appointments to another date and time.
d. Discuss the option of peritoneal dialysis.
a. Discuss what the treatment regimen means to the client.
A client is taking furosemide 40 mg/day for management of early chronic kidney disease
(CKD). To assess the therapeutic effect of the medication, what action of the nurse is best?
a. Obtain daily weights of the client.
b. Auscultate heart and breath sounds.
,c. Palpate the client's abdomen.
d. Assess the client's diet history.
a. Obtain daily weights of the client.
A 70-kg adult client with chronic kidney disease (CKD) is on a 40-g protein diet. The patient
has a reduced glomerular filtration rate and is not undergoing dialysis. Which result would be
of most concern to the nurse?
a. Albumin level of 2.5 g/dL (3.63 mcmol/L)
b. Phosphorus level of 5 mg/dL (1.62 mmol/L)
c. Sodium level of 135 mEq/L (135 mmol/L)
d. Potassium level of 5.5 mEq/L (5.5mmol/L)
a. Albumin level of 2.5 g/dL (3.63 mcmol/L)
The nurse is teaching a client with chronic kidney disease (CKD) about the sodium restriction
needed in the diet to prevent edema and hypertension. Which statement by the client indicates
that more teaching is needed?
a. "I will probably lose weight by cutting out potato chips."
b. "I will cut out bacon with my eggs every morning."
c. "My cooking style will change by not adding salt."
d. "I am thrilled that I can continue to eat fast food."
d. "I am thrilled that I can continue to eat fast food."
,A client is placed on fluid restriction because of chronic kidney disease (CKD). Which
assessment finding would alert the nurse that the client's fluid balance is stable at this time?
a. Decreased calcium levels
b. Increased phosphorus levels
c. No adventitious sounds in the lungs
d. Increased edema in the legs
c. No adventitious sounds in the lungs
The charge nurse is orienting a new nurse about care for an assigned client with an
arteriovenous (AV) fistula for hemodialysis in her left arm. Which action by the float nurse
would be considered unsafe?
a. Palpating the access site for a bruit or thrill
b. Using the right arm for a blood pressure reading
c. Administering intravenous fluids through the AV fistula
d. Checking distal pulses in the left arm
c. Administering intravenous fluids through the AV fistula
A client is having a peritoneal dialysis treatment. The nurse notes an opaque color to the
effluent. What is the priority action by the nurse?
a. Warm the dialysate solution in a microwave before instillation.
b. Obtain a sample of the effluent and send to the laboratory.
c. Flush the tubing with normal saline to maintain patency of the catheter.
d. Check the peritoneal catheter for kinking and curling
, b. Obtain a sample of the effluent and send to the laboratory.
The nurse is teaching a client how to increase the flow of dialysate into the peritoneal cavity
during dialysis. Which statement by the client demonstrates a correct understanding of the
teaching?
a. "I should leave the drainage bag above the level of my abdomen."
b. "I could flush the tubing with normal saline if the flow stops."
c. "I should take a stool softener every morning to avoid constipation."
d. "My diet should have low fiber in it to prevent any irritation."
c. "I should take a stool softener every morning to avoid constipation."
A nurse reviews the laboratory values of a client who returned from kidney transplantation 12
hours ago:
Na+ 136 mEq/L (135 mmol/L)
K+ 5 mEq/L (5mmol/L)
BUN 44mg/dL (15.7 mmol/L)
Serum Creatine 2.5 mg/dL (221 mcmol/L)
What initial intervention would the nurse anticipate?
a. Start hemodialysis immediately.
b. Discuss the need for peritoneal dialysis.
c. Increase the dose of immunosuppression.
d. Return the client to surgery for exploration
c. Increase the dose of immunosuppression.
