NUR 265 Medical-Surgical Nursing Exam 1, Galen College of Nursing, 2026 – Practice Questions with Answers and Rationales

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NUR 265 Exam 1 Medical-Surgical Nursing (2026) PDF | Galen
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College of Nursing Graded A+(100 +QUESTIONS WITH ANSWERS
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xAND RATIONALES)
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Section Questions Topic xFocus



1 1–10 Renal xSystem x& xKidney xFunction



2 11–25 Acute xKidney xInjury x(AKI)



3 26–35 Chronic xKidney xDisease x(CKD)



4 36–45 Pancreatitis



5 46–55 Cirrhosis x& xHepatic xDisorders



6 56–70 Transplant x& xImmunology x(SLE, xAIDS, xKidney/Liver xTransplant)



7 71–80 Preoperative xCare



8 81–85 Postoperative xCare x(Hemorrhage, xMalignant xHyperthermia, xUrinary xRetention)



9 86–90 Liver xBiopsy x& xParacentesis



10 91–93 TIPS xProcedure x& xPortal xHypertension



11 94–96 Hepatitis x(A, xB, xC)



12 97–98 Bariatric xSurgery


13 99–100 Postoperative xComplications x(PE, xSurgical xSite xInfection)

,Section 1: Renal System & Kidney Function (Questions 1–10)
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Question 1: The nurse is explaining kidney functions to a group of nursing students.
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Which of the following statements about kidney function is correct? (Select all that
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apply)
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A) Kidneys receive 5-10% of cardiac output under resting conditions
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B) Kidneys secrete erythropoietin to increase RBC synthesis in bone marrow
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C) Kidneys convert Vitamin D into its active form
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D) The Loop of Henle concentrates urine and allows water reabsorption
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E) Kidneys are primarily responsible for digesting proteins
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Correct Answer: B, C, D x x x x




Rationale: Kidneys receive 20-25% (not 5-10%) of cardiac output . Key functions
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include: erythropoietin production for RBC synthesis, Vitamin D activation, and
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urine concentration via the Loop of Henle. Protein digestion occurs in the GI tract,
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not the kidneys.
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Question 2: A client with nephrotic syndrome has severe proteinuria. Which of the
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following actions should the nurse take?
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A) Administer furosemide
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B) Administer lisinopril
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C) Restrict fluids
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D) Increase protein intake
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Correct Answer: B x x




Rationale: ACE inhibitors like lisinopril reduce proteinuria by lowering
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intraglomerular pressure, which slows kidney damage progression. They are
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standard therapy in nephrotic syndrome to decrease urinary protein loss .
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Question 3: The nurse is reviewing labs of assigned clients. Which client requires
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priority follow-up with the primary health care provider?
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,A) Client 2 days post-abdominal aortic aneurysm (AAA) repair with creatinine stable
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at 1.1 mg/dL
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B) Client 2 days post-AAA repair with creatinine increasing from 0.9 to 2.5 mg/dL
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C) Client with potassium 4.0 mEq/L
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D) Client with mild hyponatremia
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Correct Answer: B x x




Rationale: A significant increase in creatinine post-surgery indicates possible acute
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kidney injury, requiring urgent evaluation. This is a priority over stable findings or
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mild electrolyte abnormalities .
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Question 4: A client with CKD asks why they need to limit phosphorus in their diet.
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The nurse's best response is:
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A) "Phosphorus causes fluid retention in your body."
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B) "High phosphorus levels increase your risk of bleeding."
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C) "High phosphorus levels can lead to bone disease and calcium deposits in your
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tissues."
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D) "Phosphorus interferes with your blood pressure medications."
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Correct Answer: C x x




Rationale: In CKD, the kidneys cannot excrete phosphorus, leading to
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hyperphosphatemia. This causes calcium to be pulled from bones (renal
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osteodystrophy) and calcium-phosphate deposits in soft tissues.
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Question 5: A client with CKD is prescribed epoetin alfa (Epogen). The nurse knows
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this medication is given to treat:
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A) Hyperkalemia
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B) Metabolic acidosis
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C) Anemia
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D) Hypertension
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, Correct Answer: C x x




Rationale: Epoetin alfa is synthetic erythropoietin, which stimulates RBC
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production. CKD patients have decreased erythropoietin production, leading to
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anemia .
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Question 6: The nurse is assessing a client with CKD. Which finding is most
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concerning for uremia?
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A) Blood pressure 138/88 mm Hg
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B) Uremic frost on the skin
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C) Mild peripheral edema
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D) Hemoglobin 10.5 g/dL
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Correct Answer: B x x




Rationale: Uremic frost (crystallized urea on the skin) indicates severe, advanced
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uremia and requires immediate intervention. It occurs when BUN is extremely
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elevated .
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Question 7: A client with stage 4 CKD reports muscle cramps and tingling in the
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fingers. Which lab value should the nurse check first?
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A) Hemoglobin
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B) Calcium
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C) Sodium
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D) Phosphate
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Correct Answer: B x x




Rationale: Muscle cramps and tingling suggest hypocalcemia, common in CKD due
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to decreased Vitamin D activation and hyperphosphatemia. Hypocalcemia can
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cause tetany and seizures.
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