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NUR 265 GALEN EXAM 1 V1-V3 2026 | Adult Health
Validation | 100% Correct Answers | Pass Guaranteed
- A+ Graded
[VERSION 1 (V1): Core Concepts & Foundational Knowledge (Q1-20)]
[Section 1: Fluid & Electrolyte Balance (Q1-6)]
V1 - Q1. A nurse is reviewing the pathophysiology of fluid movement between
compartments. Which mechanism describes the movement of water from an area
of lower solute concentration to an area of higher solute concentration across a
semipermeable membrane?
A. Diffusion
B. Osmosis
C. Active transport
D. Filtration
B. Osmosis [CORRECT]
Rationale: Osmosis is the passive movement of water across a semipermeable
membrane from an area of lower solute concentration to an area of higher solute
concentration. Diffusion (A) is the movement of solutes from high to low
concentration. Active transport (C) requires energy to move substances against their
concentration gradient. Filtration (D) is the movement of fluid and solutes from an
area of high pressure to low pressure.
Correct Answer: B
V1 - Q2. A patient with heart failure is receiving a 0.9% sodium chloride (normal
saline) IV infusion. The nurse recognizes this fluid as which type of IV solution?
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Colloid
,2
B. Isotonic [CORRECT]
Rationale: 0.9% sodium chloride (normal saline) is an isotonic solution with an
osmolarity of approximately 308 mOsm/L, which is close to plasma osmolarity (275-
295 mOsm/L). Hypotonic solutions (A) have lower osmolarity than plasma and cause
cells to swell. Hypertonic solutions (C) have higher osmolarity and cause cells to
shrink. Colloids (D) contain large molecules that remain in the intravascular space.
Correct Answer: B
V1 - Q3. A patient presents with muscle weakness, flattened T waves, and U waves
on ECG. The nurse suspects which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
B. Hypokalemia [CORRECT]
Rationale: Hypokalemia (serum potassium <3.5 mEq/L) causes muscle weakness,
fatigue, and characteristic ECG changes including flattened T waves, prominent U
waves, and ST-segment depression. Hypernatremia (A) and hyponatremia (D)
primarily affect neurological status and fluid balance. Hypercalcemia (C) causes
shortened QT interval, not U waves.
Correct Answer: B
V1 - Q4. A nurse is caring for a patient with a serum calcium level of 6.8 mg/dL.
Which clinical manifestation would the nurse expect to assess?
A. Decreased deep tendon reflexes
B. Positive Chvostek's sign
C. Constipation
D. Shortened QT interval on ECG
,3
B. Positive Chvostek's sign [CORRECT]
Rationale: Hypocalcemia (serum calcium <8.5 mg/dL) causes increased
neuromuscular excitability, resulting in a positive Chvostek's sign (facial twitching
when tapping the facial nerve) and Trousseau's sign. Decreased reflexes (A),
constipation (C), and shortened QT interval (D) are manifestations of hypercalcemia,
not hypocalcemia.
Correct Answer: B
V1 - Q5. A patient receiving IV magnesium sulfate for preterm labor prevention
develops absent deep tendon reflexes and a respiratory rate of 10
breaths/minute. What is the nurse's priority action?
A. Increase the magnesium infusion rate
B. Administer calcium gluconate and stop the infusion
C. Administer naloxone
D. Apply oxygen via nasal cannula at 4 L/min
B. Administer calcium gluconate and stop the infusion [CORRECT]
Rationale: Absent deep tendon reflexes and respiratory depression (RR <12) are signs
of magnesium toxicity. The antidote for magnesium toxicity is IV calcium gluconate,
and the magnesium infusion must be stopped immediately. Increasing the rate (A)
would worsen toxicity. Naloxone (C) is for opioid overdose. Oxygen (D) is supportive
but does not address the underlying magnesium toxicity.
Correct Answer: B
V1 - Q6. A nurse is reviewing a patient's laboratory results and notes a serum
phosphorus level of 1.8 mg/dL. Which condition is most commonly associated
with this electrolyte imbalance?
A. Chronic kidney disease
B. Hyperparathyroidism
, 4
C. Alcohol withdrawal syndrome
D. Tumor lysis syndrome
B. Hyperparathyroidism [CORRECT]
Rationale: Hypophosphatemia (serum phosphorus <2.5 mg/dL) is commonly caused
by hyperparathyroidism, as parathyroid hormone increases renal excretion of
phosphorus. Chronic kidney disease (A) typically causes hyperphosphatemia due to
decreased renal excretion. Alcohol withdrawal (C) can cause hypophosphatemia but
is less common than hyperparathyroidism. Tumor lysis syndrome (D) causes
hyperphosphatemia from cell breakdown.
Correct Answer: B
[Section 2: Acid-Base Disorders (Q7-10)]
V1 - Q7. A patient with COPD presents with the following arterial blood gas (ABG)
results: pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L, PaO2 62 mmHg. The nurse
interprets this ABG as which acid-base disturbance?
A. Respiratory acidosis with partial compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
A. Respiratory acidosis with partial compensation [CORRECT]
Rationale: The pH of 7.32 indicates acidosis. The elevated PaCO2 (55 mmHg, normal
35-45) indicates the primary problem is respiratory. The elevated HCO3 (28 mEq/L,
normal 22-26) shows metabolic compensation is occurring, but since the pH remains
abnormal, compensation is only partial. Metabolic acidosis (B) would show decreased
HCO3. Respiratory alkalosis (C) would show decreased PaCO2 and elevated pH.
Metabolic alkalosis (D) would show elevated HCO3 as the primary problem.
Correct Answer: A
NUR 265 GALEN EXAM 1 V1-V3 2026 | Adult Health
Validation | 100% Correct Answers | Pass Guaranteed
- A+ Graded
[VERSION 1 (V1): Core Concepts & Foundational Knowledge (Q1-20)]
[Section 1: Fluid & Electrolyte Balance (Q1-6)]
V1 - Q1. A nurse is reviewing the pathophysiology of fluid movement between
compartments. Which mechanism describes the movement of water from an area
of lower solute concentration to an area of higher solute concentration across a
semipermeable membrane?
A. Diffusion
B. Osmosis
C. Active transport
D. Filtration
B. Osmosis [CORRECT]
Rationale: Osmosis is the passive movement of water across a semipermeable
membrane from an area of lower solute concentration to an area of higher solute
concentration. Diffusion (A) is the movement of solutes from high to low
concentration. Active transport (C) requires energy to move substances against their
concentration gradient. Filtration (D) is the movement of fluid and solutes from an
area of high pressure to low pressure.
Correct Answer: B
V1 - Q2. A patient with heart failure is receiving a 0.9% sodium chloride (normal
saline) IV infusion. The nurse recognizes this fluid as which type of IV solution?
A. Hypotonic
B. Isotonic
C. Hypertonic
D. Colloid
,2
B. Isotonic [CORRECT]
Rationale: 0.9% sodium chloride (normal saline) is an isotonic solution with an
osmolarity of approximately 308 mOsm/L, which is close to plasma osmolarity (275-
295 mOsm/L). Hypotonic solutions (A) have lower osmolarity than plasma and cause
cells to swell. Hypertonic solutions (C) have higher osmolarity and cause cells to
shrink. Colloids (D) contain large molecules that remain in the intravascular space.
Correct Answer: B
V1 - Q3. A patient presents with muscle weakness, flattened T waves, and U waves
on ECG. The nurse suspects which electrolyte imbalance?
A. Hypernatremia
B. Hypokalemia
C. Hypercalcemia
D. Hyponatremia
B. Hypokalemia [CORRECT]
Rationale: Hypokalemia (serum potassium <3.5 mEq/L) causes muscle weakness,
fatigue, and characteristic ECG changes including flattened T waves, prominent U
waves, and ST-segment depression. Hypernatremia (A) and hyponatremia (D)
primarily affect neurological status and fluid balance. Hypercalcemia (C) causes
shortened QT interval, not U waves.
Correct Answer: B
V1 - Q4. A nurse is caring for a patient with a serum calcium level of 6.8 mg/dL.
Which clinical manifestation would the nurse expect to assess?
A. Decreased deep tendon reflexes
B. Positive Chvostek's sign
C. Constipation
D. Shortened QT interval on ECG
,3
B. Positive Chvostek's sign [CORRECT]
Rationale: Hypocalcemia (serum calcium <8.5 mg/dL) causes increased
neuromuscular excitability, resulting in a positive Chvostek's sign (facial twitching
when tapping the facial nerve) and Trousseau's sign. Decreased reflexes (A),
constipation (C), and shortened QT interval (D) are manifestations of hypercalcemia,
not hypocalcemia.
Correct Answer: B
V1 - Q5. A patient receiving IV magnesium sulfate for preterm labor prevention
develops absent deep tendon reflexes and a respiratory rate of 10
breaths/minute. What is the nurse's priority action?
A. Increase the magnesium infusion rate
B. Administer calcium gluconate and stop the infusion
C. Administer naloxone
D. Apply oxygen via nasal cannula at 4 L/min
B. Administer calcium gluconate and stop the infusion [CORRECT]
Rationale: Absent deep tendon reflexes and respiratory depression (RR <12) are signs
of magnesium toxicity. The antidote for magnesium toxicity is IV calcium gluconate,
and the magnesium infusion must be stopped immediately. Increasing the rate (A)
would worsen toxicity. Naloxone (C) is for opioid overdose. Oxygen (D) is supportive
but does not address the underlying magnesium toxicity.
Correct Answer: B
V1 - Q6. A nurse is reviewing a patient's laboratory results and notes a serum
phosphorus level of 1.8 mg/dL. Which condition is most commonly associated
with this electrolyte imbalance?
A. Chronic kidney disease
B. Hyperparathyroidism
, 4
C. Alcohol withdrawal syndrome
D. Tumor lysis syndrome
B. Hyperparathyroidism [CORRECT]
Rationale: Hypophosphatemia (serum phosphorus <2.5 mg/dL) is commonly caused
by hyperparathyroidism, as parathyroid hormone increases renal excretion of
phosphorus. Chronic kidney disease (A) typically causes hyperphosphatemia due to
decreased renal excretion. Alcohol withdrawal (C) can cause hypophosphatemia but
is less common than hyperparathyroidism. Tumor lysis syndrome (D) causes
hyperphosphatemia from cell breakdown.
Correct Answer: B
[Section 2: Acid-Base Disorders (Q7-10)]
V1 - Q7. A patient with COPD presents with the following arterial blood gas (ABG)
results: pH 7.32, PaCO2 55 mmHg, HCO3 28 mEq/L, PaO2 62 mmHg. The nurse
interprets this ABG as which acid-base disturbance?
A. Respiratory acidosis with partial compensation
B. Metabolic acidosis with respiratory compensation
C. Respiratory alkalosis with metabolic compensation
D. Metabolic alkalosis with respiratory compensation
A. Respiratory acidosis with partial compensation [CORRECT]
Rationale: The pH of 7.32 indicates acidosis. The elevated PaCO2 (55 mmHg, normal
35-45) indicates the primary problem is respiratory. The elevated HCO3 (28 mEq/L,
normal 22-26) shows metabolic compensation is occurring, but since the pH remains
abnormal, compensation is only partial. Metabolic acidosis (B) would show decreased
HCO3. Respiratory alkalosis (C) would show decreased PaCO2 and elevated pH.
Metabolic alkalosis (D) would show elevated HCO3 as the primary problem.
Correct Answer: A
