Galen NSG 4100 Exam 1 | Adult Health III (2026) Actual Q&A
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1. Which of the following is the basic structural and functional unit of the kidney?
A) Nephron
B) Neuron
C) Alveolus
D) Villus
Correct Answer: Nephron
Rationale: The nephron is the basic structural and functional unit of the kidney, responsible for
filtering blood and forming urine. The neuron is the functional unit of the nervous system, the
alveolus is the gas-exchange unit of the lung, and the villus is a structure in the small intestine
that absorbs nutrients.
2. A nurse is assessing a client suspected of having acute glomerulonephritis. Which clinical
manifestation is characteristic of this condition?
A) Hypotension
B) Glucosuria
C) Hematuria
D) Polyuria
Correct Answer: Hematuria
Rationale: Hematuria (blood in the urine) is a classic hallmark of acute glomerulonephritis due
to inflammation and damage to the glomerular capillaries, which allows red blood cells to leak
into the urine. Hypertension (not hypotension) is common due to fluid retention. Glucosuria is
more typical of diabetes mellitus.
,3. A nurse is caring for an acutely ill client. Which assessment finding should prompt the nurse
to notify the healthcare provider of possible acute kidney injury (AKI)?
A) The client reports left-sided flank pain.
B) Average urine output has been 10 mL/hr for several hours.
C) The urine is cloudy with visible sediment.
D) The client is unable to initiate voiding.
Correct Answer: Average urine output has been 10 mL/hr for several hours.
Rationale: Oliguria (urine output < 400 mL/day or < 20 mL/hour) is a key indicator of acute
kidney injury. An output of 10 mL/hr is significantly below normal and warrants immediate
investigation. Flank pain and cloudy urine suggest infection or stones, not specifically AKI.
4. A client with a history of systemic lupus erythematosus is diagnosed with end-stage kidney
disease (ESKD) and has an elevated phosphorus level. The nurse teaches the client to take the
prescribed calcium acetate at what time?
A) First thing in the morning
B) With each meal
C) Daily at bedtime
D) On an empty stomach
Correct Answer: With each meal
Rationale: Calcium acetate is a phosphate binder. It works locally in the gastrointestinal tract by
binding to dietary phosphorus and preventing its absorption. To be effective, it must be taken
with meals or snacks that contain phosphorus.
,5. To reduce the risk of infection in a client with a newly transplanted kidney, the nurse's most
important action is:
A) Ensure the client wears a face mask when out of the room.
B) Place the client in a negative pressure room.
C) Wash hands carefully and frequently.
D) Restrict visitors to immediate family only.
Correct Answer: Wash hands carefully and frequently.
Rationale: Hand hygiene is the single most effective way to prevent the transmission of
infections. Transplant recipients are severely immunocompromised due to immunosuppressive
therapy, making them highly susceptible. All other options are secondary precautions, but none
replace handwashing.
6. A client who had an arteriovenous (AV) fistula created for hemodialysis is being educated
about the fistula. Which statement indicates a need for further teaching?
A) "I should not let anyone take my blood pressure on that arm."
B) "I should check for a bruit and thrill every day."
C) "I can sleep on the arm with the fistula."
D) "I should keep the fistula arm clean and dry."
Correct Answer: "I can sleep on the arm with the fistula."
Rationale: Sleeping on the arm with the AV fistula can compress the fistula and compromise
blood flow, leading to clotting or damage. Patients should avoid any pressure on the fistula arm.
The other statements are correct: blood pressures should not be taken on that arm, daily
assessment for bruit and thrill is essential, and the site should be kept clean.
, 7. Which laboratory value is the most reliable indicator of a patient's glomerular filtration rate
(GFR)?
A) Blood urea nitrogen (BUN)
B) Serum creatinine
C) Serum potassium
D) Serum albumin
Correct Answer: Serum creatinine
Rationale: Serum creatinine is the most reliable indicator of GFR because it is produced at a
relatively constant rate and is freely filtered by the glomerulus. BUN can be affected by protein
intake and hydration status, making it less reliable. Potassium and albumin are not direct
measures of GFR.
8. The hormone responsible for regulating blood glucose levels by lowering it is:
A) Glucagon
B) Insulin
C) Cortisol
D) Thyroxine
Correct Answer: Insulin
Rationale: Insulin is the hormone that lowers blood glucose levels by facilitating the uptake of
glucose into cells and promoting its storage as glycogen. Glucagon raises blood glucose, cortisol
is a stress hormone that increases glucose, and thyroxine regulates metabolism.
9. Which chamber of the heart pumps oxygenated blood to the rest of the body?
A) Right atrium
1. Which of the following is the basic structural and functional unit of the kidney?
A) Nephron
B) Neuron
C) Alveolus
D) Villus
Correct Answer: Nephron
Rationale: The nephron is the basic structural and functional unit of the kidney, responsible for
filtering blood and forming urine. The neuron is the functional unit of the nervous system, the
alveolus is the gas-exchange unit of the lung, and the villus is a structure in the small intestine
that absorbs nutrients.
2. A nurse is assessing a client suspected of having acute glomerulonephritis. Which clinical
manifestation is characteristic of this condition?
A) Hypotension
B) Glucosuria
C) Hematuria
D) Polyuria
Correct Answer: Hematuria
Rationale: Hematuria (blood in the urine) is a classic hallmark of acute glomerulonephritis due
to inflammation and damage to the glomerular capillaries, which allows red blood cells to leak
into the urine. Hypertension (not hypotension) is common due to fluid retention. Glucosuria is
more typical of diabetes mellitus.
,3. A nurse is caring for an acutely ill client. Which assessment finding should prompt the nurse
to notify the healthcare provider of possible acute kidney injury (AKI)?
A) The client reports left-sided flank pain.
B) Average urine output has been 10 mL/hr for several hours.
C) The urine is cloudy with visible sediment.
D) The client is unable to initiate voiding.
Correct Answer: Average urine output has been 10 mL/hr for several hours.
Rationale: Oliguria (urine output < 400 mL/day or < 20 mL/hour) is a key indicator of acute
kidney injury. An output of 10 mL/hr is significantly below normal and warrants immediate
investigation. Flank pain and cloudy urine suggest infection or stones, not specifically AKI.
4. A client with a history of systemic lupus erythematosus is diagnosed with end-stage kidney
disease (ESKD) and has an elevated phosphorus level. The nurse teaches the client to take the
prescribed calcium acetate at what time?
A) First thing in the morning
B) With each meal
C) Daily at bedtime
D) On an empty stomach
Correct Answer: With each meal
Rationale: Calcium acetate is a phosphate binder. It works locally in the gastrointestinal tract by
binding to dietary phosphorus and preventing its absorption. To be effective, it must be taken
with meals or snacks that contain phosphorus.
,5. To reduce the risk of infection in a client with a newly transplanted kidney, the nurse's most
important action is:
A) Ensure the client wears a face mask when out of the room.
B) Place the client in a negative pressure room.
C) Wash hands carefully and frequently.
D) Restrict visitors to immediate family only.
Correct Answer: Wash hands carefully and frequently.
Rationale: Hand hygiene is the single most effective way to prevent the transmission of
infections. Transplant recipients are severely immunocompromised due to immunosuppressive
therapy, making them highly susceptible. All other options are secondary precautions, but none
replace handwashing.
6. A client who had an arteriovenous (AV) fistula created for hemodialysis is being educated
about the fistula. Which statement indicates a need for further teaching?
A) "I should not let anyone take my blood pressure on that arm."
B) "I should check for a bruit and thrill every day."
C) "I can sleep on the arm with the fistula."
D) "I should keep the fistula arm clean and dry."
Correct Answer: "I can sleep on the arm with the fistula."
Rationale: Sleeping on the arm with the AV fistula can compress the fistula and compromise
blood flow, leading to clotting or damage. Patients should avoid any pressure on the fistula arm.
The other statements are correct: blood pressures should not be taken on that arm, daily
assessment for bruit and thrill is essential, and the site should be kept clean.
, 7. Which laboratory value is the most reliable indicator of a patient's glomerular filtration rate
(GFR)?
A) Blood urea nitrogen (BUN)
B) Serum creatinine
C) Serum potassium
D) Serum albumin
Correct Answer: Serum creatinine
Rationale: Serum creatinine is the most reliable indicator of GFR because it is produced at a
relatively constant rate and is freely filtered by the glomerulus. BUN can be affected by protein
intake and hydration status, making it less reliable. Potassium and albumin are not direct
measures of GFR.
8. The hormone responsible for regulating blood glucose levels by lowering it is:
A) Glucagon
B) Insulin
C) Cortisol
D) Thyroxine
Correct Answer: Insulin
Rationale: Insulin is the hormone that lowers blood glucose levels by facilitating the uptake of
glucose into cells and promoting its storage as glycogen. Glucagon raises blood glucose, cortisol
is a stress hormone that increases glucose, and thyroxine regulates metabolism.
9. Which chamber of the heart pumps oxygenated blood to the rest of the body?
A) Right atrium
