NUR 265 Exam 1
NUR 265 Exam Med Surg Nursing Galen
college Actual Exam 2 VERIFIED
QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS
A male client who has never smoked but has had COPD for the past 5 years is now being assessed for
cancer of the lung. The nurse knows that he is most likely to develop which type of lung cancer?
A) Adenocarcinoma.
B) Oat-cell carcinoma.
C) Malignant melanoma.
D) Squamous-cell carcinoma.
A) Adenocarcinoma.
Adenocarcinoma is the only lung cancer not related to cigarette smoking (A). It has been found to be
directly related to lung scarring and fibrosis from preexisting pulmonary disease such as TB or COPD.
, NUR 265 Exam 2
Both (B and D) are malignant lung cancers related to cigarette smoking. (C) is a skin cancer and is
related to exposure to sunlight, not to lung problems.
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy.
Which finding should the nurse consider an indication of progressive hepatic encephalopathy?
A) An increase in abdominal girth.
B) Hypertension and a bounding pulse.
C) Decreased bowel sounds.
D) Difficulty in handwriting.
D) Difficulty in handwriting.
A daily record in handwriting may provide evidence of progression or reversal of hepatic
encephalopathy leading to coma (D). (A) is a sign of ascites. (B) are not seen with hepatic
encephalopathy. (C) does not indicate an increase in serum ammonia level which is the primary cause of
hepatic encephalopathy.
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L. Which action is
most important for the nurse to implement?
A) Give 20 mEq of potassium chloride.
B) Initiate continuous cardiac monitoring.
C) Arrange a consultation with the dietician.
D) Teach about the side effects of diuretics.
B) Initiate continuous cardiac monitoring.
Hypokalemia (normal 3.5 to 5 mEq/L) causes changes in myocardial irritability and ECG waveform, so
it is most important for the nurse to initiate continuous cardiac monitoring (B) to identify ventricular
ectopy or other life-threatening dysrhythmias. Potassium chloride (A) should be given after cardiac
monitoring is initiated so that the effects of potassium replacement on the cardiac rhythm can be
monitored. (C and D) should be implemented when the client is stable.
The nurse is planning care to prevent complication for a client with multiple myeloma. Which
intervention is most important for the nurse to include?
A) Safety precautions during activity.
B) Assess for changes in size of lymph nodes.
C) Maintain a fluid intake of 3 to 4 L per day.
D) Administer narcotic analgesic around the clock.
C) Maintain a fluid intake of 3 to 4 L per day.
Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization and
hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3 to 4 L (C) to
promote excretion of serum calcium. Although the client is at risk for pathologic fractures due to diffuse
osteoporosis, mobilization and weight bearing (A) should be encouraged to promote bone reabsorption
of circulating calcium, which can cause renal complications. (B) is a component of ongoing assessment.
Chronic pain management (D) should be included in the plan of care, but prevention of complications
related to hypercalcemia is most important.
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer
has the poorest prognosis. Which information should the nurse offer the client?
, NUR 265 Exam 3
A) Stage II.
B) Invasive infiltrating ductal carcinoma.
C) T1N0M0.
D) Inflammatory with peau d'orange.
D) Inflammatory with peau d'orange.
Inflammatory breast cancer, which has a thickened appearance like an orange peel (peau d'orange), is the
most aggressive form of breast malignancies (D). Staging classifies cancer by the extension or spread of
the disease, and (A) indicates limited local spread. (B) indicates cancer cells have spread from the ducts
into the surrounding breast tissue only. TNM classification is used to indicate the extent of the disease
process according to tumor size, regional spread lymph nodes involvement, and metastasis, and (C)
indicates early cancer with small in situ involvement, no lymph node involvement, and no distant
metastases.
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the
risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method provides a
better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the past.
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the
risk for pelvic inflammatory disease (PID).
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates with
the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is judgmental and
does not provide the client any information about use of an IUD. While talking about contraceptives
may include (D), it is does not provide the best information to maintain the client's health.
A client reports unprotected sexual intercourse one week ago and is worried about HIV exposure. An
initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that seroconversion to
HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should
the nurse recommend the client return for repeat blood testing?
A) 6 to 18 months.
B) 1 to 12 months.
C) 1 to 18 weeks.
D) 6 to 12 weeks.
D) 6 to 12 weeks.
Although the HIV antigen is detectable approximately 2 weeks after exposure, seroconversion to HIV
positive may take up to 6 to 12 weeks (D) after exposure, so the client should return to repeat the serum
screen for the presence of HIV antibodies during that time frame. (A) will delay treatment if the client
tests positive. (B and C) may provide inaccurate results because the time frame maybe too early to
reevaluate the client.
A 32-year-old female client complains of severe abdominal pain each month before her menstrual period,
painful intercourse, and painful defecation. Which additional history should the nurse obtain that is
, NUR 265 Exam 4
consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives.
B) Inability to get pregnant.
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent areas of the
pelvic peritoneum. A history of infertility (B) is another common finding associated with endometriosis.
Although (A, C, and D) are common, nonspecific gynecological complaints, the most common
complaints of the client with endometriosis are pain and infertility.
The nurse is completing an admission interview and assessment on a client with a history of Parkinson's
disease. Which question should provide information relevant to the client's plan of care?
A) Have you ever experienced any paralysis of your arms or legs?
B) Have you ever sustained a severe head injury?
C) Have you ever been 'frozen' in one spot, unable to move?
D) Do you have headaches, especially ones with throbbing pain?
C) Have you ever been 'frozen' in one spot, unable to move?
Clients with Parkinson's disease frequently experience difficulty in initiating, maintaining, and
performing motor activities. They may even experience being rooted to the spot and unable to move (C).
Parkinson's disease does not cause (A). Parkinson's disease is not usually associated with (B), nor does it
typically cause (D).
A female client requests information about using the calendar method of contraception. Which
assessment is most important for the nurse to obtain?
A) Amount of weight gain or weight loss during the previous year.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
C) Skin pigmentation and hair texture for evidence of hormonal changes.
D) Previous birth-control methods and beliefs about the calendar method.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
The fertile period, which occurs 2 weeks prior to the onset of menses, is determined using an accurate
record of the number of days of the menstrual cycles for the past 6 months, so it is most important to
emphasize to the client that accuracy and compliancy of a menstrual diary (B) is the basis of the calendar
method. (A and C) may be partially related to hormonal fluctuations but are not indicators for using the
calendar method. (D) may demonstrate client understanding and compliancy but is not the most
important aspect.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH), which is
manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea.
NUR 265 Exam Med Surg Nursing Galen
college Actual Exam 2 VERIFIED
QUESTIONS AND ANSWERS WITH
DETAILED RATIONALES GRADED A+
GUARANTEED PASS
A male client who has never smoked but has had COPD for the past 5 years is now being assessed for
cancer of the lung. The nurse knows that he is most likely to develop which type of lung cancer?
A) Adenocarcinoma.
B) Oat-cell carcinoma.
C) Malignant melanoma.
D) Squamous-cell carcinoma.
A) Adenocarcinoma.
Adenocarcinoma is the only lung cancer not related to cigarette smoking (A). It has been found to be
directly related to lung scarring and fibrosis from preexisting pulmonary disease such as TB or COPD.
, NUR 265 Exam 2
Both (B and D) are malignant lung cancers related to cigarette smoking. (C) is a skin cancer and is
related to exposure to sunlight, not to lung problems.
The nurse assesses a client with advanced cirrhosis of the liver for signs of hepatic encephalopathy.
Which finding should the nurse consider an indication of progressive hepatic encephalopathy?
A) An increase in abdominal girth.
B) Hypertension and a bounding pulse.
C) Decreased bowel sounds.
D) Difficulty in handwriting.
D) Difficulty in handwriting.
A daily record in handwriting may provide evidence of progression or reversal of hepatic
encephalopathy leading to coma (D). (A) is a sign of ascites. (B) are not seen with hepatic
encephalopathy. (C) does not indicate an increase in serum ammonia level which is the primary cause of
hepatic encephalopathy.
A client who has heart failure is admitted with a serum potassium level of 2.9 mEq/L. Which action is
most important for the nurse to implement?
A) Give 20 mEq of potassium chloride.
B) Initiate continuous cardiac monitoring.
C) Arrange a consultation with the dietician.
D) Teach about the side effects of diuretics.
B) Initiate continuous cardiac monitoring.
Hypokalemia (normal 3.5 to 5 mEq/L) causes changes in myocardial irritability and ECG waveform, so
it is most important for the nurse to initiate continuous cardiac monitoring (B) to identify ventricular
ectopy or other life-threatening dysrhythmias. Potassium chloride (A) should be given after cardiac
monitoring is initiated so that the effects of potassium replacement on the cardiac rhythm can be
monitored. (C and D) should be implemented when the client is stable.
The nurse is planning care to prevent complication for a client with multiple myeloma. Which
intervention is most important for the nurse to include?
A) Safety precautions during activity.
B) Assess for changes in size of lymph nodes.
C) Maintain a fluid intake of 3 to 4 L per day.
D) Administer narcotic analgesic around the clock.
C) Maintain a fluid intake of 3 to 4 L per day.
Multiple myeloma is a malignancy of plasma cells that infiltrate bone causing demineralization and
hypercalcemia, so maintaining a urinary output of 1.5 to 2 L per day requires an intake of 3 to 4 L (C) to
promote excretion of serum calcium. Although the client is at risk for pathologic fractures due to diffuse
osteoporosis, mobilization and weight bearing (A) should be encouraged to promote bone reabsorption
of circulating calcium, which can cause renal complications. (B) is a component of ongoing assessment.
Chronic pain management (D) should be included in the plan of care, but prevention of complications
related to hypercalcemia is most important.
A client has a staging procedure for cancer of the breast and ask the nurse which type of breast cancer
has the poorest prognosis. Which information should the nurse offer the client?
, NUR 265 Exam 3
A) Stage II.
B) Invasive infiltrating ductal carcinoma.
C) T1N0M0.
D) Inflammatory with peau d'orange.
D) Inflammatory with peau d'orange.
Inflammatory breast cancer, which has a thickened appearance like an orange peel (peau d'orange), is the
most aggressive form of breast malignancies (D). Staging classifies cancer by the extension or spread of
the disease, and (A) indicates limited local spread. (B) indicates cancer cells have spread from the ducts
into the surrounding breast tissue only. TNM classification is used to indicate the extent of the disease
process according to tumor size, regional spread lymph nodes involvement, and metastasis, and (C)
indicates early cancer with small in situ involvement, no lymph node involvement, and no distant
metastases.
A client who is sexually active with several partners requests an intrauterine device (IUD) as a
contraceptive method. Which information should the nurse provide?
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the
risk for pelvic inflammatory disease (PID).
B) Getting pregnant while using an IUD is common and is not the best contraceptive choice.
C) Relying on an IUD may be a safer choice for monogamous partners, but a barrier method provides a
better option in preventing STD transmission.
D) Selecting a contraceptive device should consider choosing a successful method used in the past.
A) Using an IUD offers no protection against sexually transmitted diseases (STD), which increase the
risk for pelvic inflammatory disease (PID).
The use of an IUD provides the client with no protection from STDs (A). While pregnancy rates with
the use of an IUD are somewhat higher, (B) is not therapeutic, but judgmental. (C) is judgmental and
does not provide the client any information about use of an IUD. While talking about contraceptives
may include (D), it is does not provide the best information to maintain the client's health.
A client reports unprotected sexual intercourse one week ago and is worried about HIV exposure. An
initial HIV antibody screen (ELISA) is obtained. The nurse teaches the client that seroconversion to
HIV positive relies on antibody production by B lymphocytes after exposure to the virus. When should
the nurse recommend the client return for repeat blood testing?
A) 6 to 18 months.
B) 1 to 12 months.
C) 1 to 18 weeks.
D) 6 to 12 weeks.
D) 6 to 12 weeks.
Although the HIV antigen is detectable approximately 2 weeks after exposure, seroconversion to HIV
positive may take up to 6 to 12 weeks (D) after exposure, so the client should return to repeat the serum
screen for the presence of HIV antibodies during that time frame. (A) will delay treatment if the client
tests positive. (B and C) may provide inaccurate results because the time frame maybe too early to
reevaluate the client.
A 32-year-old female client complains of severe abdominal pain each month before her menstrual period,
painful intercourse, and painful defecation. Which additional history should the nurse obtain that is
, NUR 265 Exam 4
consistent with the client's complaints?
A) Frequent urinary tract infections.
B) Inability to get pregnant.
C) Premenstrual syndrome.
D) Chronic use of laxatives.
B) Inability to get pregnant.
Dysmenorrhea, dyspareunia, and difficulty or painful defecation are common symptoms of
endometriosis, which is the abnormal displacement of endometrial tissue in the dependent areas of the
pelvic peritoneum. A history of infertility (B) is another common finding associated with endometriosis.
Although (A, C, and D) are common, nonspecific gynecological complaints, the most common
complaints of the client with endometriosis are pain and infertility.
The nurse is completing an admission interview and assessment on a client with a history of Parkinson's
disease. Which question should provide information relevant to the client's plan of care?
A) Have you ever experienced any paralysis of your arms or legs?
B) Have you ever sustained a severe head injury?
C) Have you ever been 'frozen' in one spot, unable to move?
D) Do you have headaches, especially ones with throbbing pain?
C) Have you ever been 'frozen' in one spot, unable to move?
Clients with Parkinson's disease frequently experience difficulty in initiating, maintaining, and
performing motor activities. They may even experience being rooted to the spot and unable to move (C).
Parkinson's disease does not cause (A). Parkinson's disease is not usually associated with (B), nor does it
typically cause (D).
A female client requests information about using the calendar method of contraception. Which
assessment is most important for the nurse to obtain?
A) Amount of weight gain or weight loss during the previous year.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
C) Skin pigmentation and hair texture for evidence of hormonal changes.
D) Previous birth-control methods and beliefs about the calendar method.
B) An accurate menstrual cycle diary for the past 6 to 12 months.
The fertile period, which occurs 2 weeks prior to the onset of menses, is determined using an accurate
record of the number of days of the menstrual cycles for the past 6 months, so it is most important to
emphasize to the client that accuracy and compliancy of a menstrual diary (B) is the basis of the calendar
method. (A and C) may be partially related to hormonal fluctuations but are not indicators for using the
calendar method. (D) may demonstrate client understanding and compliancy but is not the most
important aspect.
The nurse is caring for a client with syndrome of inappropriate antidiuretic hormone (SIADH), which is
manifested by which symptoms?
A) Loss of thirst, weight gain.
B) Dependent edema, fever.
C) Polydipsia, polyuria.
D) Hypernatremia, tachypnea.
