NUR 265 Medical-Surgical Nursing Final Exam Study Guide 2026 Galen
1. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
normal, indicating uncompensated respiratory acidosis.
2. Which assessment finding is a hallmark sign of the ‘Emergent Phase’ of burn
management?
A. Fluid shift from intravascular to interstitial space
B. Increased urinary output
C. Hypokalemia
D. Decreased hematocrit
Answer: A
Rationale: During the emergent phase, massive fluid shifts occur due to increased capillary
permeability, leading to edema and potential hypovolemic shock.
,3. A nurse is caring for a patient in the compensatory stage of shock. Which
clinical manifestation should the nurse expect?
A. Increased urine output
B. Bradycardia and hypotension
C. Decreased respiratory rate
D. Tachycardia and narrowed pulse pressure
Answer: D
Rationale: In the compensatory stage, the body attempts to maintain cardiac output
through sympathetic nervous system activation, resulting in tachycardia.
4. What is the primary goal of administering Dobutamine in a patient with
cardiogenic shock?
A. To decrease heart rate
B. To increase systemic vascular resistance
C. To increase myocardial contractility
D. To promote diuresis
Answer: C
Rationale: Dobutamine is an inotropic agent that increases the force of myocardial
contraction to improve cardiac output in cardiogenic shock.
5. Using the Rule of Nines, calculate the total body surface area (TBSA) for a
patient with burns on the entire left arm and the anterior trunk.
A. 27%
B. 22.5%
C. 18%
D. 36%
Answer: A
Rationale: The entire arm is 9% and the anterior trunk is 18%. 9 + 18 = 27%.
, 6. Which laboratory value is the most sensitive indicator of acute kidney injury
(AKI)?
A. Serum Creatinine
B. BUN
C. Potassium
D. Hemoglobin
Answer: A
Rationale: Serum creatinine is a more specific and sensitive indicator of renal function
than BUN, as it is not as easily influenced by diet or hydration.
7. A patient with a history of heart failure presents with JVD, hepatomegaly, and
peripheral edema. Which condition is most likely?
A. Pulmonary Embolism
B. Left-sided Heart Failure
C. Right-sided Heart Failure
D. Septic Shock
Answer: C
Rationale: Right-sided heart failure leads to systemic venous congestion, causing JVD, liver
enlargement, and dependent edema.
8. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Epinephrine
B. Methylprednisolone
C. Albuterol
D. Diphenhydramine
Answer: A
Rationale: Epinephrine is the drug of choice for anaphylaxis because it causes
bronchodilation and vasoconstriction to counteract the allergic reaction.
1. A patient’s ABG results are: pH 7.28, PaCO2 55 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: The pH is low (acidosis), the PaCO2 is high (respiratory cause), and the HCO3 is
normal, indicating uncompensated respiratory acidosis.
2. Which assessment finding is a hallmark sign of the ‘Emergent Phase’ of burn
management?
A. Fluid shift from intravascular to interstitial space
B. Increased urinary output
C. Hypokalemia
D. Decreased hematocrit
Answer: A
Rationale: During the emergent phase, massive fluid shifts occur due to increased capillary
permeability, leading to edema and potential hypovolemic shock.
,3. A nurse is caring for a patient in the compensatory stage of shock. Which
clinical manifestation should the nurse expect?
A. Increased urine output
B. Bradycardia and hypotension
C. Decreased respiratory rate
D. Tachycardia and narrowed pulse pressure
Answer: D
Rationale: In the compensatory stage, the body attempts to maintain cardiac output
through sympathetic nervous system activation, resulting in tachycardia.
4. What is the primary goal of administering Dobutamine in a patient with
cardiogenic shock?
A. To decrease heart rate
B. To increase systemic vascular resistance
C. To increase myocardial contractility
D. To promote diuresis
Answer: C
Rationale: Dobutamine is an inotropic agent that increases the force of myocardial
contraction to improve cardiac output in cardiogenic shock.
5. Using the Rule of Nines, calculate the total body surface area (TBSA) for a
patient with burns on the entire left arm and the anterior trunk.
A. 27%
B. 22.5%
C. 18%
D. 36%
Answer: A
Rationale: The entire arm is 9% and the anterior trunk is 18%. 9 + 18 = 27%.
, 6. Which laboratory value is the most sensitive indicator of acute kidney injury
(AKI)?
A. Serum Creatinine
B. BUN
C. Potassium
D. Hemoglobin
Answer: A
Rationale: Serum creatinine is a more specific and sensitive indicator of renal function
than BUN, as it is not as easily influenced by diet or hydration.
7. A patient with a history of heart failure presents with JVD, hepatomegaly, and
peripheral edema. Which condition is most likely?
A. Pulmonary Embolism
B. Left-sided Heart Failure
C. Right-sided Heart Failure
D. Septic Shock
Answer: C
Rationale: Right-sided heart failure leads to systemic venous congestion, causing JVD, liver
enlargement, and dependent edema.
8. Which medication is considered the first-line treatment for a patient
experiencing anaphylactic shock?
A. Epinephrine
B. Methylprednisolone
C. Albuterol
D. Diphenhydramine
Answer: A
Rationale: Epinephrine is the drug of choice for anaphylaxis because it causes
bronchodilation and vasoconstriction to counteract the allergic reaction.
