NUR 265 Medical-Surgical Nursing Exam 3, Galen College of Nursing, 2026 – Practice Questions with Answers and Rationales

NUR 265 Exam 3 Medical-Surgical Nursing (2026) PDF |
Galen College of Nursing Graded A+(100 +QUESTIONS
WITH ANSWERS AND RATIONALES)



THIS EXAM INCLUDES:

• NUR 265 Exam 3


• Medical-Surgical Nursing (2026)


• Galen College of Nursing


• Graded A+


• 100+QUESTIONS


• ANSWERS WITH RATIONALES

, Traumatic Brain Injury (TBI) & Increased Intracranial Pressure (ICP)
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This section covers the highest-priority concepts for Exam 3, including assessment
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of neurological decline and emergency interventions.
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Question 1: The nurse is caring for an adult client who was recently admitted with a
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head injury following a motor vehicle crash. One hour ago, the client's vital signs
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(VS) were T: 98.6°F; P: 110; R: 26; BP: 128/68 mm Hg. Which of the following
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findings is a priority for the nurse to follow up?
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A) P: 90; R: 32; BP: 130/72 mm Hg
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B) P: 120; R: 26, BP: 110/70 mm Hg
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C) P: 56; R: 14; BP: 166/52 mm Hg
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D) P: 64, R: 30; BP: 148/78m Hg
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Correct Answer: C x x




Rationale: The combination of bradycardia (P: 56) , hypertension (BP: 166/52) ,
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and irregular respirations is Cushing's Triad, a late and ominous sign of significantly
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increased intracranial pressure (ICP) and impending brain herniation. This is a
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medical emergency requiring immediate intervention.
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Question 2: The nurse is caring for a client who sustained a closed head injury, is
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receiving mechanical ventilation, and is at risk for developing increased ICP. Which
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of the following actions should the nurse take when caring for this client?
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A) Perform passive range of motion (ROM) to the client's hips and knees.
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B) Log roll the client during turning and repositioning.
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C) Elevate the foot of the client's bed.
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D) Notify the charge nurse if the client's PaCO2, decreases from 39 to 35 mm Hg.
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Correct Answer: B x x




Rationale: Maintaining spinal alignment is critical after a head injury. The client
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should be log-rolled (turned as a unit with the head, neck, and spine aligned) to
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prevent any twisting or flexion that could increase ICP or cause further spinal cord
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injury.
x

,Question 3: The nurse is providing discharge instructions to the parents of a 15-
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year-old female who sustained a concussion while playing field hockey. Which of
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the following statements by a parent indicates a need for further teaching?
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A) "We should avoid giving any acetaminophen to treat headaches."
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B) "We need to bring our daughter back to the emergency department if she
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exhibits blurred vision."
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C) "We should provide a consistent routine at home to assist with any behavior
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changes."
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D) "We will not allow our daughter to engage in strenuous activity for at least 48
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hours."
x




Correct Answer: A x x




Rationale: Acetaminophen (Tylenol) is the recommended analgesic for headaches
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following a concussion because it does not increase the risk of bleeding, unlike
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NSAIDs (ibuprofen, naproxen) or aspirin. Complete avoidance of acetaminophen
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indicates a misunderstanding of discharge instructions.
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Neurological Disorders (Meningitis, Myasthenia Gravis, Spinal Cord Injury)
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This section focuses on recognizing critical symptoms and initiating priority nursing
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actions for complex neuro conditions.
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Question 4: The nurse working in the emergency department (ED) is admitting a
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client who is a college student and lives in a dormitory. The client has chills, nuchal
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rigidity, and a temperature (T) of 101.5° F. Which of the following actions should
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the nurse take first?
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A) Obtain a blood culture and start intravenous (IV) antibiotics
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B) Administer antipyretics as prescribed
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C) Initiate droplet isolation precautions
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D) Measure the client's oxygen saturation
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Correct Answer: C x x




Rationale: Bacterial meningitis is highly contagious and transmitted via respiratory
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droplets. The priority action is to initiate droplet precautions immediately upon
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, admission (before diagnostic confirmation) to protect staff, other patients, and
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visitors. Antibiotics are started after diagnostic tests (LP, blood cultures) are
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obtained.
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Question 5: The nurse is caring for a client who has myasthenia gravis (MG). The
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client reports increased muscle weakness and difficulty swallowing. Which of the
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following actions should the nurse take first?
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A) Administer the prescribed PRN laxative.
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B) Assess the client's respiratory status and oxygen saturation.
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C) Prepare to administer atropine sulfate.
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D) Hold the next dose of pyridostigmine.
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Correct Answer: B x x




Rationale: In a client with MG, worsening weakness and dysphagia signal a
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potential myasthenic crisis. This can rapidly progress to respiratory failure. The
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nurse's priority is to assess the airway and breathing (respiratory rate, oxygen
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saturation, lung sounds) to determine the need for immediate respiratory support.
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Question 6: The nurse is caring for a client who has paraplegia and is being
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transferred to a rehabilitation facility. The client suddenly becomes flushed,
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reports a severe pounding headache, and has a blood pressure of 190/110 mm Hg.
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Which of the following actions should the nurse take first?
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A) Administer a prescribed PRN antihypertensive.
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B) Check the client's indwelling urinary catheter for kinks or obstruction.
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C) Elevate the head of the bed to a high Fowler's position.
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D) Notify the primary health care provider (PHCP).
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Correct Answer: B x x




Rationale: These are classic signs of autonomic dysreflexia, a life-threatening
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emergency in clients with spinal cord injuries at T6 or above. The most common
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cause is a distended bladder or bowel. The priority action is to identify and remove
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the noxious stimulus—checking the catheter is the correct first step. Raising the
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HOB is also critical but follows the initial assessment for the cause.
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