NUR 265 Exam 1 V1 V2 V3 Actual Exam 2026/2027 – Real-Style Exam
Questions | 100% Correct Answers | Medical-Surgical Nursing |
Perioperative Care | Fluid & Electrolytes | Pain Management | Infection
Control | Detailed Rationales | Graded A+ Verified – Pass Guaranteed –
Instant Download
Section 1: Fluid, Electrolyte & Acid-Base Balance
Q1: A patient's morning lab work shows a serum potassium level of 2.9 mEq/L. The
nurse recognizes this finding as indicating:
A. Hyperkalemia
B. Normal potassium balance
C. Hypokalemia [CORRECT]
D. Hypernatremia
Correct Answer: C
Rationale: The best answer is hypokalemia. Normal potassium runs between 3.5 and
5.0 mEq/L, so a level of 2.9 puts your patient at real risk for cardiac dysrhythmias and
muscle weakness. On a busy medical-surgical unit, you'll want to check the patient's
ECG for flattened T waves or U waves and notify the provider right away because this
needs correction.
Q2: The nurse is reviewing a patient's electrolyte panel and notes a serum sodium level
of 150 mEq/L. This value indicates:
A. Hyponatremia
B. Normal sodium balance
C. Hypernatremia [CORRECT]
D. Hypokalemia
Correct Answer: C
Rationale: The best answer is hypernatremia. Normal sodium falls between 135 and 145
mEq/L, so 150 is elevated. In clinical practice, you'll often see this in patients who are
dehydrated or have had excessive water loss, and your priority is going to be assessing
their fluid status and neurologic function since high sodium can cause confusion and
seizures.
,Q3: When interpreting arterial blood gas results, the nurse recalls that the normal range
for arterial pH is:
A. 7.25–7.30
B. 7.35–7.45 [CORRECT]
C. 7.45–7.55
D. 7.50–7.60
Correct Answer: B
Rationale: The best answer is 7.35 to 7.45. This is the narrow window where our body's
enzymatic processes work best, and anything outside this range means your patient is
either acidotic or alkalotic. When you're looking at ABGs on the unit, always start with
the pH to figure out which direction your patient is heading.
Q4: The normal range for serum bicarbonate (HCO3-) in an adult is:
A. 18–22 mEq/L
B. 22–26 mEq/L [CORRECT]
C. 28–32 mEq/L
D. 35–45 mEq/L
Correct Answer: B
Rationale: The best answer is 22 to 26 mEq/L. Bicarbonate is our metabolic buffer, and
when you see it outside this range on an ABG, it tells you whether the kidneys are trying
to compensate for a respiratory problem or if there's a primary metabolic issue going
on.
Q5: A patient's ABG report shows a PaCO2 of 48 mmHg. The nurse understands that the
normal PaCO2 range is:
A. 20–30 mmHg
B. 30–35 mmHg
C. 35–45 mmHg [CORRECT]
D. 45–55 mmHg
Correct Answer: C
Rationale: The best answer is 35 to 45 mmHg. PaCO2 reflects how well the lungs are
ventilating and blowing off carbon dioxide, so a level of 48 tells you there's some
retention happening. This is where you look at the patient's respiratory effort and
whether they need some assistance clearing that CO2.
, Q6: A patient with a history of prolonged diarrhea is admitted with muscle weakness
and complaints of palpitations. The ECG shows flattened T waves and the presence of
U waves. The nurse suspects:
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypernatremia
D. Hyponatremia
Correct Answer: B
Rationale: The best answer is hypokalemia. When you see flattened T waves and U
waves on an ECG, that's classic for low potassium, and prolonged diarrhea is a common
cause because of GI losses. In the real world, you'd also be checking for muscle
weakness and making sure the patient isn't on any potassium-wasting diuretics that
could make this worse.
Q7: A patient with end-stage renal disease presents with peaked T waves on the ECG,
widened QRS complexes, and reports of tingling in the extremities. Which intervention is
the nurse's priority?
A. Administer potassium chloride IV push
B. Prepare to administer calcium gluconate and notify the provider [CORRECT]
C. Increase oral potassium intake
D. Administer sodium polystyrene sulfonate orally only
Correct Answer: B
Rationale: The best answer is to prepare calcium gluconate and notify the provider.
Peaked T waves and widened QRS are warning signs of severe hyperkalemia that can
progress to cardiac arrest, and calcium gluconate stabilizes the cardiac membrane. On
a medical-surgical floor, you never give potassium IV push—that's a dangerous
error—and while kayexalate has its place, the immediate threat to the heart takes
priority.
Q8: A patient admitted with heart failure is receiving diuretic therapy. The nurse notes
the patient is confused, has a headache, and reports nausea. The morning lab shows a
sodium level of 128 mEq/L. These findings are consistent with:
A. Hypernatremia
B. Hyponatremia [CORRECT]
C. Hyperkalemia
Questions | 100% Correct Answers | Medical-Surgical Nursing |
Perioperative Care | Fluid & Electrolytes | Pain Management | Infection
Control | Detailed Rationales | Graded A+ Verified – Pass Guaranteed –
Instant Download
Section 1: Fluid, Electrolyte & Acid-Base Balance
Q1: A patient's morning lab work shows a serum potassium level of 2.9 mEq/L. The
nurse recognizes this finding as indicating:
A. Hyperkalemia
B. Normal potassium balance
C. Hypokalemia [CORRECT]
D. Hypernatremia
Correct Answer: C
Rationale: The best answer is hypokalemia. Normal potassium runs between 3.5 and
5.0 mEq/L, so a level of 2.9 puts your patient at real risk for cardiac dysrhythmias and
muscle weakness. On a busy medical-surgical unit, you'll want to check the patient's
ECG for flattened T waves or U waves and notify the provider right away because this
needs correction.
Q2: The nurse is reviewing a patient's electrolyte panel and notes a serum sodium level
of 150 mEq/L. This value indicates:
A. Hyponatremia
B. Normal sodium balance
C. Hypernatremia [CORRECT]
D. Hypokalemia
Correct Answer: C
Rationale: The best answer is hypernatremia. Normal sodium falls between 135 and 145
mEq/L, so 150 is elevated. In clinical practice, you'll often see this in patients who are
dehydrated or have had excessive water loss, and your priority is going to be assessing
their fluid status and neurologic function since high sodium can cause confusion and
seizures.
,Q3: When interpreting arterial blood gas results, the nurse recalls that the normal range
for arterial pH is:
A. 7.25–7.30
B. 7.35–7.45 [CORRECT]
C. 7.45–7.55
D. 7.50–7.60
Correct Answer: B
Rationale: The best answer is 7.35 to 7.45. This is the narrow window where our body's
enzymatic processes work best, and anything outside this range means your patient is
either acidotic or alkalotic. When you're looking at ABGs on the unit, always start with
the pH to figure out which direction your patient is heading.
Q4: The normal range for serum bicarbonate (HCO3-) in an adult is:
A. 18–22 mEq/L
B. 22–26 mEq/L [CORRECT]
C. 28–32 mEq/L
D. 35–45 mEq/L
Correct Answer: B
Rationale: The best answer is 22 to 26 mEq/L. Bicarbonate is our metabolic buffer, and
when you see it outside this range on an ABG, it tells you whether the kidneys are trying
to compensate for a respiratory problem or if there's a primary metabolic issue going
on.
Q5: A patient's ABG report shows a PaCO2 of 48 mmHg. The nurse understands that the
normal PaCO2 range is:
A. 20–30 mmHg
B. 30–35 mmHg
C. 35–45 mmHg [CORRECT]
D. 45–55 mmHg
Correct Answer: C
Rationale: The best answer is 35 to 45 mmHg. PaCO2 reflects how well the lungs are
ventilating and blowing off carbon dioxide, so a level of 48 tells you there's some
retention happening. This is where you look at the patient's respiratory effort and
whether they need some assistance clearing that CO2.
, Q6: A patient with a history of prolonged diarrhea is admitted with muscle weakness
and complaints of palpitations. The ECG shows flattened T waves and the presence of
U waves. The nurse suspects:
A. Hyperkalemia
B. Hypokalemia [CORRECT]
C. Hypernatremia
D. Hyponatremia
Correct Answer: B
Rationale: The best answer is hypokalemia. When you see flattened T waves and U
waves on an ECG, that's classic for low potassium, and prolonged diarrhea is a common
cause because of GI losses. In the real world, you'd also be checking for muscle
weakness and making sure the patient isn't on any potassium-wasting diuretics that
could make this worse.
Q7: A patient with end-stage renal disease presents with peaked T waves on the ECG,
widened QRS complexes, and reports of tingling in the extremities. Which intervention is
the nurse's priority?
A. Administer potassium chloride IV push
B. Prepare to administer calcium gluconate and notify the provider [CORRECT]
C. Increase oral potassium intake
D. Administer sodium polystyrene sulfonate orally only
Correct Answer: B
Rationale: The best answer is to prepare calcium gluconate and notify the provider.
Peaked T waves and widened QRS are warning signs of severe hyperkalemia that can
progress to cardiac arrest, and calcium gluconate stabilizes the cardiac membrane. On
a medical-surgical floor, you never give potassium IV push—that's a dangerous
error—and while kayexalate has its place, the immediate threat to the heart takes
priority.
Q8: A patient admitted with heart failure is receiving diuretic therapy. The nurse notes
the patient is confused, has a headache, and reports nausea. The morning lab shows a
sodium level of 128 mEq/L. These findings are consistent with:
A. Hypernatremia
B. Hyponatremia [CORRECT]
C. Hyperkalemia
