[NUR 265 EXAM 1] – QUESTIONS AND ANSWERS | VERIFIED AND WELL DETAILED ANSWERS | PLUS RATIONALES
| GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
1. Advanced Pathophysiology
2. Advanced Pharmacology
3. Health Assessment and Diagnostic Reasoning
4. Patient Safety and Quality Improvement
5. Legal and Ethical Standards in Nursing
6. Evidence-Based Practice and Research
7. Complex Care Coordination and Interprofessional Collaboration
8. Health Promotion and Disease Prevention
9. Leadership and Management in Nursing
10. Psychosocial and Cultural Competence
Introduction
This comprehensive examination is designed to rigorously assess the knowledge, clinical judgment, and decision-
making skills essential for success in NUR 265. The exam covers a broad spectrum of core domains, including advanced
pathophysiology, pharmacology, and ethical-legal standards, ensuring a holistic evaluation of your nursing acumen.
Through a combination of multiple-choice and scenario-based questions, this assessment challenges you to apply
theoretical concepts to complex, real-world patient care situations. Emphasis is placed on critical thinking,
prioritization, and the ability to synthesize information from various sources to make safe, patient-centered decisions in
a dynamic healthcare environment.
,SECTION ONE: QUESTIONS 1–100
1. A patient with chronic heart failure is prescribed digoxin. Which assessment finding would be most indicative
of digoxin toxicity?
A. Heart rate of 60 bpm
B. Serum potassium level of 4.0 mEq/L
C. Visual disturbances such as halos around lights
D. Ankle edema of +1
🟢C
🔴 Explanation: Visual disturbances, particularly seeing halos or a yellow-green tinge (xanthopsia), are classic and
early signs of digoxin toxicity. A heart rate of 60 bpm is within normal limits, a potassium of 4.0 is normal, and +1
edema is expected in heart failure, not toxicity.
2. A nurse is providing education to a patient with type 2 diabetes who is starting metformin. Which statement
by the patient indicates a need for further teaching?
A. "I will take this medication with my meals to prevent stomach upset."
B. "I should avoid drinking excessive alcohol while on this medication."
C. "I can stop taking this medication once my blood sugar is normal."
D. "I need to let my provider know before having any surgery."
🟢C
🔴 Explanation: Metformin is a chronic medication for diabetes management; it is not meant to be stopped once
blood sugar normalizes because it controls, not cures, the condition. The other statements are correct teaching
points regarding administration, alcohol interaction, and perioperative management.
,3. A nurse is caring for a patient post-operative day 1 following a total knee arthroplasty. Which intervention is
most important to prevent a pulmonary embolism?
A. Administering prescribed subcutaneous heparin
B. Applying sequential compression devices (SCDs) continuously
C. Encouraging the patient to perform ankle pumps and foot exercises
D. Ambulating the patient with a walker three times a day
🟢A
🔴 Explanation: While all options are important in a comprehensive VTE prophylaxis plan, pharmacological
prophylaxis with an anticoagulant like heparin is the most effective single intervention to prevent pulmonary
embolism in this high-risk surgical patient. The other measures are mechanical and supportive but not the primary
defense.
4. A nurse is reviewing a patient's laboratory results and notes a potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change is most consistent with this finding?
A. Prominent U waves
B. Flattened T waves
C. Peaked T waves
D. ST-segment depression
🟢C
🔴 Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia. A classic and early ECG change associated
with hyperkalemia is tall, peaked T waves. Prominent U waves and flattened T waves are associated with
hypokalemia. ST-segment depression can be seen with many electrolyte imbalances but is not the classic sign for
hyperkalemia.
, 5. A patient who is a practicing Jehovah's Witness is admitted with severe gastrointestinal bleeding and a
hemoglobin of 5.0 g/dL. The patient refuses a blood transfusion. What is the nurse's initial best action?
A. Administer the blood transfusion to save the patient's life.
B. Notify the healthcare provider of the patient's refusal.
C. Contact the hospital's ethics committee immediately.
D. Explain the consequences of refusing the transfusion.
🟢B
🔴 Explanation: The nurse's initial action is to notify the healthcare provider of the patient's explicit refusal. This
allows the provider to initiate a discussion, explore alternatives, and respect the patient's autonomous decision while
the clinical team seeks a legally and ethically sound plan of care. Administering the blood against the patient's
wishes is assault and battery.
6. A nurse is assessing a patient's pain using the PQRST method. Which question addresses the "R" in PQRST?
A. "What does the pain feel like?"
B. "What makes the pain worse?"
C. "Where is the pain located?"
D. "What is the severity of the pain on a scale of 0 to 10?"
🟢B
🔴 Explanation: In the PQRST mnemonic for pain assessment, P stands for Provocation/Palliation (what provokes or
makes it better/worse), Q for Quality, R for Region/Radiation, S for Severity, and T for Timing. "What makes the pain
worse?" addresses the provocation/palliation aspect of the assessment, which is the 'P'.
7. A nurse is preparing to administer a high-alert medication. Which safety strategy is most important to prevent
medication errors?
| GUARANTEED PASS | LATEST EXAM UPDATE
Core Domains
1. Advanced Pathophysiology
2. Advanced Pharmacology
3. Health Assessment and Diagnostic Reasoning
4. Patient Safety and Quality Improvement
5. Legal and Ethical Standards in Nursing
6. Evidence-Based Practice and Research
7. Complex Care Coordination and Interprofessional Collaboration
8. Health Promotion and Disease Prevention
9. Leadership and Management in Nursing
10. Psychosocial and Cultural Competence
Introduction
This comprehensive examination is designed to rigorously assess the knowledge, clinical judgment, and decision-
making skills essential for success in NUR 265. The exam covers a broad spectrum of core domains, including advanced
pathophysiology, pharmacology, and ethical-legal standards, ensuring a holistic evaluation of your nursing acumen.
Through a combination of multiple-choice and scenario-based questions, this assessment challenges you to apply
theoretical concepts to complex, real-world patient care situations. Emphasis is placed on critical thinking,
prioritization, and the ability to synthesize information from various sources to make safe, patient-centered decisions in
a dynamic healthcare environment.
,SECTION ONE: QUESTIONS 1–100
1. A patient with chronic heart failure is prescribed digoxin. Which assessment finding would be most indicative
of digoxin toxicity?
A. Heart rate of 60 bpm
B. Serum potassium level of 4.0 mEq/L
C. Visual disturbances such as halos around lights
D. Ankle edema of +1
🟢C
🔴 Explanation: Visual disturbances, particularly seeing halos or a yellow-green tinge (xanthopsia), are classic and
early signs of digoxin toxicity. A heart rate of 60 bpm is within normal limits, a potassium of 4.0 is normal, and +1
edema is expected in heart failure, not toxicity.
2. A nurse is providing education to a patient with type 2 diabetes who is starting metformin. Which statement
by the patient indicates a need for further teaching?
A. "I will take this medication with my meals to prevent stomach upset."
B. "I should avoid drinking excessive alcohol while on this medication."
C. "I can stop taking this medication once my blood sugar is normal."
D. "I need to let my provider know before having any surgery."
🟢C
🔴 Explanation: Metformin is a chronic medication for diabetes management; it is not meant to be stopped once
blood sugar normalizes because it controls, not cures, the condition. The other statements are correct teaching
points regarding administration, alcohol interaction, and perioperative management.
,3. A nurse is caring for a patient post-operative day 1 following a total knee arthroplasty. Which intervention is
most important to prevent a pulmonary embolism?
A. Administering prescribed subcutaneous heparin
B. Applying sequential compression devices (SCDs) continuously
C. Encouraging the patient to perform ankle pumps and foot exercises
D. Ambulating the patient with a walker three times a day
🟢A
🔴 Explanation: While all options are important in a comprehensive VTE prophylaxis plan, pharmacological
prophylaxis with an anticoagulant like heparin is the most effective single intervention to prevent pulmonary
embolism in this high-risk surgical patient. The other measures are mechanical and supportive but not the primary
defense.
4. A nurse is reviewing a patient's laboratory results and notes a potassium level of 6.2 mEq/L. Which
electrocardiogram (ECG) change is most consistent with this finding?
A. Prominent U waves
B. Flattened T waves
C. Peaked T waves
D. ST-segment depression
🟢C
🔴 Explanation: A potassium level of 6.2 mEq/L indicates hyperkalemia. A classic and early ECG change associated
with hyperkalemia is tall, peaked T waves. Prominent U waves and flattened T waves are associated with
hypokalemia. ST-segment depression can be seen with many electrolyte imbalances but is not the classic sign for
hyperkalemia.
, 5. A patient who is a practicing Jehovah's Witness is admitted with severe gastrointestinal bleeding and a
hemoglobin of 5.0 g/dL. The patient refuses a blood transfusion. What is the nurse's initial best action?
A. Administer the blood transfusion to save the patient's life.
B. Notify the healthcare provider of the patient's refusal.
C. Contact the hospital's ethics committee immediately.
D. Explain the consequences of refusing the transfusion.
🟢B
🔴 Explanation: The nurse's initial action is to notify the healthcare provider of the patient's explicit refusal. This
allows the provider to initiate a discussion, explore alternatives, and respect the patient's autonomous decision while
the clinical team seeks a legally and ethically sound plan of care. Administering the blood against the patient's
wishes is assault and battery.
6. A nurse is assessing a patient's pain using the PQRST method. Which question addresses the "R" in PQRST?
A. "What does the pain feel like?"
B. "What makes the pain worse?"
C. "Where is the pain located?"
D. "What is the severity of the pain on a scale of 0 to 10?"
🟢B
🔴 Explanation: In the PQRST mnemonic for pain assessment, P stands for Provocation/Palliation (what provokes or
makes it better/worse), Q for Quality, R for Region/Radiation, S for Severity, and T for Timing. "What makes the pain
worse?" addresses the provocation/palliation aspect of the assessment, which is the 'P'.
7. A nurse is preparing to administer a high-alert medication. Which safety strategy is most important to prevent
medication errors?
