NUR 265 Exam 1 Practice 2026/2027 Galen College of
Nursing Medical-Surgical Nursing Comprehensive
Questions and Answers with Verified Solutions &
Expert Rationales
QUESTION 1
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the
physician with which treatment?
A) Administer lidocaine, 75 mg intravenous push
B) Perform synchronized cardioversion
C) Defibrillate the client as soon as possible
D) Administer atropine, 0.4 mg intravenous push
Correct Answer: B) Perform synchronized cardioversion
Expert Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm.
Lidocaine (Option A) is used for ventricular dysrhythmias. Defibrillation (Option C) is
reserved for life-threatening rhythms such as ventricular fibrillation and unstable
ventricular tachycardia. Atropine (Option D) is the drug of choice for symptomatic sinus
bradycardia, not atrial fibrillation.
QUESTION 2
The RN is coming on duty after report. Which patient should the RN see first?
A) Patient with anxiety, nausea, diaphoresis, and shortness of breath
B) Postoperative patient with controlled pain
C) Patient ready for discharge teaching
D) Patient with mild headache
,Correct Answer: A) Patient with anxiety, nausea, diaphoresis, and shortness of
breath
Expert Rationale: These symptoms are classic signs of an acute myocardial infarction
(MI) or cardiac event requiring immediate assessment and intervention to prevent
morbidity and mortality. This patient is exhibiting signs of acute coronary syndrome and
requires immediate evaluation and treatment .
QUESTION 3
The ED RN is assessing an 86-year-old patient with acute confusion, increased
respiratory rate (36 bpm), angina, crackles, and wheezing on auscultation. The RN
interprets this as:
A) Right-sided heart failure
B) Left-sided heart failure
C) COPD exacerbation
D) Pulmonary embolism
Correct Answer: B) Left-sided heart failure
Expert Rationale: Crackles, wheezing, tachypnea, and angina in addition to confusion
reflect pulmonary congestion and hypoxia due to left-sided heart failure, which impairs
forward cardiac output and pulmonary function. Right-sided heart failure would present
with peripheral edema and jugular venous distention. COPD exacerbation would not
typically present with the acute confusion and angina described .
QUESTION 4
A nurse is caring for a client with left-sided heart failure. Which assessment
finding is most concerning?
A) Peripheral edema
B) Crackles in bilateral lung bases
, C) Jugular vein distention
D) Weight gain of 1 lb in 24 hours
Correct Answer: B) Crackles in bilateral lung bases
Expert Rationale: Crackles indicate pulmonary congestion from fluid backing up into
the lungs, which is a hallmark of left-sided heart failure and requires prompt
intervention. Peripheral edema (A) and jugular vein distention (C) are signs of right-
sided heart failure. Weight gain of 1 lb in 24 hours (D) is concerning but does not
indicate immediate pulmonary compromise .
QUESTION 5
Following a CABG, the patient has a body temperature of 95.8°F. What measure
should be used to rewarm the patient?
A) Administer IV fluids at room temperature
B) Use thermal blankets
C) Provide a warm bath
D) Increase room temperature only
Correct Answer: B) Use thermal blankets
Expert Rationale: Hypothermia post-cardiac surgery is common and thermal blankets
provide controlled external warming, which is safer and more effective than other
methods. This helps prevent complications such as coagulopathy and cardiac
arrhythmias. IV fluids at room temperature (A) are not sufficient for rewarming. Warm
baths (C) pose safety risks. Increasing room temperature (D) alone is insufficient .
QUESTION 6
The nurse is caring for a client who had a heart transplant 24 hours ago. Which
finding indicates the client is developing a complication?
A) Hypotension
B) Bradycardia
Nursing Medical-Surgical Nursing Comprehensive
Questions and Answers with Verified Solutions &
Expert Rationales
QUESTION 1
A client on telemetry has a pattern of uncontrolled atrial fibrillation with a rapid
ventricular response. Based on this finding, the nurse anticipates assisting the
physician with which treatment?
A) Administer lidocaine, 75 mg intravenous push
B) Perform synchronized cardioversion
C) Defibrillate the client as soon as possible
D) Administer atropine, 0.4 mg intravenous push
Correct Answer: B) Perform synchronized cardioversion
Expert Rationale: With uncontrolled atrial fibrillation, the treatment of choice is
synchronized cardioversion to convert the cardiac rhythm back to normal sinus rhythm.
Lidocaine (Option A) is used for ventricular dysrhythmias. Defibrillation (Option C) is
reserved for life-threatening rhythms such as ventricular fibrillation and unstable
ventricular tachycardia. Atropine (Option D) is the drug of choice for symptomatic sinus
bradycardia, not atrial fibrillation.
QUESTION 2
The RN is coming on duty after report. Which patient should the RN see first?
A) Patient with anxiety, nausea, diaphoresis, and shortness of breath
B) Postoperative patient with controlled pain
C) Patient ready for discharge teaching
D) Patient with mild headache
,Correct Answer: A) Patient with anxiety, nausea, diaphoresis, and shortness of
breath
Expert Rationale: These symptoms are classic signs of an acute myocardial infarction
(MI) or cardiac event requiring immediate assessment and intervention to prevent
morbidity and mortality. This patient is exhibiting signs of acute coronary syndrome and
requires immediate evaluation and treatment .
QUESTION 3
The ED RN is assessing an 86-year-old patient with acute confusion, increased
respiratory rate (36 bpm), angina, crackles, and wheezing on auscultation. The RN
interprets this as:
A) Right-sided heart failure
B) Left-sided heart failure
C) COPD exacerbation
D) Pulmonary embolism
Correct Answer: B) Left-sided heart failure
Expert Rationale: Crackles, wheezing, tachypnea, and angina in addition to confusion
reflect pulmonary congestion and hypoxia due to left-sided heart failure, which impairs
forward cardiac output and pulmonary function. Right-sided heart failure would present
with peripheral edema and jugular venous distention. COPD exacerbation would not
typically present with the acute confusion and angina described .
QUESTION 4
A nurse is caring for a client with left-sided heart failure. Which assessment
finding is most concerning?
A) Peripheral edema
B) Crackles in bilateral lung bases
, C) Jugular vein distention
D) Weight gain of 1 lb in 24 hours
Correct Answer: B) Crackles in bilateral lung bases
Expert Rationale: Crackles indicate pulmonary congestion from fluid backing up into
the lungs, which is a hallmark of left-sided heart failure and requires prompt
intervention. Peripheral edema (A) and jugular vein distention (C) are signs of right-
sided heart failure. Weight gain of 1 lb in 24 hours (D) is concerning but does not
indicate immediate pulmonary compromise .
QUESTION 5
Following a CABG, the patient has a body temperature of 95.8°F. What measure
should be used to rewarm the patient?
A) Administer IV fluids at room temperature
B) Use thermal blankets
C) Provide a warm bath
D) Increase room temperature only
Correct Answer: B) Use thermal blankets
Expert Rationale: Hypothermia post-cardiac surgery is common and thermal blankets
provide controlled external warming, which is safer and more effective than other
methods. This helps prevent complications such as coagulopathy and cardiac
arrhythmias. IV fluids at room temperature (A) are not sufficient for rewarming. Warm
baths (C) pose safety risks. Increasing room temperature (D) alone is insufficient .
QUESTION 6
The nurse is caring for a client who had a heart transplant 24 hours ago. Which
finding indicates the client is developing a complication?
A) Hypotension
B) Bradycardia
