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NUR 265 EXAM 2 — 2026/2027 COMPLETE (100) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NUR
Prepare for the NUR 265 Exam 2 – Galen College with a focused study resource
designed to reinforce high-priority medical-surgical nursing concepts. It supports
review of neurological disorders, burns and shock, complex patient assessment,
emergency interventions, prioritization, and evidence-based nursing care. Use the
material to strengthen clinical reasoning, reinforce key concepts, and identify areas
that may require additional review before the exam. This resource is best suited for
Galen College of Nursing NUR 265 students preparing for Exam 3 and reviewing
advanced medical-surgical nursing concepts.
MULTIPLE CHOICE.
SECTION 1: TRANSFUSION REACTIONS (Questions 1-10)
1. A client is receiving a blood transfusion. Fifteen minutes after the
transfusion begins, the client reports chills, low back pain, and shortness
of breath. Which action should the nurse take first?
a) Slow the transfusion rate
b) Stop the transfusion immediately
c) Administer acetaminophen for chills
d) Notify the healthcare provider
Answer: b) Stop the transfusion immediately
Rationale: Chills, low back pain, and shortness of breath are signs of an
acute hemolytic transfusion reaction, a life-threatening emergency. The
priority is to stop the transfusion immediately, maintain IV access with normal
saline, and then notify the provider.
2. A client receiving a blood transfusion develops a fever and chills but no
other symptoms. The nurse should suspect which type of transfusion
reaction?
a) Hemolytic reaction
b) Febrile non-hemolytic reaction
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c) Allergic reaction
d) Transfusion-associated circulatory overload (TACO)
Answer: b) Febrile non-hemolytic reaction
Rationale: Febrile non-hemolytic reactions are characterized by fever and
chills without other symptoms. They are caused by antibodies to donor
leukocytes and are the most common type of transfusion reaction.
3. A client develops urticaria (hives) and itching during a blood
transfusion. The nurse should:
a) Stop the transfusion and notify the provider
b) Slow the transfusion rate and administer diphenhydramine
c) Continue the transfusion and monitor closely
d) Stop the transfusion and start a new unit
Answer: b) Slow the transfusion rate and administer diphenhydramine
Rationale: Urticaria and itching indicate a mild allergic reaction. The nurse
should slow the transfusion rate and administer diphenhydramine as
prescribed. If symptoms worsen, the transfusion should be stopped.
4. A client receiving a blood transfusion develops crackles in the lungs,
dyspnea, and hypertension. The nurse should suspect:
a) Hemolytic reaction
b) Febrile non-hemolytic reaction
c) Transfusion-associated circulatory overload (TACO)
d) Anaphylactic reaction
Answer: c) Transfusion-associated circulatory overload (TACO)
Rationale: TACO is caused by rapid administration of blood products, leading
to fluid overload. Symptoms include crackles, dyspnea, hypertension, and
tachycardia. Treatment includes slowing the infusion, elevating the head of
the bed, and administering diuretics.
5. A client with a history of IgA deficiency develops anaphylaxis during a
blood transfusion. Which type of transfusion reaction is this?
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a) Hemolytic reaction
b) Febrile non-hemolytic reaction
c) Allergic reaction (severe)
d) TACO
Answer: c) Allergic reaction (severe)
Rationale: Clients with IgA deficiency can develop severe anaphylactic
reactions to blood products containing IgA. Symptoms include hypotension,
bronchospasm, and respiratory distress. Treatment includes epinephrine and
stopping the transfusion.
6. The nurse is preparing to administer a blood transfusion. Which action
is most important to prevent a transfusion reaction?
a) Verify the client's identity and blood product with another nurse
b) Check the client's blood type
c) Administer the transfusion rapidly
d) Pre-medicate the client with diphenhydramine
Answer: a) Verify the client's identity and blood product with another
nurse
Rationale: Verification of the client's identity and blood product with another
nurse is the most important step to prevent transfusion reactions. Two
licensed nurses should check the client's identification, the blood product
label, and compatibility.
7. A client develops acute hemolytic transfusion reaction. Which
laboratory finding is expected?
a) Decreased hemoglobin
b) Elevated hemoglobin
c) Decreased potassium
d) Elevated bilirubin
Answer: d) Elevated bilirubin
Rationale: In an acute hemolytic transfusion reaction, RBCs are destroyed,
releasing hemoglobin and bilirubin. Elevated bilirubin, hemoglobinuria, and
elevated potassium are expected findings. Acute kidney injury may also occur.
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8. A client receiving a blood transfusion develops a temperature of 101.5°F
(38.6°C), hypotension, and hemoglobinuria. The nurse should:
a) Stop the transfusion and administer antipyretics
b) Stop the transfusion and notify the provider
c) Slow the transfusion and monitor vital signs
d) Continue the transfusion and document findings
Answer: b) Stop the transfusion and notify the provider
Rationale: Fever, hypotension, and hemoglobinuria indicate an acute
hemolytic transfusion reaction. The transfusion should be stopped
immediately and the provider notified. The blood bag and tubing should be
saved for analysis.
9. A client is receiving a blood transfusion. The nurse notes that the
client's urine is dark and tea-colored. This finding is most consistent with:
a) TACO
b) Hemolytic reaction
c) Febrile non-hemolytic reaction
d) Allergic reaction
Answer: b) Hemolytic reaction
Rationale: Dark, tea-colored urine (hemoglobinuria) is a classic sign of
hemolysis, indicating a hemolytic transfusion reaction. The transfusion
should be stopped immediately.
10. A client is receiving a blood transfusion. The nurse should monitor the
client for which early signs of a transfusion reaction?
a) Hypertension and bradycardia
b) Flushing and low back pain
c) Hypothermia and bradypnea
d) Increased urine output
Answer: b) Flushing and low back pain
Rationale: Flushing, low back pain, chills, and fever are early signs of a
NUR 265 EXAM 2 — 2026/2027 COMPLETE (100) CURRENT
TESTING QUESTIONS AND CORRECT ANSWERS WITH
DETAILED RATIONALES.
NUR
Prepare for the NUR 265 Exam 2 – Galen College with a focused study resource
designed to reinforce high-priority medical-surgical nursing concepts. It supports
review of neurological disorders, burns and shock, complex patient assessment,
emergency interventions, prioritization, and evidence-based nursing care. Use the
material to strengthen clinical reasoning, reinforce key concepts, and identify areas
that may require additional review before the exam. This resource is best suited for
Galen College of Nursing NUR 265 students preparing for Exam 3 and reviewing
advanced medical-surgical nursing concepts.
MULTIPLE CHOICE.
SECTION 1: TRANSFUSION REACTIONS (Questions 1-10)
1. A client is receiving a blood transfusion. Fifteen minutes after the
transfusion begins, the client reports chills, low back pain, and shortness
of breath. Which action should the nurse take first?
a) Slow the transfusion rate
b) Stop the transfusion immediately
c) Administer acetaminophen for chills
d) Notify the healthcare provider
Answer: b) Stop the transfusion immediately
Rationale: Chills, low back pain, and shortness of breath are signs of an
acute hemolytic transfusion reaction, a life-threatening emergency. The
priority is to stop the transfusion immediately, maintain IV access with normal
saline, and then notify the provider.
2. A client receiving a blood transfusion develops a fever and chills but no
other symptoms. The nurse should suspect which type of transfusion
reaction?
a) Hemolytic reaction
b) Febrile non-hemolytic reaction
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c) Allergic reaction
d) Transfusion-associated circulatory overload (TACO)
Answer: b) Febrile non-hemolytic reaction
Rationale: Febrile non-hemolytic reactions are characterized by fever and
chills without other symptoms. They are caused by antibodies to donor
leukocytes and are the most common type of transfusion reaction.
3. A client develops urticaria (hives) and itching during a blood
transfusion. The nurse should:
a) Stop the transfusion and notify the provider
b) Slow the transfusion rate and administer diphenhydramine
c) Continue the transfusion and monitor closely
d) Stop the transfusion and start a new unit
Answer: b) Slow the transfusion rate and administer diphenhydramine
Rationale: Urticaria and itching indicate a mild allergic reaction. The nurse
should slow the transfusion rate and administer diphenhydramine as
prescribed. If symptoms worsen, the transfusion should be stopped.
4. A client receiving a blood transfusion develops crackles in the lungs,
dyspnea, and hypertension. The nurse should suspect:
a) Hemolytic reaction
b) Febrile non-hemolytic reaction
c) Transfusion-associated circulatory overload (TACO)
d) Anaphylactic reaction
Answer: c) Transfusion-associated circulatory overload (TACO)
Rationale: TACO is caused by rapid administration of blood products, leading
to fluid overload. Symptoms include crackles, dyspnea, hypertension, and
tachycardia. Treatment includes slowing the infusion, elevating the head of
the bed, and administering diuretics.
5. A client with a history of IgA deficiency develops anaphylaxis during a
blood transfusion. Which type of transfusion reaction is this?
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a) Hemolytic reaction
b) Febrile non-hemolytic reaction
c) Allergic reaction (severe)
d) TACO
Answer: c) Allergic reaction (severe)
Rationale: Clients with IgA deficiency can develop severe anaphylactic
reactions to blood products containing IgA. Symptoms include hypotension,
bronchospasm, and respiratory distress. Treatment includes epinephrine and
stopping the transfusion.
6. The nurse is preparing to administer a blood transfusion. Which action
is most important to prevent a transfusion reaction?
a) Verify the client's identity and blood product with another nurse
b) Check the client's blood type
c) Administer the transfusion rapidly
d) Pre-medicate the client with diphenhydramine
Answer: a) Verify the client's identity and blood product with another
nurse
Rationale: Verification of the client's identity and blood product with another
nurse is the most important step to prevent transfusion reactions. Two
licensed nurses should check the client's identification, the blood product
label, and compatibility.
7. A client develops acute hemolytic transfusion reaction. Which
laboratory finding is expected?
a) Decreased hemoglobin
b) Elevated hemoglobin
c) Decreased potassium
d) Elevated bilirubin
Answer: d) Elevated bilirubin
Rationale: In an acute hemolytic transfusion reaction, RBCs are destroyed,
releasing hemoglobin and bilirubin. Elevated bilirubin, hemoglobinuria, and
elevated potassium are expected findings. Acute kidney injury may also occur.
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8. A client receiving a blood transfusion develops a temperature of 101.5°F
(38.6°C), hypotension, and hemoglobinuria. The nurse should:
a) Stop the transfusion and administer antipyretics
b) Stop the transfusion and notify the provider
c) Slow the transfusion and monitor vital signs
d) Continue the transfusion and document findings
Answer: b) Stop the transfusion and notify the provider
Rationale: Fever, hypotension, and hemoglobinuria indicate an acute
hemolytic transfusion reaction. The transfusion should be stopped
immediately and the provider notified. The blood bag and tubing should be
saved for analysis.
9. A client is receiving a blood transfusion. The nurse notes that the
client's urine is dark and tea-colored. This finding is most consistent with:
a) TACO
b) Hemolytic reaction
c) Febrile non-hemolytic reaction
d) Allergic reaction
Answer: b) Hemolytic reaction
Rationale: Dark, tea-colored urine (hemoglobinuria) is a classic sign of
hemolysis, indicating a hemolytic transfusion reaction. The transfusion
should be stopped immediately.
10. A client is receiving a blood transfusion. The nurse should monitor the
client for which early signs of a transfusion reaction?
a) Hypertension and bradycardia
b) Flushing and low back pain
c) Hypothermia and bradypnea
d) Increased urine output
Answer: b) Flushing and low back pain
Rationale: Flushing, low back pain, chills, and fever are early signs of a
