NUR 265
Advanced Medical-Surgical Nursing Exam 2
Exam 2 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Exam 2 2026/2027 UPDATE – Galen
1. A patient with a traumatic brain injury presents with a blood pressure of 190/60 mmHg, a
heart rate of 48 beats/min, and irregular respirations. Which intervention is the priority?
A. Administering IV Mannitol as ordered
B. Preparing for immediate intubation and mechanical ventilation
C. Administering a rapid bolus of isotonic saline
D. Increasing the room temperature to prevent shivering
Answer: A
Rationale: The symptoms describe Cushing’s Triad (widening pulse pressure, bradycardia,
irregular respirations), which indicates increased intracranial pressure (ICP). Mannitol is
an osmotic diuretic used to reduce ICP.
2. Which assessment finding in a patient with acute respiratory distress syndrome (ARDS)
indicates that the condition is worsening despite oxygen therapy?
A. Hypercapnia and respiratory acidosis
B. Increased clear sputum production
C. Refractory hypoxemia
D. Improvement in lung compliance
, Answer: C
Rationale: Refractory hypoxemia, where the arterial oxygen level remains low despite
increasing the fraction of inspired oxygen (FiO2), is a hallmark of ARDS worsening.
3. A patient is admitted with a T6 spinal cord injury. The nurse notes the patient is flushed,
sweating above the level of injury, and has a blood pressure of 210/110 mmHg. What is the
first nursing action?
A. Administer hydralazine intravenously
B. Check for bladder distension or fecal impaction
C. Place the patient in a supine position
D. Elevate the head of the bed to 90 degrees
Answer: D
Rationale: These are signs of autonomic dysreflexia. The priority is to sit the patient
upright to help lower blood pressure via orthostatic effect, then identify and remove the
triggering stimulus.
4. A patient on a mechanical ventilator triggers the high-pressure alarm. Which condition
should the nurse investigate first?
A. A leak in the endotracheal tube cuff
B. Extubation of the patient
C. Disconnection from the ventilator circuit
Advanced Medical-Surgical Nursing Exam 2
Exam 2 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Exam 2 2026/2027 UPDATE – Galen
1. A patient with a traumatic brain injury presents with a blood pressure of 190/60 mmHg, a
heart rate of 48 beats/min, and irregular respirations. Which intervention is the priority?
A. Administering IV Mannitol as ordered
B. Preparing for immediate intubation and mechanical ventilation
C. Administering a rapid bolus of isotonic saline
D. Increasing the room temperature to prevent shivering
Answer: A
Rationale: The symptoms describe Cushing’s Triad (widening pulse pressure, bradycardia,
irregular respirations), which indicates increased intracranial pressure (ICP). Mannitol is
an osmotic diuretic used to reduce ICP.
2. Which assessment finding in a patient with acute respiratory distress syndrome (ARDS)
indicates that the condition is worsening despite oxygen therapy?
A. Hypercapnia and respiratory acidosis
B. Increased clear sputum production
C. Refractory hypoxemia
D. Improvement in lung compliance
, Answer: C
Rationale: Refractory hypoxemia, where the arterial oxygen level remains low despite
increasing the fraction of inspired oxygen (FiO2), is a hallmark of ARDS worsening.
3. A patient is admitted with a T6 spinal cord injury. The nurse notes the patient is flushed,
sweating above the level of injury, and has a blood pressure of 210/110 mmHg. What is the
first nursing action?
A. Administer hydralazine intravenously
B. Check for bladder distension or fecal impaction
C. Place the patient in a supine position
D. Elevate the head of the bed to 90 degrees
Answer: D
Rationale: These are signs of autonomic dysreflexia. The priority is to sit the patient
upright to help lower blood pressure via orthostatic effect, then identify and remove the
triggering stimulus.
4. A patient on a mechanical ventilator triggers the high-pressure alarm. Which condition
should the nurse investigate first?
A. A leak in the endotracheal tube cuff
B. Extubation of the patient
C. Disconnection from the ventilator circuit
