NUR 265
Advanced Medical-Surgical Nursing Final
Examination
Final Exam • Comprehensive Study Guide
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 Final Examination 2026/2027 UPDATE- Galen
1. A patient with ARDS is being ventilated with high levels of PEEP. Which assessment finding
should the nurse prioritize as a potential complication of this setting?
A. Increased cardiac output
B. Improved renal perfusion
C. Subcutaneous emphysema and decreased breath sounds
D. Decreased intracranial pressure
Answer: C
Rationale: High PEEP levels increase the risk of barotrauma, which can lead to
pneumothorax, manifested by subcutaneous emphysema and decreased breath sounds.
2. Which hemodynamic profile is most characteristic of early septic shock?
A. Decreased SVR, increased CO, decreased CVP
B. Increased SVR, decreased CO, increased CVP
C. Increased SVR, increased CO, increased PAWP
D. Decreased SVR, decreased CO, increased PAWP
Answer: A
, Rationale: Early (hyperdynamic) septic shock involves massive vasodilation (low SVR)
and a compensatory increase in cardiac output, with low filling pressures due to capillary
leak.
3. A patient is admitted with a T4 spinal cord injury. The nurse notes a BP of 210/110,
bradycardia, and a severe headache. What is the priority nursing action?
A. Place the patient in a high-Fowler’s position
B. Perform a digital rectal exam to check for impaction
C. Administer a prescribed beta-blocker
D. Check the urinary catheter for kinks
Answer: A
Rationale: These are signs of autonomic dysreflexia. The immediate first action is to sit the
patient up (high-Fowler’s) to lower blood pressure via orthostatic effect before identifying
the noxious stimulus.
4. In the management of Hyperosmolar Hyperglycemic State (HHS), which intervention is the
primary focus of initial treatment?
A. Intravenous insulin bolus followed by a drip
B. Aggressive fluid resuscitation with Normal Saline
C. Potassium replacement regardless of serum levels
D. Administration of sodium bicarbonate for acidosis
Advanced Medical-Surgical Nursing Final
Examination
Final Exam • Comprehensive Study Guide
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 Final Examination 2026/2027 UPDATE- Galen
1. A patient with ARDS is being ventilated with high levels of PEEP. Which assessment finding
should the nurse prioritize as a potential complication of this setting?
A. Increased cardiac output
B. Improved renal perfusion
C. Subcutaneous emphysema and decreased breath sounds
D. Decreased intracranial pressure
Answer: C
Rationale: High PEEP levels increase the risk of barotrauma, which can lead to
pneumothorax, manifested by subcutaneous emphysema and decreased breath sounds.
2. Which hemodynamic profile is most characteristic of early septic shock?
A. Decreased SVR, increased CO, decreased CVP
B. Increased SVR, decreased CO, increased CVP
C. Increased SVR, increased CO, increased PAWP
D. Decreased SVR, decreased CO, increased PAWP
Answer: A
, Rationale: Early (hyperdynamic) septic shock involves massive vasodilation (low SVR)
and a compensatory increase in cardiac output, with low filling pressures due to capillary
leak.
3. A patient is admitted with a T4 spinal cord injury. The nurse notes a BP of 210/110,
bradycardia, and a severe headache. What is the priority nursing action?
A. Place the patient in a high-Fowler’s position
B. Perform a digital rectal exam to check for impaction
C. Administer a prescribed beta-blocker
D. Check the urinary catheter for kinks
Answer: A
Rationale: These are signs of autonomic dysreflexia. The immediate first action is to sit the
patient up (high-Fowler’s) to lower blood pressure via orthostatic effect before identifying
the noxious stimulus.
4. In the management of Hyperosmolar Hyperglycemic State (HHS), which intervention is the
primary focus of initial treatment?
A. Intravenous insulin bolus followed by a drip
B. Aggressive fluid resuscitation with Normal Saline
C. Potassium replacement regardless of serum levels
D. Administration of sodium bicarbonate for acidosis
