NUR 265
Exam 1 Advanced
Medical-Surgical Nursing Practice Test
Exam 1 • 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 Exam 1 Advanced Medical-Surgical Nursing Practice Test 2026/2027 UPDATE –
GALEN
1. A patient with ARDS is being mechanically 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. Subcutaneous emphysema and decreased breath sounds
C. Improved oxygen saturation
D. Increased urinary output
Answer: B
Rationale: High PEEP levels increase intrathoracic pressure, which can cause barotrauma
(pneumothorax or subcutaneous emphysema) and decrease venous return, leading to
hypotension, not increased cardiac output.
2. A patient’s ABG results are: pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Uncompensated Respiratory Acidosis
B. Compensated Respiratory Alkalosis
C. Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
, Answer: A
Rationale: The pH is low (<7.35) indicating acidosis. The PaCO2 is high (>45) matching the
pH (Respiratory). The HCO3 is normal, meaning no compensation has occurred yet.
3. Which clinical manifestation is a hallmark sign of the ‘progressive stage’ of shock?
A. Cold, clammy skin and mottled extremities
B. Metabolic alkalosis
C. Increased bowel sounds
D. Increased urinary output
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail. Perfusion to the
periphery decreases significantly, resulting in cold, mottled skin and organ dysfunction.
4. The nurse is caring for a patient on a ventilator. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Auscultate for a pneumothorax
C. Suction the patient’s airway
D. Silence the alarm and observe
Answer: C
Exam 1 Advanced
Medical-Surgical Nursing Practice Test
Exam 1 • 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 Exam 1 Advanced Medical-Surgical Nursing Practice Test 2026/2027 UPDATE –
GALEN
1. A patient with ARDS is being mechanically 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. Subcutaneous emphysema and decreased breath sounds
C. Improved oxygen saturation
D. Increased urinary output
Answer: B
Rationale: High PEEP levels increase intrathoracic pressure, which can cause barotrauma
(pneumothorax or subcutaneous emphysema) and decrease venous return, leading to
hypotension, not increased cardiac output.
2. A patient’s ABG results are: pH 7.28, PaCO2 50 mmHg, and HCO3 24 mEq/L. How should
the nurse interpret these results?
A. Uncompensated Respiratory Acidosis
B. Compensated Respiratory Alkalosis
C. Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
, Answer: A
Rationale: The pH is low (<7.35) indicating acidosis. The PaCO2 is high (>45) matching the
pH (Respiratory). The HCO3 is normal, meaning no compensation has occurred yet.
3. Which clinical manifestation is a hallmark sign of the ‘progressive stage’ of shock?
A. Cold, clammy skin and mottled extremities
B. Metabolic alkalosis
C. Increased bowel sounds
D. Increased urinary output
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail. Perfusion to the
periphery decreases significantly, resulting in cold, mottled skin and organ dysfunction.
4. The nurse is caring for a patient on a ventilator. The high-pressure alarm sounds. Which
action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Auscultate for a pneumothorax
C. Suction the patient’s airway
D. Silence the alarm and observe
Answer: C
