NUR 265 ADVANCED MEDICAL-
SURGICAL NURSING EXAM 2
QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT - GALEN
COLLEGE OF NURSING.
1. A patient with heart failure is receiving digoxin. Which laboratory result would most
concern the nurse regarding potential toxicity?
A. Sodium 138 mEq/L
B. Magnesium 2.0 mEq/L
C. Calcium 9.2 mg/dL
D. Potassium 3.1 mEq/L
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
potassium and digoxin compete for the same binding sites on the Na+/K+ ATPase pump.
2. Which initial intervention should the nurse perform for a patient experiencing ventricular
fibrillation?
A. Administer 1 mg of epinephrine IV push
B. Perform immediate synchronized cardioversion
,C. Initiate high-quality CPR and prepare for defibrillation
D. Administer a 300 mg bolus of amiodarone
Answer: C
Conceptual Explanation: Ventricular fibrillation is a pulseless, non-perfusing rhythm.
Immediate CPR followed by unsynchronized defibrillation is the gold standard of care.
3. A patient in the ICU is on a mechanical ventilator with a PEEP of 15 cm H2O. Which
complication is the patient at highest risk for?
A. Increased cardiac output
B. Metabolic Alkalosis
C. Hypervolemia
D. Pneumothorax
Answer: D
Conceptual Explanation: High levels of PEEP (Positive End-Expiratory Pressure) increase
the risk of barotrauma, which can lead to a pneumothorax.
4. What is the hallmark clinical manifestation of the ‘exudative’ phase of Acute Respiratory
Distress Syndrome (ARDS)?
A. Development of fibrotic lung tissue
B. Hypercapnia due to alveolar collapse
C. Refractory hypoxemia despite oxygen therapy
, D. Decreased pulmonary capillary permeability
Answer: C
Conceptual Explanation: Refractory hypoxemia, where arterial oxygen levels do not
increase with supplemental oxygen, is a classic sign of ARDS caused by shunting.
5. The nurse is caring for a patient in hypovolemic shock. Which hemodynamic finding is
expected?
A. Decreased Systemic Vascular Resistance (SVR)
B. Increased Central Venous Pressure (CVP)
C. Increased Pulmonary Artery Wedge Pressure (PAWP)
D. Decreased Cardiac Output (CO)
Answer: D
Conceptual Explanation: In hypovolemic shock, there is a lack of volume, leading to
decreased preload and a subsequent decrease in cardiac output.
6. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg.
Which position is most appropriate for this patient?
A. Trendelenburg position
B. Head of bed elevated 30-45 degrees, neck midline
C. Supine with legs elevated
D. Side-lying with knees flexed
SURGICAL NURSING EXAM 2
QUESTIONS AND ANSWERS | 2026
UPDATE | 100% CORRECT - GALEN
COLLEGE OF NURSING.
1. A patient with heart failure is receiving digoxin. Which laboratory result would most
concern the nurse regarding potential toxicity?
A. Sodium 138 mEq/L
B. Magnesium 2.0 mEq/L
C. Calcium 9.2 mg/dL
D. Potassium 3.1 mEq/L
Answer: D
Conceptual Explanation: Hypokalemia increases the risk of digoxin toxicity because
potassium and digoxin compete for the same binding sites on the Na+/K+ ATPase pump.
2. Which initial intervention should the nurse perform for a patient experiencing ventricular
fibrillation?
A. Administer 1 mg of epinephrine IV push
B. Perform immediate synchronized cardioversion
,C. Initiate high-quality CPR and prepare for defibrillation
D. Administer a 300 mg bolus of amiodarone
Answer: C
Conceptual Explanation: Ventricular fibrillation is a pulseless, non-perfusing rhythm.
Immediate CPR followed by unsynchronized defibrillation is the gold standard of care.
3. A patient in the ICU is on a mechanical ventilator with a PEEP of 15 cm H2O. Which
complication is the patient at highest risk for?
A. Increased cardiac output
B. Metabolic Alkalosis
C. Hypervolemia
D. Pneumothorax
Answer: D
Conceptual Explanation: High levels of PEEP (Positive End-Expiratory Pressure) increase
the risk of barotrauma, which can lead to a pneumothorax.
4. What is the hallmark clinical manifestation of the ‘exudative’ phase of Acute Respiratory
Distress Syndrome (ARDS)?
A. Development of fibrotic lung tissue
B. Hypercapnia due to alveolar collapse
C. Refractory hypoxemia despite oxygen therapy
, D. Decreased pulmonary capillary permeability
Answer: C
Conceptual Explanation: Refractory hypoxemia, where arterial oxygen levels do not
increase with supplemental oxygen, is a classic sign of ARDS caused by shunting.
5. The nurse is caring for a patient in hypovolemic shock. Which hemodynamic finding is
expected?
A. Decreased Systemic Vascular Resistance (SVR)
B. Increased Central Venous Pressure (CVP)
C. Increased Pulmonary Artery Wedge Pressure (PAWP)
D. Decreased Cardiac Output (CO)
Answer: D
Conceptual Explanation: In hypovolemic shock, there is a lack of volume, leading to
decreased preload and a subsequent decrease in cardiac output.
6. A patient with a traumatic brain injury has an intracranial pressure (ICP) of 22 mmHg.
Which position is most appropriate for this patient?
A. Trendelenburg position
B. Head of bed elevated 30-45 degrees, neck midline
C. Supine with legs elevated
D. Side-lying with knees flexed
