NUR 265 ADVANCED CONCEPTS OF
MEDICAL-SURGICAL NURSING EXAM
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with severe burns in the emergent phase is being resuscitated. Which laboratory
finding most accurately reflects the physiological changes during this period?
A. Hypernatremia and metabolic alkalosis
B. Hyperkalemia and metabolic acidosis
C. Hypokalemia and respiratory alkalosis
D. Hyponatremia and metabolic alkalosis
Answer: B
Conceptual Explanation: During the emergent phase of a burn, massive cell destruction
releases potassium into the extracellular space (hyperkalemia), and the loss of bicarbonate
along with anaerobic metabolism leads to metabolic acidosis.
2. A patient presents with a MAP of 55 mmHg, HR 128 bpm, and CVP 2 mmHg. The nurse
anticipates an order for which initial intervention?
A. Administer a 500 mL bolus of 0.9% Normal Saline
,B. Start a Norepinephrine infusion
C. Administer Furosemide 40 mg IV
D. Initiate Dobutamine at 5 mcg/kg/min
Answer: A
Conceptual Explanation: Low MAP, high HR, and low CVP (Normal CVP 2-8 mmHg)
suggest hypovolemia. The priority is volume resuscitation before considering vasopressors.
3. When caring for a patient on mechanical ventilation, the high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Disconnect the patient and manually bag
C. Increase the oxygen concentration to 100%
D. Auscultate the patient’s breath sounds
Answer: D
Conceptual Explanation: High-pressure alarms are caused by increased resistance (e.g.,
secretions, bronchospasm, or pneumothorax). Assessment of the patient’s airway and
breath sounds is the immediate priority.
4. A patient with a spinal cord injury at T4 reports a sudden, throbbing headache and has a
blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Administer PRN Hydralazine
, B. Lower the head of the bed to a flat position
C. Assess the patient for bladder distension
D. Perform a neurological check every 15 minutes
Answer: C
Conceptual Explanation: These symptoms indicate autonomic dysreflexia. The priority is
to identify and remove the noxious stimulus, most commonly a full bladder or impacted
bowel.
5. A client in the ICU has the following ABG results: pH 7.28, PaCO2 55, HCO3 26. How should
the nurse interpret these results?
A. Uncompensated Metabolic Acidosis
B. Partially Compensated Respiratory Acidosis
C. Fully Compensated Respiratory Acidosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is high (>45), while the
HCO3 is normal, indicating the kidneys have not yet compensated for the respiratory
problem.
MEDICAL-SURGICAL NURSING EXAM
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with severe burns in the emergent phase is being resuscitated. Which laboratory
finding most accurately reflects the physiological changes during this period?
A. Hypernatremia and metabolic alkalosis
B. Hyperkalemia and metabolic acidosis
C. Hypokalemia and respiratory alkalosis
D. Hyponatremia and metabolic alkalosis
Answer: B
Conceptual Explanation: During the emergent phase of a burn, massive cell destruction
releases potassium into the extracellular space (hyperkalemia), and the loss of bicarbonate
along with anaerobic metabolism leads to metabolic acidosis.
2. A patient presents with a MAP of 55 mmHg, HR 128 bpm, and CVP 2 mmHg. The nurse
anticipates an order for which initial intervention?
A. Administer a 500 mL bolus of 0.9% Normal Saline
,B. Start a Norepinephrine infusion
C. Administer Furosemide 40 mg IV
D. Initiate Dobutamine at 5 mcg/kg/min
Answer: A
Conceptual Explanation: Low MAP, high HR, and low CVP (Normal CVP 2-8 mmHg)
suggest hypovolemia. The priority is volume resuscitation before considering vasopressors.
3. When caring for a patient on mechanical ventilation, the high-pressure alarm sounds.
Which action should the nurse take first?
A. Check for a leak in the ventilator circuit
B. Disconnect the patient and manually bag
C. Increase the oxygen concentration to 100%
D. Auscultate the patient’s breath sounds
Answer: D
Conceptual Explanation: High-pressure alarms are caused by increased resistance (e.g.,
secretions, bronchospasm, or pneumothorax). Assessment of the patient’s airway and
breath sounds is the immediate priority.
4. A patient with a spinal cord injury at T4 reports a sudden, throbbing headache and has a
blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Administer PRN Hydralazine
, B. Lower the head of the bed to a flat position
C. Assess the patient for bladder distension
D. Perform a neurological check every 15 minutes
Answer: C
Conceptual Explanation: These symptoms indicate autonomic dysreflexia. The priority is
to identify and remove the noxious stimulus, most commonly a full bladder or impacted
bowel.
5. A client in the ICU has the following ABG results: pH 7.28, PaCO2 55, HCO3 26. How should
the nurse interpret these results?
A. Uncompensated Metabolic Acidosis
B. Partially Compensated Respiratory Acidosis
C. Fully Compensated Respiratory Acidosis
D. Uncompensated Respiratory Acidosis
Answer: D
Conceptual Explanation: The pH is acidic (<7.35) and the PaCO2 is high (>45), while the
HCO3 is normal, indicating the kidneys have not yet compensated for the respiratory
problem.
