1|Page
2026 NUR 265 EXAM 3 | A
COMPREHENSIVE SET OF QUESTIONS
AND ANSWERS | FALL 2025/26 UPDATE |
100% CORRECT [QUESTION 1-100] AND
ANSWERS UPDATED 2026/2027 | 100%
VERIFIED | DETAILED RATIONALES –
PASS GUARANTEED A+ GRADED |
INSTANT DOWNLOAD
INTRODUCTION
The 2026 NUR 265 Exam 3 is an advanced medical-surgical nursing assessment designed to
evaluate a student's ability to apply complex clinical concepts, recognize patient deterioration,
prioritize interventions, and make safe nursing decisions. The examination emphasizes
application rather than simple memorization, requiring students to connect assessment findings
with pathophysiology, complications, interventions, and expected outcomes.
Major areas commonly associated with this examination include acute burns and burn
management, shock and fluid-volume disturbances, traumatic brain injury, increased intracranial
pressure, neurological emergencies, spinal cord injury, respiratory compromise, cardiovascular
instability, infection prevention, medication management, and critical-care nursing priorities.
This comprehensive practice bank contains 150 challenging, original, scenario-based questions
designed to strengthen clinical judgment. Questions emphasize ABC prioritization, recognizing
subtle deterioration, interpreting assessment findings, selecting the safest intervention, evaluating
treatment response, and anticipating complications. Each question contains four options, one best
answer, and a detailed rationale explaining the reasoning behind the correct choice and why the
alternatives are less appropriate.
Use this resource as an intensive review tool: answer each question independently first, identify
weak areas, then study the rationale before moving to the next item.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
,2|Page
Burn depth, TBSA, fluid resuscitation,
Burns & Thermal Injury 1–30 inhalation injury, wound care, grafts, infection, 20%
nutrition
Shock & Hemodynamic Hypovolemic, distributive, cardiogenic, septic
31–55 17%
Instability shock, perfusion, fluids, vasopressors
Traumatic Brain Injury TBI, ICP, Cushing response, neurological
56–80 17%
& Increased ICP assessment, cerebral perfusion, interventions
Spinal Cord & SCI, spinal shock, neurogenic shock, autonomic
81–100 13%
Neurological Emergencies dysreflexia, seizures
Airway compromise, mechanical ventilation,
Respiratory Emergencies 101–115 10%
ARDS, oxygenation, ABGs
Cardiovascular & Dysrhythmias, acute coronary syndrome, heart
116–130 9%
Perfusion Problems failure, perfusion
Critical-Care Nursing & Infection, renal dysfunction, electrolytes,
131–150 14%
Complications medications, prioritization
TOTAL 150 Integrated NUR 265 clinical judgment 100%
QUESTIONS 1–150
BURNS AND THERMAL INJURY
Q1:
A client is rescued from a house fire and has facial burns, singed nasal hair, soot around the
mouth, and a hoarse voice. Which intervention should the nurse prioritize?
A) Apply topical antimicrobial cream
B) Prepare for early airway management and provide prescribed high-concentration
oxygen
C) Begin oral fluids
D) Cover all burns with dry gauze before assessing the airway
Rationale: The correct answer is B because facial burns, soot, and hoarseness strongly suggest
inhalation injury and progressive airway edema. Early airway management may become difficult
once edema worsens. Option A addresses wound care but does not address the immediate airway
threat. Option C is inappropriate because a client with potential airway compromise should not
receive oral fluids. Option D delays the highest-priority airway assessment.
Q2:
A client has a superficial partial-thickness burn involving the anterior chest. Which finding is
most consistent with this depth of injury?
,3|Page
A) Dry, leathery, painless skin
B) Blistering with a moist, red, painful wound
C) Charred tissue extending through muscle
D) Completely intact skin without erythema
Rationale: The correct answer is B because superficial partial-thickness burns involve the
epidermis and upper dermis and typically produce erythema, blistering, moisture, and significant
pain. Option A is characteristic of deeper full-thickness injury. Option C describes a much more
extensive injury. Option D does not describe a burn.
Q3:
A client with a large thermal injury has been receiving IV fluids. Which assessment finding best
indicates that fluid resuscitation is achieving an adequate response?
A) Increasing peripheral edema
B) Increasing heart rate
C) Urine output maintained at an appropriate level for the client's size and condition
D) Increasing hematocrit
Rationale: The correct answer is C because urine output is an important bedside indicator of
renal perfusion and adequacy of resuscitation in major burns. Option A can occur with excessive
fluid administration and does not independently prove adequate perfusion. Option B indicates
worsening stress or inadequate volume. Option D may reflect hemoconcentration rather than
adequate resuscitation.
Q4:
A client with extensive burns develops circumferential burns around the chest and increasing
difficulty ventilating. What complication should the nurse suspect?
A) Hypoglycemia
B) Pulmonary embolism
C) Restricted chest expansion from circumferential eschar
D) Acute kidney injury
Rationale: The correct answer is C because circumferential full-thickness burns can form rigid
eschar that restricts chest expansion. Escharotomy may be required to restore ventilation. The
other conditions do not directly explain restricted chest-wall movement.
Q5:
A client with a circumferential full-thickness burn to the arm develops increasing pain,
paresthesia, and diminished distal pulses. Which intervention should the nurse anticipate?
, 4|Page
A) Apply an ice pack
B) Massage the extremity
C) Urgent evaluation for escharotomy or compartment-related compromise
D) Place the arm below heart level
Rationale: The correct answer is C because circumferential eschar can compromise circulation
and produce neurovascular deterioration. Ice may worsen tissue injury, massage is
inappropriate, and dependent positioning may worsen edema.
Q6:
A client with extensive burns asks why a high-calorie, high-protein diet is prescribed. Which
explanation is most appropriate?
A) "It prevents all wound infections."
B) "It eliminates the need for IV fluids."
C) "Your body has greatly increased metabolic and protein requirements during wound
healing."
D) "It prevents fluid loss through the kidneys."
Rationale: The correct answer is C because major burns create a hypermetabolic state and
increase protein requirements for tissue repair. Nutrition does not eliminate infection risk or
replace fluid resuscitation.
Q7:
A burn client develops increasing wound pain, foul odor, spreading erythema beyond the wound
margin, and purulent drainage. Which complication is most concerning?
A) Normal inflammatory healing
B) Mild dehydration
C) Wound infection with possible systemic involvement
D) Improved tissue perfusion
Rationale: The correct answer is C because spreading erythema, purulent drainage, foul odor,
and worsening pain suggest infection. The findings are not expected features of uncomplicated
healing.
Q8:
A client with an open burn wound is being cared for by several nurses. Which practice best
prevents autocontamination?
A) Use the same gloves for all wound areas
B) Change gloves and use clean technique when moving between contaminated and less-
contaminated wound areas
2026 NUR 265 EXAM 3 | A
COMPREHENSIVE SET OF QUESTIONS
AND ANSWERS | FALL 2025/26 UPDATE |
100% CORRECT [QUESTION 1-100] AND
ANSWERS UPDATED 2026/2027 | 100%
VERIFIED | DETAILED RATIONALES –
PASS GUARANTEED A+ GRADED |
INSTANT DOWNLOAD
INTRODUCTION
The 2026 NUR 265 Exam 3 is an advanced medical-surgical nursing assessment designed to
evaluate a student's ability to apply complex clinical concepts, recognize patient deterioration,
prioritize interventions, and make safe nursing decisions. The examination emphasizes
application rather than simple memorization, requiring students to connect assessment findings
with pathophysiology, complications, interventions, and expected outcomes.
Major areas commonly associated with this examination include acute burns and burn
management, shock and fluid-volume disturbances, traumatic brain injury, increased intracranial
pressure, neurological emergencies, spinal cord injury, respiratory compromise, cardiovascular
instability, infection prevention, medication management, and critical-care nursing priorities.
This comprehensive practice bank contains 150 challenging, original, scenario-based questions
designed to strengthen clinical judgment. Questions emphasize ABC prioritization, recognizing
subtle deterioration, interpreting assessment findings, selecting the safest intervention, evaluating
treatment response, and anticipating complications. Each question contains four options, one best
answer, and a detailed rationale explaining the reasoning behind the correct choice and why the
alternatives are less appropriate.
Use this resource as an intensive review tool: answer each question independently first, identify
weak areas, then study the rationale before moving to the next item.
CONTENT AREA OVERVIEW
Content Area Questions Key Topics Weight
,2|Page
Burn depth, TBSA, fluid resuscitation,
Burns & Thermal Injury 1–30 inhalation injury, wound care, grafts, infection, 20%
nutrition
Shock & Hemodynamic Hypovolemic, distributive, cardiogenic, septic
31–55 17%
Instability shock, perfusion, fluids, vasopressors
Traumatic Brain Injury TBI, ICP, Cushing response, neurological
56–80 17%
& Increased ICP assessment, cerebral perfusion, interventions
Spinal Cord & SCI, spinal shock, neurogenic shock, autonomic
81–100 13%
Neurological Emergencies dysreflexia, seizures
Airway compromise, mechanical ventilation,
Respiratory Emergencies 101–115 10%
ARDS, oxygenation, ABGs
Cardiovascular & Dysrhythmias, acute coronary syndrome, heart
116–130 9%
Perfusion Problems failure, perfusion
Critical-Care Nursing & Infection, renal dysfunction, electrolytes,
131–150 14%
Complications medications, prioritization
TOTAL 150 Integrated NUR 265 clinical judgment 100%
QUESTIONS 1–150
BURNS AND THERMAL INJURY
Q1:
A client is rescued from a house fire and has facial burns, singed nasal hair, soot around the
mouth, and a hoarse voice. Which intervention should the nurse prioritize?
A) Apply topical antimicrobial cream
B) Prepare for early airway management and provide prescribed high-concentration
oxygen
C) Begin oral fluids
D) Cover all burns with dry gauze before assessing the airway
Rationale: The correct answer is B because facial burns, soot, and hoarseness strongly suggest
inhalation injury and progressive airway edema. Early airway management may become difficult
once edema worsens. Option A addresses wound care but does not address the immediate airway
threat. Option C is inappropriate because a client with potential airway compromise should not
receive oral fluids. Option D delays the highest-priority airway assessment.
Q2:
A client has a superficial partial-thickness burn involving the anterior chest. Which finding is
most consistent with this depth of injury?
,3|Page
A) Dry, leathery, painless skin
B) Blistering with a moist, red, painful wound
C) Charred tissue extending through muscle
D) Completely intact skin without erythema
Rationale: The correct answer is B because superficial partial-thickness burns involve the
epidermis and upper dermis and typically produce erythema, blistering, moisture, and significant
pain. Option A is characteristic of deeper full-thickness injury. Option C describes a much more
extensive injury. Option D does not describe a burn.
Q3:
A client with a large thermal injury has been receiving IV fluids. Which assessment finding best
indicates that fluid resuscitation is achieving an adequate response?
A) Increasing peripheral edema
B) Increasing heart rate
C) Urine output maintained at an appropriate level for the client's size and condition
D) Increasing hematocrit
Rationale: The correct answer is C because urine output is an important bedside indicator of
renal perfusion and adequacy of resuscitation in major burns. Option A can occur with excessive
fluid administration and does not independently prove adequate perfusion. Option B indicates
worsening stress or inadequate volume. Option D may reflect hemoconcentration rather than
adequate resuscitation.
Q4:
A client with extensive burns develops circumferential burns around the chest and increasing
difficulty ventilating. What complication should the nurse suspect?
A) Hypoglycemia
B) Pulmonary embolism
C) Restricted chest expansion from circumferential eschar
D) Acute kidney injury
Rationale: The correct answer is C because circumferential full-thickness burns can form rigid
eschar that restricts chest expansion. Escharotomy may be required to restore ventilation. The
other conditions do not directly explain restricted chest-wall movement.
Q5:
A client with a circumferential full-thickness burn to the arm develops increasing pain,
paresthesia, and diminished distal pulses. Which intervention should the nurse anticipate?
, 4|Page
A) Apply an ice pack
B) Massage the extremity
C) Urgent evaluation for escharotomy or compartment-related compromise
D) Place the arm below heart level
Rationale: The correct answer is C because circumferential eschar can compromise circulation
and produce neurovascular deterioration. Ice may worsen tissue injury, massage is
inappropriate, and dependent positioning may worsen edema.
Q6:
A client with extensive burns asks why a high-calorie, high-protein diet is prescribed. Which
explanation is most appropriate?
A) "It prevents all wound infections."
B) "It eliminates the need for IV fluids."
C) "Your body has greatly increased metabolic and protein requirements during wound
healing."
D) "It prevents fluid loss through the kidneys."
Rationale: The correct answer is C because major burns create a hypermetabolic state and
increase protein requirements for tissue repair. Nutrition does not eliminate infection risk or
replace fluid resuscitation.
Q7:
A burn client develops increasing wound pain, foul odor, spreading erythema beyond the wound
margin, and purulent drainage. Which complication is most concerning?
A) Normal inflammatory healing
B) Mild dehydration
C) Wound infection with possible systemic involvement
D) Improved tissue perfusion
Rationale: The correct answer is C because spreading erythema, purulent drainage, foul odor,
and worsening pain suggest infection. The findings are not expected features of uncomplicated
healing.
Q8:
A client with an open burn wound is being cared for by several nurses. Which practice best
prevents autocontamination?
A) Use the same gloves for all wound areas
B) Change gloves and use clean technique when moving between contaminated and less-
contaminated wound areas
