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NUR 265 FINAL EXAM ADVANCED CONCEPTS OF MEDICAL-SURGICAL
NURSING QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED
QUESTIONS & ANSWERS
NUR 265 FINAL EXAM –QUESTIONS
Advanced Concepts of Medical-Surgical Nursing
Galen College of Nursing
SECTION 1: PRIORITIZATION & DELEGATION (Questions 1–30)
1. The charge nurse is making shift assignments on a medical-surgical unit. Which
client should be assigned to the most experienced RN?
A) A client with stable diabetes mellitus requiring insulin administration
B) A client with a new tracheostomy who is unstable
C) A client who is being discharged home with a new colostomy
D) A client with a urinary tract infection requiring antibiotics
Answer: B) A client with a new tracheostomy who is unstable
Rationale: The most unstable client or the client with the highest acuity should be
assigned to the most experienced nurse to ensure safe, competent care. A new
tracheostomy requires complex assessment and intervention skills.
2. The nurse is prioritizing care for four assigned clients. Which client should the
nurse see first?
A) A client receiving morphine sulfate via a PCA pump with a respiratory rate of 8
breaths/min
B) A client 2 days post-op knee replacement who has not had a bowel movement
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a surgical wound who requests pain medication
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Answer: A) A client receiving morphine sulfate via a PCA pump with a respiratory
rate of 8 breaths/min
Rationale: A respiratory rate of 8 indicates respiratory depression, a life-threatening
adverse effect of opioid analgesics. This client requires immediate assessment and
intervention.
3. The RN is delegating tasks to an LPN. Which task is appropriate to delegate?
A) Performing an initial admission assessment
B) Administering oral medications to stable clients
C) Teaching a client about insulin administration
D) Developing a plan of care
Answer: B) Administering oral medications to stable clients
Rationale: LPNs can administer oral medications to stable clients. Admission
assessment, teaching, and care planning are within the RN scope of practice and
require higher-level nursing judgment.
4. The RN is delegating a task to a UAP. Which task is appropriate to delegate?
A) Assessing a client's skin integrity
B) Ambulating a client with a gait belt
C) Administering medications
D) Teaching a client about diet
Answer: B) Ambulating a client with a gait belt
Rationale: Ambulating a client is a routine task that can be delegated to UAPs.
Assessment, medication administration, and teaching require RN-level education and
judgment.
5. A client is admitted with a diagnosis of dehydration. Which task can the nurse
delegate to the UAP?
A) Assessing the client's skin turgor
B) Measuring the client's intake and output
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C) Evaluating the effectiveness of fluid replacement
D) Educating the client about fluid intake
Answer: B) Measuring the client's intake and output
Rationale: Measuring intake and output is a routine task that can be delegated to UAPs.
Assessment, evaluation, and teaching require RN-level education and judgment.
6. The nurse is caring for four clients. Which client should be seen first based on
Maslow's hierarchy of needs?
A) A client who is 2 days post-op and reports pain
B) A client who is experiencing shortness of breath and hypoxia
C) A client who needs discharge teaching
D) A client who requests a sleeping pill
Answer: B) A client who is experiencing shortness of breath and hypoxia
Rationale: Shortness of breath and hypoxia are life-threatening conditions requiring
immediate assessment and intervention based on the ABCs and Maslow's hierarchy
(physiologic needs first).
7. A client with a new diagnosis of stroke is experiencing difficulty swallowing.
Which action should the nurse take first?
A) Place the client on NPO status
B) Refer the client to speech therapy
C) Assess the client's gag reflex
D) Offer the client thickened liquids
Answer: C) Assess the client's gag reflex
Rationale: The nurse should first assess the client's gag reflex and swallowing ability
before determining the appropriate diet and interventions to prevent aspiration.
8. The nurse is caring for a client with a central line. Which task can be delegated to
an LPN?
A) Assessing the insertion site
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B) Changing the central line dressing
C) Administering IV antibiotics
D) Evaluating the client's response to treatment
Answer: B) Changing the central line dressing
Rationale: LPNs can perform sterile dressing changes for stable clients with central
lines. Assessment, IV medication administration (in some states), and evaluation
require RN-level practice.
9. A client with a new colostomy requires teaching about ostomy care. Which staff
member should be assigned to provide this teaching?
A) UAP
B) LPN
C) RN
D) Nursing assistant
Answer: C) RN
Rationale: Teaching is within the RN scope of practice. The RN should provide teaching
about ostomy care and evaluate the client's understanding.
10. The RN is delegating a task to a UAP. Which statement demonstrates
appropriate delegation communication?
A) "Take the client's vital signs and report any abnormal findings to me."
B) "Take the client's vital signs whenever you have time."
C) "Take the client's vital signs and document them in the chart."
D) "Take the client's vital signs and tell me if anything is wrong."
Answer: A) "Take the client's vital signs and report any abnormal findings to me."
Rationale: The RN should provide clear, specific instructions, including what to do,
when to report, and how to communicate findings.
11. What are the "Five Rights" of Delegation?
NUR 265 FINAL EXAM ADVANCED CONCEPTS OF MEDICAL-SURGICAL
NURSING QUESTIONS LATEST EDITION 2026 – 2027 VERSION SOLVED
QUESTIONS & ANSWERS
NUR 265 FINAL EXAM –QUESTIONS
Advanced Concepts of Medical-Surgical Nursing
Galen College of Nursing
SECTION 1: PRIORITIZATION & DELEGATION (Questions 1–30)
1. The charge nurse is making shift assignments on a medical-surgical unit. Which
client should be assigned to the most experienced RN?
A) A client with stable diabetes mellitus requiring insulin administration
B) A client with a new tracheostomy who is unstable
C) A client who is being discharged home with a new colostomy
D) A client with a urinary tract infection requiring antibiotics
Answer: B) A client with a new tracheostomy who is unstable
Rationale: The most unstable client or the client with the highest acuity should be
assigned to the most experienced nurse to ensure safe, competent care. A new
tracheostomy requires complex assessment and intervention skills.
2. The nurse is prioritizing care for four assigned clients. Which client should the
nurse see first?
A) A client receiving morphine sulfate via a PCA pump with a respiratory rate of 8
breaths/min
B) A client 2 days post-op knee replacement who has not had a bowel movement
C) A client with diabetes who has a blood glucose of 180 mg/dL
D) A client with a surgical wound who requests pain medication
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Answer: A) A client receiving morphine sulfate via a PCA pump with a respiratory
rate of 8 breaths/min
Rationale: A respiratory rate of 8 indicates respiratory depression, a life-threatening
adverse effect of opioid analgesics. This client requires immediate assessment and
intervention.
3. The RN is delegating tasks to an LPN. Which task is appropriate to delegate?
A) Performing an initial admission assessment
B) Administering oral medications to stable clients
C) Teaching a client about insulin administration
D) Developing a plan of care
Answer: B) Administering oral medications to stable clients
Rationale: LPNs can administer oral medications to stable clients. Admission
assessment, teaching, and care planning are within the RN scope of practice and
require higher-level nursing judgment.
4. The RN is delegating a task to a UAP. Which task is appropriate to delegate?
A) Assessing a client's skin integrity
B) Ambulating a client with a gait belt
C) Administering medications
D) Teaching a client about diet
Answer: B) Ambulating a client with a gait belt
Rationale: Ambulating a client is a routine task that can be delegated to UAPs.
Assessment, medication administration, and teaching require RN-level education and
judgment.
5. A client is admitted with a diagnosis of dehydration. Which task can the nurse
delegate to the UAP?
A) Assessing the client's skin turgor
B) Measuring the client's intake and output
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C) Evaluating the effectiveness of fluid replacement
D) Educating the client about fluid intake
Answer: B) Measuring the client's intake and output
Rationale: Measuring intake and output is a routine task that can be delegated to UAPs.
Assessment, evaluation, and teaching require RN-level education and judgment.
6. The nurse is caring for four clients. Which client should be seen first based on
Maslow's hierarchy of needs?
A) A client who is 2 days post-op and reports pain
B) A client who is experiencing shortness of breath and hypoxia
C) A client who needs discharge teaching
D) A client who requests a sleeping pill
Answer: B) A client who is experiencing shortness of breath and hypoxia
Rationale: Shortness of breath and hypoxia are life-threatening conditions requiring
immediate assessment and intervention based on the ABCs and Maslow's hierarchy
(physiologic needs first).
7. A client with a new diagnosis of stroke is experiencing difficulty swallowing.
Which action should the nurse take first?
A) Place the client on NPO status
B) Refer the client to speech therapy
C) Assess the client's gag reflex
D) Offer the client thickened liquids
Answer: C) Assess the client's gag reflex
Rationale: The nurse should first assess the client's gag reflex and swallowing ability
before determining the appropriate diet and interventions to prevent aspiration.
8. The nurse is caring for a client with a central line. Which task can be delegated to
an LPN?
A) Assessing the insertion site
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B) Changing the central line dressing
C) Administering IV antibiotics
D) Evaluating the client's response to treatment
Answer: B) Changing the central line dressing
Rationale: LPNs can perform sterile dressing changes for stable clients with central
lines. Assessment, IV medication administration (in some states), and evaluation
require RN-level practice.
9. A client with a new colostomy requires teaching about ostomy care. Which staff
member should be assigned to provide this teaching?
A) UAP
B) LPN
C) RN
D) Nursing assistant
Answer: C) RN
Rationale: Teaching is within the RN scope of practice. The RN should provide teaching
about ostomy care and evaluate the client's understanding.
10. The RN is delegating a task to a UAP. Which statement demonstrates
appropriate delegation communication?
A) "Take the client's vital signs and report any abnormal findings to me."
B) "Take the client's vital signs whenever you have time."
C) "Take the client's vital signs and document them in the chart."
D) "Take the client's vital signs and tell me if anything is wrong."
Answer: A) "Take the client's vital signs and report any abnormal findings to me."
Rationale: The RN should provide clear, specific instructions, including what to do,
when to report, and how to communicate findings.
11. What are the "Five Rights" of Delegation?
