NUR 265
Exam 1 Advanced Medical-Surgical Nursing Mastery
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 Mastery 2026/2027 UPDATE – Galen
College
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 58 mmHg, and HCO3 26
mEq/L. Which condition does this reflect?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg with a normal
bicarbonate (22-26) indicates the cause is respiratory in nature.
2. A client is admitted with a 40% total body surface area (TBSA) burn. During the first 24
hours, which fluid shift is the nurse’s primary concern?
A. Intravascular to interstitial
B. Intracellular to interstitial
C. Interstitial to intravascular
D. Intravascular to intracellular
, Answer: A
Rationale: The ‘capillary leak’ syndrome in major burns leads to a massive shift of fluid,
electrolytes, and plasma proteins from the intravascular space into the interstitial space,
causing third-spacing and hypovolemic shock.
3. A patient in septic shock has a lactic acid level of 6.2 mmol/L. What is the physiological
significance of this finding?
A. Anaerobic metabolism is occurring due to inadequate tissue perfusion.
B. Kidney function is improving.
C. Aerobic metabolism is occurring at the cellular level.
D. The patient is experiencing metabolic alkalosis.
Answer: A
Rationale: Elevated lactic acid (normal < 2) is a marker of cellular hypoxia and anaerobic
metabolism, indicating poor tissue perfusion in shock states.
4. A client is exhibiting tall, peaked T-waves on their EKG. Which electrolyte imbalance should
the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
Exam 1 Advanced Medical-Surgical Nursing Mastery
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 Mastery 2026/2027 UPDATE – Galen
College
1. A patient’s arterial blood gas (ABG) results are: pH 7.28, PaCO2 58 mmHg, and HCO3 26
mEq/L. Which condition does this reflect?
A. Metabolic Alkalosis
B. Respiratory Acidosis
C. Metabolic Acidosis
D. Respiratory Alkalosis
Answer: B
Rationale: A pH below 7.35 indicates acidosis, and a PaCO2 above 45 mmHg with a normal
bicarbonate (22-26) indicates the cause is respiratory in nature.
2. A client is admitted with a 40% total body surface area (TBSA) burn. During the first 24
hours, which fluid shift is the nurse’s primary concern?
A. Intravascular to interstitial
B. Intracellular to interstitial
C. Interstitial to intravascular
D. Intravascular to intracellular
, Answer: A
Rationale: The ‘capillary leak’ syndrome in major burns leads to a massive shift of fluid,
electrolytes, and plasma proteins from the intravascular space into the interstitial space,
causing third-spacing and hypovolemic shock.
3. A patient in septic shock has a lactic acid level of 6.2 mmol/L. What is the physiological
significance of this finding?
A. Anaerobic metabolism is occurring due to inadequate tissue perfusion.
B. Kidney function is improving.
C. Aerobic metabolism is occurring at the cellular level.
D. The patient is experiencing metabolic alkalosis.
Answer: A
Rationale: Elevated lactic acid (normal < 2) is a marker of cellular hypoxia and anaerobic
metabolism, indicating poor tissue perfusion in shock states.
4. A client is exhibiting tall, peaked T-waves on their EKG. Which electrolyte imbalance should
the nurse suspect?
A. Hyperkalemia
B. Hypokalemia
C. Hypernatremia
D. Hypocalcemia
