NUR 265
EXAM 3
Medical-Surgical Nursing
Galen College of Nursing
Tested Qs & Verified Answers with Rationales
This Exam Features:
NUR 265 Exam 3 Medical-Surgical Nursing (Galen
College) including 50 Tested questions written
to mirror actual course exams. Covers core Med-
Surg concepts with clear, accurate, and student-
friendly explanations. Perfect for mastering high-priority topics
and boosting exam confidence.
### 1. The nurse is working in the emergency department and is
admitting a client who has sustained a traumatic brain injury (TBI)
,following a motor vehicle crash. It is a priority for the nurse to notify
the primary health care provider if the client:
A. Takes prescribed warfarin daily
B. Has a headache rated 4/10
C. Has a blood pressure reading of 120/80 mm Hg
D. Has no history of seizures
Correct Answer: A. Takes prescribed warfarin daily
Rationale: Clients on warfarin are at increased risk for intracranial
hemorrhage after a TBI due to anticoagulation increasing the risk of
bleeding. Promptly informing the provider allows for rapid assessment and
possible reversal of anticoagulation to prevent secondary brain injury.
---
### 2. The charge nurse observes a newly hired nurse caring for a
client who sustained a closed head injury, is receiving mechanical
ventilation, and is at risk for developing increased intracranial
pressure (ICP). Which of the following actions performed by the newly
hired nurse requires intervention by the charge nurse?
A. Raising the foot of the client's bed
B. Clustering client care activities
C. Maintaining the head of the bed elevated at 30 degrees
D. Administering analgesics as prescribed
Correct Answer: A. Raising the foot of the client's bed
Rationale: Raising the foot of the bed can increase ICP by reducing
venous drainage from the brain. Patients at risk for elevated ICP should
have the head of the bed elevated 30 degrees with the head in a neutral
position to promote venous outflow and reduce ICP. Clustering care is
encouraged to limit stimulation.
, ---
### 3. The newly hired nurse is caring for a client who was admitted
12 hours ago with a TBI and is at risk for developing ICP. It requires
intervention by the nurse preceptor if the newly hired nurse is
observed:
A. Clustering client care activities
B. Administering prescribed sedatives
C. Placing the client in Trendelenburg position
D. Monitoring neurological status frequently
Correct Answer: C. Placing the client in Trendelenburg position
Rationale: Trendelenburg position increases venous pressure and thus
ICP. Clients at risk for ICP need to avoid any position that impedes venous
drainage from the brain. Clustering care and frequent neuro checks are
appropriate.
---
### 4. The nurse is assessing clients for the risk of sustaining
traumatic brain injury (TBI). Which of the following clients should the
nurse identify as being at greatest risk?
A. 20-year-old college student who participates on the football team
B. 45-year-old office worker
C. 70-year-old retired teacher who uses a walker
D. 30-year-old marathon runner
Correct Answer: A. 20-year-old college student who participates on the
football team
EXAM 3
Medical-Surgical Nursing
Galen College of Nursing
Tested Qs & Verified Answers with Rationales
This Exam Features:
NUR 265 Exam 3 Medical-Surgical Nursing (Galen
College) including 50 Tested questions written
to mirror actual course exams. Covers core Med-
Surg concepts with clear, accurate, and student-
friendly explanations. Perfect for mastering high-priority topics
and boosting exam confidence.
### 1. The nurse is working in the emergency department and is
admitting a client who has sustained a traumatic brain injury (TBI)
,following a motor vehicle crash. It is a priority for the nurse to notify
the primary health care provider if the client:
A. Takes prescribed warfarin daily
B. Has a headache rated 4/10
C. Has a blood pressure reading of 120/80 mm Hg
D. Has no history of seizures
Correct Answer: A. Takes prescribed warfarin daily
Rationale: Clients on warfarin are at increased risk for intracranial
hemorrhage after a TBI due to anticoagulation increasing the risk of
bleeding. Promptly informing the provider allows for rapid assessment and
possible reversal of anticoagulation to prevent secondary brain injury.
---
### 2. The charge nurse observes a newly hired nurse caring for a
client who sustained a closed head injury, is receiving mechanical
ventilation, and is at risk for developing increased intracranial
pressure (ICP). Which of the following actions performed by the newly
hired nurse requires intervention by the charge nurse?
A. Raising the foot of the client's bed
B. Clustering client care activities
C. Maintaining the head of the bed elevated at 30 degrees
D. Administering analgesics as prescribed
Correct Answer: A. Raising the foot of the client's bed
Rationale: Raising the foot of the bed can increase ICP by reducing
venous drainage from the brain. Patients at risk for elevated ICP should
have the head of the bed elevated 30 degrees with the head in a neutral
position to promote venous outflow and reduce ICP. Clustering care is
encouraged to limit stimulation.
, ---
### 3. The newly hired nurse is caring for a client who was admitted
12 hours ago with a TBI and is at risk for developing ICP. It requires
intervention by the nurse preceptor if the newly hired nurse is
observed:
A. Clustering client care activities
B. Administering prescribed sedatives
C. Placing the client in Trendelenburg position
D. Monitoring neurological status frequently
Correct Answer: C. Placing the client in Trendelenburg position
Rationale: Trendelenburg position increases venous pressure and thus
ICP. Clients at risk for ICP need to avoid any position that impedes venous
drainage from the brain. Clustering care and frequent neuro checks are
appropriate.
---
### 4. The nurse is assessing clients for the risk of sustaining
traumatic brain injury (TBI). Which of the following clients should the
nurse identify as being at greatest risk?
A. 20-year-old college student who participates on the football team
B. 45-year-old office worker
C. 70-year-old retired teacher who uses a walker
D. 30-year-old marathon runner
Correct Answer: A. 20-year-old college student who participates on the
football team
