NUR 265 Advanced Med Surg Exam 1 Prep Latest Test
Bank 2026 with 300 Exam Questions and Correct Answers
with Rationales Review/ NUR 265 Exam 1 Prep 2026 (Galen)
An adult with a body mass index (BMI) of 22 kg/m2 is being admitted to the
hospital for elective knee surgery. Which assessment finding would the nurse
report to the health care provider?
a. Tympany on percussion of the abdomen
b. Liver edge 3 cm below the costal margin
c. Bowel sounds of 20/min in each quadrant
d. Aortic pulsations visible in the epigastric area
ANS: B
Normally the lower border of the liver is not palpable below the ribs, so this
finding suggests hepatomegaly. Visible aortic pulsations in the epigastrium, active
bowel sounds, and abdominal tympany are within normal findings for an adult of
normal weight.
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient
with acute gastrointestinal (GI) bleeding. Which assessment finding is most
important for the nurse to communicate to the health care provider?
a. The bowel sounds are hyperactive in all four quadrants.
b. The patient's lungs have crackles audible to the midchest.
c. The nasogastric (NG) suction is returning coffee-ground material.
d. The patient's blood pressure (BP) has increased to 142/84 mm Hg.
ANS: B
The patient's lung sounds indicate that pulmonary edema may be developing
because of the rapid infusion of IV fluid and that the fluid infusion rate would be
slowed. The return of coffee-ground material in an NG tube is expected for a
patient with upper GI bleeding. The BP is slightly elevated but would not be an
indication to contact the health care provider immediately. Hyperactive bowel
sounds are common when a patient has GI bleeding.
Which condition would the nurse anticipate when caring for a patient with a
history of a total gastrectomy?
a. Constipation
pg. 1
,b. Dehydration
c. Elevated total serum cholesterol
d. Cobalamin (vitamin B12) deficiency
ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor, which is
needed for cobalamin (vitamin B12) absorption. Because the stomach absorbs only
small amounts of water and nutrients, the patient is not at higher risk for
dehydration, elevated cholesterol, or constipation.
A patient has just returned to the nursing unit after an
esophagogastroduodenoscopy (EGD). Which action by assistive personnel (AP)
requires that the registered nurse (RN) intervene?
a. Offering the patient a pitcher of water
b. Positioning the patient on the right side
c. Checking the vital signs every 30 minutes
d. Swabbing the patient's mouth with a wet cloth
ANS: A
Immediately after EGD, the patient will have a decreased gag reflex and is at risk
for aspiration. Assessment for return of the gag reflex should be done by the RN.
The other actions by the AP are appropriate.
A patient is being scheduled for endoscopic retrograde cholangiopancreatography
(ERCP) as soon as possible. Which prescribed action would the nurse take first?
a. Place the patient on NPO status.
b. Administer sedative medications.
c. Ensure the consent form is signed.
d. Teach the patient about the procedure.
ANS: A
The patient will need to be NPO for 8 hours before the ERCP is done, so the
nurse's initial action should be to place the patient on NPO status. The other actions
can be done after the patient is NPO.
While interviewing a young adult patient, the nurse learns that the patient has a
family history of familial adenomatous polyposis (FAP). Which area of patient
knowledge would the nurse plan to assess?
a. Preventing noninfectious hepatitis
b. Treating inflammatory bowel disease
pg. 2
,c. Risk for developing colorectal cancer
d. Using antacids and proton pump inhibitors
ANS: C
FAP is a genetic condition that greatly increases the risk for colorectal cancer.
Noninfectious hepatitis, use of medications that treat increased gastric pH, and
inflammatory bowel disease are not related to FAP.
Which finding for a young adult who follows a vegan diet may indicate the need
for cobalamin supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling
ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the
patient will be most at risk for signs of cobalamin deficiency, such as glossitis,
anorexia, sore mouth and tongue, pallor, neurologic problems (e.g., depression,
dizziness), weight loss, nausea, constipation, and anemia. The other symptoms
listed are associated with other nutritional deficiencies but would not be associated
with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum
albumin level is being admitted. Which assessment finding would the nurse
expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies
ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease.
The blood pressure and level of consciousness are not directly affected by
malnutrition. Food allergies are not an indicator of nutritional status.
Which menu choice best indicates that the patient is implementing the nurse's
suggestion to choose high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
pg. 3
, c. Fresh fruit salad with yogurt topping
d. Fried chicken with potatoes and gravy
ANS: D
Foods that are high in calories include fried foods and those covered with sauces.
High-protein foods include meat and dairy products. The other choices are lower in
calories and protein.
A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein
level, and low serum transferrin and albumin levels. What should the nurse
encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate
ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein stores.
The BMI is in the obese range, so increasing caloric intake is not indicated. The
data do not indicate a need for increased carbohydrate or iron intake.
A patient who has just been started on enteral nutrition of full-strength formula at
100 mL/hr has 6 liquid stools the first day. Which action would the nurse plan to
take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube.
ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the
feeding rate or decrease the concentration of the feeding. Water should be given
when patients receive enteral feedings to prevent dehydration. When a closed
enteral feeding system is used, the tubing and formula are changed every 24 hours.
High residual volumes do not contribute to diarrhea.
A young adult with extensive facial injuries from a motor vehicle crash is receiving
continuous enteral nutrition through a percutaneous endoscopic gastrostomy
(PEG). Which action will the nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
pg. 4
Bank 2026 with 300 Exam Questions and Correct Answers
with Rationales Review/ NUR 265 Exam 1 Prep 2026 (Galen)
An adult with a body mass index (BMI) of 22 kg/m2 is being admitted to the
hospital for elective knee surgery. Which assessment finding would the nurse
report to the health care provider?
a. Tympany on percussion of the abdomen
b. Liver edge 3 cm below the costal margin
c. Bowel sounds of 20/min in each quadrant
d. Aortic pulsations visible in the epigastric area
ANS: B
Normally the lower border of the liver is not palpable below the ribs, so this
finding suggests hepatomegaly. Visible aortic pulsations in the epigastrium, active
bowel sounds, and abdominal tympany are within normal findings for an adult of
normal weight.
The nurse is administering IV fluid boluses and nasogastric irrigation to a patient
with acute gastrointestinal (GI) bleeding. Which assessment finding is most
important for the nurse to communicate to the health care provider?
a. The bowel sounds are hyperactive in all four quadrants.
b. The patient's lungs have crackles audible to the midchest.
c. The nasogastric (NG) suction is returning coffee-ground material.
d. The patient's blood pressure (BP) has increased to 142/84 mm Hg.
ANS: B
The patient's lung sounds indicate that pulmonary edema may be developing
because of the rapid infusion of IV fluid and that the fluid infusion rate would be
slowed. The return of coffee-ground material in an NG tube is expected for a
patient with upper GI bleeding. The BP is slightly elevated but would not be an
indication to contact the health care provider immediately. Hyperactive bowel
sounds are common when a patient has GI bleeding.
Which condition would the nurse anticipate when caring for a patient with a
history of a total gastrectomy?
a. Constipation
pg. 1
,b. Dehydration
c. Elevated total serum cholesterol
d. Cobalamin (vitamin B12) deficiency
ANS: D
The patient with a total gastrectomy does not secrete intrinsic factor, which is
needed for cobalamin (vitamin B12) absorption. Because the stomach absorbs only
small amounts of water and nutrients, the patient is not at higher risk for
dehydration, elevated cholesterol, or constipation.
A patient has just returned to the nursing unit after an
esophagogastroduodenoscopy (EGD). Which action by assistive personnel (AP)
requires that the registered nurse (RN) intervene?
a. Offering the patient a pitcher of water
b. Positioning the patient on the right side
c. Checking the vital signs every 30 minutes
d. Swabbing the patient's mouth with a wet cloth
ANS: A
Immediately after EGD, the patient will have a decreased gag reflex and is at risk
for aspiration. Assessment for return of the gag reflex should be done by the RN.
The other actions by the AP are appropriate.
A patient is being scheduled for endoscopic retrograde cholangiopancreatography
(ERCP) as soon as possible. Which prescribed action would the nurse take first?
a. Place the patient on NPO status.
b. Administer sedative medications.
c. Ensure the consent form is signed.
d. Teach the patient about the procedure.
ANS: A
The patient will need to be NPO for 8 hours before the ERCP is done, so the
nurse's initial action should be to place the patient on NPO status. The other actions
can be done after the patient is NPO.
While interviewing a young adult patient, the nurse learns that the patient has a
family history of familial adenomatous polyposis (FAP). Which area of patient
knowledge would the nurse plan to assess?
a. Preventing noninfectious hepatitis
b. Treating inflammatory bowel disease
pg. 2
,c. Risk for developing colorectal cancer
d. Using antacids and proton pump inhibitors
ANS: C
FAP is a genetic condition that greatly increases the risk for colorectal cancer.
Noninfectious hepatitis, use of medications that treat increased gastric pH, and
inflammatory bowel disease are not related to FAP.
Which finding for a young adult who follows a vegan diet may indicate the need
for cobalamin supplementation?
a. Glossitis
b. Ecchymoses
c. Dry, scaly skin
d. Gingival swelling
ANS: A
Cobalamin (vitamin B12) cannot be obtained from foods of plant origin, so the
patient will be most at risk for signs of cobalamin deficiency, such as glossitis,
anorexia, sore mouth and tongue, pallor, neurologic problems (e.g., depression,
dizziness), weight loss, nausea, constipation, and anemia. The other symptoms
listed are associated with other nutritional deficiencies but would not be associated
with a vegan diet.
A 76-yr-old woman with a body mass index (BMI) of 17 kg/m2 and a low serum
albumin level is being admitted. Which assessment finding would the nurse
expect?
a. Restlessness
b. Hypertension
c. Pitting edema
d. Food allergies
ANS: C
Edema occurs when serum albumin levels and plasma oncotic pressure decrease.
The blood pressure and level of consciousness are not directly affected by
malnutrition. Food allergies are not an indicator of nutritional status.
Which menu choice best indicates that the patient is implementing the nurse's
suggestion to choose high-calorie, high-protein foods?
a. Baked fish with applesauce
b. Beef noodle soup and canned corn
pg. 3
, c. Fresh fruit salad with yogurt topping
d. Fried chicken with potatoes and gravy
ANS: D
Foods that are high in calories include fried foods and those covered with sauces.
High-protein foods include meat and dairy products. The other choices are lower in
calories and protein.
A patient has a body mass index (BMI) of 31 kg/m2, a normal C-reactive protein
level, and low serum transferrin and albumin levels. What should the nurse
encourage the patient to increase in the diet?
a. Iron
b. Protein
c. Calories
d. Carbohydrate
ANS: B
The patient's C-reactive protein and transferrin levels indicate low protein stores.
The BMI is in the obese range, so increasing caloric intake is not indicated. The
data do not indicate a need for increased carbohydrate or iron intake.
A patient who has just been started on enteral nutrition of full-strength formula at
100 mL/hr has 6 liquid stools the first day. Which action would the nurse plan to
take?
a. Slow the infusion rate of the feeding.
b. Check gastric residual volumes more often.
c. Change the enteral feeding system and formula every 8 hours.
d. Discontinue administration of water through the feeding tube.
ANS: A
Loose stools indicate poor absorption of nutrients and indicate a need to slow the
feeding rate or decrease the concentration of the feeding. Water should be given
when patients receive enteral feedings to prevent dehydration. When a closed
enteral feeding system is used, the tubing and formula are changed every 24 hours.
High residual volumes do not contribute to diarrhea.
A young adult with extensive facial injuries from a motor vehicle crash is receiving
continuous enteral nutrition through a percutaneous endoscopic gastrostomy
(PEG). Which action will the nurse include in the plan of care?
a. Keep the patient positioned lying on the left side.
pg. 4
