NUR 265 Exam 3 Galen College Of Nursing
Questions And Answers Latest Update 2026
1. A patient admitted with severe sepsis exhibits a blood pressure of 82/46
mmHg, a heart rate of 118 bpm, and a serum lactate level of 4.2 mmol/L.
Following an initial 30 mL/kg isotonic crystalloid fluid bolus, the patient's mean
arterial pressure (MAP) remains at 58 mmHg. Which provider order should the
nurse implement next?
A. Administer a second 30 mL/kg fluid bolus of packed red blood cells.
B. Initiate a continuous infusion of norepinephrine.
C. Apply a non-rebreather mask at 15 L/min.
D. Administer IV furosemide to protect renal perfusion.
2. The nurse is monitoring a patient with a pulmonary artery (Swan-Ganz)
catheter. The current readings reveal a Central Venous Pressure (CVP) of 2 mmHg,
a Pulmonary Artery Wedge Pressure (PAWP) of 4 mmHg, and a Cardiac Index (CI)
of 1.8 L/min/m². Which physiological state do these parameters most closely
reflect?
A. Hypovolemic shock
B. Cardiac tamponade
C. Anaphylactic shock
D. Cardiogenic shock
,3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving
mechanical ventilation. The ventilator settings include a high positive end-
expiratory pressure (PEEP) of 15 cm H₂O. For which critical complication should
the nurse monitor most closely?
A. Oxygen toxicity
B. Barotrauma and decreased cardiac output
C. Respiratory alkalosis and hypoxemia
D. Increased systemic vascular resistance (SVR)
4. A nurse cares for a patient who sustained full-thickness burns to 40% of their
total body surface area (TBSA) 6 hours ago. The nurse notes a drop in urine
output to 15 mL/hour over the last two hours. What is the priority nursing action?
A. Draw blood for emergency serum creatinine and BUN evaluation.
B. Administer an ordered dose of IV furosemide.
C. Increase the rate of the IV lactated Ringer's infusion.
D. Insert a larger urinary catheter to ensure accurate drainage.
5. The nurse notes the sudden onset of a wide-complex tachycardia on the
telemetry monitor of an assigned patient. Upon entering the room, the patient is
unresponsive, pulseless, and gasping for breath. What is the nurse's immediate
action?
A. Administer an immediate IV bolus of amiodarone.
B. Prepare the patient for urgent synchronized cardioversion.
, C. Initiate cardiopulmonary resuscitation (CPR) and call for the crash
cart/defibrillator.
D. Perform a vagal maneuver or carotid massage.
6. A patient in the intensive care unit is exhibiting signs of Multiple Organ
Dysfunction Syndrome (MODS) secondary to pancreatitis. Which assessment
finding best indicates the development of the hematological system dysfunction?
A. An increased reticulocyte count.
B. A gradual drop in the total white blood cell count.
C. Petechiae, oozing from IV sites, and a prolonged PT/INR.
D. Elevated liver enzymes (AST and ALT).
7. During the assessment of a patient with an acute myocardial infarction, the
nurse notes the development of crackles throughout both lung fields, a
respiratory rate of 28/min, and an arterial oxygen saturation (SaO 2 ) of 88% on
room air. Which type of shock should the nurse suspect?
A. Obstructive shock
B. Hypovolemic shock
C. Neurogenic shock
D. Cardiogenic shock
8. A nurse is caring for a patient on mechanical ventilation who suddenly triggers
a high-pressure limit alarm. After entering the room, the nurse observes that the
patient is agitated, coughing, and has asymmetrical chest expansion. What should
the nurse's next step be?
Questions And Answers Latest Update 2026
1. A patient admitted with severe sepsis exhibits a blood pressure of 82/46
mmHg, a heart rate of 118 bpm, and a serum lactate level of 4.2 mmol/L.
Following an initial 30 mL/kg isotonic crystalloid fluid bolus, the patient's mean
arterial pressure (MAP) remains at 58 mmHg. Which provider order should the
nurse implement next?
A. Administer a second 30 mL/kg fluid bolus of packed red blood cells.
B. Initiate a continuous infusion of norepinephrine.
C. Apply a non-rebreather mask at 15 L/min.
D. Administer IV furosemide to protect renal perfusion.
2. The nurse is monitoring a patient with a pulmonary artery (Swan-Ganz)
catheter. The current readings reveal a Central Venous Pressure (CVP) of 2 mmHg,
a Pulmonary Artery Wedge Pressure (PAWP) of 4 mmHg, and a Cardiac Index (CI)
of 1.8 L/min/m². Which physiological state do these parameters most closely
reflect?
A. Hypovolemic shock
B. Cardiac tamponade
C. Anaphylactic shock
D. Cardiogenic shock
,3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving
mechanical ventilation. The ventilator settings include a high positive end-
expiratory pressure (PEEP) of 15 cm H₂O. For which critical complication should
the nurse monitor most closely?
A. Oxygen toxicity
B. Barotrauma and decreased cardiac output
C. Respiratory alkalosis and hypoxemia
D. Increased systemic vascular resistance (SVR)
4. A nurse cares for a patient who sustained full-thickness burns to 40% of their
total body surface area (TBSA) 6 hours ago. The nurse notes a drop in urine
output to 15 mL/hour over the last two hours. What is the priority nursing action?
A. Draw blood for emergency serum creatinine and BUN evaluation.
B. Administer an ordered dose of IV furosemide.
C. Increase the rate of the IV lactated Ringer's infusion.
D. Insert a larger urinary catheter to ensure accurate drainage.
5. The nurse notes the sudden onset of a wide-complex tachycardia on the
telemetry monitor of an assigned patient. Upon entering the room, the patient is
unresponsive, pulseless, and gasping for breath. What is the nurse's immediate
action?
A. Administer an immediate IV bolus of amiodarone.
B. Prepare the patient for urgent synchronized cardioversion.
, C. Initiate cardiopulmonary resuscitation (CPR) and call for the crash
cart/defibrillator.
D. Perform a vagal maneuver or carotid massage.
6. A patient in the intensive care unit is exhibiting signs of Multiple Organ
Dysfunction Syndrome (MODS) secondary to pancreatitis. Which assessment
finding best indicates the development of the hematological system dysfunction?
A. An increased reticulocyte count.
B. A gradual drop in the total white blood cell count.
C. Petechiae, oozing from IV sites, and a prolonged PT/INR.
D. Elevated liver enzymes (AST and ALT).
7. During the assessment of a patient with an acute myocardial infarction, the
nurse notes the development of crackles throughout both lung fields, a
respiratory rate of 28/min, and an arterial oxygen saturation (SaO 2 ) of 88% on
room air. Which type of shock should the nurse suspect?
A. Obstructive shock
B. Hypovolemic shock
C. Neurogenic shock
D. Cardiogenic shock
8. A nurse is caring for a patient on mechanical ventilation who suddenly triggers
a high-pressure limit alarm. After entering the room, the nurse observes that the
patient is agitated, coughing, and has asymmetrical chest expansion. What should
the nurse's next step be?
