NUR 265 Exam 1: Advanced Medical-
Surgical Nursing | Questions and
Verified Answers | 100% Correct | Grade
A
This is a High-Yield Practice Questions & Rationales
This NUR 265 Exam 1 is a critical, high-stakes Advanced Medical-Surgical Nursing exam
focusing heavily on complex multi-system disorders, critical care interventions, and NCLEX-
style clinical judgment.
This primary 100 practice questions bank for this exam target acute alterations in
perfusion, complex renal pathology, cardiac dysrhythmias, and traumatic emergency
interventions.
📋 NUR 265 Exam 1 Description & Core Blueprint
Exam 1 tests your ability to prioritize nursing actions, interpret critical lab values, and
recognize life-threatening complications. The core content spans three major physiological
systems:
1. Complex Renal & Urinary Disorders
Acute Kidney Injury (AKI): Differentiating prerenal (dehydration, NSAIDs), intrarenal (toxins),
and postrenal (obstruction) failures. Recognizing the RIFLE criteria (Risk, Injury, Failure
stages) based on creatinine and GFR.
Nephrotic Syndrome: Identifying classic hallmarks like massive proteinuria (>3.5g/24 hours),
severe hypoalbuminemia, and generalized edema. Treatment protocols include ACE
inhibitors, immunosuppressants, and statins.
Chronic Kidney Disease (CKD): Fluid and electrolyte management, dialysis complications,
and managing hyperkalemia.
2. Advanced Cardiac Concepts & Dysrhythmias
Cardiac Dysrhythmias: Reading and responding to lethal rhythms on an ECG strip. You must
know the immediate nursing interventions for Ventricular Fibrillation (V-Fib), Ventricular
Tachycardia (V-Tach), Asystole, and Atrial Fibrillation (A-Fib). [1]
1
, Emergency Cardiac Interventions: Medication paths like Epinephrine, Amiodarone, and
Atropine, as well as pre- and post-cardiac catheterization care (e.g., monitoring for a
hematoma or sudden drainage >150 mL/hour).
Inflammatory Heart Diseases: Signs, symptoms, and nursing care for Pericarditis,
Endocarditis, and Myocarditis.
Aortic Aneurysms (AAA): Critical blood pressure parameters, monitoring for signs of rupture
(sudden leg or back pain), and auscultating for bruits.
3. Neurological Emergencies & Trauma
Traumatic Brain Injury (TBI): Assessment priorities using the Glasgow Coma Scale (GCS).
Recognizing medical emergencies like Cushing’s Triad (widening pulse pressure, bradycardia,
irregular respirations).
Cerebrospinal Fluid (CSF) Leaks: Performing the "halo sign" test on clear drainage from the
nose (rhinorrhea) or ears (otorrhea) to verify glucose content.
Q1. What dietary restrictions are recommended in chronic kidney disease
according to the source? [Multiple Choice]
A) Only limit sodium, other intake unrestricted
B) No fluid limits unless on dialysis
C) Restrict protein early, limit potassium, fluid, and sodium
D) Increase protein and potassium to preserve function
Answer: Restrict protein early, limit potassium, fluid, and sodium
Explanation: The source recommends restricting protein early to preserve kidney function and
also limiting potassium, fluid, and sodium to prevent complications like hyperkalemia and volume
overload. Increasing protein or potassium would risk worsening uremia or hyperkalemia. The
source does not advise no fluid limits; instead fluid restriction is part of management. Limiting
only sodium ignores other important restrictions named in the guidance.
Q2. What is the definition of azotemia as given in the text? [Multiple Choice]
A) Fluid restriction to 1000-1500 mL/day
B) Nitrogenous waste build up
C) Extensive, irreversible scarring of the liver
2
, D) A sterile home dialysis procedure
Answer: Nitrogenous waste build up
Explanation: Azotemia refers specifically to accumulation of nitrogenous wastes (like urea) in the
blood when the kidneys fail to clear them. The other options describe cirrhosis, an AKI dietary
recommendation, and peritoneal dialysis — all items in the source but unrelated to the meaning
of azotemia.
Q3. Which of the following is listed among common causes of cirrhosis in the
source? [Multiple Choice]
A) Fluid restriction to 1000-1500 mL/day for AKI
B) ETOH, viral hepatitis (HEP C), autoimmune hepatitis, and hepatotoxic drugs
C) Palpation and auscultation for bruit and thrill
D) NSAIDs, metformin, diuretics, and contrast dye
Answer: ETOH, viral hepatitis (HEP C), autoimmune hepatitis, and hepatotoxic drugs
Explanation: The source lists alcohol (ETOH), viral hepatitis such as hepatitis C, autoimmune
hepatitis, and hepatotoxic drugs/chemicals (for example acetaminophen) as common causes of
cirrhosis. The first incorrect choice lists nephrotoxic agents, the second describes AV fistula
assessment steps, and the third is an AKI dietary recommendation — none are causes of cirrhosis
per the material.
Q4. In the diagram, which two actions correspond to bedside assessment of an
arteriovenous (AV) fistula's function? [Multiple Choice]
A) Warm the solution and wear a mask
B) Feel vibration and listen for sound
C) Avoid heavy lifting and apply pressure
D) Monitor for aneurysm and take daily weights
Answer: Feel vibration and listen for sound
Explanation: An AV fistula is assessed clinically by palpation (feeling a vibration or thrill) and
auscultation (hearing a bruit). "Feel vibration and listen for sound" maps to these assessment
actions. Avoiding heavy lifting and avoiding pressure are protective instructions but not
assessment methods. Monitoring for aneurysm is a complication to watch for, not the primary
bedside functional assessment. Warming solution and wearing a mask are steps for peritoneal
dialysis, unrelated to AV fistula assessment.
3
, Q5. Which of the following matches the described features of peritoneal dialysis
in the source? [Multiple Choice]
A) Sterile home procedure with abdominal catheter, wear a mask, warmed solution
(not microwave), reposition to mix
B) Done 3× weekly for 4–5 hours in center with heparin use
C) Use Lactulose to lower ammonia in encephalopathy
D) Restrict protein, sodium, and fluids to 1000–1500 mL/day
Answer: Sterile home procedure with abdominal catheter, wear a mask, warmed
solution (not microwave), reposition to mix
Explanation: Peritoneal dialysis is a sterile home-based technique using an abdominal catheter;
the source advises wearing a mask, warming solution with a heating bag or blanket (not a
microwave), and turning/repositioning to mix the dialysate. The first incorrect choice describes
hemodialysis, the second is dietary guidance for AKI/CKD, and the third is a treatment for
elevated ammonia in hepatic encephalopathy — none describe peritoneal dialysis.
Q6. Which dietary instruction applies to a patient with acute kidney injury
(unless the issue is perfusion-related)? [Multiple Choice]
A) Fluid restriction: 1000-1500mL day
B) High protein diet to promote healing
C) Unlimited fluid intake if urine output is high
D) No sodium restriction required
Answer: Fluid restriction: 1000-1500mL day
Explanation: For AKI (except when the problem is perfusion-related), fluid is commonly restricted
to about 1000–1500 mL/day to avoid volume overload. The source advises low protein and low
sodium, not high protein or no sodium restriction. Unlimited fluids would risk overload unless
perfusion is the problem; the guidance is explicit about restricting fluids.
Q7. Which of the following is listed as a common nephrotoxic drug in the source
text? [Multiple Choice]
A) Heparin
B) Lactulose
C) Acetaminophen
D) NSAIDS
4
Surgical Nursing | Questions and
Verified Answers | 100% Correct | Grade
A
This is a High-Yield Practice Questions & Rationales
This NUR 265 Exam 1 is a critical, high-stakes Advanced Medical-Surgical Nursing exam
focusing heavily on complex multi-system disorders, critical care interventions, and NCLEX-
style clinical judgment.
This primary 100 practice questions bank for this exam target acute alterations in
perfusion, complex renal pathology, cardiac dysrhythmias, and traumatic emergency
interventions.
📋 NUR 265 Exam 1 Description & Core Blueprint
Exam 1 tests your ability to prioritize nursing actions, interpret critical lab values, and
recognize life-threatening complications. The core content spans three major physiological
systems:
1. Complex Renal & Urinary Disorders
Acute Kidney Injury (AKI): Differentiating prerenal (dehydration, NSAIDs), intrarenal (toxins),
and postrenal (obstruction) failures. Recognizing the RIFLE criteria (Risk, Injury, Failure
stages) based on creatinine and GFR.
Nephrotic Syndrome: Identifying classic hallmarks like massive proteinuria (>3.5g/24 hours),
severe hypoalbuminemia, and generalized edema. Treatment protocols include ACE
inhibitors, immunosuppressants, and statins.
Chronic Kidney Disease (CKD): Fluid and electrolyte management, dialysis complications,
and managing hyperkalemia.
2. Advanced Cardiac Concepts & Dysrhythmias
Cardiac Dysrhythmias: Reading and responding to lethal rhythms on an ECG strip. You must
know the immediate nursing interventions for Ventricular Fibrillation (V-Fib), Ventricular
Tachycardia (V-Tach), Asystole, and Atrial Fibrillation (A-Fib). [1]
1
, Emergency Cardiac Interventions: Medication paths like Epinephrine, Amiodarone, and
Atropine, as well as pre- and post-cardiac catheterization care (e.g., monitoring for a
hematoma or sudden drainage >150 mL/hour).
Inflammatory Heart Diseases: Signs, symptoms, and nursing care for Pericarditis,
Endocarditis, and Myocarditis.
Aortic Aneurysms (AAA): Critical blood pressure parameters, monitoring for signs of rupture
(sudden leg or back pain), and auscultating for bruits.
3. Neurological Emergencies & Trauma
Traumatic Brain Injury (TBI): Assessment priorities using the Glasgow Coma Scale (GCS).
Recognizing medical emergencies like Cushing’s Triad (widening pulse pressure, bradycardia,
irregular respirations).
Cerebrospinal Fluid (CSF) Leaks: Performing the "halo sign" test on clear drainage from the
nose (rhinorrhea) or ears (otorrhea) to verify glucose content.
Q1. What dietary restrictions are recommended in chronic kidney disease
according to the source? [Multiple Choice]
A) Only limit sodium, other intake unrestricted
B) No fluid limits unless on dialysis
C) Restrict protein early, limit potassium, fluid, and sodium
D) Increase protein and potassium to preserve function
Answer: Restrict protein early, limit potassium, fluid, and sodium
Explanation: The source recommends restricting protein early to preserve kidney function and
also limiting potassium, fluid, and sodium to prevent complications like hyperkalemia and volume
overload. Increasing protein or potassium would risk worsening uremia or hyperkalemia. The
source does not advise no fluid limits; instead fluid restriction is part of management. Limiting
only sodium ignores other important restrictions named in the guidance.
Q2. What is the definition of azotemia as given in the text? [Multiple Choice]
A) Fluid restriction to 1000-1500 mL/day
B) Nitrogenous waste build up
C) Extensive, irreversible scarring of the liver
2
, D) A sterile home dialysis procedure
Answer: Nitrogenous waste build up
Explanation: Azotemia refers specifically to accumulation of nitrogenous wastes (like urea) in the
blood when the kidneys fail to clear them. The other options describe cirrhosis, an AKI dietary
recommendation, and peritoneal dialysis — all items in the source but unrelated to the meaning
of azotemia.
Q3. Which of the following is listed among common causes of cirrhosis in the
source? [Multiple Choice]
A) Fluid restriction to 1000-1500 mL/day for AKI
B) ETOH, viral hepatitis (HEP C), autoimmune hepatitis, and hepatotoxic drugs
C) Palpation and auscultation for bruit and thrill
D) NSAIDs, metformin, diuretics, and contrast dye
Answer: ETOH, viral hepatitis (HEP C), autoimmune hepatitis, and hepatotoxic drugs
Explanation: The source lists alcohol (ETOH), viral hepatitis such as hepatitis C, autoimmune
hepatitis, and hepatotoxic drugs/chemicals (for example acetaminophen) as common causes of
cirrhosis. The first incorrect choice lists nephrotoxic agents, the second describes AV fistula
assessment steps, and the third is an AKI dietary recommendation — none are causes of cirrhosis
per the material.
Q4. In the diagram, which two actions correspond to bedside assessment of an
arteriovenous (AV) fistula's function? [Multiple Choice]
A) Warm the solution and wear a mask
B) Feel vibration and listen for sound
C) Avoid heavy lifting and apply pressure
D) Monitor for aneurysm and take daily weights
Answer: Feel vibration and listen for sound
Explanation: An AV fistula is assessed clinically by palpation (feeling a vibration or thrill) and
auscultation (hearing a bruit). "Feel vibration and listen for sound" maps to these assessment
actions. Avoiding heavy lifting and avoiding pressure are protective instructions but not
assessment methods. Monitoring for aneurysm is a complication to watch for, not the primary
bedside functional assessment. Warming solution and wearing a mask are steps for peritoneal
dialysis, unrelated to AV fistula assessment.
3
, Q5. Which of the following matches the described features of peritoneal dialysis
in the source? [Multiple Choice]
A) Sterile home procedure with abdominal catheter, wear a mask, warmed solution
(not microwave), reposition to mix
B) Done 3× weekly for 4–5 hours in center with heparin use
C) Use Lactulose to lower ammonia in encephalopathy
D) Restrict protein, sodium, and fluids to 1000–1500 mL/day
Answer: Sterile home procedure with abdominal catheter, wear a mask, warmed
solution (not microwave), reposition to mix
Explanation: Peritoneal dialysis is a sterile home-based technique using an abdominal catheter;
the source advises wearing a mask, warming solution with a heating bag or blanket (not a
microwave), and turning/repositioning to mix the dialysate. The first incorrect choice describes
hemodialysis, the second is dietary guidance for AKI/CKD, and the third is a treatment for
elevated ammonia in hepatic encephalopathy — none describe peritoneal dialysis.
Q6. Which dietary instruction applies to a patient with acute kidney injury
(unless the issue is perfusion-related)? [Multiple Choice]
A) Fluid restriction: 1000-1500mL day
B) High protein diet to promote healing
C) Unlimited fluid intake if urine output is high
D) No sodium restriction required
Answer: Fluid restriction: 1000-1500mL day
Explanation: For AKI (except when the problem is perfusion-related), fluid is commonly restricted
to about 1000–1500 mL/day to avoid volume overload. The source advises low protein and low
sodium, not high protein or no sodium restriction. Unlimited fluids would risk overload unless
perfusion is the problem; the guidance is explicit about restricting fluids.
Q7. Which of the following is listed as a common nephrotoxic drug in the source
text? [Multiple Choice]
A) Heparin
B) Lactulose
C) Acetaminophen
D) NSAIDS
4
