NUR 265 EXAM 1 – MEDICAL-SURGICAL NURSING 2026/2027 |300 VERIFIED QUESTIONS & ANSWERS WITH DETAILED RATIONALES 100% PASS GUARANTEED – GRADED A+ (GALEN)

NUR 265 EXAM 1 – MEDICAL-SURGICAL NURSING 2026/2027 |300
VERIFIED QUESTIONS & ANSWERS WITH DETAILED RATIONALES
100% PASS GUARANTEED – GRADED A+ (GALEN)

SECTION 1: FLUID & ELECTROLYTE IMBALANCES (Questions 1–60)
QUESTION 1
A patient presents with confusion, lethargy, and a seizure. Which electrolyte
imbalance is most likely?
A) Hypernatremia
B) Hyponatremia
C) Hyperkalemia
D) Hypocalcemia
Correct Answer: B
Rationale: Low sodium causes cerebral edema, neurologic symptoms, and seizure
risk. Hyponatremia leads to water shifting into brain cells, causing swelling and
neurological impairment.

QUESTION 2
Which lab value is the best indicator of renal function?
A) ALT
B) Creatinine
C) WBC
D) Hemoglobin
Correct Answer: B
Rationale: Creatinine reflects kidney filtration efficiency; elevations suggest renal
dysfunction. ALT assesses liver function, WBC indicates infection, and hemoglobin
measures oxygen-carrying capacity.

QUESTION 3
A patient with severe vomiting for 3 days is at risk for which acid-base imbalance?
A) Metabolic acidosis
B) Metabolic alkalosis
C) Respiratory alkalosis

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,D) Respiratory acidosis
Correct Answer: B
Rationale: Loss of gastric acid (HCl) through vomiting raises serum bicarbonate,
causing metabolic alkalosis. The stomach loses hydrogen ions, leading to an
alkaline state.

QUESTION 4
A patient with heart failure should be monitored for which of the following?
A) Daily weight
B) Intake and output
C) Peripheral edema
D) All of the above
Correct Answer: D
Rationale: Monitoring daily weight, intake/output, and peripheral edema helps
detect worsening fluid retention and prevent fluid overload complications.

QUESTION 5
A patient with hyperkalemia requires which priority nursing action?
A) Continuous ECG monitoring
B) Administer prescribed medications
C) Restrict potassium intake
D) All of the above
Correct Answer: D
Rationale: Hyperkalemia is life-threatening and requires multiple interventions
including ECG monitoring, potassium-restricting diet, and medications such as
Kayexalate, insulin with dextrose, or calcium gluconate.

QUESTION 6
What is the normal range for serum potassium?
A) 1.5–2.5 mEq/L
B) 3.5–5.0 mEq/L
C) 5.5–7.0 mEq/L
D) 8.0–10.0 mEq/L

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,Correct Answer: B
Rationale: Normal serum potassium is 3.5–5.0 mEq/L. Levels below 3.5 indicate
hypokalemia; levels above 5.0 indicate hyperkalemia, both of which can cause
life-threatening cardiac arrhythmias.

QUESTION 7
Which ECG change is characteristic of hyperkalemia?
A) U waves
B) Peaked T waves
C) Prolonged PR interval
D) ST depression
Correct Answer: B
Rationale: Peaked (tall, tented) T waves are the earliest ECG sign of hyperkalemia.
U waves are associated with hypokalemia. Prolonged PR interval and ST
depression can occur but are not the classic finding.

QUESTION 8
Which ECG change is characteristic of hypokalemia?
A) Peaked T waves
B) U waves
C) Widened QRS
D) Prolonged QT
Correct Answer: B
Rationale: U waves (small deflections following the T wave) are characteristic of
hypokalemia. Peaked T waves indicate hyperkalemia.

QUESTION 9
A patient has a serum sodium of 155 mEq/L. The nurse recognizes this as:
A) Hyponatremia
B) Hypernatremia
C) Normal sodium
D) Critical low
Correct Answer: B

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, Rationale: Normal serum sodium is 135–145 mEq/L. A level of 155 mEq/L
indicates hypernatremia, which can result from dehydration, excessive sodium
intake, or impaired thirst mechanism.

QUESTION 10
Which assessment finding is most concerning in a patient with hypernatremia?
A) Thirst
B) Dry mucous membranes
C) Altered mental status
D) Decreased urine output
Correct Answer: C
Rationale: Altered mental status indicates neurological involvement from cellular
dehydration in the brain, which is the most serious complication of
hypernatremia. Thirst, dry mucous membranes, and decreased urine output are
also signs but less immediately life-threatening.

QUESTION 11
A patient with chronic kidney disease has a serum calcium of 7.2 mg/dL. The
nurse should monitor for:
A) Tetany and muscle spasms
B) Hypertension and tachycardia
C) Polyuria and polydipsia
D) Flaccid paralysis
Correct Answer: A
Rationale: Normal calcium is 8.5–10.5 mg/dL. Hypocalcemia causes
neuromuscular irritability, leading to tetany, muscle spasms, Chvostek's sign, and
Trousseau's sign. Flaccid paralysis is associated with hyperkalemia.

QUESTION 12
The nurse assesses a positive Chvostek's sign. This indicates:
A) Hypercalcemia
B) Hypocalcemia
C) Hyperkalemia

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