with Answers & Detailed Clinical Rationales | Updated 2026 | A+ Graded
TABLE OF CONTENTS
| Section | Topic | Questions |
|---------|-------|-----------|
| 1 | Exam Overview & Test Plan | — |
| 2 | Gastrointestinal & Liver Disorders – Cirrhosis, Pancreatitis, Hepatic Encephalopathy |
Questions 1–50 |
| 3 | Renal Disorders – Acute Kidney Injury, Chronic Kidney Disease, Dialysis | Questions 51–100
|
| 4 | Fluid & Electrolyte Imbalances – Hyperkalemia, Hyponatremia, Dehydration, SIADH |
Questions 101–140 |
| 5 | Cardiac Disorders – Myocardial Infarction, Heart Failure, Dysrhythmias, Cardiac Tamponade
| Questions 141–190 |
| 6 | Preoperative & Intraoperative Care – NPO Guidelines, Anticoagulants, Malignant
Hyperthermia | Questions 191–220 |
| 7 | Postoperative Complications – Hemorrhage, PE, Ileus, Urinary Retention, Wound Healing |
Questions 221–250 |
| 8 | Emergency & Critical Care Nursing – Prioritization, Triage, Clinical Judgment | Questions
251–280 |
| 9 | Ethical & Legal Principles in Nursing – Autonomy, Beneficence, Nonmaleficence, Justice |
Questions 281–300 |
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EXAM OVERVIEW
,| Feature | Details |
|---------|---------|
| Exam | NUR 265 Advanced Concepts of Medical-Surgical Nursing – Exam 1 |
| Course | Galen College of Nursing |
| Format | Multiple Choice, NGN-Style Clinical Scenarios |
| Emphasis | Clinical Judgment, Priority-Setting, Critical Thinking, Evidence-Based Interventions
|
Test Plan Weightings
| Content Area | Approx. Weight |
|--------------|----------------|
| Gastrointestinal & Liver Disorders | 18% |
| Renal Disorders & Dialysis | 18% |
| Fluid & Electrolyte Imbalances | 15% |
| Cardiac Disorders | 20% |
| Preoperative & Intraoperative Care | 8% |
| Postoperative Complications | 8% |
| Emergency & Critical Care Nursing | 8% |
| Ethical & Legal Principles | 5% |
Core Domains Covered
1. Gastrointestinal & Liver Disorders – Cirrhosis, portal hypertension, ascites, esophageal
varices, hepatic encephalopathy, lactulose therapy, pancreatitis, pancreatic enzyme
replacement
,2. Renal Disorders – Acute kidney injury (prerenal, intrarenal, postrenal), chronic kidney disease,
uremia, peritoneal dialysis, hemodialysis, disequilibrium syndrome
3. Fluid & Electrolyte Imbalances – Hyperkalemia (ECG changes, peaked T waves), hypokalemia,
hyponatremia, SIADH, dehydration, acid-base balance
4. Cardiac Disorders – Myocardial infarction (troponin, 12-lead ECG), heart failure (EF 35%),
cardiac tamponade (classic signs), endocarditis, dysrhythmias (PVCs, V-fib, AFib), nitroglycerin,
dopamine, tenecteplase
5. Perioperative Nursing – Preoperative NPO guidelines, anticoagulant management, malignant
hyperthermia precautions, postoperative complications (hemorrhage, PE, ileus, urinary
retention)
6. Wound Healing & Pressure Injuries – Wound staging, dehiscence, evisceration, infection
control
7. Emergency & Disaster Nursing – Prioritization, triage, emergency care protocols, clinical
judgment
8. Ethical & Legal Principles – Autonomy, beneficence, nonmaleficence, justice, confidentiality,
Patient Bill of Rights
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SECTION 1: GASTROINTESTINAL & LIVER DISORDERS – CIRRHOSIS, PANCREATITIS, HEPATIC
ENCEPHALOPATHY
, Questions 1–50
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Question 1
The RN is caring for a patient with cirrhosis who develops increasing abdominal girth with
abdominal discomfort. What should the RN expect as a new order from the healthcare
provider?
A) Furosemide (Lasix)
B) Spironolactone
C) Beta-blockers
D) Albumin
Correct Answer: B
Rationale: Ascites from cirrhosis often requires potassium-sparing diuretics like spironolactone
to manage fluid retention by antagonizing aldosterone. This choice considers electrolyte
balance and renal function. Furosemide (A) may be used but often requires potassium
supplementation. Beta-blockers (C) are used for portal hypertension and variceal prevention.
Albumin (D) may be used in some cases but is not the primary treatment for ascites.
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Question 2
The RN is caring for a patient with pancreatitis. What should the RN continue to monitor to
decrease the risk of complications?