NUR 265 Medical-Surgical Nursing Exam | High-Yield Practice
Questions, Correct Answers & Detailed Explanations
2026/2027
Question 1
A client with chronic stable angina is prescribed sublingual nitroglycerin
tablets. Which of the following instructions should the nurse include
when teaching the client about proper storage and administration of
the medication?
• A. "Keep the tablets in a clear plastic pillbox in your pocket for
easy daily access."
• B. "Store the tablets in their original dark, airtight glass container
and replace them every 6 months."
• C. "If your chest pain is not relieved after taking one tablet, wait
15 minutes before taking a second dose."
• D. "Swallow the tablet whole with a full glass of water
immediately upon feeling chest pressure."
Correct Answer: B. "Store the tablets in their original dark, airtight glass
container and replace them every 6 months."
Detailed Rationale: Nitroglycerin is unstable and degrades when
exposed to light, heat, moisture, and air. It must be stored in its original
dark glass bottle with a tight-fitting cap and discarded after 6 months.
Tablets are placed sublingually (not swallowed), and a dose can be
repeated every 5 minutes for up to 3 doses while calling emergency
services if pain persists.
Question 2
,A client with chronic obstructive pulmonary disease (COPD) is admitted
with an acute exacerbation. The client's arterial blood gas results show
pH 7.32, PaCO2 58 mmHg, PaO2 55 mmHg, and HCO3 31 mEq/L. Which
of the following oxygen delivery systems is most appropriate for
managing this client?
• A. Non-rebreather mask at 15 L/min.
• B. Simple face mask at 8 L/min.
• C. Nasal cannula at 1 to 2 L/min or a Venturi mask.
• D. High-flow nasal cannula at 50 L/min with 100% FiO2.
Correct Answer: C. Nasal cannula at 1 to 2 L/min or a Venturi mask.
Detailed Rationale: Clients with chronic hypercapnia rely on their
hypoxic drive to breathe. High-flow or high-concentration oxygen can
suppress this drive, leading to worsening hypoventilation and carbon
dioxide narcosis. Controlled, low-flow oxygen delivery (via nasal cannula
or Venturi mask for precise FiO2) is critical to safely improve
oxygenation without removing the hypoxic stimulus.
Question 3
A client receiving peritoneal dialysis reports that the dialysate effluent is
draining very slowly and notes intermittent cessation of flow. Which of
the following nursing actions should the nurse perform first?
• A. Instill 50 mL of sterile water into the peritoneal catheter to
flush out resistance.
• B. Have the client change positions, check for kinks in the tubing,
or gently milk the tubing to dislodge fibrin clots.
, • C. Clamp the peritoneal catheter permanently and prepare the
client for conversion to hemodialysis.
• D. Administer a high-dose loop diuretic intravenously to stimulate
renal fluid excretion.
Correct Answer: B. Have the client change positions, check for kinks in
the tubing, or gently milk the tubing to dislodge fibrin clots.
Detailed Rationale: Slow or obstructed outflow in peritoneal dialysis is
frequently caused by catheter malposition, kinking of the tubing, or
fibrin clot occlusion. Simple non-invasive interventions such as
repositioning the client, checking the line for kinks, or milking the
tubing should be attempted first.
Question 4
A client is admitted to the medical unit with central diabetes insipidus
following head trauma. Which of the following laboratory and clinical
findings should the nurse expect to assess?
• A. Hyponatremia, high urine specific gravity, and concentrated
urine output.
• B. Hypernatremia, low urine specific gravity, and excessive
polyuria (dilute urine).
• C. Hypokalemia, weight gain, and generalized edema.
• D. Normal serum sodium with severe oliguria and elevated blood
pressure.
Correct Answer: B. Hypernatremia, low urine specific gravity, and
excessive polyuria (dilute urine).
, Detailed Rationale: Central diabetes insipidus is caused by a deficiency
of antidiuretic hormone (ADH), resulting in the kidneys' inability to
reabsorb water. This leads to massive volumes of dilute urine (polyuria
with low specific gravity), hypernatremia, and intense thirst (polydipsia).
Question 5
A client undergoes a carotid endarterectomy to treat severe carotid
artery stenosis. In the immediate postoperative period, which of the
following assessments is the nurse's highest priority?
• A. Monitoring for signs of neurological deficits and assessing
cranial nerve function (e.g., facial symmetry, swallowing).
• B. Encouraging the client to cough and deep breathe every hour to
clear airway secretions.
• C. Applying ice packs to the neck continuously to prevent swelling.
• D. Assisting the client to ambulate in the hallway within 2 hours of
surgery.
Correct Answer: A. Monitoring for signs of neurological deficits and
assessing cranial nerve function (e.g., facial symmetry, swallowing).
Detailed Rationale: Following a carotid endarterectomy, clients are at
risk for stroke, hemorrhage, and cranial nerve injury (due to proximity
of surgical sites affecting cranial nerves VII, X, XI, and XII). Assessing
neurological status and cranial nerve function is vital for detecting early
complications.
Question 6
A client with a history of peptic ulcer disease is brought to the
emergency department reporting sudden, severe, sharp upper
Questions, Correct Answers & Detailed Explanations
2026/2027
Question 1
A client with chronic stable angina is prescribed sublingual nitroglycerin
tablets. Which of the following instructions should the nurse include
when teaching the client about proper storage and administration of
the medication?
• A. "Keep the tablets in a clear plastic pillbox in your pocket for
easy daily access."
• B. "Store the tablets in their original dark, airtight glass container
and replace them every 6 months."
• C. "If your chest pain is not relieved after taking one tablet, wait
15 minutes before taking a second dose."
• D. "Swallow the tablet whole with a full glass of water
immediately upon feeling chest pressure."
Correct Answer: B. "Store the tablets in their original dark, airtight glass
container and replace them every 6 months."
Detailed Rationale: Nitroglycerin is unstable and degrades when
exposed to light, heat, moisture, and air. It must be stored in its original
dark glass bottle with a tight-fitting cap and discarded after 6 months.
Tablets are placed sublingually (not swallowed), and a dose can be
repeated every 5 minutes for up to 3 doses while calling emergency
services if pain persists.
Question 2
,A client with chronic obstructive pulmonary disease (COPD) is admitted
with an acute exacerbation. The client's arterial blood gas results show
pH 7.32, PaCO2 58 mmHg, PaO2 55 mmHg, and HCO3 31 mEq/L. Which
of the following oxygen delivery systems is most appropriate for
managing this client?
• A. Non-rebreather mask at 15 L/min.
• B. Simple face mask at 8 L/min.
• C. Nasal cannula at 1 to 2 L/min or a Venturi mask.
• D. High-flow nasal cannula at 50 L/min with 100% FiO2.
Correct Answer: C. Nasal cannula at 1 to 2 L/min or a Venturi mask.
Detailed Rationale: Clients with chronic hypercapnia rely on their
hypoxic drive to breathe. High-flow or high-concentration oxygen can
suppress this drive, leading to worsening hypoventilation and carbon
dioxide narcosis. Controlled, low-flow oxygen delivery (via nasal cannula
or Venturi mask for precise FiO2) is critical to safely improve
oxygenation without removing the hypoxic stimulus.
Question 3
A client receiving peritoneal dialysis reports that the dialysate effluent is
draining very slowly and notes intermittent cessation of flow. Which of
the following nursing actions should the nurse perform first?
• A. Instill 50 mL of sterile water into the peritoneal catheter to
flush out resistance.
• B. Have the client change positions, check for kinks in the tubing,
or gently milk the tubing to dislodge fibrin clots.
, • C. Clamp the peritoneal catheter permanently and prepare the
client for conversion to hemodialysis.
• D. Administer a high-dose loop diuretic intravenously to stimulate
renal fluid excretion.
Correct Answer: B. Have the client change positions, check for kinks in
the tubing, or gently milk the tubing to dislodge fibrin clots.
Detailed Rationale: Slow or obstructed outflow in peritoneal dialysis is
frequently caused by catheter malposition, kinking of the tubing, or
fibrin clot occlusion. Simple non-invasive interventions such as
repositioning the client, checking the line for kinks, or milking the
tubing should be attempted first.
Question 4
A client is admitted to the medical unit with central diabetes insipidus
following head trauma. Which of the following laboratory and clinical
findings should the nurse expect to assess?
• A. Hyponatremia, high urine specific gravity, and concentrated
urine output.
• B. Hypernatremia, low urine specific gravity, and excessive
polyuria (dilute urine).
• C. Hypokalemia, weight gain, and generalized edema.
• D. Normal serum sodium with severe oliguria and elevated blood
pressure.
Correct Answer: B. Hypernatremia, low urine specific gravity, and
excessive polyuria (dilute urine).
, Detailed Rationale: Central diabetes insipidus is caused by a deficiency
of antidiuretic hormone (ADH), resulting in the kidneys' inability to
reabsorb water. This leads to massive volumes of dilute urine (polyuria
with low specific gravity), hypernatremia, and intense thirst (polydipsia).
Question 5
A client undergoes a carotid endarterectomy to treat severe carotid
artery stenosis. In the immediate postoperative period, which of the
following assessments is the nurse's highest priority?
• A. Monitoring for signs of neurological deficits and assessing
cranial nerve function (e.g., facial symmetry, swallowing).
• B. Encouraging the client to cough and deep breathe every hour to
clear airway secretions.
• C. Applying ice packs to the neck continuously to prevent swelling.
• D. Assisting the client to ambulate in the hallway within 2 hours of
surgery.
Correct Answer: A. Monitoring for signs of neurological deficits and
assessing cranial nerve function (e.g., facial symmetry, swallowing).
Detailed Rationale: Following a carotid endarterectomy, clients are at
risk for stroke, hemorrhage, and cranial nerve injury (due to proximity
of surgical sites affecting cranial nerves VII, X, XI, and XII). Assessing
neurological status and cranial nerve function is vital for detecting early
complications.
Question 6
A client with a history of peptic ulcer disease is brought to the
emergency department reporting sudden, severe, sharp upper
