NUR 265 Advanced Nursing Concepts, Patient Care, and
Clinical Decision-Making Assessment & Medical-Surgical
Nursing - Exams 1, 2, 3, Midterm & Final Ultimate Bundle |
2026/2027 Edition | 200 Verified Questions - 170 Questions
with Answers
NUR 265 Exams 1-3, Midterm & Final 2026-170 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive bundle provides 200 verified questions covering the full scope of NUR 265
Advanced Nursing Concepts and Medical-Surgical Nursing. It is meticulously aligned with the
2026/2027 curriculum and evidence-based practice guidelines. Each question is accompanied by
detailed rationales to enhance clinical reasoning and decision-making. Ideal for exam preparation, this
resource ensures mastery of complex patient care scenarios and advanced nursing interventions.
Key Features:
Advanced patient assessment and clinical judgment
Medical-surgical nursing management across systems
Pharmacological and non-pharmacological interventions
Priority setting and delegation in complex care
Evidence-based practice and quality improvement
Comprehensive rationales for correct and incorrect options
Updates for 2026:
- Updated to reflect 2026/2027 NCLEX-RN test plan and clinical guidelines
- Integrated latest evidence-based practice recommendations
- Expanded rationales to include nursing implications and safety considerations
- Revised to include emerging topics in medical-surgical nursing
- Enhanced alignment with current textbook editions and course objectives
Abstract:
This ultimate bundle for NUR 265 offers a rigorous compilation of 200 exam-style questions designed to evaluate
and reinforce advanced nursing knowledge and clinical acumen. The content spans critical areas of
medical-surgical nursing, including cardiovascular, respiratory, neurological, renal, endocrine, and
gastrointestinal systems, as well as perioperative care and emergency nursing. Each question is crafted to mimic
the complexity of real-world clinical scenarios, requiring synthesis of pathophysiology, pharmacology, and nursing
interventions. Detailed rationales are provided for both correct and incorrect answers, fostering a deeper
understanding of underlying principles and common misconceptions. The bundle is organized to align with the
sequence of Exams 1, 2, 3, midterm, and final, allowing for systematic review and self-assessment. Updated for the
2026/2027 academic year, this resource reflects the latest evidence-based guidelines and NCLEX-RN test plan,
ensuring students are well-prepared for both course examinations and licensure. With a focus on clinical
decision-making, prioritization, and patient safety, this bundle serves as an indispensable tool for nursing students
striving for excellence.
Keywords:
NUR 265, Medical-Surgical Nursing, Advanced Nursing Concepts, Clinical Decision-Making, Exam Prep,
NCLEX-RN, Patient Care, Nursing Rationales
Page 1
,Answer Format:
Each question is presented in multiple-choice or alternate format, followed by the correct answer and a
comprehensive rationale explaining why it is correct. Incorrect options are also analyzed to clarify common
misconceptions. Rationales include nursing implications, safety considerations, and evidence-based practice links.
Compliance Checklist:
Aligned with 2026/2027 NUR 265 course objectives
Reflects latest NCLEX-RN test plan and clinical guidelines
Includes 200 verified questions with evidence-based rationales
Covers all major content areas for Exams 1-3, midterm, and final
Updated to incorporate current medical-surgical nursing best practices
Designed to promote critical thinking and clinical judgment
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations of Advanced 1-20 evidence-based practice, patient safety, 10%
Nursing Practice quality improvement, ethical/legal issues,
health promotion
Cardiovascular & Hematologic 21-50 heart failure, MI, arrhythmias, hypertension, 15%
Disorders DVT, anemia, coagulopathies
Respiratory Disorders 51-70 COPD, asthma, pneumonia, ARDS, 10%
pulmonary embolism, mechanical
ventilation
Neurological & Neurosensory 71-90 stroke, seizures, meningitis, head injury, 10%
Disorders Parkinson's, Alzheimer's
Renal & Urinary Disorders 91-110 AKI, CKD, dialysis, UTIs, nephrolithiasis, 10%
fluid/electrolyte imbalances
Endocrine & Metabolic 111-130 diabetes mellitus, thyroid disorders, adrenal 10%
Disorders insufficiency, DKA, HHS
Gastrointestinal & Hepatic 131-150 GI bleed, pancreatitis, liver failure, 10%
Disorders inflammatory bowel disease, bowel
obstruction
Perioperative & Emergency 151-170 preoperative assessment, postoperative 10%
Nursing complications, shock, trauma, sepsis
Complex Patient Care & 171-190 multiple organ dysfunction, sepsis, burns, 10%
Multisystem Issues fluid resuscitation, critical care monitoring
Leadership, Delegation, and 191-200 delegation, prioritization, assignment, 5%
Prioritization supervision, ethical dilemmas
Page 2
,Q1. A patient with septic shock has a pulmonary artery catheter in place. The nurse
notes a cardiac output of 3.2 L/min, systemic vascular resistance of 600 dynes/sec/cm,
and a mixed venous oxygen saturation (SvO) of 55%. Which intervention is most
appropriate based on these hemodynamic findings?
A. Administer a fluid bolus of 500 mL crystalloid
B. Start a continuous infusion of norepinephrine
C. Titrate up the dobutamine infusion
D. Prepare for immediate intubation
Correct Answer: C. Titrate up the dobutamine infusion
Rationale: The low cardiac output, low SVR, and low SvO ‚ indicate inadequate tissue
perfusion with low cardiac output and oxygen delivery. Dobutamine increases cardiac
contractility and output, improving oxygen delivery. Fluid bolus might be considered if
preload is low, but the primary issue here is pump function. Norepinephrine would worsen
cardiac output by increasing afterload. Intubation is not directly indicated by these
numbers.
Why Wrong:
A - Fluid bolus is not the priority when cardiac output is low and SVR is low; the
issue is contractility, not preload.
B - Norepinephrine increases afterload, which could further reduce cardiac output in a
low-output state.
D - Intubation is not indicated by the hemodynamic values; it addresses
oxygenation/ventilation, not the low cardiac output.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Priorities in Critical Care
Nursing, 9th ed., Ch. 12.
Q2. A patient with a traumatic brain injury has an intraventricular catheter draining
cerebrospinal fluid. The nurse notes a sustained rise in intracranial pressure (ICP) to
25 mm Hg for 10 minutes despite previously stable readings. Which action should the
nurse take first?
A. Elevate the head of the bed to 60 degrees
B. Administer a bolus of mannitol 1 g/kg IV
C. Check the drainage system for a kink or obstruction
D. Notify the neurosurgeon immediately
Correct Answer: C. Check the drainage system for a kink or obstruction
Rationale: The first action is to assess the drainage system patency because a kink or
obstruction can cause a sudden rise in ICP. Elevating the head of the bed is a general
measure but not the first priority. Mannitol is given for sustained ICP elevation, but the
immediate check is the system. Notifying the provider is important but after
troubleshooting.
Page 3
, Why Wrong:
A - Elevating the head of the bed is a standard ICP reduction measure but is not the
first action when the catheter may be blocked.
B - Mannitol is used for sustained ICP elevation, but the immediate priority is to
verify the drainage system is functioning.
D - Notifying the neurosurgeon is important, but the nurse should first troubleshoot
the system to gather more information.
Reference: Hickey, J.V. (2024). The Clinical Practice of Neurological and Neurosurgical
Nursing, 8th ed., Ch. 15.
Q3. A patient with heart failure is receiving a continuous infusion of milrinone. The
nurse reviews the following lab results: potassium 3.2 mEq/L, magnesium 1.6 mg/dL,
BUN 24 mg/dL, creatinine 1.3 mg/dL. Which assessment finding is most important to
monitor?
A. Urine output of 20 mL/hr
B. Heart rate of 72 bpm with occasional premature ventricular contractions
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 16/min
Correct Answer: B. Heart rate of 72 bpm with occasional premature ventricular
contractions
Rationale: Milrinone increases intracellular cAMP and can cause arrhythmias, especially
in the presence of hypokalemia and hypomagnesemia. The occasional PVCs are a warning
sign of increased ventricular irritability. Urine output and blood pressure are important
but not as directly related to the electrolyte imbalances. Respiratory rate is not a primary
concern.
Why Wrong:
A - Oliguria is a concern in heart failure, but hypokalemia and arrhythmia risk are
more immediate with milrinone.
C - Blood pressure is stable, but the arrhythmia risk is more critical due to electrolyte
abnormalities.
D - Respiratory rate is normal and not a primary concern with milrinone therapy.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 26.
Q4. A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L
and an ECG showing peaked T waves. The nurse anticipates which immediate
intervention?
A. IV calcium gluconate 10%
B. IV sodium bicarbonate 50 mEq
C. IV insulin with dextrose 50%
D. Oral sodium polystyrene sulfonate (Kayexalate)
Page 4
Clinical Decision-Making Assessment & Medical-Surgical
Nursing - Exams 1, 2, 3, Midterm & Final Ultimate Bundle |
2026/2027 Edition | 200 Verified Questions - 170 Questions
with Answers
NUR 265 Exams 1-3, Midterm & Final 2026-170 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive bundle provides 200 verified questions covering the full scope of NUR 265
Advanced Nursing Concepts and Medical-Surgical Nursing. It is meticulously aligned with the
2026/2027 curriculum and evidence-based practice guidelines. Each question is accompanied by
detailed rationales to enhance clinical reasoning and decision-making. Ideal for exam preparation, this
resource ensures mastery of complex patient care scenarios and advanced nursing interventions.
Key Features:
Advanced patient assessment and clinical judgment
Medical-surgical nursing management across systems
Pharmacological and non-pharmacological interventions
Priority setting and delegation in complex care
Evidence-based practice and quality improvement
Comprehensive rationales for correct and incorrect options
Updates for 2026:
- Updated to reflect 2026/2027 NCLEX-RN test plan and clinical guidelines
- Integrated latest evidence-based practice recommendations
- Expanded rationales to include nursing implications and safety considerations
- Revised to include emerging topics in medical-surgical nursing
- Enhanced alignment with current textbook editions and course objectives
Abstract:
This ultimate bundle for NUR 265 offers a rigorous compilation of 200 exam-style questions designed to evaluate
and reinforce advanced nursing knowledge and clinical acumen. The content spans critical areas of
medical-surgical nursing, including cardiovascular, respiratory, neurological, renal, endocrine, and
gastrointestinal systems, as well as perioperative care and emergency nursing. Each question is crafted to mimic
the complexity of real-world clinical scenarios, requiring synthesis of pathophysiology, pharmacology, and nursing
interventions. Detailed rationales are provided for both correct and incorrect answers, fostering a deeper
understanding of underlying principles and common misconceptions. The bundle is organized to align with the
sequence of Exams 1, 2, 3, midterm, and final, allowing for systematic review and self-assessment. Updated for the
2026/2027 academic year, this resource reflects the latest evidence-based guidelines and NCLEX-RN test plan,
ensuring students are well-prepared for both course examinations and licensure. With a focus on clinical
decision-making, prioritization, and patient safety, this bundle serves as an indispensable tool for nursing students
striving for excellence.
Keywords:
NUR 265, Medical-Surgical Nursing, Advanced Nursing Concepts, Clinical Decision-Making, Exam Prep,
NCLEX-RN, Patient Care, Nursing Rationales
Page 1
,Answer Format:
Each question is presented in multiple-choice or alternate format, followed by the correct answer and a
comprehensive rationale explaining why it is correct. Incorrect options are also analyzed to clarify common
misconceptions. Rationales include nursing implications, safety considerations, and evidence-based practice links.
Compliance Checklist:
Aligned with 2026/2027 NUR 265 course objectives
Reflects latest NCLEX-RN test plan and clinical guidelines
Includes 200 verified questions with evidence-based rationales
Covers all major content areas for Exams 1-3, midterm, and final
Updated to incorporate current medical-surgical nursing best practices
Designed to promote critical thinking and clinical judgment
Content Area Overview:
Content Area Questions Key Topics Weight
Foundations of Advanced 1-20 evidence-based practice, patient safety, 10%
Nursing Practice quality improvement, ethical/legal issues,
health promotion
Cardiovascular & Hematologic 21-50 heart failure, MI, arrhythmias, hypertension, 15%
Disorders DVT, anemia, coagulopathies
Respiratory Disorders 51-70 COPD, asthma, pneumonia, ARDS, 10%
pulmonary embolism, mechanical
ventilation
Neurological & Neurosensory 71-90 stroke, seizures, meningitis, head injury, 10%
Disorders Parkinson's, Alzheimer's
Renal & Urinary Disorders 91-110 AKI, CKD, dialysis, UTIs, nephrolithiasis, 10%
fluid/electrolyte imbalances
Endocrine & Metabolic 111-130 diabetes mellitus, thyroid disorders, adrenal 10%
Disorders insufficiency, DKA, HHS
Gastrointestinal & Hepatic 131-150 GI bleed, pancreatitis, liver failure, 10%
Disorders inflammatory bowel disease, bowel
obstruction
Perioperative & Emergency 151-170 preoperative assessment, postoperative 10%
Nursing complications, shock, trauma, sepsis
Complex Patient Care & 171-190 multiple organ dysfunction, sepsis, burns, 10%
Multisystem Issues fluid resuscitation, critical care monitoring
Leadership, Delegation, and 191-200 delegation, prioritization, assignment, 5%
Prioritization supervision, ethical dilemmas
Page 2
,Q1. A patient with septic shock has a pulmonary artery catheter in place. The nurse
notes a cardiac output of 3.2 L/min, systemic vascular resistance of 600 dynes/sec/cm,
and a mixed venous oxygen saturation (SvO) of 55%. Which intervention is most
appropriate based on these hemodynamic findings?
A. Administer a fluid bolus of 500 mL crystalloid
B. Start a continuous infusion of norepinephrine
C. Titrate up the dobutamine infusion
D. Prepare for immediate intubation
Correct Answer: C. Titrate up the dobutamine infusion
Rationale: The low cardiac output, low SVR, and low SvO ‚ indicate inadequate tissue
perfusion with low cardiac output and oxygen delivery. Dobutamine increases cardiac
contractility and output, improving oxygen delivery. Fluid bolus might be considered if
preload is low, but the primary issue here is pump function. Norepinephrine would worsen
cardiac output by increasing afterload. Intubation is not directly indicated by these
numbers.
Why Wrong:
A - Fluid bolus is not the priority when cardiac output is low and SVR is low; the
issue is contractility, not preload.
B - Norepinephrine increases afterload, which could further reduce cardiac output in a
low-output state.
D - Intubation is not indicated by the hemodynamic values; it addresses
oxygenation/ventilation, not the low cardiac output.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Priorities in Critical Care
Nursing, 9th ed., Ch. 12.
Q2. A patient with a traumatic brain injury has an intraventricular catheter draining
cerebrospinal fluid. The nurse notes a sustained rise in intracranial pressure (ICP) to
25 mm Hg for 10 minutes despite previously stable readings. Which action should the
nurse take first?
A. Elevate the head of the bed to 60 degrees
B. Administer a bolus of mannitol 1 g/kg IV
C. Check the drainage system for a kink or obstruction
D. Notify the neurosurgeon immediately
Correct Answer: C. Check the drainage system for a kink or obstruction
Rationale: The first action is to assess the drainage system patency because a kink or
obstruction can cause a sudden rise in ICP. Elevating the head of the bed is a general
measure but not the first priority. Mannitol is given for sustained ICP elevation, but the
immediate check is the system. Notifying the provider is important but after
troubleshooting.
Page 3
, Why Wrong:
A - Elevating the head of the bed is a standard ICP reduction measure but is not the
first action when the catheter may be blocked.
B - Mannitol is used for sustained ICP elevation, but the immediate priority is to
verify the drainage system is functioning.
D - Notifying the neurosurgeon is important, but the nurse should first troubleshoot
the system to gather more information.
Reference: Hickey, J.V. (2024). The Clinical Practice of Neurological and Neurosurgical
Nursing, 8th ed., Ch. 15.
Q3. A patient with heart failure is receiving a continuous infusion of milrinone. The
nurse reviews the following lab results: potassium 3.2 mEq/L, magnesium 1.6 mg/dL,
BUN 24 mg/dL, creatinine 1.3 mg/dL. Which assessment finding is most important to
monitor?
A. Urine output of 20 mL/hr
B. Heart rate of 72 bpm with occasional premature ventricular contractions
C. Blood pressure of 110/70 mm Hg
D. Respiratory rate of 16/min
Correct Answer: B. Heart rate of 72 bpm with occasional premature ventricular
contractions
Rationale: Milrinone increases intracellular cAMP and can cause arrhythmias, especially
in the presence of hypokalemia and hypomagnesemia. The occasional PVCs are a warning
sign of increased ventricular irritability. Urine output and blood pressure are important
but not as directly related to the electrolyte imbalances. Respiratory rate is not a primary
concern.
Why Wrong:
A - Oliguria is a concern in heart failure, but hypokalemia and arrhythmia risk are
more immediate with milrinone.
C - Blood pressure is stable, but the arrhythmia risk is more critical due to electrolyte
abnormalities.
D - Respiratory rate is normal and not a primary concern with milrinone therapy.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th ed., Ch. 26.
Q4. A patient with acute kidney injury (AKI) has a serum potassium of 6.8 mEq/L
and an ECG showing peaked T waves. The nurse anticipates which immediate
intervention?
A. IV calcium gluconate 10%
B. IV sodium bicarbonate 50 mEq
C. IV insulin with dextrose 50%
D. Oral sodium polystyrene sulfonate (Kayexalate)
Page 4
