NUR 265 Medical-Surgical Nursing - Exam 3 Ultimate
Practice Exam | 2026/2027 Edition | 200+ Verified Questions -
160 Questions with Answers
NUR 265 Medical-Surgical Nursing Exam 3 2026-160 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive practice exam is meticulously designed for nursing students preparing for NUR
265 Medical-Surgical Nursing Exam 3. With over 200 verified questions, it covers critical content
areas including cardiovascular, respiratory, and renal disorders, as well as perioperative care and
fluid/electrolyte imbalances. Each question is accompanied by detailed rationales and explanations to
reinforce understanding and promote clinical reasoning. Updated for the 2026/2027 academic year, this
resource aligns with current evidence-based practice and NCLEX-RN test plan. It is an essential tool
for achieving a high score and mastering medical-surgical nursing concepts.
Key Features:
Cardiovascular disorders: heart failure, myocardial infarction, arrhythmias
Respiratory disorders: COPD, pneumonia, pulmonary embolism
Renal and urinary disorders: acute kidney injury, chronic kidney disease, urinary tract infections
Perioperative nursing care: preoperative, intraoperative, and postoperative management
Fluid and electrolyte imbalances: sodium, potassium, calcium, and magnesium disturbances
Comprehensive rationales and NCLEX-style questions with detailed explanations
Updates for 2026:
- Revised to include the latest evidence-based guidelines for 2026/2027
- Added new questions on emerging pharmacological treatments and nursing interventions
- Updated rationales to reflect current NCLEX-RN test plan and clinical practice standards
- Enhanced answer explanations to include distractors analysis and critical thinking tips
- Expanded coverage of patient safety and quality improvement concepts
Abstract:
This practice examination serves as an authoritative resource for nursing students enrolled in NUR 265
Medical-Surgical Nursing, specifically targeting Exam 3 content. The document comprises over 200 carefully
selected questions that mirror the format and complexity of actual nursing school exams and the NCLEX-RN. Each
question is followed by a comprehensive rationale that not only explains the correct answer but also dissects
incorrect options, thereby fostering a deeper understanding of medical-surgical nursing principles. The content is
organized by major body systems and nursing care domains, ensuring a systematic review. Updated to reflect the
2026/2027 academic year, this resource integrates current clinical guidelines, pharmacological updates, and
evidence-based interventions. It is designed to enhance critical thinking, clinical judgment, and test-taking skills,
ultimately preparing students to excel in their examinations and future nursing practice.
Keywords:
Medical-Surgical Nursing, NUR 265, Exam 3, Practice Questions, NCLEX-RN, Nursing Rationales,
Cardiovascular Disorders, Perioperative Care
Answer Format:
Each question is presented in NCLEX-style multiple-choice format with four options. Following each question, a
detailed answer explanation is provided, including the correct answer, a rationale for why it is correct, and an
analysis of why the other options are incorrect. Rationales are evidence-based and aligned with current nursing
standards, promoting clinical reasoning and application.
Page 1
,Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and nursing curriculum standards
Updated to reflect 2026/2027 evidence-based practice guidelines
Includes 200+ verified questions with accurate answers and rationales
Covers all major content areas of NUR 265 Exam 3
Designed to promote critical thinking and clinical judgment
Suitable for self-assessment and comprehensive review
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-50 Heart failure, Myocardial infarction, 25%
Arrhythmias, Hypertension, Cardiac
medications
Respiratory Disorders 51-90 COPD, Pneumonia, Pulmonary embolism, 20%
Asthma, Oxygen therapy
Renal and Urinary Disorders 91-130 Acute kidney injury, Chronic kidney 20%
disease, Urinary tract infections, Dialysis,
Fluid balance
Perioperative Nursing Care 131-160 Preoperative assessment, Intraoperative 15%
safety, Postoperative complications, Pain
management, Wound care
Fluid and Electrolyte Imbalances 161-190 Sodium imbalances, Potassium imbalances, 15%
Calcium and magnesium disturbances,
Acid-base balance, IV therapy
Miscellaneous Medical-Surgical 191-200+ Endocrine disorders, Gastrointestinal 5%
Topics disorders, Neurological disorders, Infection
control, Patient education
Page 2
,Q1. In a patient with septic shock and acute respiratory distress syndrome (ARDS),
which ventilator strategy is most appropriate to minimize ventilator-induced lung
injury?
A. High tidal volume (10-12 mL/kg) with low PEEP
B. Low tidal volume (6 mL/kg ideal body weight) with high PEEP
C. Low tidal volume (6 mL/kg) with low PEEP
D. High tidal volume (8-10 mL/kg) with high PEEP
Correct Answer: B. Low tidal volume (6 mL/kg ideal body weight) with high PEEP
Rationale: Low tidal volume (6 mL/kg) and high PEEP are recommended to prevent
alveolar overdistension and maintain alveolar recruitment, thus reducing
ventilator-associated lung injury. High tidal volumes can cause volutrauma and worsen
ARDS.
Why Wrong:
A - High tidal volumes cause volutrauma and are contraindicated in ARDS.
C - Low PEEP may not adequately recruit collapsed alveoli, leading to atelectrauma.
D - High tidal volumes with high PEEP increases risk of overdistension and
barotrauma.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Critical Care Nursing, 9th
Ed., Ch. 12.
Q2. A patient with chronic kidney disease (CKD) is prescribed erythropoietin. Which
laboratory value should be monitored to evaluate the effectiveness of therapy?
A. Serum creatinine
B. Hemoglobin and hematocrit
C. Serum potassium
D. White blood cell count
Correct Answer: B. Hemoglobin and hematocrit
Rationale: Erythropoietin stimulates red blood cell production, so hemoglobin and
hematocrit levels are the direct indicators of therapeutic response. Creatinine reflects
kidney function, potassium and WBC are not affected by erythropoietin.
Why Wrong:
A - Creatinine assesses kidney function, not erythropoietin efficacy.
C - Potassium may be elevated in CKD but does not indicate response to
erythropoietin.
D - WBC count is unrelated to erythropoietin therapy.
Reference: Lewis, S.L., et al. (2026). Medical-Surgical Nursing, 11th Ed., Ch. 45.
Page 3
, Q3. A patient with a pulmonary embolism is receiving heparin. Which laboratory test
is used to monitor therapeutic anticoagulation?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: Heparin acts on the intrinsic pathway and is monitored by aPTT, which should
be 1.5-2.5 times the control. PT/INR monitor warfarin, and platelet count is for
heparin-induced thrombocytopenia.
Why Wrong:
A - PT is used to monitor warfarin, not heparin.
C - INR is also for warfarin monitoring.
D - Platelet count is not the therapeutic monitor for heparin.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 34.
Q4. Which of the following findings is most indicative of a tension pneumothorax in a
patient on mechanical ventilation?
A. Sudden increase in peak airway pressure, hypotension, and absent breath sounds on
one side
B. Gradual decrease in oxygen saturation and crackles on auscultation
C. Elevated temperature and purulent sputum
D. Decreased heart rate and increased blood pressure
Correct Answer: A. Sudden increase in peak airway pressure, hypotension, and
absent breath sounds on one side
Rationale: Tension pneumothorax causes increased intrathoracic pressure, leading to
increased peak airway pressures, hypotension, and unilateral absent breath sounds. This
is a medical emergency requiring immediate decompression.
Why Wrong:
B - Crackles are more typical of pulmonary edema or pneumonia.
C - Fever and purulent sputum suggest infection, not pneumothorax.
D - Tension pneumothorax typically causes tachycardia and hypotension, not
bradycardia.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 9th Ed., Ch. 14.
Q5. A patient with acute coronary syndrome is prescribed nitroglycerin. What is the
primary mechanism of action?
A. Inhibition of platelet aggregation
Page 4
Practice Exam | 2026/2027 Edition | 200+ Verified Questions -
160 Questions with Answers
NUR 265 Medical-Surgical Nursing Exam 3 2026-160 QUESTIONS AND ANSWERS ALREADY GRADED A+.
100% Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive practice exam is meticulously designed for nursing students preparing for NUR
265 Medical-Surgical Nursing Exam 3. With over 200 verified questions, it covers critical content
areas including cardiovascular, respiratory, and renal disorders, as well as perioperative care and
fluid/electrolyte imbalances. Each question is accompanied by detailed rationales and explanations to
reinforce understanding and promote clinical reasoning. Updated for the 2026/2027 academic year, this
resource aligns with current evidence-based practice and NCLEX-RN test plan. It is an essential tool
for achieving a high score and mastering medical-surgical nursing concepts.
Key Features:
Cardiovascular disorders: heart failure, myocardial infarction, arrhythmias
Respiratory disorders: COPD, pneumonia, pulmonary embolism
Renal and urinary disorders: acute kidney injury, chronic kidney disease, urinary tract infections
Perioperative nursing care: preoperative, intraoperative, and postoperative management
Fluid and electrolyte imbalances: sodium, potassium, calcium, and magnesium disturbances
Comprehensive rationales and NCLEX-style questions with detailed explanations
Updates for 2026:
- Revised to include the latest evidence-based guidelines for 2026/2027
- Added new questions on emerging pharmacological treatments and nursing interventions
- Updated rationales to reflect current NCLEX-RN test plan and clinical practice standards
- Enhanced answer explanations to include distractors analysis and critical thinking tips
- Expanded coverage of patient safety and quality improvement concepts
Abstract:
This practice examination serves as an authoritative resource for nursing students enrolled in NUR 265
Medical-Surgical Nursing, specifically targeting Exam 3 content. The document comprises over 200 carefully
selected questions that mirror the format and complexity of actual nursing school exams and the NCLEX-RN. Each
question is followed by a comprehensive rationale that not only explains the correct answer but also dissects
incorrect options, thereby fostering a deeper understanding of medical-surgical nursing principles. The content is
organized by major body systems and nursing care domains, ensuring a systematic review. Updated to reflect the
2026/2027 academic year, this resource integrates current clinical guidelines, pharmacological updates, and
evidence-based interventions. It is designed to enhance critical thinking, clinical judgment, and test-taking skills,
ultimately preparing students to excel in their examinations and future nursing practice.
Keywords:
Medical-Surgical Nursing, NUR 265, Exam 3, Practice Questions, NCLEX-RN, Nursing Rationales,
Cardiovascular Disorders, Perioperative Care
Answer Format:
Each question is presented in NCLEX-style multiple-choice format with four options. Following each question, a
detailed answer explanation is provided, including the correct answer, a rationale for why it is correct, and an
analysis of why the other options are incorrect. Rationales are evidence-based and aligned with current nursing
standards, promoting clinical reasoning and application.
Page 1
,Compliance Checklist:
Aligned with the latest NCLEX-RN test plan and nursing curriculum standards
Updated to reflect 2026/2027 evidence-based practice guidelines
Includes 200+ verified questions with accurate answers and rationales
Covers all major content areas of NUR 265 Exam 3
Designed to promote critical thinking and clinical judgment
Suitable for self-assessment and comprehensive review
Content Area Overview:
Content Area Questions Key Topics Weight
Cardiovascular Disorders 1-50 Heart failure, Myocardial infarction, 25%
Arrhythmias, Hypertension, Cardiac
medications
Respiratory Disorders 51-90 COPD, Pneumonia, Pulmonary embolism, 20%
Asthma, Oxygen therapy
Renal and Urinary Disorders 91-130 Acute kidney injury, Chronic kidney 20%
disease, Urinary tract infections, Dialysis,
Fluid balance
Perioperative Nursing Care 131-160 Preoperative assessment, Intraoperative 15%
safety, Postoperative complications, Pain
management, Wound care
Fluid and Electrolyte Imbalances 161-190 Sodium imbalances, Potassium imbalances, 15%
Calcium and magnesium disturbances,
Acid-base balance, IV therapy
Miscellaneous Medical-Surgical 191-200+ Endocrine disorders, Gastrointestinal 5%
Topics disorders, Neurological disorders, Infection
control, Patient education
Page 2
,Q1. In a patient with septic shock and acute respiratory distress syndrome (ARDS),
which ventilator strategy is most appropriate to minimize ventilator-induced lung
injury?
A. High tidal volume (10-12 mL/kg) with low PEEP
B. Low tidal volume (6 mL/kg ideal body weight) with high PEEP
C. Low tidal volume (6 mL/kg) with low PEEP
D. High tidal volume (8-10 mL/kg) with high PEEP
Correct Answer: B. Low tidal volume (6 mL/kg ideal body weight) with high PEEP
Rationale: Low tidal volume (6 mL/kg) and high PEEP are recommended to prevent
alveolar overdistension and maintain alveolar recruitment, thus reducing
ventilator-associated lung injury. High tidal volumes can cause volutrauma and worsen
ARDS.
Why Wrong:
A - High tidal volumes cause volutrauma and are contraindicated in ARDS.
C - Low PEEP may not adequately recruit collapsed alveoli, leading to atelectrauma.
D - High tidal volumes with high PEEP increases risk of overdistension and
barotrauma.
Reference: Urden, L.D., Stacy, K.M., & Lough, M.E. (2026). Critical Care Nursing, 9th
Ed., Ch. 12.
Q2. A patient with chronic kidney disease (CKD) is prescribed erythropoietin. Which
laboratory value should be monitored to evaluate the effectiveness of therapy?
A. Serum creatinine
B. Hemoglobin and hematocrit
C. Serum potassium
D. White blood cell count
Correct Answer: B. Hemoglobin and hematocrit
Rationale: Erythropoietin stimulates red blood cell production, so hemoglobin and
hematocrit levels are the direct indicators of therapeutic response. Creatinine reflects
kidney function, potassium and WBC are not affected by erythropoietin.
Why Wrong:
A - Creatinine assesses kidney function, not erythropoietin efficacy.
C - Potassium may be elevated in CKD but does not indicate response to
erythropoietin.
D - WBC count is unrelated to erythropoietin therapy.
Reference: Lewis, S.L., et al. (2026). Medical-Surgical Nursing, 11th Ed., Ch. 45.
Page 3
, Q3. A patient with a pulmonary embolism is receiving heparin. Which laboratory test
is used to monitor therapeutic anticoagulation?
A. Prothrombin time (PT)
B. Activated partial thromboplastin time (aPTT)
C. International normalized ratio (INR)
D. Platelet count
Correct Answer: B. Activated partial thromboplastin time (aPTT)
Rationale: Heparin acts on the intrinsic pathway and is monitored by aPTT, which should
be 1.5-2.5 times the control. PT/INR monitor warfarin, and platelet count is for
heparin-induced thrombocytopenia.
Why Wrong:
A - PT is used to monitor warfarin, not heparin.
C - INR is also for warfarin monitoring.
D - Platelet count is not the therapeutic monitor for heparin.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 34.
Q4. Which of the following findings is most indicative of a tension pneumothorax in a
patient on mechanical ventilation?
A. Sudden increase in peak airway pressure, hypotension, and absent breath sounds on
one side
B. Gradual decrease in oxygen saturation and crackles on auscultation
C. Elevated temperature and purulent sputum
D. Decreased heart rate and increased blood pressure
Correct Answer: A. Sudden increase in peak airway pressure, hypotension, and
absent breath sounds on one side
Rationale: Tension pneumothorax causes increased intrathoracic pressure, leading to
increased peak airway pressures, hypotension, and unilateral absent breath sounds. This
is a medical emergency requiring immediate decompression.
Why Wrong:
B - Crackles are more typical of pulmonary edema or pneumonia.
C - Fever and purulent sputum suggest infection, not pneumothorax.
D - Tension pneumothorax typically causes tachycardia and hypotension, not
bradycardia.
Reference: Urden, L.D., et al. (2026). Critical Care Nursing, 9th Ed., Ch. 14.
Q5. A patient with acute coronary syndrome is prescribed nitroglycerin. What is the
primary mechanism of action?
A. Inhibition of platelet aggregation
Page 4
