NUR 265 Exam 2 Actual Exam Prep Document | 2026/2027
Edition | 200 Verified Questions - 180 Questions with Answers
NUR 265 Med-Surg Nursing Exam 2 2026-180 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NUR 265 Exam 2 contains 200 verified questions
and answers covering essential topics in medical-surgical nursing, pharmacology, patient care, and
pathophysiology. Designed for the 2026/2027 academic year, this resource provides detailed rationales
and evidence-based explanations to enhance understanding and retention. Ideal for nursing students
seeking to excel in their med-surg exams, this guide ensures thorough preparation with up-to-date
content aligned with current guidelines.
Key Features:
Medical-Surgical Nursing: Comprehensive coverage of adult health conditions, perioperative care, and nursing
interventions.
Pharmacology: Drug classifications, mechanisms of action, side effects, and nursing considerations for
common med-surg medications.
Patient Care: Prioritization, delegation, safety, and patient education strategies.
Pathophysiology: Disease processes, etiology, and clinical manifestations across body systems.
Evidence-Based Practice: Rationales grounded in latest research and clinical guidelines.
Exam-Style Questions: Multiple-choice and alternate format questions mirroring actual exam patterns.
Updates for 2026:
- Revised to include 2026/2027 NCLEX-RN test plan updates.
- Incorporated latest evidence-based practice guidelines for med-surg nursing.
- Expanded pharmacology section with new drug classifications and safety alerts.
- Enhanced rationales with detailed explanations for correct and incorrect options.
- Added more case-based scenarios to improve clinical reasoning skills.
Abstract:
This exam preparation document is meticulously crafted for nursing students enrolled in NUR 265, focusing on
medical-surgical nursing. It encompasses 200 verified questions that span critical areas including pharmacology,
patient care, and pathophysiology, ensuring a holistic review. Each question is accompanied by a comprehensive
rationale that not only explains the correct answer but also clarifies why other options are incorrect, fostering
deeper understanding. The content is aligned with the latest 2026/2027 academic standards and NCLEX-RN test
plan, making it an indispensable tool for exam success. By integrating evidence-based practice and clinical
scenarios, this guide promotes critical thinking and application of knowledge in real-world settings. Whether used
for self-assessment or group study, this resource is designed to boost confidence and performance on the NUR 265
Exam 2.
Keywords:
Med-Surg Nursing, Pharmacology, Pathophysiology, Patient Care, NCLEX-RN, Exam Prep, NUR 265
Answer Format:
Each question is presented in a format similar to the actual exam, followed by the correct answer and a detailed
rationale. Rationales explain the underlying concepts, nursing implications, and why the other options are incorrect.
This format reinforces learning and helps students understand the 'why' behind each answer.
Compliance Checklist:
Aligned with 2026/2027 NCLEX-RN test plan
Page 1
, Updated per latest evidence-based practice guidelines
Verified questions with accurate answers and rationales
Covers all major content areas of NUR 265 Exam 2
Suitable for self-study and exam review
Formatted for easy reading and quick reference
Content Area Overview:
Content Area Questions Key Topics Weight
Medical-Surgical Nursing 1-50 Perioperative care, wound healing, infection 25%
control, fluid/electrolyte imbalance, shock
Pharmacology 51-100 Analgesics, antibiotics, anticoagulants, 25%
cardiovascular drugs, respiratory drugs
Patient Care 101-150 Prioritization, delegation, patient education, 25%
safety, ethical/legal issues
Pathophysiology 151-200 Cardiovascular disorders, respiratory 25%
disorders, renal disorders, neurological
disorders, endocrine disorders
Page 2
,Q1. A patient with chronic heart failure is started on sacubitril/valsartan. Which
laboratory value warrants immediate attention before initiating this therapy?
A. Serum potassium 5.2 mEq/L
B. Serum creatinine 1.8 mg/dL
C. Blood urea nitrogen 24 mg/dL
D. Hemoglobin A1c 7.1%
Correct Answer: A. Serum potassium 5.2 mEq/L
Rationale: Sacubitril/valsartan is contraindicated in patients with a history of angioedema
and should be avoided with concurrent ACE inhibitor use. Hyperkalemia is a significant
risk; potassium >5.0 mEq/L is a relative contraindication. Creatinine elevation is
important but not an absolute contraindication at this level.
Why Wrong:
B - Creatinine 1.8 mg/dL may require dose adjustment but is not an absolute
contraindication.
C - BUN elevation is not a specific contraindication for sacubitril/valsartan.
D - A1c is unrelated to initiation of sacubitril/valsartan.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 25.
Q2. In a patient with suspected sepsis, which combination of findings most accurately
indicates the transition from systemic inflammatory response syndrome (SIRS) to
septic shock?
A. WBC 14,000/mm³, heart rate 110 bpm, respiratory rate 24/min
B. Lactate 4 mmol/L, mean arterial pressure 60 mmHg despite fluid resuscitation,
vasopressor requirement
C. Temperature 38.3°C, PaCO2 28 mmHg, platelet count 150,000/mm³
D. Urine output 0.5 mL/kg/hr, creatinine 1.2 mg/dL, blood glucose 140 mg/dL
Correct Answer: B. Lactate 4 mmol/L, mean arterial pressure 60 mmHg despite fluid
resuscitation, vasopressor requirement
Rationale: Septic shock is defined by sepsis with persistent hypotension requiring
vasopressors to maintain MAP 65 mmHg and lactate >2 mmol/L despite adequate fluid
resuscitation. Elevated lactate and vasopressor dependence indicate tissue hypoperfusion
and shock, distinguishing it from SIRS.
Why Wrong:
A - These findings meet SIRS criteria but do not indicate shock.
C - This is a mix of SIRS criteria without evidence of organ dysfunction or
hypotension.
D - These are not specific for septic shock; urine output and creatinine may indicate
acute kidney injury but not shock definition.
Page 3
, Reference: McCance, K.L., & Huether, S.E. (2026). Pathophysiology: The Biologic Basis
for Disease in Adults and Children, 9th Ed., Ch. 24.
Q3. A patient receiving IV heparin for deep vein thrombosis has an aPTT of 110
seconds (therapeutic range 60-80 seconds). Which intervention is most appropriate?
A. Continue current infusion rate and recheck aPTT in 6 hours
B. Stop the infusion for 1 hour and then restart at a lower rate
C. Administer protamine sulfate 1 mg per 100 units of heparin
D. Decrease the infusion rate by 2 units/kg/hr and recheck aPTT in 4 hours
Correct Answer: D. Decrease the infusion rate by 2 units/kg/hr and recheck aPTT in
4 hours
Rationale: An aPTT above therapeutic range indicates increased bleeding risk. The
standard protocol is to decrease the infusion rate and recheck aPTT per protocol.
Stopping the infusion is reserved for severe bleeding or critical elevations. Protamine is
used for reversal in emergency bleeding.
Why Wrong:
A - Continuing the same rate would maintain supratherapeutic levels, increasing
bleeding risk.
B - Stopping the infusion for 1 hour may be too aggressive; a rate reduction is
typically sufficient.
C - Protamine is for major bleeding or urgent reversal, not routine management of
elevated aPTT.
Reference: American College of Chest Physicians (2026). Antithrombotic Therapy
Guidelines, CHEST.
Q4. Which pathophysiological mechanism best explains the development of acute
respiratory distress syndrome (ARDS) following sepsis?
A. Type II alveolar cell hyperplasia leading to surfactant overproduction
B. Neutrophil-mediated endothelial and epithelial injury causing alveolar-capillary
membrane disruption
C. Bronchial smooth muscle constriction and mucus plugging
D. Pulmonary venous hypertension from left ventricular failure
Correct Answer: B. Neutrophil-mediated endothelial and epithelial injury causing
alveolar-capillary membrane disruption
Rationale: ARDS is characterized by diffuse alveolar damage from an inflammatory
cascade, with neutrophil activation releasing cytokines, reactive oxygen species, and
proteases, which disrupt the alveolar-capillary membrane, leading to protein-rich
pulmonary edema.
Page 4
Edition | 200 Verified Questions - 180 Questions with Answers
NUR 265 Med-Surg Nursing Exam 2 2026-180 QUESTIONS AND ANSWERS ALREADY GRADED A+. 100%
Verified Solutions | Updated Per Latest Guidelines | Graded A+
This comprehensive exam preparation document for NUR 265 Exam 2 contains 200 verified questions
and answers covering essential topics in medical-surgical nursing, pharmacology, patient care, and
pathophysiology. Designed for the 2026/2027 academic year, this resource provides detailed rationales
and evidence-based explanations to enhance understanding and retention. Ideal for nursing students
seeking to excel in their med-surg exams, this guide ensures thorough preparation with up-to-date
content aligned with current guidelines.
Key Features:
Medical-Surgical Nursing: Comprehensive coverage of adult health conditions, perioperative care, and nursing
interventions.
Pharmacology: Drug classifications, mechanisms of action, side effects, and nursing considerations for
common med-surg medications.
Patient Care: Prioritization, delegation, safety, and patient education strategies.
Pathophysiology: Disease processes, etiology, and clinical manifestations across body systems.
Evidence-Based Practice: Rationales grounded in latest research and clinical guidelines.
Exam-Style Questions: Multiple-choice and alternate format questions mirroring actual exam patterns.
Updates for 2026:
- Revised to include 2026/2027 NCLEX-RN test plan updates.
- Incorporated latest evidence-based practice guidelines for med-surg nursing.
- Expanded pharmacology section with new drug classifications and safety alerts.
- Enhanced rationales with detailed explanations for correct and incorrect options.
- Added more case-based scenarios to improve clinical reasoning skills.
Abstract:
This exam preparation document is meticulously crafted for nursing students enrolled in NUR 265, focusing on
medical-surgical nursing. It encompasses 200 verified questions that span critical areas including pharmacology,
patient care, and pathophysiology, ensuring a holistic review. Each question is accompanied by a comprehensive
rationale that not only explains the correct answer but also clarifies why other options are incorrect, fostering
deeper understanding. The content is aligned with the latest 2026/2027 academic standards and NCLEX-RN test
plan, making it an indispensable tool for exam success. By integrating evidence-based practice and clinical
scenarios, this guide promotes critical thinking and application of knowledge in real-world settings. Whether used
for self-assessment or group study, this resource is designed to boost confidence and performance on the NUR 265
Exam 2.
Keywords:
Med-Surg Nursing, Pharmacology, Pathophysiology, Patient Care, NCLEX-RN, Exam Prep, NUR 265
Answer Format:
Each question is presented in a format similar to the actual exam, followed by the correct answer and a detailed
rationale. Rationales explain the underlying concepts, nursing implications, and why the other options are incorrect.
This format reinforces learning and helps students understand the 'why' behind each answer.
Compliance Checklist:
Aligned with 2026/2027 NCLEX-RN test plan
Page 1
, Updated per latest evidence-based practice guidelines
Verified questions with accurate answers and rationales
Covers all major content areas of NUR 265 Exam 2
Suitable for self-study and exam review
Formatted for easy reading and quick reference
Content Area Overview:
Content Area Questions Key Topics Weight
Medical-Surgical Nursing 1-50 Perioperative care, wound healing, infection 25%
control, fluid/electrolyte imbalance, shock
Pharmacology 51-100 Analgesics, antibiotics, anticoagulants, 25%
cardiovascular drugs, respiratory drugs
Patient Care 101-150 Prioritization, delegation, patient education, 25%
safety, ethical/legal issues
Pathophysiology 151-200 Cardiovascular disorders, respiratory 25%
disorders, renal disorders, neurological
disorders, endocrine disorders
Page 2
,Q1. A patient with chronic heart failure is started on sacubitril/valsartan. Which
laboratory value warrants immediate attention before initiating this therapy?
A. Serum potassium 5.2 mEq/L
B. Serum creatinine 1.8 mg/dL
C. Blood urea nitrogen 24 mg/dL
D. Hemoglobin A1c 7.1%
Correct Answer: A. Serum potassium 5.2 mEq/L
Rationale: Sacubitril/valsartan is contraindicated in patients with a history of angioedema
and should be avoided with concurrent ACE inhibitor use. Hyperkalemia is a significant
risk; potassium >5.0 mEq/L is a relative contraindication. Creatinine elevation is
important but not an absolute contraindication at this level.
Why Wrong:
B - Creatinine 1.8 mg/dL may require dose adjustment but is not an absolute
contraindication.
C - BUN elevation is not a specific contraindication for sacubitril/valsartan.
D - A1c is unrelated to initiation of sacubitril/valsartan.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 25.
Q2. In a patient with suspected sepsis, which combination of findings most accurately
indicates the transition from systemic inflammatory response syndrome (SIRS) to
septic shock?
A. WBC 14,000/mm³, heart rate 110 bpm, respiratory rate 24/min
B. Lactate 4 mmol/L, mean arterial pressure 60 mmHg despite fluid resuscitation,
vasopressor requirement
C. Temperature 38.3°C, PaCO2 28 mmHg, platelet count 150,000/mm³
D. Urine output 0.5 mL/kg/hr, creatinine 1.2 mg/dL, blood glucose 140 mg/dL
Correct Answer: B. Lactate 4 mmol/L, mean arterial pressure 60 mmHg despite fluid
resuscitation, vasopressor requirement
Rationale: Septic shock is defined by sepsis with persistent hypotension requiring
vasopressors to maintain MAP 65 mmHg and lactate >2 mmol/L despite adequate fluid
resuscitation. Elevated lactate and vasopressor dependence indicate tissue hypoperfusion
and shock, distinguishing it from SIRS.
Why Wrong:
A - These findings meet SIRS criteria but do not indicate shock.
C - This is a mix of SIRS criteria without evidence of organ dysfunction or
hypotension.
D - These are not specific for septic shock; urine output and creatinine may indicate
acute kidney injury but not shock definition.
Page 3
, Reference: McCance, K.L., & Huether, S.E. (2026). Pathophysiology: The Biologic Basis
for Disease in Adults and Children, 9th Ed., Ch. 24.
Q3. A patient receiving IV heparin for deep vein thrombosis has an aPTT of 110
seconds (therapeutic range 60-80 seconds). Which intervention is most appropriate?
A. Continue current infusion rate and recheck aPTT in 6 hours
B. Stop the infusion for 1 hour and then restart at a lower rate
C. Administer protamine sulfate 1 mg per 100 units of heparin
D. Decrease the infusion rate by 2 units/kg/hr and recheck aPTT in 4 hours
Correct Answer: D. Decrease the infusion rate by 2 units/kg/hr and recheck aPTT in
4 hours
Rationale: An aPTT above therapeutic range indicates increased bleeding risk. The
standard protocol is to decrease the infusion rate and recheck aPTT per protocol.
Stopping the infusion is reserved for severe bleeding or critical elevations. Protamine is
used for reversal in emergency bleeding.
Why Wrong:
A - Continuing the same rate would maintain supratherapeutic levels, increasing
bleeding risk.
B - Stopping the infusion for 1 hour may be too aggressive; a rate reduction is
typically sufficient.
C - Protamine is for major bleeding or urgent reversal, not routine management of
elevated aPTT.
Reference: American College of Chest Physicians (2026). Antithrombotic Therapy
Guidelines, CHEST.
Q4. Which pathophysiological mechanism best explains the development of acute
respiratory distress syndrome (ARDS) following sepsis?
A. Type II alveolar cell hyperplasia leading to surfactant overproduction
B. Neutrophil-mediated endothelial and epithelial injury causing alveolar-capillary
membrane disruption
C. Bronchial smooth muscle constriction and mucus plugging
D. Pulmonary venous hypertension from left ventricular failure
Correct Answer: B. Neutrophil-mediated endothelial and epithelial injury causing
alveolar-capillary membrane disruption
Rationale: ARDS is characterized by diffuse alveolar damage from an inflammatory
cascade, with neutrophil activation releasing cytokines, reactive oxygen species, and
proteases, which disrupt the alveolar-capillary membrane, leading to protein-rich
pulmonary edema.
Page 4
