NUR 265 Exam 3 Version 1 and 2 New | Actual Questions and
Answers | 2026 Update | 100% Correct - Galen College of
Nursing 2 Versions
Excel on your advanced clinical milestone with this definitive 2026 NUR 265 Exam 3
study package featuring both Version 1 and Version 2, precisely tailored for Galen
College of Nursing. This comprehensive test bank includes actual exam questions
paired with 100% verified correct answers and detailed clinical rationales covering
advanced med-surg concepts, critical care interventions, multi-system organ failure, and
emergency nursing protocols. It is an indispensable resource for pre-licensure nursing
students looking to optimize study efficiency, master clinical judgment case studies, and
confidently guarantee an A+ grade.
Question #1
The nurse is administering a drug that has a high first-pass effect. Which route of
administration would MOST effectively bypass this effect?
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Correct Answer: B
Rationale: The first-pass effect refers to metabolism of a drug in the liver before it reaches
systemic circulation. Sublingual administration bypasses the portal circulation, avoiding
first-pass metabolism. Oral (A) and rectal (C) partially undergo first-pass. IM (D) avoids it
but sublingual is the classic bypass route.
Question #2
A client is prescribed a medication with a narrow therapeutic index. Which of the
following is the nurse's priority action?
A. Administer the medication with food
B. Monitor serum drug levels regularly
C. Teach the client to double the dose if a dose is missed
D. Encourage the client to take the medication at bedtime
,Correct Answer: B
Rationale: A narrow therapeutic index means the difference between therapeutic and toxic
doses is small. Monitoring serum levels is critical to maintain safety. Doubling doses (C) is
dangerous. Food (A) and bedtime (D) are not specific to narrow therapeutic index drugs.
Question #3
A client is prescribed digoxin for heart failure. Which of the following laboratory values
should the nurse monitor to assess for digoxin toxicity?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium levels must be
monitored. Sodium (B), calcium (C), and magnesium (D) are not as directly linked to
digoxin toxicity risk.
Question #4
The nurse is administering warfarin to a client with atrial fibrillation. Which of the
following herbal supplements should the nurse instruct the client to avoid due to
increased bleeding risk?
A. St. John's wort
B. Ginkgo biloba
C. Echinacea
D. Garlic
Correct Answer: B
Rationale: Ginkgo biloba, along with garlic, ginger, and ginseng, increases bleeding risk
when taken with warfarin. St. John's wort (A) decreases warfarin levels. Echinacea (C) has
immune effects. Garlic (D) also increases bleeding, but Ginkgo is the classic example in
many textbooks. Given the options, B is the most recognized.
,Question #5
A client is prescribed morphine sulfate for severe pain. Which of the following is the
most serious adverse effect the nurse must monitor for?
A. Constipation
B. Nausea
C. Respiratory depression
D. Urinary retention
Correct Answer: C
Rationale: Respiratory depression is the most life-threatening adverse effect of opioids.
Constipation (A), nausea (B), and urinary retention (D) are common but not immediately
life-threatening.
Question #6
The nurse is administering an aminoglycoside antibiotic (e.g., gentamicin). Which of the
following adverse effects requires the most vigilant monitoring?
A. Hepatotoxicity
B. Ototoxicity and nephrotoxicity
C. Cardiotoxicity
D. Bone marrow suppression
Correct Answer: B
Rationale: Aminoglycosides are known for ototoxicity (damage to cranial nerve VIII) and
nephrotoxicity. Hepatotoxicity (A) is not typical. Cardiotoxicity (C) is not primary. Bone
marrow suppression (D) is seen with other drugs.
Question #7
A client is prescribed a beta-blocker (metoprolol). Which of the following assessment
findings would indicate a therapeutic effect?
A. Heart rate increased from 80 to 100 bpm
B. Blood pressure decreased from 150/90 to 120/80 mmHg
C. Respiratory rate increased from 16 to 22 breaths/min
D. Blood glucose increased from 100 to 150 mg/dL
, Correct Answer: B
Rationale: Beta-blockers lower heart rate and blood pressure. A decreased BP indicates a
therapeutic effect. Increased heart rate (A) is the opposite. Respiratory rate (C) and blood
glucose (D) are not primary therapeutic targets for beta-blockers.
Question #8
The nurse is providing education to a client starting an ACE inhibitor (lisinopril). Which
of the following adverse effects should the client be instructed to report?
A. Dry cough
B. Weight gain
C. Constipation
D. Blurred vision
Correct Answer: A
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors due to
bradykinin accumulation. Weight gain (B) is not typical. Constipation (C) and blurred
vision (D) are not specific to ACE inhibitors.
Question #9
A client with a history of peptic ulcer disease is prescribed a nonsteroidal anti-
inflammatory drug (NSAID) for arthritis. Which of the following medications should the
nurse anticipate to be prescribed concurrently to protect the gastric mucosa?
A. Misoprostol
B. Omeprazole
C. Sucralfate
D. Ranitidine
Correct Answer: A
Rationale: Misoprostol is a prostaglandin analog that reduces gastric acid secretion and
protects the mucosa. Omeprazole (B) and ranitidine (D) reduce acid but do not directly
replace prostaglandins. Sucralfate (C) coats ulcers.
Answers | 2026 Update | 100% Correct - Galen College of
Nursing 2 Versions
Excel on your advanced clinical milestone with this definitive 2026 NUR 265 Exam 3
study package featuring both Version 1 and Version 2, precisely tailored for Galen
College of Nursing. This comprehensive test bank includes actual exam questions
paired with 100% verified correct answers and detailed clinical rationales covering
advanced med-surg concepts, critical care interventions, multi-system organ failure, and
emergency nursing protocols. It is an indispensable resource for pre-licensure nursing
students looking to optimize study efficiency, master clinical judgment case studies, and
confidently guarantee an A+ grade.
Question #1
The nurse is administering a drug that has a high first-pass effect. Which route of
administration would MOST effectively bypass this effect?
A. Oral
B. Sublingual
C. Rectal
D. Intramuscular
Correct Answer: B
Rationale: The first-pass effect refers to metabolism of a drug in the liver before it reaches
systemic circulation. Sublingual administration bypasses the portal circulation, avoiding
first-pass metabolism. Oral (A) and rectal (C) partially undergo first-pass. IM (D) avoids it
but sublingual is the classic bypass route.
Question #2
A client is prescribed a medication with a narrow therapeutic index. Which of the
following is the nurse's priority action?
A. Administer the medication with food
B. Monitor serum drug levels regularly
C. Teach the client to double the dose if a dose is missed
D. Encourage the client to take the medication at bedtime
,Correct Answer: B
Rationale: A narrow therapeutic index means the difference between therapeutic and toxic
doses is small. Monitoring serum levels is critical to maintain safety. Doubling doses (C) is
dangerous. Food (A) and bedtime (D) are not specific to narrow therapeutic index drugs.
Question #3
A client is prescribed digoxin for heart failure. Which of the following laboratory values
should the nurse monitor to assess for digoxin toxicity?
A. Serum potassium
B. Serum sodium
C. Serum calcium
D. Serum magnesium
Correct Answer: A
Rationale: Hypokalemia increases the risk of digoxin toxicity. Potassium levels must be
monitored. Sodium (B), calcium (C), and magnesium (D) are not as directly linked to
digoxin toxicity risk.
Question #4
The nurse is administering warfarin to a client with atrial fibrillation. Which of the
following herbal supplements should the nurse instruct the client to avoid due to
increased bleeding risk?
A. St. John's wort
B. Ginkgo biloba
C. Echinacea
D. Garlic
Correct Answer: B
Rationale: Ginkgo biloba, along with garlic, ginger, and ginseng, increases bleeding risk
when taken with warfarin. St. John's wort (A) decreases warfarin levels. Echinacea (C) has
immune effects. Garlic (D) also increases bleeding, but Ginkgo is the classic example in
many textbooks. Given the options, B is the most recognized.
,Question #5
A client is prescribed morphine sulfate for severe pain. Which of the following is the
most serious adverse effect the nurse must monitor for?
A. Constipation
B. Nausea
C. Respiratory depression
D. Urinary retention
Correct Answer: C
Rationale: Respiratory depression is the most life-threatening adverse effect of opioids.
Constipation (A), nausea (B), and urinary retention (D) are common but not immediately
life-threatening.
Question #6
The nurse is administering an aminoglycoside antibiotic (e.g., gentamicin). Which of the
following adverse effects requires the most vigilant monitoring?
A. Hepatotoxicity
B. Ototoxicity and nephrotoxicity
C. Cardiotoxicity
D. Bone marrow suppression
Correct Answer: B
Rationale: Aminoglycosides are known for ototoxicity (damage to cranial nerve VIII) and
nephrotoxicity. Hepatotoxicity (A) is not typical. Cardiotoxicity (C) is not primary. Bone
marrow suppression (D) is seen with other drugs.
Question #7
A client is prescribed a beta-blocker (metoprolol). Which of the following assessment
findings would indicate a therapeutic effect?
A. Heart rate increased from 80 to 100 bpm
B. Blood pressure decreased from 150/90 to 120/80 mmHg
C. Respiratory rate increased from 16 to 22 breaths/min
D. Blood glucose increased from 100 to 150 mg/dL
, Correct Answer: B
Rationale: Beta-blockers lower heart rate and blood pressure. A decreased BP indicates a
therapeutic effect. Increased heart rate (A) is the opposite. Respiratory rate (C) and blood
glucose (D) are not primary therapeutic targets for beta-blockers.
Question #8
The nurse is providing education to a client starting an ACE inhibitor (lisinopril). Which
of the following adverse effects should the client be instructed to report?
A. Dry cough
B. Weight gain
C. Constipation
D. Blurred vision
Correct Answer: A
Rationale: A persistent dry cough is a common adverse effect of ACE inhibitors due to
bradykinin accumulation. Weight gain (B) is not typical. Constipation (C) and blurred
vision (D) are not specific to ACE inhibitors.
Question #9
A client with a history of peptic ulcer disease is prescribed a nonsteroidal anti-
inflammatory drug (NSAID) for arthritis. Which of the following medications should the
nurse anticipate to be prescribed concurrently to protect the gastric mucosa?
A. Misoprostol
B. Omeprazole
C. Sucralfate
D. Ranitidine
Correct Answer: A
Rationale: Misoprostol is a prostaglandin analog that reduces gastric acid secretion and
protects the mucosa. Omeprazole (B) and ranitidine (D) reduce acid but do not directly
replace prostaglandins. Sucralfate (C) coats ulcers.
