NUR 265 Advanced Medical-Surgical Nursing Final E… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Medical-Surgical Nursing Final
Examination 2026/2027 UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 265 Advanced Medical-Surgical Nursing Final E… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the emergent phase of a 45% total body surface area (TBSA) burn has a blood
pressure of 88/50 mmHg and a heart rate of 130 bpm. Which intervention should the nurse
prioritize first?
A. burn has a blood pressure of 88/50 mmHg and a heart rate of 130 bpm. Which intervention should
the nurse prioritize first?
B. Applying topical silver sulfadiazine to the burn sites
C. Performing a thorough wound debridement
D. Initiating rapid fluid resuscitation using the Parkland formula
Answer: D
Rationale: In the emergent phase of burn injury, the primary threat is hypovolemic shock. Priority must
be given to fluid resuscitation to maintain organ perfusion. Antibiotics and wound care follow
stabilization. This is important because the nurse must choose the action that keeps the client safest
while still meeting their basic needs. Always think about safety first when answering these questions.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level.
2. A client is admitted with suspected Neurogenic Shock following a spinal cord injury at T3.
Which clinical finding best distinguishes this from Hypovolemic Shock?
A. Tachycardia and cool, clammy skin
B. Bradycardia and warm, dry skin
C. Hypotension and decreased urine output
D. Narrowed pulse pressure and tachypnea
Answer: B
Rationale: Neurogenic shock is characterized by the loss of sympathetic tone, leading to bradycardia
and vasodilation (warm/dry skin), whereas hypovolemic shock typically presents with compensatory
tachycardia and vasoconstriction. Understanding this helps the nurse notice early warning signs and
act before the problem gets worse. Early action often prevents bigger complications for the client.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Medical-Surgical Nursing Final E… 2026/2027 • Verified • Assured Grade A+
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high PEEP. The nurse notes a sudden drop in SpO2 and absent breath
sounds on the right side. What is the most likely complication?
A. Pulmonary embolism
B. Ventilator-associated pneumonia
C. Endotracheal tube displacement
D. Tension pneumothorax
Answer: D
Rationale: High levels of Positive End-Expiratory Pressure (PEEP) increase the risk of barotrauma,
which can lead to a tension pneumothorax, evidenced by sudden desaturation and absent unilateral
breath sounds. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. In practice, this guides the nurse to
set priorities and protect the client from harm. Safety, nutrition, and clear communication are frequent
priorities.
4. During the assessment of a patient with a traumatic brain injury, the nurse observes the
patient extending the arms and legs with pronation of the arms and plantar flexion. How
should the nurse document this?
A. Decorticate posturing
B. Decerebrate posturing
C. Flaccid paralysis
D. Babinski reflex
Answer: B
Rationale: Decerebrate posturing involves extension of the extremities and indicates more severe
brainstem damage than decorticate (flexion) posturing. Exam questions often test whether you can
pick the most practical and safe choice for the client in real situations. Focus on what the nurse can
actually do right now. This is important because the nurse must choose the action that keeps the client
safest while still meeting their basic needs. Always think about safety first when answering these
questions.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Medical-Surgical Nursing Final
Examination 2026/2027 UPDATE Galen College
ACTUAL EXAM QUESTIONS & VERIFIED ANSWERS
with Clear, Detailed Rationales
Document Type: Exam (Elaborations) / Study Guide
Academic Year:
Total Questions: 50 Multiple Choice
Includes: Correct Answers + Rationales
Grade: A+ Assured
ASSURED GRADE A+
Exam (Elaborations) • Detailed Rationales Page 1
,NUR 265 Advanced Medical-Surgical Nursing Final E… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the emergent phase of a 45% total body surface area (TBSA) burn has a blood
pressure of 88/50 mmHg and a heart rate of 130 bpm. Which intervention should the nurse
prioritize first?
A. burn has a blood pressure of 88/50 mmHg and a heart rate of 130 bpm. Which intervention should
the nurse prioritize first?
B. Applying topical silver sulfadiazine to the burn sites
C. Performing a thorough wound debridement
D. Initiating rapid fluid resuscitation using the Parkland formula
Answer: D
Rationale: In the emergent phase of burn injury, the primary threat is hypovolemic shock. Priority must
be given to fluid resuscitation to maintain organ perfusion. Antibiotics and wound care follow
stabilization. This is important because the nurse must choose the action that keeps the client safest
while still meeting their basic needs. Always think about safety first when answering these questions.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level.
2. A client is admitted with suspected Neurogenic Shock following a spinal cord injury at T3.
Which clinical finding best distinguishes this from Hypovolemic Shock?
A. Tachycardia and cool, clammy skin
B. Bradycardia and warm, dry skin
C. Hypotension and decreased urine output
D. Narrowed pulse pressure and tachypnea
Answer: B
Rationale: Neurogenic shock is characterized by the loss of sympathetic tone, leading to bradycardia
and vasodilation (warm/dry skin), whereas hypovolemic shock typically presents with compensatory
tachycardia and vasoconstriction. Understanding this helps the nurse notice early warning signs and
act before the problem gets worse. Early action often prevents bigger complications for the client.
Remembering this point will help you decide the best nursing action when similar questions appear on
the exam. Link the answer to the client’s current condition and risk level.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Medical-Surgical Nursing Final E… 2026/2027 • Verified • Assured Grade A+
3. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with high PEEP. The nurse notes a sudden drop in SpO2 and absent breath
sounds on the right side. What is the most likely complication?
A. Pulmonary embolism
B. Ventilator-associated pneumonia
C. Endotracheal tube displacement
D. Tension pneumothorax
Answer: D
Rationale: High levels of Positive End-Expiratory Pressure (PEEP) increase the risk of barotrauma,
which can lead to a tension pneumothorax, evidenced by sudden desaturation and absent unilateral
breath sounds. In practice, this guides the nurse to set priorities and protect the client from harm.
Safety, nutrition, and clear communication are frequent priorities. In practice, this guides the nurse to
set priorities and protect the client from harm. Safety, nutrition, and clear communication are frequent
priorities.
4. During the assessment of a patient with a traumatic brain injury, the nurse observes the
patient extending the arms and legs with pronation of the arms and plantar flexion. How
should the nurse document this?
A. Decorticate posturing
B. Decerebrate posturing
C. Flaccid paralysis
D. Babinski reflex
Answer: B
Rationale: Decerebrate posturing involves extension of the extremities and indicates more severe
brainstem damage than decorticate (flexion) posturing. Exam questions often test whether you can
pick the most practical and safe choice for the client in real situations. Focus on what the nurse can
actually do right now. This is important because the nurse must choose the action that keeps the client
safest while still meeting their basic needs. Always think about safety first when answering these
questions.
Exam (Elaborations) • Detailed Rationales Page 3
