NUR 265 Advanced Med-Surg Final Exam Prep 2026/20… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Med-Surg Final Exam Prep 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 Med-Surg Final Exam Prep 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A client with a 45% TBSA burn weighs 70 kg. Using the Parkland formula
(4mL/kg/%TBSA), calculate the total fluid volume to be administered in the first 8 hours of
resuscitation.
A. , calculate the total fluid volume to be administered in the first 8 hours of resuscitation.
B. 6,300 mL
C. 3,150 mL
D. 25,200 mL
Answer: B
Rationale: The Parkland formula calculates total 24-hour fluid: 4mL x 70kg x 45 = 12,600 mL. Half of
this volume (6,300 mL) is administered in the first 8 hours. This knowledge supports safe care and
helps the nurse teach the client and family clearly and simply. Clear teaching improves cooperation
and reduces anxiety. 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.
2. A nurse is caring for a client with a C5 spinal cord injury. The client reports a pounding
headache and has a blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Check the client’s bladder for distension or a kinked catheter.
B. Administer prescribed antihypertensive medication.
C. Place the client in a supine position to stabilize the spine.
D. Perform a neurological assessment using the Glasgow Coma Scale.
Answer: A
Rationale: The symptoms suggest autonomic dysreflexia. The priority is to remove the triggering
stimulus, most commonly a distended bladder or fecal impaction. Knowing the reason behind the
correct answer makes it easier to rule out the wrong options quickly. Look for the choice that protects
the client and matches the priority need. Clear understanding of this concept improves both test
performance and everyday clinical judgment. Practice applying it to short case scenarios to lock the
idea in place.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Med-Surg Final Exam Prep 2026/20… 2026/2027 • Verified • Assured Grade A+
3. Which arterial blood gas (ABG) result indicates partially compensated respiratory
acidosis?
A. pH 7.50, PaCO2 30, HCO3 20
B. pH 7.42, PaCO2 38, HCO3 24
C. pH 7.28, PaCO2 55, HCO3 22
D. pH 7.32, PaCO2 50, HCO3 29
Answer: D
Rationale: In partially compensated respiratory acidosis, the pH is low, PaCO2 is high, and the HCO3
is high (attempting to compensate). Knowing the reason behind the correct answer makes it easier to
rule out the wrong options quickly. Look for the choice that protects the client and matches the priority
need. 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.
4. A client is in the progressive stage of hypovolemic shock. Which clinical finding should
the nurse expect?
A. Increased urinary output
B. Metabolic alkalosis
C. Narrowing pulse pressure and bradycardia
D. Cold, clammy skin and rapid, weak pulse
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, leading to decreased
tissue perfusion, cold/clammy skin, and tachycardia. Clear understanding of this concept improves
both test performance and everyday clinical judgment. Practice applying it to short case scenarios to
lock the idea in place. 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.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Med-Surg Final Exam Prep 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 Med-Surg Final Exam Prep 2026/20… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A client with a 45% TBSA burn weighs 70 kg. Using the Parkland formula
(4mL/kg/%TBSA), calculate the total fluid volume to be administered in the first 8 hours of
resuscitation.
A. , calculate the total fluid volume to be administered in the first 8 hours of resuscitation.
B. 6,300 mL
C. 3,150 mL
D. 25,200 mL
Answer: B
Rationale: The Parkland formula calculates total 24-hour fluid: 4mL x 70kg x 45 = 12,600 mL. Half of
this volume (6,300 mL) is administered in the first 8 hours. This knowledge supports safe care and
helps the nurse teach the client and family clearly and simply. Clear teaching improves cooperation
and reduces anxiety. 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.
2. A nurse is caring for a client with a C5 spinal cord injury. The client reports a pounding
headache and has a blood pressure of 190/100 mmHg. What is the priority nursing action?
A. Check the client’s bladder for distension or a kinked catheter.
B. Administer prescribed antihypertensive medication.
C. Place the client in a supine position to stabilize the spine.
D. Perform a neurological assessment using the Glasgow Coma Scale.
Answer: A
Rationale: The symptoms suggest autonomic dysreflexia. The priority is to remove the triggering
stimulus, most commonly a distended bladder or fecal impaction. Knowing the reason behind the
correct answer makes it easier to rule out the wrong options quickly. Look for the choice that protects
the client and matches the priority need. Clear understanding of this concept improves both test
performance and everyday clinical judgment. Practice applying it to short case scenarios to lock the
idea in place.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Med-Surg Final Exam Prep 2026/20… 2026/2027 • Verified • Assured Grade A+
3. Which arterial blood gas (ABG) result indicates partially compensated respiratory
acidosis?
A. pH 7.50, PaCO2 30, HCO3 20
B. pH 7.42, PaCO2 38, HCO3 24
C. pH 7.28, PaCO2 55, HCO3 22
D. pH 7.32, PaCO2 50, HCO3 29
Answer: D
Rationale: In partially compensated respiratory acidosis, the pH is low, PaCO2 is high, and the HCO3
is high (attempting to compensate). Knowing the reason behind the correct answer makes it easier to
rule out the wrong options quickly. Look for the choice that protects the client and matches the priority
need. 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.
4. A client is in the progressive stage of hypovolemic shock. Which clinical finding should
the nurse expect?
A. Increased urinary output
B. Metabolic alkalosis
C. Narrowing pulse pressure and bradycardia
D. Cold, clammy skin and rapid, weak pulse
Answer: D
Rationale: In the progressive stage of shock, compensatory mechanisms fail, leading to decreased
tissue perfusion, cold/clammy skin, and tachycardia. Clear understanding of this concept improves
both test performance and everyday clinical judgment. Practice applying it to short case scenarios to
lock the idea in place. 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.
Exam (Elaborations) • Detailed Rationales Page 3
