NUR 265 Advanced Med-Surg Final Exam 2026/2027 UP… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Med-Surg Final Exam 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 2026/2027 UP… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the compensatory stage of shock exhibits which physiological response?
A. Increased heart rate and peripheral vasoconstriction
B. Metabolic acidosis due to anaerobic metabolism
C. Decreased level of consciousness and lethargy
D. Failure of the sodium-potassium pump
Answer: A
Rationale: In the compensatory stage, the body activates the sympathetic nervous system to maintain
cardiac output and blood pressure through tachycardia and vasoconstriction. 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. 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.
2. Which assessment finding is most indicative of the progressive stage of shock?
A. Mean arterial pressure (MAP) less than 60 mmHg
B. Narrowing pulse pressure
C. Respiratory rate of 22 breaths per minute
D. Hyperactive bowel sounds
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail, and the MAP drops below 60
mmHg, leading to organ dysfunction. In practice, this guides the nurse to set priorities and protect the
client from harm. Safety, nutrition, and clear communication are frequent priorities. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Med-Surg Final Exam 2026/2027 UP… 2026/2027 • Verified • Assured Grade A+
3. A patient with septic shock is receiving aggressive fluid resuscitation. Which finding
indicates adequate tissue perfusion?
A. Central venous pressure (CVP) of 2 mmHg
B. Urine output of 0.5 mL/kg/hr
C. Heart rate of 110 beats per minute
D. Lactate level of 5 mmol/L
Answer: B
Rationale: Adequate urine output (0.5 mL/kg/hr or 30 mL/hr) is a primary indicator of improved organ
perfusion. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities. 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 patient has suffered a 40% total body surface area (TBSA) burn. During the emergent
phase, which electrolyte imbalance is expected?
A. burn. During the emergent phase, which electrolyte imbalance is expected?
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction from burns releases potassium into the extracellular fluid, resulting in
hyperkalemia. 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 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Advanced Med-Surg Final Exam 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 2026/2027 UP… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the compensatory stage of shock exhibits which physiological response?
A. Increased heart rate and peripheral vasoconstriction
B. Metabolic acidosis due to anaerobic metabolism
C. Decreased level of consciousness and lethargy
D. Failure of the sodium-potassium pump
Answer: A
Rationale: In the compensatory stage, the body activates the sympathetic nervous system to maintain
cardiac output and blood pressure through tachycardia and vasoconstriction. 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. 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.
2. Which assessment finding is most indicative of the progressive stage of shock?
A. Mean arterial pressure (MAP) less than 60 mmHg
B. Narrowing pulse pressure
C. Respiratory rate of 22 breaths per minute
D. Hyperactive bowel sounds
Answer: A
Rationale: In the progressive stage, compensatory mechanisms fail, and the MAP drops below 60
mmHg, leading to organ dysfunction. In practice, this guides the nurse to set priorities and protect the
client from harm. Safety, nutrition, and clear communication are frequent priorities. This knowledge
supports safe care and helps the nurse teach the client and family clearly and simply. Clear teaching
improves cooperation and reduces anxiety.
Exam (Elaborations) • Detailed Rationales Page 2
, NUR 265 Advanced Med-Surg Final Exam 2026/2027 UP… 2026/2027 • Verified • Assured Grade A+
3. A patient with septic shock is receiving aggressive fluid resuscitation. Which finding
indicates adequate tissue perfusion?
A. Central venous pressure (CVP) of 2 mmHg
B. Urine output of 0.5 mL/kg/hr
C. Heart rate of 110 beats per minute
D. Lactate level of 5 mmol/L
Answer: B
Rationale: Adequate urine output (0.5 mL/kg/hr or 30 mL/hr) is a primary indicator of improved organ
perfusion. In practice, this guides the nurse to set priorities and protect the client from harm. Safety,
nutrition, and clear communication are frequent priorities. 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 patient has suffered a 40% total body surface area (TBSA) burn. During the emergent
phase, which electrolyte imbalance is expected?
A. burn. During the emergent phase, which electrolyte imbalance is expected?
B. Hypernatremia
C. Hyperkalemia
D. Hypocalcemia
Answer: C
Rationale: Cellular destruction from burns releases potassium into the extracellular fluid, resulting in
hyperkalemia. 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 3
