NUR 265 Final Exam - Advanced Medical-Surgical Nu… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Final Exam - Advanced Medical-Surgical Nursing
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 Final Exam - Advanced Medical-Surgical Nu… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the oliguric phase of acute kidney injury (AKI) has a potassium level of 6.8
mEq/L. Which prescribed medication should the nurse prioritize to protect the heart from
lethal arrhythmias?
A. Calcium gluconate
B. Sodium polystyrene sulfonate (Kayexalate)
C. Regular insulin and D50W
D. Furosemide (Lasix)
Answer: A
Rationale: While other medications help lower potassium, calcium gluconate is administered first to
stabilize the myocardial cell membrane and prevent life-threatening dysrhythmias. 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. This knowledge supports safe care and helps the
nurse teach the client and family clearly and simply. Clear teaching improves cooperation and reduces
anxiety.
2. A nurse is caring for a patient with septic shock. Which hemodynamic parameter is most
characteristic of the early (hyperdynamic) phase?
A. Increased Systemic Vascular Resistance (SVR)
B. Increased Cardiac Index (CI)
C. Decreased Cardiac Output (CO)
D. Decreased Central Venous Pressure (CVP)
Answer: B
Rationale: In early septic shock, vasodilation causes a decrease in SVR, but the body compensates
by increasing Heart Rate and Stroke Volume, leading to a high Cardiac Index/Output. 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 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 Final Exam - Advanced Medical-Surgical Nu… 2026/2027 • Verified • Assured Grade A+
3. A patient with a history of cirrhosis presents with confusion, asterixis, and a high
ammonia level. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Neomycin
C. Lactulose
D. Propranolol
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool and is the primary
treatment for hepatic encephalopathy. 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. 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.
4. When caring for a patient with an endotracheal tube, the high-pressure alarm on the
ventilator sounds. Which action should the nurse take first?
A. Suction the patient’s airway
B. Check for a leak in the cuff
C. Call the respiratory therapist
D. Disconnect the patient and manually ventilate
Answer: A
Rationale: High-pressure alarms are often caused by obstructions like secretions, biting the tube, or
kinks. Suctioning is a primary intervention to clear secretions. 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. 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.
Exam (Elaborations) • Detailed Rationales Page 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Final Exam - Advanced Medical-Surgical Nursing
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 Final Exam - Advanced Medical-Surgical Nu… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the oliguric phase of acute kidney injury (AKI) has a potassium level of 6.8
mEq/L. Which prescribed medication should the nurse prioritize to protect the heart from
lethal arrhythmias?
A. Calcium gluconate
B. Sodium polystyrene sulfonate (Kayexalate)
C. Regular insulin and D50W
D. Furosemide (Lasix)
Answer: A
Rationale: While other medications help lower potassium, calcium gluconate is administered first to
stabilize the myocardial cell membrane and prevent life-threatening dysrhythmias. 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. This knowledge supports safe care and helps the
nurse teach the client and family clearly and simply. Clear teaching improves cooperation and reduces
anxiety.
2. A nurse is caring for a patient with septic shock. Which hemodynamic parameter is most
characteristic of the early (hyperdynamic) phase?
A. Increased Systemic Vascular Resistance (SVR)
B. Increased Cardiac Index (CI)
C. Decreased Cardiac Output (CO)
D. Decreased Central Venous Pressure (CVP)
Answer: B
Rationale: In early septic shock, vasodilation causes a decrease in SVR, but the body compensates
by increasing Heart Rate and Stroke Volume, leading to a high Cardiac Index/Output. 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 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 Final Exam - Advanced Medical-Surgical Nu… 2026/2027 • Verified • Assured Grade A+
3. A patient with a history of cirrhosis presents with confusion, asterixis, and a high
ammonia level. Which medication should the nurse anticipate administering?
A. Spironolactone
B. Neomycin
C. Lactulose
D. Propranolol
Answer: C
Rationale: Lactulose promotes the excretion of ammonia through the stool and is the primary
treatment for hepatic encephalopathy. 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. 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.
4. When caring for a patient with an endotracheal tube, the high-pressure alarm on the
ventilator sounds. Which action should the nurse take first?
A. Suction the patient’s airway
B. Check for a leak in the cuff
C. Call the respiratory therapist
D. Disconnect the patient and manually ventilate
Answer: A
Rationale: High-pressure alarms are often caused by obstructions like secretions, biting the tube, or
kinks. Suctioning is a primary intervention to clear secretions. 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. 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.
Exam (Elaborations) • Detailed Rationales Page 3
