NUR 265 Final Exam - Advanced Med-Surg Comprehens… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Final Exam - Advanced Med-Surg Comprehensive
Practice 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 Med-Surg Comprehens… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The nurse notes a blood pressure of 190/100 mmHg and bradycardia. What is
the priority nursing action?
A. Check the patient’s bladder for distention or a kinked catheter.
B. Administer an antihypertensive medication as ordered.
C. Place the patient in a supine position to stabilize blood pressure.
D. Perform a neurological assessment to check for increased intracranial pressure.
Answer: A
Rationale: The patient is exhibiting signs of autonomic dysreflexia, a medical emergency in SCI
patients. The first priority is to identify and remove the noxious stimulus, most commonly a full bladder
or impacted bowel. The patient should be sat upright immediately. 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.
2. Which clinical finding is most characteristic of the ‘cold’ or hypodynamic phase of septic
shock?
A. Increased cardiac output and warm, flushed skin.
B. Bounding peripheral pulses and tachypnea.
C. Hyperglycemia and respiratory alkalosis.
D. Cool, clammy skin, decreased urine output, and metabolic acidosis.
Answer: D
Rationale: In the late or cold phase of septic shock, cardiac output falls, peripheral vasoconstriction
occurs to compensate, leading to cool/clammy skin, oliguria, and tissue hypoxia resulting in metabolic
acidosis. This knowledge supports safe care and helps the nurse teach the client and family clearly
and simply. Clear teaching improves cooperation and reduces anxiety. 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 (Elaborations) • Detailed Rationales Page 2
, NUR 265 Final Exam - Advanced Med-Surg Comprehens… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with a diagnosis of Acute Respiratory Distress Syndrome (ARDS).
The nurse understands that the primary pathophysiological change in ARDS is:
A. Damage to the alveolar-capillary membrane leading to non-cardiogenic pulmonary edema.
B. Increased airway resistance due to bronchospasm.
C. Decreased surfactant production due to chronic smoking.
D. Obstruction of the pulmonary artery by a large embolus.
Answer: A
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, which increases
permeability, allowing fluid to leak into the alveoli, causing severe hypoxia and decreased lung
compliance. 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.
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.
4. The nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm
begins to sound. Which of the following is a possible cause?
A. The patient is biting the endotracheal tube.
B. The patient has disconnected the endotracheal tube.
C. A leak in the ventilator circuit.
D. The cuff on the endotracheal tube has deflated.
Answer: A
Rationale: High-pressure alarms are triggered by increased resistance, such as the patient biting the
tube, secretions in the airway, kinks in the tubing, or decreased lung compliance. Leaks cause
low-pressure alarms. 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.
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 3
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Final Exam - Advanced Med-Surg Comprehensive
Practice 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 Med-Surg Comprehens… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient with a T6 spinal cord injury reports a sudden, throbbing headache and nasal
congestion. The nurse notes a blood pressure of 190/100 mmHg and bradycardia. What is
the priority nursing action?
A. Check the patient’s bladder for distention or a kinked catheter.
B. Administer an antihypertensive medication as ordered.
C. Place the patient in a supine position to stabilize blood pressure.
D. Perform a neurological assessment to check for increased intracranial pressure.
Answer: A
Rationale: The patient is exhibiting signs of autonomic dysreflexia, a medical emergency in SCI
patients. The first priority is to identify and remove the noxious stimulus, most commonly a full bladder
or impacted bowel. The patient should be sat upright immediately. 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.
2. Which clinical finding is most characteristic of the ‘cold’ or hypodynamic phase of septic
shock?
A. Increased cardiac output and warm, flushed skin.
B. Bounding peripheral pulses and tachypnea.
C. Hyperglycemia and respiratory alkalosis.
D. Cool, clammy skin, decreased urine output, and metabolic acidosis.
Answer: D
Rationale: In the late or cold phase of septic shock, cardiac output falls, peripheral vasoconstriction
occurs to compensate, leading to cool/clammy skin, oliguria, and tissue hypoxia resulting in metabolic
acidosis. This knowledge supports safe care and helps the nurse teach the client and family clearly
and simply. Clear teaching improves cooperation and reduces anxiety. 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 (Elaborations) • Detailed Rationales Page 2
, NUR 265 Final Exam - Advanced Med-Surg Comprehens… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with a diagnosis of Acute Respiratory Distress Syndrome (ARDS).
The nurse understands that the primary pathophysiological change in ARDS is:
A. Damage to the alveolar-capillary membrane leading to non-cardiogenic pulmonary edema.
B. Increased airway resistance due to bronchospasm.
C. Decreased surfactant production due to chronic smoking.
D. Obstruction of the pulmonary artery by a large embolus.
Answer: A
Rationale: ARDS is characterized by damage to the alveolar-capillary membrane, which increases
permeability, allowing fluid to leak into the alveoli, causing severe hypoxia and decreased lung
compliance. 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.
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.
4. The nurse is caring for a patient on a mechanical ventilator. The high-pressure alarm
begins to sound. Which of the following is a possible cause?
A. The patient is biting the endotracheal tube.
B. The patient has disconnected the endotracheal tube.
C. A leak in the ventilator circuit.
D. The cuff on the endotracheal tube has deflated.
Answer: A
Rationale: High-pressure alarms are triggered by increased resistance, such as the patient biting the
tube, secretions in the airway, kinks in the tubing, or decreased lung compliance. Leaks cause
low-pressure alarms. 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.
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 3
