NUR 265 Med-Surg Exam 2 Practice 2026/2027 UPDATE… 2026/2027 • Verified • Assured Grade A+
✓ VERIFIED • 2026/2027 UPDATE • 100% ACCURATE
NUR 265 Med-Surg Exam 2 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 Med-Surg Exam 2 Practice 2026/2027 UPDATE… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the ICU is showing signs of septic shock. Which of the following findings is
the most critical early indicator of inadequate tissue perfusion?
A. Systolic blood pressure of 95 mmHg
B. Urine output of 35 mL/hr
C. Heart rate of 110 beats per minute
D. Serum lactate level of 4.2 mmol/L
Answer: D
Rationale: Serum lactate levels are a key indicator of anaerobic metabolism and tissue hypoxia, often
rising before significant hypotension occurs in sepsis. 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. 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.
2. When caring for a patient with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the priority action?
A. Increase the suction to 20 cm H2O
B. Document this as a normal finding for a patient with a pneumothorax
C. Check the system for an air leak starting at the insertion site
D. Clamp the chest tube immediately
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which requires
investigation. Intermittent bubbling is expected in a patient with a pneumothorax. 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. 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 Med-Surg Exam 2 Practice 2026/2027 UPDATE… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). The nurse
understands that the primary pathophysiological change in ARDS is:
A. Chronic inflammation of the bronchioles
B. Increased alveolar-capillary membrane permeability
C. Decreased production of red blood cells
D. Obstruction of the pulmonary artery by a fat embolus
Answer: B
Rationale: ARDS involves damage to the alveolar-capillary membrane, leading to fluid leaking into the
alveoli, resulting in severe hypoxia. 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.
4. Which assessment finding is most characteristic of a patient experiencing Neurogenic
Shock?
A. Tachycardia and cool, clammy skin
B. Bradycardia and warm, dry skin
C. Hypertension and bounding pulses
D. Narrowed pulse pressure and tachypnea
Answer: B
Rationale: Neurogenic shock causes a loss of sympathetic tone, leading to vasodilation (warm/dry
skin) and a lack of compensatory tachycardia (bradycardia). 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 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 Med-Surg Exam 2 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 Med-Surg Exam 2 Practice 2026/2027 UPDATE… 2026/2027 • Verified • Assured Grade A+
Questions & Verified Answers
1. A patient in the ICU is showing signs of septic shock. Which of the following findings is
the most critical early indicator of inadequate tissue perfusion?
A. Systolic blood pressure of 95 mmHg
B. Urine output of 35 mL/hr
C. Heart rate of 110 beats per minute
D. Serum lactate level of 4.2 mmol/L
Answer: D
Rationale: Serum lactate levels are a key indicator of anaerobic metabolism and tissue hypoxia, often
rising before significant hypotension occurs in sepsis. 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. 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.
2. When caring for a patient with a chest tube, the nurse notes continuous bubbling in the
water-seal chamber. What is the priority action?
A. Increase the suction to 20 cm H2O
B. Document this as a normal finding for a patient with a pneumothorax
C. Check the system for an air leak starting at the insertion site
D. Clamp the chest tube immediately
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak, which requires
investigation. Intermittent bubbling is expected in a patient with a pneumothorax. 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. 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 Med-Surg Exam 2 Practice 2026/2027 UPDATE… 2026/2027 • Verified • Assured Grade A+
3. A patient is admitted with Acute Respiratory Distress Syndrome (ARDS). The nurse
understands that the primary pathophysiological change in ARDS is:
A. Chronic inflammation of the bronchioles
B. Increased alveolar-capillary membrane permeability
C. Decreased production of red blood cells
D. Obstruction of the pulmonary artery by a fat embolus
Answer: B
Rationale: ARDS involves damage to the alveolar-capillary membrane, leading to fluid leaking into the
alveoli, resulting in severe hypoxia. 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.
4. Which assessment finding is most characteristic of a patient experiencing Neurogenic
Shock?
A. Tachycardia and cool, clammy skin
B. Bradycardia and warm, dry skin
C. Hypertension and bounding pulses
D. Narrowed pulse pressure and tachypnea
Answer: B
Rationale: Neurogenic shock causes a loss of sympathetic tone, leading to vasodilation (warm/dry
skin) and a lack of compensatory tachycardia (bradycardia). 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 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
