NUR 265 EXAM 3 QUESTIONS AND CORRECT
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
, • Advanced Medical-Surgical Nursing
• Respiratory Disorders (ARDS, COPD, Pneumonia, TB, Chest
Tubes)
• Cardiovascular Disorders (Heart Failure, MI, Dysrhythmias,
Pericarditis, Endocarditis, DVT/PE)
• Renal Disorders (AKI, CKD, Dialysis, Electrolyte
Management)
• Gastrointestinal & Hepatic Disorders (Esophageal Varices,
Cirrhosis)
• Neurological Disorders (Head Injury, ICP, Stroke, Seizures)
• Endocrine Disorders
• Fluid & Electrolyte Imbalances
• Shock & Sepsis
• Emergency & Disaster Nursing
Introduction
This comprehensive examination is designed to assess advanced
knowledge and clinical reasoning in medical-surgical nursing. It
encompasses critical concepts essential for safe and effective
patient care across multiple body systems. The exam consists of
multiple-choice questions and clinical scenarios that challenge the
student to apply theoretical knowledge to real-world situations.
Emphasis is placed on prioritization, evidence-based practice, and
decision-making skills necessary for the competent nursing
professional. Success on this examination demonstrates readiness
for advanced clinical practice and safe patient management.
SECTION ONE: QUESTIONS 1–50
Question 1
A patient with chronic obstructive pulmonary disease (COPD) is
admitted with acute respiratory distress. Arterial blood gas (ABG)
results reveal pH 7.30, PaCO₂ 58 mmHg, HCO₃⁻ 30 mEq/L, and PaO₂ 55
mmHg. Which interpretation is most accurate?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
, C. Uncompensated respiratory acidosis
D. Fully compensated respiratory acidosis
B. Partially compensated respiratory acidosis
RATIONALE: The ABG shows acidosis (pH 7.30) with elevated PaCO₂
(58 mmHg), indicating a respiratory acidosis. The elevated HCO₃⁻ (30
mEq/L) shows metabolic compensation. Since the pH is still below
normal, compensation is partial, not full.
Question 2
The nurse is caring for a patient with a chest tube following a
pneumothorax. Which assessment finding requires immediate
intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling of fluid in the water seal chamber with respiration
C. 75 mL of sanguineous drainage in the collection chamber over 4
hours
D. Subcutaneous emphysema at the insertion site
A. Continuous bubbling in the water seal chamber
RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak, which can be from the patient (e.g.,
bronchopleural fistula) or from the system. This requires immediate
assessment and intervention to maintain chest tube integrity and lung
re-expansion. Tidaling is normal. Drainage of 75 mL over 4 hours is
within acceptable parameters. Subcutaneous emphysema, while
concerning, is not immediately life-threatening.
Question 3
ANSWERS (VERIFIED ANSWERS) PLUS RATIONALES
2026 Q&A | INSTANT DOWNLOAD PDF
Core Domains
, • Advanced Medical-Surgical Nursing
• Respiratory Disorders (ARDS, COPD, Pneumonia, TB, Chest
Tubes)
• Cardiovascular Disorders (Heart Failure, MI, Dysrhythmias,
Pericarditis, Endocarditis, DVT/PE)
• Renal Disorders (AKI, CKD, Dialysis, Electrolyte
Management)
• Gastrointestinal & Hepatic Disorders (Esophageal Varices,
Cirrhosis)
• Neurological Disorders (Head Injury, ICP, Stroke, Seizures)
• Endocrine Disorders
• Fluid & Electrolyte Imbalances
• Shock & Sepsis
• Emergency & Disaster Nursing
Introduction
This comprehensive examination is designed to assess advanced
knowledge and clinical reasoning in medical-surgical nursing. It
encompasses critical concepts essential for safe and effective
patient care across multiple body systems. The exam consists of
multiple-choice questions and clinical scenarios that challenge the
student to apply theoretical knowledge to real-world situations.
Emphasis is placed on prioritization, evidence-based practice, and
decision-making skills necessary for the competent nursing
professional. Success on this examination demonstrates readiness
for advanced clinical practice and safe patient management.
SECTION ONE: QUESTIONS 1–50
Question 1
A patient with chronic obstructive pulmonary disease (COPD) is
admitted with acute respiratory distress. Arterial blood gas (ABG)
results reveal pH 7.30, PaCO₂ 58 mmHg, HCO₃⁻ 30 mEq/L, and PaO₂ 55
mmHg. Which interpretation is most accurate?
A. Uncompensated metabolic acidosis
B. Partially compensated respiratory acidosis
, C. Uncompensated respiratory acidosis
D. Fully compensated respiratory acidosis
B. Partially compensated respiratory acidosis
RATIONALE: The ABG shows acidosis (pH 7.30) with elevated PaCO₂
(58 mmHg), indicating a respiratory acidosis. The elevated HCO₃⁻ (30
mEq/L) shows metabolic compensation. Since the pH is still below
normal, compensation is partial, not full.
Question 2
The nurse is caring for a patient with a chest tube following a
pneumothorax. Which assessment finding requires immediate
intervention?
A. Continuous bubbling in the water seal chamber
B. Tidaling of fluid in the water seal chamber with respiration
C. 75 mL of sanguineous drainage in the collection chamber over 4
hours
D. Subcutaneous emphysema at the insertion site
A. Continuous bubbling in the water seal chamber
RATIONALE: Continuous bubbling in the water seal chamber
indicates an air leak, which can be from the patient (e.g.,
bronchopleural fistula) or from the system. This requires immediate
assessment and intervention to maintain chest tube integrity and lung
re-expansion. Tidaling is normal. Drainage of 75 mL over 4 hours is
within acceptable parameters. Subcutaneous emphysema, while
concerning, is not immediately life-threatening.
Question 3
