NUR 265
Advanced Medical-Surgical Nursing Final Exam
Prep
Final Exam • Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Final Exam Prep 2026/2027 UPDATE – Galen
1. A patient in the emergent phase of a 40% total body surface area (TBSA) burn has a serum
potassium level of 6.2 mEq/L. What is the primary cause of this finding?
A. Acute kidney injury
B. Excessive potassium replacement in the IV fluids
C. Destruction of cells and release of intracellular ions
D. Hemoconcentration due to fluid loss
Answer: C
Rationale: In the emergent phase of burns, massive cell destruction releases potassium
from the intracellular space into the extracellular fluid, leading to hyperkalemia.
2. Using the Parkland Formula, calculate the total fluid volume required in the first 24 hours
for a 70kg patient with a 50% TBSA burn.
A. 7,000 mL
B. 28,000 mL
C. 10,500 mL
D. 14,000 mL
Answer: D
, Rationale: Parkland Formula: 4mL x kg x %TBSA. 4 x 70 x 50 = 14,000 mL.
3. Which clinical manifestation is most indicative of the ‘progressive stage’ of shock?
A. Narrowing pulse pressure
B. Hyperactive bowel sounds
C. Lactic acid levels remaining within normal range
D. Mean Arterial Pressure (MAP) decrease of 20 mmHg from baseline
Answer: D
Rationale: In the progressive stage, compensatory mechanisms fail; a MAP drop of >20
mmHg and metabolic acidosis are hallmark signs.
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with PEEP. Which assessment finding requires immediate intervention?
A. PaO2 of 80 mmHg
B. FiO2 of 60%
C. Subcutaneous emphysema on the upper chest
D. Pulse oximetry of 92%
Answer: C
Rationale: Subcutaneous emphysema can indicate barotrauma or a pneumothorax, a
serious complication of high PEEP in ARDS.
Advanced Medical-Surgical Nursing Final Exam
Prep
Final Exam • Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Final Exam Prep 2026/2027 UPDATE – Galen
1. A patient in the emergent phase of a 40% total body surface area (TBSA) burn has a serum
potassium level of 6.2 mEq/L. What is the primary cause of this finding?
A. Acute kidney injury
B. Excessive potassium replacement in the IV fluids
C. Destruction of cells and release of intracellular ions
D. Hemoconcentration due to fluid loss
Answer: C
Rationale: In the emergent phase of burns, massive cell destruction releases potassium
from the intracellular space into the extracellular fluid, leading to hyperkalemia.
2. Using the Parkland Formula, calculate the total fluid volume required in the first 24 hours
for a 70kg patient with a 50% TBSA burn.
A. 7,000 mL
B. 28,000 mL
C. 10,500 mL
D. 14,000 mL
Answer: D
, Rationale: Parkland Formula: 4mL x kg x %TBSA. 4 x 70 x 50 = 14,000 mL.
3. Which clinical manifestation is most indicative of the ‘progressive stage’ of shock?
A. Narrowing pulse pressure
B. Hyperactive bowel sounds
C. Lactic acid levels remaining within normal range
D. Mean Arterial Pressure (MAP) decrease of 20 mmHg from baseline
Answer: D
Rationale: In the progressive stage, compensatory mechanisms fail; a MAP drop of >20
mmHg and metabolic acidosis are hallmark signs.
4. A patient with Acute Respiratory Distress Syndrome (ARDS) is receiving mechanical
ventilation with PEEP. Which assessment finding requires immediate intervention?
A. PaO2 of 80 mmHg
B. FiO2 of 60%
C. Subcutaneous emphysema on the upper chest
D. Pulse oximetry of 92%
Answer: C
Rationale: Subcutaneous emphysema can indicate barotrauma or a pneumothorax, a
serious complication of high PEEP in ARDS.
