Page 1 of 34
NUR 265 – MEDICAL-SURGICAL NURSING – EXAM 1
(NCLEX-STYLE) 2026/2027 COMPLETE CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for NUR 265 Exam 1 with this focused Medical-Surgical Nursing study
resource designed to reinforce essential nursing concepts and clinical knowledge.
Use it to review patient assessment, clinical decision-making, disease processes,
nursing interventions, and key medical-surgical topics. This resource can help
strengthen your understanding, identify areas that may require additional study, and
improve exam readiness. It provides a structured supplement to your coursework for a
more confident approach to Exam 1.
MULTIPLE CHOICE.
Section 1: Nursing Process, Clinical Judgment & Foundational Concepts
(Q1–Q15)
1. A nurse is performing a comprehensive assessment on a newly
admitted client. Which step of the nursing process is being performed?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Answer: A
Rationale: The first step of the nursing process is assessment, which
involves collecting subjective and objective data about the client's health
status.
2. Which of the following is an example of subjective data?
A. Blood pressure 120/80 mmHg
B. Client reports pain 6/10
C. Temperature 98.6°F
D. Heart rate 72 bpm
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Answer: B
Rationale: Subjective data is reported by the client, such as pain or
nausea. Objective data is measurable and observable, such as vital signs.
3. Which of the following is an example of objective data?
A. Client reports headache
B. Client reports nausea
C. Temperature of 101.2°F
D. Client reports dizziness
Answer: C
Rationale: Objective data is measurable and observable, such as a
temperature reading.
4. A nurse is using the SBAR communication tool during handoff. What
does the "B" stand for?
A. Baseline
B. Background
C. Behavior
D. Barrier
Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation.
5. A client with neutropenia is receiving chemotherapy. Which
intervention is most important to prevent infection?
A. Administering prophylactic antibiotics
B. Placing the client in protective isolation
C. Restricting visitors
D. Monitoring vital signs every 4 hours
Answer: B
Rationale: Protective isolation is the most important intervention for
neutropenic clients (ANC <500 cells/mm³). This includes a private room,
strict hand hygiene, and avoiding fresh flowers, raw foods, and live plants.
6. The nurse is assessing a client who is suspected of having a pulmonary
embolism (PE). Which finding is most consistent with this diagnosis?
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A. Bradycardia and hypotension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with green sputum
D. Hypertension and bounding pulses
Answer: B
Rationale: PE classically presents with sudden onset of pleuritic chest
pain, dyspnea, tachypnea, and tachycardia. Bradycardia and
hypertension are not typical.
7. A nurse is prioritizing care for four clients. Which client should the
nurse see first?
A. A client with chronic kidney disease who missed a dialysis session
B. A client with acute decompensated heart failure and oxygen saturation of
82%
C. A client with diabetes requesting a snack
D. A client with a fractured femur requesting pain medication
Answer: B
Rationale: Using the ABCs (Airway, Breathing, Circulation), a client with an
oxygen saturation of 82% is the highest priority.
8. A client with acute decompensated heart failure presents with severe
dyspnea, pink frothy sputum, and oxygen saturation of 82% on room air.
Which intervention should the nurse implement first?
A. Place the patient in high Fowler's position
B. Administer IV furosemide
C. Apply a non-rebreather mask at 15 L/min
D. Insert a Foley catheter
Answer: A
Rationale: High Fowler's position reduces venous return to the heart,
decreases pulmonary congestion, and improves ventilation. While oxygen
and diuretics are important, positioning is the immediate priority.
9. The nurse is caring for a client with acute kidney injury (AKI) in the
oliguric phase. Which laboratory finding requires immediate intervention?
A. Serum potassium 6.2 mEq/L
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B. Serum sodium 135 mEq/L
C. Serum calcium 9.0 mg/dL
D. Serum magnesium 2.0 mg/dL
Answer: A
Rationale: Hyperkalemia (potassium >6.0 mEq/L) is a life-threatening
complication of AKI that can cause cardiac dysrhythmias and requires
immediate intervention.
10. A client with acute kidney injury (AKI) is in the diuretic phase. Which
intervention is most important?
A. Restrict total fluid intake to 500 mL per day
B. Monitor for hypovolemia and electrolyte imbalances
C. Administer potassium supplements
D. Prepare the client for dialysis
Answer: B
Rationale: In the diuretic phase of AKI, large volumes of urine are
excreted, leading to potential hypovolemia, dehydration, and electrolyte
losses (hypokalemia, hyponatremia).
11. A patient is scheduled for hemodialysis. Which medication should the
nurse hold prior to the procedure?
A. Antihypertensive medications
B. Iron supplements
C. Phosphate binders
D. ACE inhibitors
Answer: A
Rationale: Antihypertensive medications may be held prior to dialysis to
prevent hypotension during the procedure.
12. A nurse is teaching a client about a low-potassium diet. Which food
should the client avoid?
A. Apples
B. Bananas
C. White bread
D. Rice
NUR 265 – MEDICAL-SURGICAL NURSING – EXAM 1
(NCLEX-STYLE) 2026/2027 COMPLETE CURRENT TESTING
QUESTIONS AND CORRECT ANSWERS WITH DETAILED
RATIONALES.
NURSING
Prepare for NUR 265 Exam 1 with this focused Medical-Surgical Nursing study
resource designed to reinforce essential nursing concepts and clinical knowledge.
Use it to review patient assessment, clinical decision-making, disease processes,
nursing interventions, and key medical-surgical topics. This resource can help
strengthen your understanding, identify areas that may require additional study, and
improve exam readiness. It provides a structured supplement to your coursework for a
more confident approach to Exam 1.
MULTIPLE CHOICE.
Section 1: Nursing Process, Clinical Judgment & Foundational Concepts
(Q1–Q15)
1. A nurse is performing a comprehensive assessment on a newly
admitted client. Which step of the nursing process is being performed?
A. Assessment
B. Diagnosis
C. Planning
D. Evaluation
Answer: A
Rationale: The first step of the nursing process is assessment, which
involves collecting subjective and objective data about the client's health
status.
2. Which of the following is an example of subjective data?
A. Blood pressure 120/80 mmHg
B. Client reports pain 6/10
C. Temperature 98.6°F
D. Heart rate 72 bpm
, Page 2 of 34
Answer: B
Rationale: Subjective data is reported by the client, such as pain or
nausea. Objective data is measurable and observable, such as vital signs.
3. Which of the following is an example of objective data?
A. Client reports headache
B. Client reports nausea
C. Temperature of 101.2°F
D. Client reports dizziness
Answer: C
Rationale: Objective data is measurable and observable, such as a
temperature reading.
4. A nurse is using the SBAR communication tool during handoff. What
does the "B" stand for?
A. Baseline
B. Background
C. Behavior
D. Barrier
Answer: B
Rationale: SBAR stands for Situation, Background, Assessment, and
Recommendation.
5. A client with neutropenia is receiving chemotherapy. Which
intervention is most important to prevent infection?
A. Administering prophylactic antibiotics
B. Placing the client in protective isolation
C. Restricting visitors
D. Monitoring vital signs every 4 hours
Answer: B
Rationale: Protective isolation is the most important intervention for
neutropenic clients (ANC <500 cells/mm³). This includes a private room,
strict hand hygiene, and avoiding fresh flowers, raw foods, and live plants.
6. The nurse is assessing a client who is suspected of having a pulmonary
embolism (PE). Which finding is most consistent with this diagnosis?
, Page 3 of 34
A. Bradycardia and hypotension
B. Sudden onset of pleuritic chest pain and dyspnea
C. Productive cough with green sputum
D. Hypertension and bounding pulses
Answer: B
Rationale: PE classically presents with sudden onset of pleuritic chest
pain, dyspnea, tachypnea, and tachycardia. Bradycardia and
hypertension are not typical.
7. A nurse is prioritizing care for four clients. Which client should the
nurse see first?
A. A client with chronic kidney disease who missed a dialysis session
B. A client with acute decompensated heart failure and oxygen saturation of
82%
C. A client with diabetes requesting a snack
D. A client with a fractured femur requesting pain medication
Answer: B
Rationale: Using the ABCs (Airway, Breathing, Circulation), a client with an
oxygen saturation of 82% is the highest priority.
8. A client with acute decompensated heart failure presents with severe
dyspnea, pink frothy sputum, and oxygen saturation of 82% on room air.
Which intervention should the nurse implement first?
A. Place the patient in high Fowler's position
B. Administer IV furosemide
C. Apply a non-rebreather mask at 15 L/min
D. Insert a Foley catheter
Answer: A
Rationale: High Fowler's position reduces venous return to the heart,
decreases pulmonary congestion, and improves ventilation. While oxygen
and diuretics are important, positioning is the immediate priority.
9. The nurse is caring for a client with acute kidney injury (AKI) in the
oliguric phase. Which laboratory finding requires immediate intervention?
A. Serum potassium 6.2 mEq/L
, Page 4 of 34
B. Serum sodium 135 mEq/L
C. Serum calcium 9.0 mg/dL
D. Serum magnesium 2.0 mg/dL
Answer: A
Rationale: Hyperkalemia (potassium >6.0 mEq/L) is a life-threatening
complication of AKI that can cause cardiac dysrhythmias and requires
immediate intervention.
10. A client with acute kidney injury (AKI) is in the diuretic phase. Which
intervention is most important?
A. Restrict total fluid intake to 500 mL per day
B. Monitor for hypovolemia and electrolyte imbalances
C. Administer potassium supplements
D. Prepare the client for dialysis
Answer: B
Rationale: In the diuretic phase of AKI, large volumes of urine are
excreted, leading to potential hypovolemia, dehydration, and electrolyte
losses (hypokalemia, hyponatremia).
11. A patient is scheduled for hemodialysis. Which medication should the
nurse hold prior to the procedure?
A. Antihypertensive medications
B. Iron supplements
C. Phosphate binders
D. ACE inhibitors
Answer: A
Rationale: Antihypertensive medications may be held prior to dialysis to
prevent hypotension during the procedure.
12. A nurse is teaching a client about a low-potassium diet. Which food
should the client avoid?
A. Apples
B. Bananas
C. White bread
D. Rice
