NUR 265 FINAL EXAM - ADVANCED
MEDICAL-SURGICAL NURSING
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with ARDS is receiving mechanical ventilation with a PEEP of 15 cm H2O. Which
assessment finding requires immediate intervention?
A. Respiratory rate of 24 breaths/min
B. SpO2 of 93%
C. Blood pressure of 82/48 mmHg
D. PaO2 of 80 mmHg
Answer: C
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return and cardiac output, leading to hypotension.
2. During the emergent phase of a burn injury, which electrolyte imbalance is the nurse most
likely to observe?
A. Hyperkalemia
B. Hypercalcemia
,C. Hypokalemia
D. Hypernatremia
Answer: A
Conceptual Explanation: In the emergent phase, massive cellular destruction causes
potassium to leak out of the cells into the extracellular fluid, resulting in hyperkalemia.
3. A patient in the ICU has a CVP of 1 mmHg and a PAOP of 3 mmHg. Which IV fluid order
should the nurse prioritize?
A. Dextrose 5% in water (D5W)
B. Furosemide 40 mg IV push
C. Dopamine infusion at 5 mcg/kg/min
D. Normal Saline 500 mL bolus
Answer: D
Conceptual Explanation: Low CVP and PAOP indicate hypovolemia. Volume resuscitation
with isotonic fluids like Normal Saline is the priority intervention.
4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin
B. Hypotension with narrow pulse pressure
C. Increased heart rate and narrowed pulse pressure
, D. Metabolic acidosis and anuria
Answer: C
Conceptual Explanation: In the compensatory stage, the SNS triggers tachycardia and
vasoconstriction to maintain cardiac output; blood pressure often remains normal but the
pulse pressure narrows.
5. A nurse is caring for a patient with a T4 spinal cord injury. The patient reports a sudden
throbbing headache and has a BP of 190/100. What is the priority action?
A. Place the patient in a sitting position
B. Perform a digital rectal exam to check for impaction
C. Administer PRN antihypertensive medication
D. Assess the urinary catheter for kinks
Answer: A
Conceptual Explanation: Autonomic dysreflexia is a medical emergency. The first action is
to sit the patient upright to lower blood pressure via orthostatic effect, followed by
identifying the noxious stimulus.
6. When assessing a patient with acute pancreatitis, which finding indicates the development
of Grey Turner’s sign?
A. Bluish discoloration around the umbilicus
B. Ecchymosis in the flank area
MEDICAL-SURGICAL NURSING
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient with ARDS is receiving mechanical ventilation with a PEEP of 15 cm H2O. Which
assessment finding requires immediate intervention?
A. Respiratory rate of 24 breaths/min
B. SpO2 of 93%
C. Blood pressure of 82/48 mmHg
D. PaO2 of 80 mmHg
Answer: C
Conceptual Explanation: High levels of PEEP increase intrathoracic pressure, which can
decrease venous return and cardiac output, leading to hypotension.
2. During the emergent phase of a burn injury, which electrolyte imbalance is the nurse most
likely to observe?
A. Hyperkalemia
B. Hypercalcemia
,C. Hypokalemia
D. Hypernatremia
Answer: A
Conceptual Explanation: In the emergent phase, massive cellular destruction causes
potassium to leak out of the cells into the extracellular fluid, resulting in hyperkalemia.
3. A patient in the ICU has a CVP of 1 mmHg and a PAOP of 3 mmHg. Which IV fluid order
should the nurse prioritize?
A. Dextrose 5% in water (D5W)
B. Furosemide 40 mg IV push
C. Dopamine infusion at 5 mcg/kg/min
D. Normal Saline 500 mL bolus
Answer: D
Conceptual Explanation: Low CVP and PAOP indicate hypovolemia. Volume resuscitation
with isotonic fluids like Normal Saline is the priority intervention.
4. Which clinical manifestation is a hallmark sign of the compensatory stage of shock?
A. Cold, clammy skin
B. Hypotension with narrow pulse pressure
C. Increased heart rate and narrowed pulse pressure
, D. Metabolic acidosis and anuria
Answer: C
Conceptual Explanation: In the compensatory stage, the SNS triggers tachycardia and
vasoconstriction to maintain cardiac output; blood pressure often remains normal but the
pulse pressure narrows.
5. A nurse is caring for a patient with a T4 spinal cord injury. The patient reports a sudden
throbbing headache and has a BP of 190/100. What is the priority action?
A. Place the patient in a sitting position
B. Perform a digital rectal exam to check for impaction
C. Administer PRN antihypertensive medication
D. Assess the urinary catheter for kinks
Answer: A
Conceptual Explanation: Autonomic dysreflexia is a medical emergency. The first action is
to sit the patient upright to lower blood pressure via orthostatic effect, followed by
identifying the noxious stimulus.
6. When assessing a patient with acute pancreatitis, which finding indicates the development
of Grey Turner’s sign?
A. Bluish discoloration around the umbilicus
B. Ecchymosis in the flank area
