NUR 265 ADVANCED MED-SURG EXAM 1 STUDY GUIDE -
CARDIAC, RENAL, HEPATIC & PANCREATIC DISORDERS
- GALEN COLLEGE OF NURSING 2026.PDF
145 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 265 ADVANCED MED-SURG EXAM 1 STUDY GUIDE - CARDIAC, RENAL, HEPATIC & PANCREATIC
DISORDERS - GALEN COLLEGE OF NURSING 2026.PDF. It contains 145 carefully selected questions that
reflect the most current exam content and testing strategies. Each question is accompanied by a correct answer
and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 145 Questions
Foundations - Application - NUR 265 Advanced Med-surg 1 Study Guide Cardiac Renal Hepatic &
Pancreatic Disorders Galen College OF Nursing 2026 PDF Advanced Medical-surgical Nursing Cardiac Renal
Hepatic & Pancreatic Disorders Undergraduate YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Cardiac Disorders 1-25 Acute, Finding, Heart Failure, Prescribed, Kidney
Assessment Diagnostics
AND Hemodynamic
Monitoring
Cardiac Disorders Acute 26-50 Acute, Finding, Intervention, Heart Failure, Kidney
Coronary Syndrome Heart
Failure AND Dysrhythmias
Renal Disorders Acute 51-75 Finding, Acute, Prescribed, Failure, Intervention
Kidney Injury AND Chronic
Kidney Disease
Renal Disorders Electrolyte 76-100 Acute, Finding, Heart Failure, Prescribed, Decompensated Heart
Imbalances Dialysis AND
Renal Replacement Therapy
Hepatic Disorders Cirrhosis 101-125 Finding, Acute, Kidney, Chronic, Pancreatitis
Portal Hypertension AND
Esophageal Varices
Hepatic Disorders Hepatitis 126-145 Acute, Finding, Prescribed, Heart Failure, Cirrhosis
Liver Failure AND Hepatic
Encephalopathy
TOTAL 145 All questions include answers and detailed rationales
,Section A - Cardiac Disorders Assessment Diagnostics
AND Hemodynamic Monitoring
Q1.
A patient with acute decompensated heart failure has a BNP of 1,850 pg/mL. Which
intervention should the nurse anticipate as first-line to reduce preload?
A. Administer IV furosemide B. Initiate dobutamine infusion
C. Start carvedilol D. Place a transvenous pacemaker
Correct: A - Administer IV furosemide
Rationale:IV loop diuretics such as furosemide are first-line to reduce preload in acute
decompensated heart failure by promoting diuresis and decreasing circulating volume.
Dobutamine is an inotrope for low cardiac output, carvedilol is a beta-blocker for chronic HF,
and a pacemaker treats conduction abnormalities, not preload.
Why the other answers are wrong:
B. Dobutamine increases contractility but does not primarily reduce preload.
C. Carvedilol is used for chronic heart failure and would worsen acute decompensation.
D. A pacemaker addresses conduction issues, not volume overload.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 29
Q2.
A patient with chronic kidney disease has a potassium level of 6.8 mEq/L and peaked T
waves on ECG. Which medication should the nurse prepare to administer first?
A. Sodium polystyrene sulfonate B. IV calcium gluconate
C. Regular insulin with dextrose D. Sodium bicarbonate
Correct: B - IV calcium gluconate
Rationale:IV calcium gluconate is administered first to stabilize the myocardium and prevent
lethal arrhythmias in hyperkalemia with ECG changes. Insulin with dextrose and bicarbonate
shift potassium intracellularly, and polystyrene sulfonate removes potassium slowly via the GI
tract.
Why the other answers are wrong:
A. Polystyrene sulfonate works slowly and does not protect the heart immediately.
C. Insulin with dextrose shifts potassium but does not immediately stabilize cardiac
membranes.
D. Bicarbonate is adjunctive and not the first-line for cardiac stabilization.
Page 3
, Section A - Cardiac Disorders Assessment Diagnostics AND Hemodynamic Monitoring
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 47
Q3.
Which assessment finding is most indicative of acute pancreatitis?
A. Pain relieved by leaning forward B. Pain worsened by eating
C. Pain in the right lower quadrant D. Pain relieved by supine positioning
Correct: A - Pain relieved by leaning forward
Rationale:Acute pancreatitis typically causes severe epigastric pain that radiates to the back
and is relieved by leaning forward or fetal positioning. Pain worsened by eating is common
but less specific; RLQ pain suggests appendicitis; supine positioning usually worsens pain.
Why the other answers are wrong:
B. Pain worsened by eating is nonspecific and seen in many GI disorders.
C. RLQ pain is more consistent with appendicitis or Crohn's disease.
D. Supine positioning typically increases pancreatic pain.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 50
Q4.
A patient with heart failure is prescribed spironolactone. Which lab value should the nurse
monitor most closely?
A. Serum potassium B. Serum sodium
C. Serum calcium D. Serum magnesium
Correct: A - Serum potassium
Rationale:Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia,
especially when combined with ACE inhibitors or ARBs. Sodium, calcium, and magnesium
are less directly affected but potassium is the priority due to arrhythmia risk.
Why the other answers are wrong:
B. Sodium may decrease slightly but is not the primary risk.
C. Calcium is not significantly affected by spironolactone.
D. Magnesium is not the main electrolyte affected.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 48
Q5.
Which finding in a patient with acute kidney injury indicates the onset of the diuretic
phase?
A. Urine output increases to 2 L/day B. BUN and creatinine rise sharply
Page 4
CARDIAC, RENAL, HEPATIC & PANCREATIC DISORDERS
- GALEN COLLEGE OF NURSING 2026.PDF
145 Questions with Answers and Detailed Rationales
100 PERCENT GUARANTEED PASS
INSTANT DOWNLOAD ANSWERS INCLUDED
IMPORTANCE OF THIS DOCUMENT
This comprehensive examination preparation guide has been meticulously developed to help you succeed in the
NUR 265 ADVANCED MED-SURG EXAM 1 STUDY GUIDE - CARDIAC, RENAL, HEPATIC & PANCREATIC
DISORDERS - GALEN COLLEGE OF NURSING 2026.PDF. It contains 145 carefully selected questions that
reflect the most current exam content and testing strategies. Each question is accompanied by a correct answer
and a detailed rationale that explains the underlying pathophysiology, pharmacology, or clinical reasoning.
Self-Assessment – Test your knowledge and Exam Preparation – Familiarize yourself with the
identify areas requiring further question format and content
study areas
Concept Reinforcement – Deepen your Confidence Building – Develop test-taking
understanding through strategies and reduce
evidence-based exam anxiety
rationales
Time Management – Practice answering
questions under simulated
exam conditions
Review Summary 145 Questions
Foundations - Application - NUR 265 Advanced Med-surg 1 Study Guide Cardiac Renal Hepatic &
Pancreatic Disorders Galen College OF Nursing 2026 PDF Advanced Medical-surgical Nursing Cardiac Renal
Hepatic & Pancreatic Disorders Undergraduate YEAR 3 BSN
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Cardiac Disorders 1-25 Acute, Finding, Heart Failure, Prescribed, Kidney
Assessment Diagnostics
AND Hemodynamic
Monitoring
Cardiac Disorders Acute 26-50 Acute, Finding, Intervention, Heart Failure, Kidney
Coronary Syndrome Heart
Failure AND Dysrhythmias
Renal Disorders Acute 51-75 Finding, Acute, Prescribed, Failure, Intervention
Kidney Injury AND Chronic
Kidney Disease
Renal Disorders Electrolyte 76-100 Acute, Finding, Heart Failure, Prescribed, Decompensated Heart
Imbalances Dialysis AND
Renal Replacement Therapy
Hepatic Disorders Cirrhosis 101-125 Finding, Acute, Kidney, Chronic, Pancreatitis
Portal Hypertension AND
Esophageal Varices
Hepatic Disorders Hepatitis 126-145 Acute, Finding, Prescribed, Heart Failure, Cirrhosis
Liver Failure AND Hepatic
Encephalopathy
TOTAL 145 All questions include answers and detailed rationales
,Section A - Cardiac Disorders Assessment Diagnostics
AND Hemodynamic Monitoring
Q1.
A patient with acute decompensated heart failure has a BNP of 1,850 pg/mL. Which
intervention should the nurse anticipate as first-line to reduce preload?
A. Administer IV furosemide B. Initiate dobutamine infusion
C. Start carvedilol D. Place a transvenous pacemaker
Correct: A - Administer IV furosemide
Rationale:IV loop diuretics such as furosemide are first-line to reduce preload in acute
decompensated heart failure by promoting diuresis and decreasing circulating volume.
Dobutamine is an inotrope for low cardiac output, carvedilol is a beta-blocker for chronic HF,
and a pacemaker treats conduction abnormalities, not preload.
Why the other answers are wrong:
B. Dobutamine increases contractility but does not primarily reduce preload.
C. Carvedilol is used for chronic heart failure and would worsen acute decompensation.
D. A pacemaker addresses conduction issues, not volume overload.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 29
Q2.
A patient with chronic kidney disease has a potassium level of 6.8 mEq/L and peaked T
waves on ECG. Which medication should the nurse prepare to administer first?
A. Sodium polystyrene sulfonate B. IV calcium gluconate
C. Regular insulin with dextrose D. Sodium bicarbonate
Correct: B - IV calcium gluconate
Rationale:IV calcium gluconate is administered first to stabilize the myocardium and prevent
lethal arrhythmias in hyperkalemia with ECG changes. Insulin with dextrose and bicarbonate
shift potassium intracellularly, and polystyrene sulfonate removes potassium slowly via the GI
tract.
Why the other answers are wrong:
A. Polystyrene sulfonate works slowly and does not protect the heart immediately.
C. Insulin with dextrose shifts potassium but does not immediately stabilize cardiac
membranes.
D. Bicarbonate is adjunctive and not the first-line for cardiac stabilization.
Page 3
, Section A - Cardiac Disorders Assessment Diagnostics AND Hemodynamic Monitoring
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 47
Q3.
Which assessment finding is most indicative of acute pancreatitis?
A. Pain relieved by leaning forward B. Pain worsened by eating
C. Pain in the right lower quadrant D. Pain relieved by supine positioning
Correct: A - Pain relieved by leaning forward
Rationale:Acute pancreatitis typically causes severe epigastric pain that radiates to the back
and is relieved by leaning forward or fetal positioning. Pain worsened by eating is common
but less specific; RLQ pain suggests appendicitis; supine positioning usually worsens pain.
Why the other answers are wrong:
B. Pain worsened by eating is nonspecific and seen in many GI disorders.
C. RLQ pain is more consistent with appendicitis or Crohn's disease.
D. Supine positioning typically increases pancreatic pain.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 50
Q4.
A patient with heart failure is prescribed spironolactone. Which lab value should the nurse
monitor most closely?
A. Serum potassium B. Serum sodium
C. Serum calcium D. Serum magnesium
Correct: A - Serum potassium
Rationale:Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia,
especially when combined with ACE inhibitors or ARBs. Sodium, calcium, and magnesium
are less directly affected but potassium is the priority due to arrhythmia risk.
Why the other answers are wrong:
B. Sodium may decrease slightly but is not the primary risk.
C. Calcium is not significantly affected by spironolactone.
D. Magnesium is not the main electrolyte affected.
Reference: Lehne, R.A. (2026). Pharmacology for Nursing Care, 12th Ed., Ch. 48
Q5.
Which finding in a patient with acute kidney injury indicates the onset of the diuretic
phase?
A. Urine output increases to 2 L/day B. BUN and creatinine rise sharply
Page 4
