NUR 265 EXAM 3 STUDY GUIDE 2026 | TBI, ICP, SPINAL
CORD INJURY, GUILLAIN-BARRÉ, MYASTHENIA GRAVIS,
BURNS, SHOCK & SEPSIS | GALEN COLLEGE OF NURSING
149 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 EXAM 3 STUDY GUIDE 2026 | TBI, ICP, SPINAL CORD INJURY, GUILLAIN-BARRÉ, MYASTHENIA
GRAVIS, BURNS, SHOCK & SEPSIS | GALEN COLLEGE OF NURSING. It contains 149 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 149 Questions
Foundations - Application - NUR 265 3 Study Guide 2026 TBI ICP Spinal CORD Injury Guillain-barr
Myasthenia Gravis Burns Shock & Sepsis Galen College OF Nursing Medical-surgical Nursing / Critical
CARE Nursing Undergraduate YEAR 3 Baccalaureate Nursing Galen College OF Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Traumatic Brain Injury TBI 1-25 Injury, Finding, Pressure, Spinal CORD, Intervention
Pathophysiology
Assessment AND Nursing
Management
Increased Intracranial 26-50 Injury, First, Finding, Spinal, Severe
Pressure ICP Monitoring
Complications AND
Interventions
Spinal CORD Injury Levels 51-75 Finding, Injury, Intervention, Spinal CORD, Admitted
Manifestations AND
Collaborative CARE
Guillain-barr Syndrome 76-100 Injury, Finding, Pressure, Severe, Spinal CORD
Pathophysiology
Assessment AND Nursing
Management
Myasthenia Gravis 101-125 Injury, Finding, Spinal, Severe, Admitted
Pathophysiology
Assessment AND Nursing
Management
Burns Classification Fluid 126-149 Injury, Finding, Severe, Spinal CORD, Admitted
Resuscitation AND Wound
CARE
TOTAL 149 All questions include answers and detailed rationales
,Section A - Traumatic Brain Injury TBI Pathophysiology
Assessment AND Nursing Management
Q1.
A patient with a severe traumatic brain injury has an intracranial pressure (ICP) of 22 mm
Hg and a mean arterial pressure (MAP) of 70 mm Hg. What is the cerebral perfusion
pressure (CPP), and what is the priority nursing action?
A. CPP is 48 mm Hg; maintain the head of B. CPP is 92 mm Hg; continue current
bed flat to promote venous return. management and reassess in 4 hours.
C. CPP is 48 mm Hg; notify the provider and D. CPP is 92 mm Hg; hyperventilate the
prepare for interventions to increase MAP. patient to reduce ICP.
Correct: C - CPP is 48 mm Hg; notify the provider and prepare for interventions to
increase MAP.
Rationale:CPP = MAP - ICP = 70 - 22 = 48 mm Hg, which is below the recommended target
of 60-70 mm Hg. The priority is to increase MAP while reducing ICP; the provider must be
notified. Flat positioning would worsen ICP, and hyperventilation is not indicated for CPP of
92.
Why the other answers are wrong:
A. Flat positioning impairs venous drainage and can further increase ICP.
B. CPP is 48, not 92; delaying reassessment is unsafe.
D. CPP is 48, not 92; hyperventilation is not the priority for low CPP.
Reference: Bader, M.K. et al. (2024). AANN Core Curriculum for Neuroscience Nursing, 6th Ed., Ch. 14
Q2.
A patient with a T6 spinal cord injury suddenly develops severe hypertension,
bradycardia, and a pounding headache. Which nursing action is the priority?
A. Administer a prescribed antihypertensive B. Check for a distended bladder or fecal
and elevate the head of the bed. impaction as the trigger.
C. Perform a rectal exam to rule out D. Place the patient supine and administer
impaction immediately. IV fluids.
Correct: B - Check for a distended bladder or fecal impaction as the trigger.
Rationale:These findings indicate autonomic dysreflexia, a life-threatening emergency
triggered by noxious stimuli below the injury level, most commonly bladder distention or fecal
impaction. The priority is to identify and remove the trigger. Rectal exam can worsen the
response; supine positioning and fluids are contraindicated.
Why the other answers are wrong:
Page 3
, Section A - Traumatic Brain Injury TBI Pathophysiology Assessment AND Nursing Management
A. Antihypertensives are used after removing the trigger, not as the first action.
C. Rectal manipulation can exacerbate autonomic dysreflexia.
D. Supine positioning and fluids would worsen hypertension.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 61
Q3.
A patient with Guillain-Barré syndrome is admitted with ascending weakness. Which
assessment finding requires immediate intervention?
A. Deep tendon reflexes are absent in the B. The patient reports tingling in the fingers
lower extremities. and toes.
C. Vital capacity has dropped from 15 mL/kg D. The patient has difficulty swallowing solid
to 8 mL/kg. foods.
Correct: C - Vital capacity has dropped from 15 mL/kg to 8 mL/kg.
Rationale:A vital capacity below 10-15 mL/kg indicates impending respiratory failure and
requires immediate intervention, often mechanical ventilation. Absent reflexes and
paresthesias are expected in GBS. Dysphagia is concerning but not as immediately
life-threatening as respiratory compromise.
Why the other answers are wrong:
A. Areflexia is a hallmark finding in GBS, not an emergency.
B. Paresthesias are common and expected in GBS.
D. Dysphagia is important but not the most immediate threat compared to respiratory failure.
Reference: Lewis, S.L. et al. (2023). Medical-Surgical Nursing, 12th Ed., Ch. 60
Q4.
A patient with myasthenia gravis is prescribed pyridostigmine. Which statement indicates
the patient understands the teaching?
A. I should take the medication at bedtime to B. I will take the medication 30-60 minutes
prevent morning weakness. before meals to improve swallowing.
C. I can skip a dose if I feel stronger than D. I should take the medication with a
usual. high-fiber meal to prevent diarrhea.
Correct: B - I will take the medication 30-60 minutes before meals to improve swallowing.
Rationale:Pyridostigmine is best taken 30-60 minutes before meals to improve chewing and
swallowing when the medication peaks. Bedtime dosing can cause nocturnal weakness and
is not routine. Skipping doses can precipitate crisis. High-fiber meals are not specifically
required with this medication.
Why the other answers are wrong:
Page 4
CORD INJURY, GUILLAIN-BARRÉ, MYASTHENIA GRAVIS,
BURNS, SHOCK & SEPSIS | GALEN COLLEGE OF NURSING
149 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 EXAM 3 STUDY GUIDE 2026 | TBI, ICP, SPINAL CORD INJURY, GUILLAIN-BARRÉ, MYASTHENIA
GRAVIS, BURNS, SHOCK & SEPSIS | GALEN COLLEGE OF NURSING. It contains 149 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 149 Questions
Foundations - Application - NUR 265 3 Study Guide 2026 TBI ICP Spinal CORD Injury Guillain-barr
Myasthenia Gravis Burns Shock & Sepsis Galen College OF Nursing Medical-surgical Nursing / Critical
CARE Nursing Undergraduate YEAR 3 Baccalaureate Nursing Galen College OF Nursing
All answers with rationales
,Table of Contents
Content Area Questions Key Topics
Traumatic Brain Injury TBI 1-25 Injury, Finding, Pressure, Spinal CORD, Intervention
Pathophysiology
Assessment AND Nursing
Management
Increased Intracranial 26-50 Injury, First, Finding, Spinal, Severe
Pressure ICP Monitoring
Complications AND
Interventions
Spinal CORD Injury Levels 51-75 Finding, Injury, Intervention, Spinal CORD, Admitted
Manifestations AND
Collaborative CARE
Guillain-barr Syndrome 76-100 Injury, Finding, Pressure, Severe, Spinal CORD
Pathophysiology
Assessment AND Nursing
Management
Myasthenia Gravis 101-125 Injury, Finding, Spinal, Severe, Admitted
Pathophysiology
Assessment AND Nursing
Management
Burns Classification Fluid 126-149 Injury, Finding, Severe, Spinal CORD, Admitted
Resuscitation AND Wound
CARE
TOTAL 149 All questions include answers and detailed rationales
,Section A - Traumatic Brain Injury TBI Pathophysiology
Assessment AND Nursing Management
Q1.
A patient with a severe traumatic brain injury has an intracranial pressure (ICP) of 22 mm
Hg and a mean arterial pressure (MAP) of 70 mm Hg. What is the cerebral perfusion
pressure (CPP), and what is the priority nursing action?
A. CPP is 48 mm Hg; maintain the head of B. CPP is 92 mm Hg; continue current
bed flat to promote venous return. management and reassess in 4 hours.
C. CPP is 48 mm Hg; notify the provider and D. CPP is 92 mm Hg; hyperventilate the
prepare for interventions to increase MAP. patient to reduce ICP.
Correct: C - CPP is 48 mm Hg; notify the provider and prepare for interventions to
increase MAP.
Rationale:CPP = MAP - ICP = 70 - 22 = 48 mm Hg, which is below the recommended target
of 60-70 mm Hg. The priority is to increase MAP while reducing ICP; the provider must be
notified. Flat positioning would worsen ICP, and hyperventilation is not indicated for CPP of
92.
Why the other answers are wrong:
A. Flat positioning impairs venous drainage and can further increase ICP.
B. CPP is 48, not 92; delaying reassessment is unsafe.
D. CPP is 48, not 92; hyperventilation is not the priority for low CPP.
Reference: Bader, M.K. et al. (2024). AANN Core Curriculum for Neuroscience Nursing, 6th Ed., Ch. 14
Q2.
A patient with a T6 spinal cord injury suddenly develops severe hypertension,
bradycardia, and a pounding headache. Which nursing action is the priority?
A. Administer a prescribed antihypertensive B. Check for a distended bladder or fecal
and elevate the head of the bed. impaction as the trigger.
C. Perform a rectal exam to rule out D. Place the patient supine and administer
impaction immediately. IV fluids.
Correct: B - Check for a distended bladder or fecal impaction as the trigger.
Rationale:These findings indicate autonomic dysreflexia, a life-threatening emergency
triggered by noxious stimuli below the injury level, most commonly bladder distention or fecal
impaction. The priority is to identify and remove the trigger. Rectal exam can worsen the
response; supine positioning and fluids are contraindicated.
Why the other answers are wrong:
Page 3
, Section A - Traumatic Brain Injury TBI Pathophysiology Assessment AND Nursing Management
A. Antihypertensives are used after removing the trigger, not as the first action.
C. Rectal manipulation can exacerbate autonomic dysreflexia.
D. Supine positioning and fluids would worsen hypertension.
Reference: Hinkle, J.L. & Cheever, K.H. (2022). Brunner & Suddarth's Textbook of Medical-Surgical
Nursing, 15th Ed., Ch. 61
Q3.
A patient with Guillain-Barré syndrome is admitted with ascending weakness. Which
assessment finding requires immediate intervention?
A. Deep tendon reflexes are absent in the B. The patient reports tingling in the fingers
lower extremities. and toes.
C. Vital capacity has dropped from 15 mL/kg D. The patient has difficulty swallowing solid
to 8 mL/kg. foods.
Correct: C - Vital capacity has dropped from 15 mL/kg to 8 mL/kg.
Rationale:A vital capacity below 10-15 mL/kg indicates impending respiratory failure and
requires immediate intervention, often mechanical ventilation. Absent reflexes and
paresthesias are expected in GBS. Dysphagia is concerning but not as immediately
life-threatening as respiratory compromise.
Why the other answers are wrong:
A. Areflexia is a hallmark finding in GBS, not an emergency.
B. Paresthesias are common and expected in GBS.
D. Dysphagia is important but not the most immediate threat compared to respiratory failure.
Reference: Lewis, S.L. et al. (2023). Medical-Surgical Nursing, 12th Ed., Ch. 60
Q4.
A patient with myasthenia gravis is prescribed pyridostigmine. Which statement indicates
the patient understands the teaching?
A. I should take the medication at bedtime to B. I will take the medication 30-60 minutes
prevent morning weakness. before meals to improve swallowing.
C. I can skip a dose if I feel stronger than D. I should take the medication with a
usual. high-fiber meal to prevent diarrhea.
Correct: B - I will take the medication 30-60 minutes before meals to improve swallowing.
Rationale:Pyridostigmine is best taken 30-60 minutes before meals to improve chewing and
swallowing when the medication peaks. Bedtime dosing can cause nocturnal weakness and
is not routine. Skipping doses can precipitate crisis. High-fiber meals are not specifically
required with this medication.
Why the other answers are wrong:
Page 4
