NUR 265 Exam 2 (2 Versions) – Galen Medical-
Surgical Nursing – (2026/2027) Actual Questions &
Answers, 100% Guarantee Pass
=== START OF EXAM ===
NUR 265 MEDICAL-SURGICAL NURSING
EXAM 2 – VERSION 1 & VERSION 2
GALEN COLLEGE OF NURSING | 2026/2027 UPDATE
VERIFIED QUESTIONS & ANSWERS WITH RATIONALES
VERSION 1: RESPIRATORY & CARDIOVASCULAR FOCUS
1. A nurse is caring for a client who developed acute respiratory distress syndrome
(ARDS) and has been placed on mechanical ventilation. Which is the priority
nursing action?
a) Initiate prescribed total parenteral nutrition (TPN)
b) Monitor ventilator settings closely and provide sedation as ordered
c) Reposition the client every 4 hours
d) Administer high doses of corticosteroids
1
, Answer: b) Monitor ventilator settings closely and provide sedation as ordered
Rationale: Maintaining mechanical ventilation with proper settings is critical to
prevent further lung injury in ARDS. Sedation reduces oxygen demand and
facilitates ventilation. TPN is important but not priority; repositioning every 2
hours is preferred over 4 hours [citation:2][citation:4].
2. A nurse has been made aware of the following client situations. The nurse should
initially follow up with the client who is receiving:
a) Mechanical ventilation with PEEP and develops left tracheal deviation
b) Client post-abdominal surgery with mild pain
c) Client with stable angina
d) Client with controlled diabetes mellitus
Answer: a) Mechanical ventilation with PEEP and develops left tracheal
deviation
Rationale: Tracheal deviation is an emergency sign of tension pneumothorax or
major lung collapse requiring immediate intervention. This is life-threatening and
must be addressed first [citation:2][citation:4].
3. The nurse is caring for a client receiving mechanical ventilation via an
endotracheal tube (ET) who is unable to speak. The client's family is frightened
that the client has permanent loss of voice. Which response should the nurse make?
a) "The tube is causing a temporary loss of the voice."
b) "Your family member will never speak again."
c) "We will talk about a permanent voice prosthesis today."
d) "They can speak but are choosing not to."
Answer: a) "The tube is causing a temporary loss of the voice."
2
, Rationale: An ET tube passes through the vocal cords and prevents phonation,
causing temporary voice loss. This usually resolves after extubation
[citation:2][citation:4].
4. The nurse is caring for a client receiving mechanical ventilation. Which
indicates a correct understanding about managing a client on a ventilator?
a) Suction the client every 2 hours routinely
b) Suction the client when the high-pressure alarm sounds
c) Turn off alarms to prevent noise stress
d) Secure the endotracheal tube loosely to allow movement
Answer: b) Suction the client when the high-pressure alarm sounds
Rationale: High-pressure alarms often indicate increased airway resistance or
obstruction (e.g., secretions). Suctioning helps clear airway. Routine suctioning can
cause trauma and infection. Alarms should never be silenced; the ET tube should
be secured tightly to prevent accidental extubation [citation:2][citation:4].
5. A nurse is caring for a client suspected of having a pulmonary embolism (PE).
Which finding is consistent with this diagnosis?
a) Bradycardia
b) Productive cough with yellow sputum
c) Cough
d) Lower extremity edema
Answer: c) Cough
Rationale: A cough, often dry or nonproductive, is a common symptom of PE
due to irritation or infarction of the pulmonary tissues. Other hallmark symptoms
include sudden-onset dyspnea, pleuritic chest pain, and tachypnea. Tachycardia,
3
, not bradycardia, is typical. Lower extremity edema may indicate a DVT (source of
PE) but is not a direct finding of PE itself [citation:9].
6. The nurse is caring for a client who is 4 days postoperative and suddenly
develops difficulty breathing and sharp chest pain. The nurse has called the rapid
response team (RRT), raised the head of the bed (HOB), and applied oxygen.
Which is the next priority action?
a) Draw blood for an ABG
b) Prepare for intubation
c) Assist with a CT scan
d) Stay with the client to provide emotional support
Answer: d) Stay with the client to provide emotional support
Rationale: After activating the emergency team and initiating the ABCs, the
nurse's priority is to remain with the client. The client experiencing a pulmonary
embolism (PE) is likely anxious, frightened, and may be hypoxic. The nurse
provides essential monitoring, reassurance, and can assist the RRT immediately as
they arrive [citation:9].
7. The nurse is reinforcing education to a client starting warfarin (Coumadin) after
a mechanical heart valve replacement. Which client statement indicates a need for
further teaching?
a) "I will get my blood drawn regularly to check my INR."
b) "I will tell my dentist that I am on this medication."
c) "I should avoid anything rectally, such as enemas or suppositories."
d) "I can take ibuprofen for my occasional headaches."
Answer: d) "I can take ibuprofen for my occasional headaches."
4
Surgical Nursing – (2026/2027) Actual Questions &
Answers, 100% Guarantee Pass
=== START OF EXAM ===
NUR 265 MEDICAL-SURGICAL NURSING
EXAM 2 – VERSION 1 & VERSION 2
GALEN COLLEGE OF NURSING | 2026/2027 UPDATE
VERIFIED QUESTIONS & ANSWERS WITH RATIONALES
VERSION 1: RESPIRATORY & CARDIOVASCULAR FOCUS
1. A nurse is caring for a client who developed acute respiratory distress syndrome
(ARDS) and has been placed on mechanical ventilation. Which is the priority
nursing action?
a) Initiate prescribed total parenteral nutrition (TPN)
b) Monitor ventilator settings closely and provide sedation as ordered
c) Reposition the client every 4 hours
d) Administer high doses of corticosteroids
1
, Answer: b) Monitor ventilator settings closely and provide sedation as ordered
Rationale: Maintaining mechanical ventilation with proper settings is critical to
prevent further lung injury in ARDS. Sedation reduces oxygen demand and
facilitates ventilation. TPN is important but not priority; repositioning every 2
hours is preferred over 4 hours [citation:2][citation:4].
2. A nurse has been made aware of the following client situations. The nurse should
initially follow up with the client who is receiving:
a) Mechanical ventilation with PEEP and develops left tracheal deviation
b) Client post-abdominal surgery with mild pain
c) Client with stable angina
d) Client with controlled diabetes mellitus
Answer: a) Mechanical ventilation with PEEP and develops left tracheal
deviation
Rationale: Tracheal deviation is an emergency sign of tension pneumothorax or
major lung collapse requiring immediate intervention. This is life-threatening and
must be addressed first [citation:2][citation:4].
3. The nurse is caring for a client receiving mechanical ventilation via an
endotracheal tube (ET) who is unable to speak. The client's family is frightened
that the client has permanent loss of voice. Which response should the nurse make?
a) "The tube is causing a temporary loss of the voice."
b) "Your family member will never speak again."
c) "We will talk about a permanent voice prosthesis today."
d) "They can speak but are choosing not to."
Answer: a) "The tube is causing a temporary loss of the voice."
2
, Rationale: An ET tube passes through the vocal cords and prevents phonation,
causing temporary voice loss. This usually resolves after extubation
[citation:2][citation:4].
4. The nurse is caring for a client receiving mechanical ventilation. Which
indicates a correct understanding about managing a client on a ventilator?
a) Suction the client every 2 hours routinely
b) Suction the client when the high-pressure alarm sounds
c) Turn off alarms to prevent noise stress
d) Secure the endotracheal tube loosely to allow movement
Answer: b) Suction the client when the high-pressure alarm sounds
Rationale: High-pressure alarms often indicate increased airway resistance or
obstruction (e.g., secretions). Suctioning helps clear airway. Routine suctioning can
cause trauma and infection. Alarms should never be silenced; the ET tube should
be secured tightly to prevent accidental extubation [citation:2][citation:4].
5. A nurse is caring for a client suspected of having a pulmonary embolism (PE).
Which finding is consistent with this diagnosis?
a) Bradycardia
b) Productive cough with yellow sputum
c) Cough
d) Lower extremity edema
Answer: c) Cough
Rationale: A cough, often dry or nonproductive, is a common symptom of PE
due to irritation or infarction of the pulmonary tissues. Other hallmark symptoms
include sudden-onset dyspnea, pleuritic chest pain, and tachypnea. Tachycardia,
3
, not bradycardia, is typical. Lower extremity edema may indicate a DVT (source of
PE) but is not a direct finding of PE itself [citation:9].
6. The nurse is caring for a client who is 4 days postoperative and suddenly
develops difficulty breathing and sharp chest pain. The nurse has called the rapid
response team (RRT), raised the head of the bed (HOB), and applied oxygen.
Which is the next priority action?
a) Draw blood for an ABG
b) Prepare for intubation
c) Assist with a CT scan
d) Stay with the client to provide emotional support
Answer: d) Stay with the client to provide emotional support
Rationale: After activating the emergency team and initiating the ABCs, the
nurse's priority is to remain with the client. The client experiencing a pulmonary
embolism (PE) is likely anxious, frightened, and may be hypoxic. The nurse
provides essential monitoring, reassurance, and can assist the RRT immediately as
they arrive [citation:9].
7. The nurse is reinforcing education to a client starting warfarin (Coumadin) after
a mechanical heart valve replacement. Which client statement indicates a need for
further teaching?
a) "I will get my blood drawn regularly to check my INR."
b) "I will tell my dentist that I am on this medication."
c) "I should avoid anything rectally, such as enemas or suppositories."
d) "I can take ibuprofen for my occasional headaches."
Answer: d) "I can take ibuprofen for my occasional headaches."
4
