NUR 265 EXAM 1 (3 EXAM
SETS) – MEDICAL-
SURGICAL NURSING –
(2026/2027) GALEN
ACTUAL QUESTIONS &
ANSWERS, 100%
GUARANTEE PASS
NUR 265 Exam 1 – Advanced Medical-Surgical Nursing
Practice Exam | Questions with Bolded Correct Answers &
Rationales
Galen College of Nursing | 2026/2027 Curriculum Aligned
Section 1: Fluid, Electrolyte & Acid-Base Imbalances
(Questions 1–10)
,1. A patient's ABG results are pH 7.30, PaCO2 55 mm Hg, and HCO3 24 mEq/L.
Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory cause), while the
bicarbonate is normal, indicating uncompensated respiratory acidosis .
2. Intracellular fluid (ICF) constitutes approximately what percentage of total body
weight?
A. 20%
B. 30%
C. 40%
D. 60%
Rationale: Intracellular fluid is about 40% of body weight, while extracellular fluid is
about 20% .
3. Oncotic pressure is specifically the pulling force of which substance?
A. Sodium
B. Potassium
C. Albumin
D. Glucose
Rationale: Oncotic pressure is the pulling force of albumin. Albumin is the biggest
solvent, exerts a lot of force, and pulls a significant amount of fluid toward itself .
4. Hypervolemic hyponatremia is characterized by:
A. Low sodium and low fluid volume
B. Excess water that dilutes sodium
C. High sodium and high fluid volume
D. Low potassium and high sodium
Rationale: Hypervolemic hyponatremia involves excess water, causing sodium to be
diluted. It can be caused by too much ADH or kidney failure .
5. Symptoms of hypervolemic hyponatremia include:
,A. Hypertension and bradycardia
B. Headaches, lethargy, confusion, muscle cramps/spasms
C. Polyuria and polydipsia
D. Dry skin and decreased urine output
Rationale: Symptoms include headaches, lethargy, confusion, apathy, muscle
cramps/spasms, nausea, vomiting, and diarrhea .
6. During hypernatremia, what happens to cells?
A. They swell and may burst
B. They become dehydrated and shrink
C. They remain unchanged
D. They multiply rapidly
Rationale: Hypernatremia causes cells to become dehydrated and shrink due to water
shifting out of the cells .
7. Which electrolyte imbalance is most likely to cause a positive Chvostek's sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypernatremia
Rationale: Chvostek's sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia .
8. Which clinical manifestation is a hallmark sign of hypocalcemia?
A. Polyuria
B. Positive Trousseau's sign
C. Shortened QT interval
D. Bone pain
Rationale: Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff) is
a classic indicator of hypocalcemia .
9. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG
change should the nurse expect?
A. Prominent U waves
B. Prolonged PR interval
, C. ST-segment depression
D. Tall, peaked T waves
Rationale: Hyperkalemia typically causes tall, peaked T waves, widened QRS complexes,
and potentially cardiac arrest .
10. Which finding indicates hypokalemia?
A. Tall, peaked T waves
B. U waves on ECG
C. Hypertension
D. Hyperactive reflexes
Rationale: Hypokalemia causes U waves, flattened T waves, and muscle weakness .
Section 2: Renal Disorders – AKI & CKD (Questions 11–20)
11. What is Acute Kidney Injury (AKI)?
A. Abrupt loss of kidney function
B. Gradual loss of kidney function over months
C. Kidney stones blocking urine flow
D. Chronic inflammation of the glomeruli
Rationale: AKI is an abrupt loss of kidney function. During AKI, GFR decreases, and BUN
and creatinine increase .
12. Which of the following is a prerenal cause of acute kidney injury?
A. Glomerulonephritis
B. Severe dehydration
C. Enlarged prostate
D. Contrast-induced nephropathy
Rationale: Prerenal AKI is caused by decreased perfusion to the kidneys. Severe
dehydration reduces blood flow to the kidneys. Glomerulonephritis is an intrarenal
cause, and an enlarged prostate is a postrenal cause .
13. What is intrarenal AKI?
SETS) – MEDICAL-
SURGICAL NURSING –
(2026/2027) GALEN
ACTUAL QUESTIONS &
ANSWERS, 100%
GUARANTEE PASS
NUR 265 Exam 1 – Advanced Medical-Surgical Nursing
Practice Exam | Questions with Bolded Correct Answers &
Rationales
Galen College of Nursing | 2026/2027 Curriculum Aligned
Section 1: Fluid, Electrolyte & Acid-Base Imbalances
(Questions 1–10)
,1. A patient's ABG results are pH 7.30, PaCO2 55 mm Hg, and HCO3 24 mEq/L.
Which acid-base imbalance does this represent?
A. Metabolic Acidosis
B. Respiratory Acidosis
C. Respiratory Alkalosis
D. Metabolic Alkalosis
Rationale: The pH is low (acidosis) and the PaCO2 is high (respiratory cause), while the
bicarbonate is normal, indicating uncompensated respiratory acidosis .
2. Intracellular fluid (ICF) constitutes approximately what percentage of total body
weight?
A. 20%
B. 30%
C. 40%
D. 60%
Rationale: Intracellular fluid is about 40% of body weight, while extracellular fluid is
about 20% .
3. Oncotic pressure is specifically the pulling force of which substance?
A. Sodium
B. Potassium
C. Albumin
D. Glucose
Rationale: Oncotic pressure is the pulling force of albumin. Albumin is the biggest
solvent, exerts a lot of force, and pulls a significant amount of fluid toward itself .
4. Hypervolemic hyponatremia is characterized by:
A. Low sodium and low fluid volume
B. Excess water that dilutes sodium
C. High sodium and high fluid volume
D. Low potassium and high sodium
Rationale: Hypervolemic hyponatremia involves excess water, causing sodium to be
diluted. It can be caused by too much ADH or kidney failure .
5. Symptoms of hypervolemic hyponatremia include:
,A. Hypertension and bradycardia
B. Headaches, lethargy, confusion, muscle cramps/spasms
C. Polyuria and polydipsia
D. Dry skin and decreased urine output
Rationale: Symptoms include headaches, lethargy, confusion, apathy, muscle
cramps/spasms, nausea, vomiting, and diarrhea .
6. During hypernatremia, what happens to cells?
A. They swell and may burst
B. They become dehydrated and shrink
C. They remain unchanged
D. They multiply rapidly
Rationale: Hypernatremia causes cells to become dehydrated and shrink due to water
shifting out of the cells .
7. Which electrolyte imbalance is most likely to cause a positive Chvostek's sign?
A. Hyperkalemia
B. Hyponatremia
C. Hypocalcemia
D. Hypernatremia
Rationale: Chvostek's sign (facial twitching when the facial nerve is tapped) is a classic
sign of neuromuscular irritability associated with hypocalcemia .
8. Which clinical manifestation is a hallmark sign of hypocalcemia?
A. Polyuria
B. Positive Trousseau's sign
C. Shortened QT interval
D. Bone pain
Rationale: Trousseau's sign (carpal spasm induced by inflating a blood pressure cuff) is
a classic indicator of hypocalcemia .
9. A patient presents with a serum potassium level of 6.2 mEq/L. Which ECG
change should the nurse expect?
A. Prominent U waves
B. Prolonged PR interval
, C. ST-segment depression
D. Tall, peaked T waves
Rationale: Hyperkalemia typically causes tall, peaked T waves, widened QRS complexes,
and potentially cardiac arrest .
10. Which finding indicates hypokalemia?
A. Tall, peaked T waves
B. U waves on ECG
C. Hypertension
D. Hyperactive reflexes
Rationale: Hypokalemia causes U waves, flattened T waves, and muscle weakness .
Section 2: Renal Disorders – AKI & CKD (Questions 11–20)
11. What is Acute Kidney Injury (AKI)?
A. Abrupt loss of kidney function
B. Gradual loss of kidney function over months
C. Kidney stones blocking urine flow
D. Chronic inflammation of the glomeruli
Rationale: AKI is an abrupt loss of kidney function. During AKI, GFR decreases, and BUN
and creatinine increase .
12. Which of the following is a prerenal cause of acute kidney injury?
A. Glomerulonephritis
B. Severe dehydration
C. Enlarged prostate
D. Contrast-induced nephropathy
Rationale: Prerenal AKI is caused by decreased perfusion to the kidneys. Severe
dehydration reduces blood flow to the kidneys. Glomerulonephritis is an intrarenal
cause, and an enlarged prostate is a postrenal cause .
13. What is intrarenal AKI?
