NUR 265 EXAMS 1-3 & FINAL MED-SURG –
GALEN COLLEGE ACTUAL QUESTIONS &
ANSWERS (2026 MASTER BUNDLE)
Ace your advanced medical-surgical nursing assessments
with this comprehensive question master study bank
explicitly built for Galen College NUR 265 courses. Every
high-yield question features clear multiple-choice options, a
verified answer key, and immediate, in-depth rationales
designed to sharpen your critical thinking and clinical
judgment. Perfect for mastering complex concepts like fluid
resuscitation, renal failure, cardiac dysrhythmias, and shock
management, this premium resource guarantees top scores
on your modular exams and final test.
Question 1: A nurse is caring for a patient who is 24 hours
postoperative following a total thyroidectomy. Which of the
following findings is the priority for the nurse to report to the
provider?
A) Mild pain at the incision site
B) Productive cough with clear sputum
C) Laryngeal stridor
D) Urinary output of 120 mL over 4 hours
,Answer: C) Laryngeal stridor
Rationale: Laryngeal stridor indicates acute airway
obstruction or laryngospasm, which is a life-threatening
emergency. This can occur post-thyroidectomy due to
swelling or hypocalcemia-induced tetany (damage to
parathyroid glands). Airway management is always the top
priority.
Question 2: A patient with acute pancreatitis is admitted to the
medical-surg unit. Which laboratory result should the nurse
expect to see significantly elevated?
A) Serum calcium
B) Serum amylase
C) Serum potassium
D) Hemoglobin
Answer: B) Serum amylase
Rationale: Serum amylase and lipase rise rapidly within hours
of the onset of acute pancreatitis due to cellular injury of the
pancreas. Calcium levels typically drop (hypocalcemia) in
severe pancreatitis.
Question 3: A nurse is assessing a client with a history of left-
sided heart failure. Which of the following clinical manifestations
should the nurse expect to find?
A) Jugular venous distention
B) Pulmonary crackles
,C) Peripheral edema
D) Hepatomegaly
Answer: B) Pulmonary crackles
Rationale: Left-sided heart failure causes blood to back up
into the pulmonary circulation, leading to pulmonary
congestion, crackles, shortness of breath, and orthopnea.
Right-sided failure causes systemic manifestations like JVD
and peripheral edema.
Question 4: A patient with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse anticipate executing
immediately?
A) Administer regular insulin IV with 50% dextrose
B) Administer oral iron supplements
C) Increase oral fluid intake
D) Administer epoetin alfa subcutaneously
Answer: A) Administer regular insulin IV with 50% dextrose
Rationale: Hyperkalemia (>5.0 mEq/L) is dangerous and can
cause cardiac dysrhythmias. IV insulin drives potassium out
of the extracellular fluid and back into the cells. Dextrose is
given simultaneously to prevent hypoglycemia.
Question 5: A client is admitted to the emergency department with
a severe burn injury covering 35% of their total body surface area
(TBSA). Which intravenous fluid should the nurse expect to infuse
during the initial 24 hours of resuscitation?
, A) 0.45% Sodium Chloride
B) 5% Dextrose in Water (D5W)
C) Lactated Ringer's
D) 3% Hypertonic Saline
Answer: C) Lactated Ringer's
Rationale: Lactated Ringer's is an isotonic crystalloid solution
that closely mirrors the electrolyte composition of human
plasma. It is the fluid of choice for burn shock resuscitation
because it helps correct metabolic acidosis and replaces lost
intravascular volume without causing hyperchloremic
acidosis.
Question 6: A nurse is assessing a patient with a chest tube
inserted for a pneumothorax. The nurse notes continuous,
vigorous bubbling in the water-seal chamber. How should the
nurse interpret this finding?
A) This is a normal, expected finding indicating lung re-expansion.
B) There is an air leak present somewhere in the drainage
system.
C) The suction control system is turned off.
D) The drainage system is completely full and needs
replacement.
Answer: B) There is an air leak present somewhere in the
drainage system.
Rationale: Intermittent bubbling in the water-seal chamber is
normal during expiration or coughing in a pneumothorax
GALEN COLLEGE ACTUAL QUESTIONS &
ANSWERS (2026 MASTER BUNDLE)
Ace your advanced medical-surgical nursing assessments
with this comprehensive question master study bank
explicitly built for Galen College NUR 265 courses. Every
high-yield question features clear multiple-choice options, a
verified answer key, and immediate, in-depth rationales
designed to sharpen your critical thinking and clinical
judgment. Perfect for mastering complex concepts like fluid
resuscitation, renal failure, cardiac dysrhythmias, and shock
management, this premium resource guarantees top scores
on your modular exams and final test.
Question 1: A nurse is caring for a patient who is 24 hours
postoperative following a total thyroidectomy. Which of the
following findings is the priority for the nurse to report to the
provider?
A) Mild pain at the incision site
B) Productive cough with clear sputum
C) Laryngeal stridor
D) Urinary output of 120 mL over 4 hours
,Answer: C) Laryngeal stridor
Rationale: Laryngeal stridor indicates acute airway
obstruction or laryngospasm, which is a life-threatening
emergency. This can occur post-thyroidectomy due to
swelling or hypocalcemia-induced tetany (damage to
parathyroid glands). Airway management is always the top
priority.
Question 2: A patient with acute pancreatitis is admitted to the
medical-surg unit. Which laboratory result should the nurse
expect to see significantly elevated?
A) Serum calcium
B) Serum amylase
C) Serum potassium
D) Hemoglobin
Answer: B) Serum amylase
Rationale: Serum amylase and lipase rise rapidly within hours
of the onset of acute pancreatitis due to cellular injury of the
pancreas. Calcium levels typically drop (hypocalcemia) in
severe pancreatitis.
Question 3: A nurse is assessing a client with a history of left-
sided heart failure. Which of the following clinical manifestations
should the nurse expect to find?
A) Jugular venous distention
B) Pulmonary crackles
,C) Peripheral edema
D) Hepatomegaly
Answer: B) Pulmonary crackles
Rationale: Left-sided heart failure causes blood to back up
into the pulmonary circulation, leading to pulmonary
congestion, crackles, shortness of breath, and orthopnea.
Right-sided failure causes systemic manifestations like JVD
and peripheral edema.
Question 4: A patient with chronic kidney disease (CKD) has a
serum potassium level of 6.2 mEq/L. Which of the following
provider orders should the nurse anticipate executing
immediately?
A) Administer regular insulin IV with 50% dextrose
B) Administer oral iron supplements
C) Increase oral fluid intake
D) Administer epoetin alfa subcutaneously
Answer: A) Administer regular insulin IV with 50% dextrose
Rationale: Hyperkalemia (>5.0 mEq/L) is dangerous and can
cause cardiac dysrhythmias. IV insulin drives potassium out
of the extracellular fluid and back into the cells. Dextrose is
given simultaneously to prevent hypoglycemia.
Question 5: A client is admitted to the emergency department with
a severe burn injury covering 35% of their total body surface area
(TBSA). Which intravenous fluid should the nurse expect to infuse
during the initial 24 hours of resuscitation?
, A) 0.45% Sodium Chloride
B) 5% Dextrose in Water (D5W)
C) Lactated Ringer's
D) 3% Hypertonic Saline
Answer: C) Lactated Ringer's
Rationale: Lactated Ringer's is an isotonic crystalloid solution
that closely mirrors the electrolyte composition of human
plasma. It is the fluid of choice for burn shock resuscitation
because it helps correct metabolic acidosis and replaces lost
intravascular volume without causing hyperchloremic
acidosis.
Question 6: A nurse is assessing a patient with a chest tube
inserted for a pneumothorax. The nurse notes continuous,
vigorous bubbling in the water-seal chamber. How should the
nurse interpret this finding?
A) This is a normal, expected finding indicating lung re-expansion.
B) There is an air leak present somewhere in the drainage
system.
C) The suction control system is turned off.
D) The drainage system is completely full and needs
replacement.
Answer: B) There is an air leak present somewhere in the
drainage system.
Rationale: Intermittent bubbling in the water-seal chamber is
normal during expiration or coughing in a pneumothorax
