NUR 253 EXAM 3 — GALEN COLLEGE OF NURSING 2026/2027 | 75 QUESTIONS AND
CORRECT ANSWERS | ALREADY GRADED A+ | 100% VERIFIED
Galen College of Nursing — NUR 253 (Medical-Surgical Nursing) Exam 3 | Core Domains: Advanced
Adult Health Concepts, Complex Pathophysiology, Pharmacologic Management, Priority Nursing
Interventions, Clinical Judgment & Decision-Making, Patient Safety, Risk Reduction, and Care
Coordination | Program-Aligned Structure | Exam-Ready Format
Exam Structure
The NUR 253 Exam 3 assessment commonly consists of:
● 75 multiple-choice questions
● Single-best-answer format
● Application-based and clinical-judgment-focused items
Introduction
This NUR 253 Exam 3 format for the 2026/2027 cycle reflects the standard unit examination structure
used in professional nursing programs such as Galen College of Nursing. It emphasizes integration of
complex medical-surgical concepts, safe medication administration, prioritization of nursing care,
interpretation of clinical data, and application of evidence-based nursing practice.
Answer Format
All correct answers must be presented in bold and green, followed by concise, clinically focused
rationales explaining nursing priorities, patient-safety considerations, and why alternative options are less
appropriate.
1. A patient with heart failure is prescribed furosemide 40 mg IV. Which laboratory value
should the nurse monitor most closely?
A. Calcium
B. Glucose
C. Potassium
D. Sodium
, Furosemide is a loop diuretic that causes significant potassium loss, leading to hypokalemia.
Hypokalemia increases the risk of cardiac dysrhythmias, especially in patients with heart failure.
Potassium levels must be monitored regularly during therapy.
2. The nurse is caring for a patient with a new diagnosis of type 1 diabetes mellitus. Which
statement by the patient indicates understanding of insulin use?
A. "I will skip my insulin if I’m not eating breakfast."
B. "I can store my insulin in the freezer to make it last longer."
C. "I need to take insulin even when I’m sick."
D. "I only need insulin when my blood sugar is over 300 mg/dL."
Patients with type 1 diabetes require exogenous insulin for survival, even during illness. Illness can
increase blood glucose due to stress hormones, so insulin must not be omitted. Skipping insulin can
lead to diabetic ketoacidosis (DKA).
3. A patient is admitted with suspected pulmonary embolism. Which assessment finding is
most concerning?
A. Productive cough
B. Fever of 100.4°F (38°C)
C. Sudden onset of dyspnea and pleuritic chest pain
D. Rhonchi on lung auscultation
Sudden dyspnea, tachypnea, pleuritic chest pain, and hypoxia are classic signs of pulmonary
embolism. These require immediate intervention, including oxygen, diagnostic imaging (e.g., CT
angiogram), and potential anticoagulation.
4. The nurse is preparing to administer warfarin to a patient with atrial fibrillation. Which
lab value is most critical to review before administration?
A. Hemoglobin
B. Platelet count
, C. INR
D. BUN
Warfarin therapy is monitored using the International Normalized Ratio (INR). The therapeutic
range for atrial fibrillation is typically 2.0–3.0. An elevated INR increases bleeding risk; a low INR
increases clot risk.
5. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.0 mEq/L.
Which intervention should the nurse anticipate first?
A. Administer oral potassium supplements
B. Increase IV fluids with potassium
C. Prepare to administer sodium polystyrene sulfonate (Kayexalate)
D. Encourage bananas and oranges
Hyperkalemia (K⁺ >5.0 mEq/L) is life-threatening in CKD due to impaired excretion. Kayexalate
binds potassium in the GI tract for excretion. ECG changes (e.g., peaked T waves) require immediate
attention. Bananas and potassium supplements are contraindicated.
6. Which finding in a patient 24 hours post-op from abdominal surgery requires immediate
notification of the provider?
A. Incisional pain rated 4/10
B. Oral temperature of 99.2°F (37.3°C)
C. Abdominal distension with absent bowel sounds
D. Urine output of 30 mL/hr
Absent bowel sounds with distension may indicate paralytic ileus or bowel obstruction—common but
potentially serious post-op complications. While some ileus is expected, worsening signs require
evaluation to rule out obstruction or peritonitis.
7. A patient is receiving a blood transfusion and develops chills, fever, and back pain. What
is the nurse’s first action?
CORRECT ANSWERS | ALREADY GRADED A+ | 100% VERIFIED
Galen College of Nursing — NUR 253 (Medical-Surgical Nursing) Exam 3 | Core Domains: Advanced
Adult Health Concepts, Complex Pathophysiology, Pharmacologic Management, Priority Nursing
Interventions, Clinical Judgment & Decision-Making, Patient Safety, Risk Reduction, and Care
Coordination | Program-Aligned Structure | Exam-Ready Format
Exam Structure
The NUR 253 Exam 3 assessment commonly consists of:
● 75 multiple-choice questions
● Single-best-answer format
● Application-based and clinical-judgment-focused items
Introduction
This NUR 253 Exam 3 format for the 2026/2027 cycle reflects the standard unit examination structure
used in professional nursing programs such as Galen College of Nursing. It emphasizes integration of
complex medical-surgical concepts, safe medication administration, prioritization of nursing care,
interpretation of clinical data, and application of evidence-based nursing practice.
Answer Format
All correct answers must be presented in bold and green, followed by concise, clinically focused
rationales explaining nursing priorities, patient-safety considerations, and why alternative options are less
appropriate.
1. A patient with heart failure is prescribed furosemide 40 mg IV. Which laboratory value
should the nurse monitor most closely?
A. Calcium
B. Glucose
C. Potassium
D. Sodium
, Furosemide is a loop diuretic that causes significant potassium loss, leading to hypokalemia.
Hypokalemia increases the risk of cardiac dysrhythmias, especially in patients with heart failure.
Potassium levels must be monitored regularly during therapy.
2. The nurse is caring for a patient with a new diagnosis of type 1 diabetes mellitus. Which
statement by the patient indicates understanding of insulin use?
A. "I will skip my insulin if I’m not eating breakfast."
B. "I can store my insulin in the freezer to make it last longer."
C. "I need to take insulin even when I’m sick."
D. "I only need insulin when my blood sugar is over 300 mg/dL."
Patients with type 1 diabetes require exogenous insulin for survival, even during illness. Illness can
increase blood glucose due to stress hormones, so insulin must not be omitted. Skipping insulin can
lead to diabetic ketoacidosis (DKA).
3. A patient is admitted with suspected pulmonary embolism. Which assessment finding is
most concerning?
A. Productive cough
B. Fever of 100.4°F (38°C)
C. Sudden onset of dyspnea and pleuritic chest pain
D. Rhonchi on lung auscultation
Sudden dyspnea, tachypnea, pleuritic chest pain, and hypoxia are classic signs of pulmonary
embolism. These require immediate intervention, including oxygen, diagnostic imaging (e.g., CT
angiogram), and potential anticoagulation.
4. The nurse is preparing to administer warfarin to a patient with atrial fibrillation. Which
lab value is most critical to review before administration?
A. Hemoglobin
B. Platelet count
, C. INR
D. BUN
Warfarin therapy is monitored using the International Normalized Ratio (INR). The therapeutic
range for atrial fibrillation is typically 2.0–3.0. An elevated INR increases bleeding risk; a low INR
increases clot risk.
5. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.0 mEq/L.
Which intervention should the nurse anticipate first?
A. Administer oral potassium supplements
B. Increase IV fluids with potassium
C. Prepare to administer sodium polystyrene sulfonate (Kayexalate)
D. Encourage bananas and oranges
Hyperkalemia (K⁺ >5.0 mEq/L) is life-threatening in CKD due to impaired excretion. Kayexalate
binds potassium in the GI tract for excretion. ECG changes (e.g., peaked T waves) require immediate
attention. Bananas and potassium supplements are contraindicated.
6. Which finding in a patient 24 hours post-op from abdominal surgery requires immediate
notification of the provider?
A. Incisional pain rated 4/10
B. Oral temperature of 99.2°F (37.3°C)
C. Abdominal distension with absent bowel sounds
D. Urine output of 30 mL/hr
Absent bowel sounds with distension may indicate paralytic ileus or bowel obstruction—common but
potentially serious post-op complications. While some ileus is expected, worsening signs require
evaluation to rule out obstruction or peritonitis.
7. A patient is receiving a blood transfusion and develops chills, fever, and back pain. What
is the nurse’s first action?
