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NUR 265 Exam 3 Medical-Surgical Nursing
EXAM LATEST VERSION WITH 300 QUESTIONS
AND CORRECT DETAILED SOLUTIONS JUST
RELEASED THIS YEAR
NUR 265 Exam 3 Medical-Surgical Nursing
Comprehensive Practice Exam (Questions 1-300)
This comprehensive practice exam is designed to help you prepare for the NUR 265 Exam 3 at
Galen College of Nursing. It features 300 high-yield, NCLEX-style questions with verified
answers and detailed rationales covering essential Med-Surg concepts commonly tested in
Exam 3. Topics include neurologic emergencies, critical care, respiratory disorders,
cardiovascular conditions, endocrine emergencies, fluid/electrolyte imbalances, renal
disorders, GI disorders, and more.
SECTION 1: NEUROLOGIC EMERGENCIES & CRITICAL CARE (Questions 1-60)
1. A patient is admitted with suspected meningitis. Which assessment finding is most
concerning and requires immediate intervention?
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A) Headache and photophobia
B) Nuchal rigidity and fever
C) A positive Kernig's sign
D) A rapidly decreasing level of consciousness
Answer: D
A rapidly decreasing level of consciousness indicates increased intracranial pressure (ICP) and
potential herniation, which is a life-threatening emergency. While nuchal rigidity, headache,
photophobia, and Kernig's sign are classic findings in meningitis, they do not indicate the same
level of immediate neurological threat as a declining LOC.
2. The nurse is caring for a patient with a severe traumatic brain injury (TBI). Which intervention
is the priority to prevent secondary brain injury?
A) Maintaining strict bed rest
B) Administering stool softeners
C) Maintaining a cerebral perfusion pressure (CPP) ≥ 60 mmHg
D) Placing the patient in Trendelenburg position
Answer: C
Maintaining a CPP ≥ 60 mmHg ensures adequate blood flow to the brain, preventing ischemia
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and secondary injury. Stool softeners help prevent straining (which increases ICP) but are not the
priority. Trendelenburg position increases ICP and should be avoided.
3. A patient with increased intracranial pressure (ICP) is exhibiting Cushing's triad. Which
findings are characteristic of this triad?
A) Hypotension, bradycardia, and irregular respirations
B) Hypertension, bradycardia, and irregular respirations
C) Hypertension, tachycardia, and tachypnea
D) Hypotension, tachycardia, and Cheyne-Stokes respirations
Answer: B
Cushing's triad consists of hypertension (widening pulse pressure), bradycardia, and irregular
respirations. It is a late sign of increased ICP and indicates impending herniation.
4. A patient is admitted with a subarachnoid hemorrhage (SAH) from a ruptured cerebral
aneurysm. What is the nurse's priority intervention during the acute phase?
A) Administering IV anticoagulants
B) Maintaining strict bed rest and preventing straining
C) Encouraging oral fluids to prevent dehydration
D) Preparing the patient for immediate discharge
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Answer: B
Strict bed rest and preventing straining (e.g., stool softeners, avoiding Valsalva maneuver) are
critical to prevent re-bleeding of the aneurysm. Anticoagulants would increase the risk of
bleeding. Fluid management is complex and should not be simplified to "encouraging oral
fluids."
5. A patient is being treated for status epilepticus. Which medication should the nurse
anticipate administering first?
A) Oral phenytoin (Dilantin)
B) IV lorazepam (Ativan)
C) IV phenobarbital
D) Oral valproic acid (Depakote)
Answer: B
IV lorazepam (a benzodiazepine) is the first-line treatment for status epilepticus due to its rapid
onset of action. Phenytoin and phenobarbital are used as second-line agents. Oral medications
are not appropriate for an emergency situation.
6. The nurse is caring for a patient with a spinal cord injury (SCI) at the T6 level. Which
assessment finding indicates the patient is developing autonomic dysreflexia?
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SUCCESS!
NUR 265 Exam 3 Medical-Surgical Nursing
EXAM LATEST VERSION WITH 300 QUESTIONS
AND CORRECT DETAILED SOLUTIONS JUST
RELEASED THIS YEAR
NUR 265 Exam 3 Medical-Surgical Nursing
Comprehensive Practice Exam (Questions 1-300)
This comprehensive practice exam is designed to help you prepare for the NUR 265 Exam 3 at
Galen College of Nursing. It features 300 high-yield, NCLEX-style questions with verified
answers and detailed rationales covering essential Med-Surg concepts commonly tested in
Exam 3. Topics include neurologic emergencies, critical care, respiratory disorders,
cardiovascular conditions, endocrine emergencies, fluid/electrolyte imbalances, renal
disorders, GI disorders, and more.
SECTION 1: NEUROLOGIC EMERGENCIES & CRITICAL CARE (Questions 1-60)
1. A patient is admitted with suspected meningitis. Which assessment finding is most
concerning and requires immediate intervention?
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A) Headache and photophobia
B) Nuchal rigidity and fever
C) A positive Kernig's sign
D) A rapidly decreasing level of consciousness
Answer: D
A rapidly decreasing level of consciousness indicates increased intracranial pressure (ICP) and
potential herniation, which is a life-threatening emergency. While nuchal rigidity, headache,
photophobia, and Kernig's sign are classic findings in meningitis, they do not indicate the same
level of immediate neurological threat as a declining LOC.
2. The nurse is caring for a patient with a severe traumatic brain injury (TBI). Which intervention
is the priority to prevent secondary brain injury?
A) Maintaining strict bed rest
B) Administering stool softeners
C) Maintaining a cerebral perfusion pressure (CPP) ≥ 60 mmHg
D) Placing the patient in Trendelenburg position
Answer: C
Maintaining a CPP ≥ 60 mmHg ensures adequate blood flow to the brain, preventing ischemia
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and secondary injury. Stool softeners help prevent straining (which increases ICP) but are not the
priority. Trendelenburg position increases ICP and should be avoided.
3. A patient with increased intracranial pressure (ICP) is exhibiting Cushing's triad. Which
findings are characteristic of this triad?
A) Hypotension, bradycardia, and irregular respirations
B) Hypertension, bradycardia, and irregular respirations
C) Hypertension, tachycardia, and tachypnea
D) Hypotension, tachycardia, and Cheyne-Stokes respirations
Answer: B
Cushing's triad consists of hypertension (widening pulse pressure), bradycardia, and irregular
respirations. It is a late sign of increased ICP and indicates impending herniation.
4. A patient is admitted with a subarachnoid hemorrhage (SAH) from a ruptured cerebral
aneurysm. What is the nurse's priority intervention during the acute phase?
A) Administering IV anticoagulants
B) Maintaining strict bed rest and preventing straining
C) Encouraging oral fluids to prevent dehydration
D) Preparing the patient for immediate discharge
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Answer: B
Strict bed rest and preventing straining (e.g., stool softeners, avoiding Valsalva maneuver) are
critical to prevent re-bleeding of the aneurysm. Anticoagulants would increase the risk of
bleeding. Fluid management is complex and should not be simplified to "encouraging oral
fluids."
5. A patient is being treated for status epilepticus. Which medication should the nurse
anticipate administering first?
A) Oral phenytoin (Dilantin)
B) IV lorazepam (Ativan)
C) IV phenobarbital
D) Oral valproic acid (Depakote)
Answer: B
IV lorazepam (a benzodiazepine) is the first-line treatment for status epilepticus due to its rapid
onset of action. Phenytoin and phenobarbital are used as second-line agents. Oral medications
are not appropriate for an emergency situation.
6. The nurse is caring for a patient with a spinal cord injury (SCI) at the T6 level. Which
assessment finding indicates the patient is developing autonomic dysreflexia?
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