NUR 265
Advanced Medical-Surgical Nursing Final Exam
Final Exam • Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Final Exam 2026/2027 UPDATE – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L and
tall, peaked T-waves on the EKG. Which medication should the nurse expect to administer
first to stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium polystyrene sulfonate
C. Insulin and Dextrose
D. Furosemide
Answer: A
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
myocardial cell membrane and prevent life-threatening arrhythmias, though it does not
lower the potassium level itself.
2. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
ventilator setting change should the nurse anticipate to improve oxygenation without causing
barotrauma?
A. Increase Tidal Volume to 12 mL/kg
B. Increase Positive End-Expiratory Pressure (PEEP)
C. Decrease PEEP to 5 cm H2O
, D. Decrease the Inspiratory:Expiratory (I:E) ratio
Answer: B
Rationale: PEEP is increased in ARDS to open collapsed alveoli (recruitment) and improve
gas exchange. Low tidal volume ventilation is used to prevent barotrauma.
3. A patient is admitted with a Suspected Spinal Cord Injury (SCI) at the T6 level. The nurse
notes a sudden increase in blood pressure to 190/110 mmHg, a pounding headache, and
bradycardia. What is the priority nursing action?
A. Administer a bolus of IV fluids
B. Apply sequential compression devices
C. Place the patient in a supine position
D. Check the patient for bladder distention or fecal impaction
Answer: D
Rationale: These are classic signs of Autonomic Dysreflexia, often triggered by a full
bladder or bowel. The nurse must identify and remove the stimulus while sitting the
patient upright.
4. A patient has just returned from a kidney transplant. Which assessment finding is most
indicative of hyperacute organ rejection?
A. Increased urine output and decreased creatinine
B. Gradual increase in BUN over several weeks
Advanced Medical-Surgical Nursing Final Exam
Final Exam • Comprehensive Study Guide
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NUR 265
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 265 Advanced Medical-Surgical Nursing Final Exam 2026/2027 UPDATE – Galen
1. A patient with a history of heart failure presents with a potassium level of 6.2 mEq/L and
tall, peaked T-waves on the EKG. Which medication should the nurse expect to administer
first to stabilize the cardiac membrane?
A. Calcium gluconate
B. Sodium polystyrene sulfonate
C. Insulin and Dextrose
D. Furosemide
Answer: A
Rationale: Calcium gluconate is administered in severe hyperkalemia to stabilize the
myocardial cell membrane and prevent life-threatening arrhythmias, though it does not
lower the potassium level itself.
2. A patient in the ICU is diagnosed with Acute Respiratory Distress Syndrome (ARDS). Which
ventilator setting change should the nurse anticipate to improve oxygenation without causing
barotrauma?
A. Increase Tidal Volume to 12 mL/kg
B. Increase Positive End-Expiratory Pressure (PEEP)
C. Decrease PEEP to 5 cm H2O
, D. Decrease the Inspiratory:Expiratory (I:E) ratio
Answer: B
Rationale: PEEP is increased in ARDS to open collapsed alveoli (recruitment) and improve
gas exchange. Low tidal volume ventilation is used to prevent barotrauma.
3. A patient is admitted with a Suspected Spinal Cord Injury (SCI) at the T6 level. The nurse
notes a sudden increase in blood pressure to 190/110 mmHg, a pounding headache, and
bradycardia. What is the priority nursing action?
A. Administer a bolus of IV fluids
B. Apply sequential compression devices
C. Place the patient in a supine position
D. Check the patient for bladder distention or fecal impaction
Answer: D
Rationale: These are classic signs of Autonomic Dysreflexia, often triggered by a full
bladder or bowel. The nurse must identify and remove the stimulus while sitting the
patient upright.
4. A patient has just returned from a kidney transplant. Which assessment finding is most
indicative of hyperacute organ rejection?
A. Increased urine output and decreased creatinine
B. Gradual increase in BUN over several weeks
