NUR 265
Final Exam Advanced Medical-Surgical Nursing
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 Final Exam: Advanced Medical-Surgical Nursing 2026/2027 UPDATE – Galen
1. A patient in the ICU is being treated for hypovolemic shock. The nurse notes the patient
has a CVP of 1 mmHg and a BP of 88/50. Which intervention is the priority?
A. Administering a dose of norepinephrine
B. Increasing the maintenance IV rate to 125 mL/hr
C. Initiating rapid infusion of isotonic crystalloids
D. Placing the patient in High-Fowler’s position
Answer: C
Rationale: Low CVP (normal 2-8 mmHg) and hypotension indicate fluid volume deficit.
Initial treatment for hypovolemic shock is rapid fluid resuscitation with isotonic solutions
like 0.9% NS or Lactated Ringer’s.
2. Which clinical finding is most characteristic of neurogenic shock, distinguishing it from
other types of shock?
A. Bradycardia and warm, dry skin
B. Tachycardia and cool, clammy skin
C. Hypotension and tachypnea
D. Bounding pulses and fever
, Answer: A
Rationale: Neurogenic shock involves a loss of sympathetic tone, leading to vasodilation
(warm skin) and a lack of compensatory tachycardia (bradycardia), unlike hypovolemic or
cardiogenic shock.
3. A patient with a traumatic brain injury (TBI) has an ICP of 22 mmHg. Which nursing action is
contraindicated?
A. Maintaining the head of bed at 30 degrees
B. Administering PRN mannitol as ordered
C. Clustering nursing activities to allow for rest
D. Hyperventilating the patient to a pCO2 of 25 mmHg
Answer: C
Rationale: While rest is good, clustering care increases metabolic demand and can cause
dangerous spikes in ICP. Care should be spaced out. Severe hyperventilation (below 30-35
mmHg) is also generally avoided unless as a brief emergency measure due to risk of
ischemia.
4. During the compensatory stage of shock, the nurse expects to see which physiological
response?
A. Respiratory failure and peripheral edema
B. Metabolic acidosis and lethargy
Final Exam Advanced Medical-Surgical Nursing
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 Final Exam: Advanced Medical-Surgical Nursing 2026/2027 UPDATE – Galen
1. A patient in the ICU is being treated for hypovolemic shock. The nurse notes the patient
has a CVP of 1 mmHg and a BP of 88/50. Which intervention is the priority?
A. Administering a dose of norepinephrine
B. Increasing the maintenance IV rate to 125 mL/hr
C. Initiating rapid infusion of isotonic crystalloids
D. Placing the patient in High-Fowler’s position
Answer: C
Rationale: Low CVP (normal 2-8 mmHg) and hypotension indicate fluid volume deficit.
Initial treatment for hypovolemic shock is rapid fluid resuscitation with isotonic solutions
like 0.9% NS or Lactated Ringer’s.
2. Which clinical finding is most characteristic of neurogenic shock, distinguishing it from
other types of shock?
A. Bradycardia and warm, dry skin
B. Tachycardia and cool, clammy skin
C. Hypotension and tachypnea
D. Bounding pulses and fever
, Answer: A
Rationale: Neurogenic shock involves a loss of sympathetic tone, leading to vasodilation
(warm skin) and a lack of compensatory tachycardia (bradycardia), unlike hypovolemic or
cardiogenic shock.
3. A patient with a traumatic brain injury (TBI) has an ICP of 22 mmHg. Which nursing action is
contraindicated?
A. Maintaining the head of bed at 30 degrees
B. Administering PRN mannitol as ordered
C. Clustering nursing activities to allow for rest
D. Hyperventilating the patient to a pCO2 of 25 mmHg
Answer: C
Rationale: While rest is good, clustering care increases metabolic demand and can cause
dangerous spikes in ICP. Care should be spaced out. Severe hyperventilation (below 30-35
mmHg) is also generally avoided unless as a brief emergency measure due to risk of
ischemia.
4. During the compensatory stage of shock, the nurse expects to see which physiological
response?
A. Respiratory failure and peripheral edema
B. Metabolic acidosis and lethargy
