NUR 265 ADVANCED MEDICAL-
SURGICAL NURSING EXAM 1
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the intensive care unit is diagnosed with Acute Respiratory Distress Syndrome
(ARDS). Which clinical manifestation is considered the hallmark of this condition?
A. Refractory hypoxemia despite increasing concentrations of inspired oxygen
B. Hypercapnia that responds quickly to oxygen therapy
C. Increased lung compliance and decreased work of breathing
D. Respiratory alkalosis caused by hypoventilation
Answer: A
Conceptual Explanation: Refractory hypoxemia, where the partial pressure of arterial
oxygen (PaO2) remains low despite receiving high levels of supplemental oxygen, is the
hallmark sign of ARDS due to significant shunting.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Suction the patient to clear potential secretions in the airway
,B. Check for a disconnect between the ET tube and the ventilator
C. Change the ventilator settings to increase the pressure limit
D. Check the patient for signs of a cuff leak
Answer: A
Conceptual Explanation: High-pressure alarms are triggered by increased resistance.
Common causes include secretions, biting the tube, or tubing kinks. Suctioning is a priority
intervention to clear the airway. Disconnects trigger low-pressure alarms.
3. A patient with a major burn injury is in the emergent phase. Which electrolyte imbalance is
the nurse most likely to observe?
A. Hypokalemia and Hypernatremia
B. Hypomagnesemia and Hyperchloremia
C. Hypercalcemia and Hypophosphatemia
D. Hyperkalemia and Hyponatremia
Answer: D
Conceptual Explanation: During the emergent phase of a burn, massive cell destruction
releases potassium into the extracellular fluid (Hyperkalemia), while sodium shifts into the
interstitial space along with fluid (Hyponatremia).
, 4. The nurse is evaluating the ABG results for a patient: pH 7.30, PaCO2 52 mmHg, HCO3 28
mEq/L. How should the nurse interpret these results?
A. Partially Compensated Respiratory Acidosis
B. Fully Compensated Respiratory Acidosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is acidic (<7.35). The PaCO2 is high (>45), matching the
acidotic pH (Respiratory). The HCO3 is high (>26), indicating the kidneys are attempting to
compensate, but since the pH is not normal, it is ‘partially compensated.’
5. In a patient experiencing Hypovolemic Shock, which hemodynamic parameter would the
nurse expect to find?
A. Decreased Pulmonary Artery Wedge Pressure (PAWP)
B. Increased Cardiac Output (CO)
C. Decreased Systemic Vascular Resistance (SVR)
D. Decreased Pulmonary Artery Wedge Pressure (PAWP)
D. Increased Central Venous Pressure (CVP)
Answer: A
SURGICAL NURSING EXAM 1
QUESTIONS AND ANSWERS WITH
VERIFIED SOLUTIONS 2026/2027
UPDATE. JUST RELEASED
1. A patient in the intensive care unit is diagnosed with Acute Respiratory Distress Syndrome
(ARDS). Which clinical manifestation is considered the hallmark of this condition?
A. Refractory hypoxemia despite increasing concentrations of inspired oxygen
B. Hypercapnia that responds quickly to oxygen therapy
C. Increased lung compliance and decreased work of breathing
D. Respiratory alkalosis caused by hypoventilation
Answer: A
Conceptual Explanation: Refractory hypoxemia, where the partial pressure of arterial
oxygen (PaO2) remains low despite receiving high levels of supplemental oxygen, is the
hallmark sign of ARDS due to significant shunting.
2. A nurse is caring for a patient on mechanical ventilation. The high-pressure alarm sounds.
Which action should the nurse take first?
A. Suction the patient to clear potential secretions in the airway
,B. Check for a disconnect between the ET tube and the ventilator
C. Change the ventilator settings to increase the pressure limit
D. Check the patient for signs of a cuff leak
Answer: A
Conceptual Explanation: High-pressure alarms are triggered by increased resistance.
Common causes include secretions, biting the tube, or tubing kinks. Suctioning is a priority
intervention to clear the airway. Disconnects trigger low-pressure alarms.
3. A patient with a major burn injury is in the emergent phase. Which electrolyte imbalance is
the nurse most likely to observe?
A. Hypokalemia and Hypernatremia
B. Hypomagnesemia and Hyperchloremia
C. Hypercalcemia and Hypophosphatemia
D. Hyperkalemia and Hyponatremia
Answer: D
Conceptual Explanation: During the emergent phase of a burn, massive cell destruction
releases potassium into the extracellular fluid (Hyperkalemia), while sodium shifts into the
interstitial space along with fluid (Hyponatremia).
, 4. The nurse is evaluating the ABG results for a patient: pH 7.30, PaCO2 52 mmHg, HCO3 28
mEq/L. How should the nurse interpret these results?
A. Partially Compensated Respiratory Acidosis
B. Fully Compensated Respiratory Acidosis
C. Uncompensated Metabolic Acidosis
D. Partially Compensated Metabolic Alkalosis
Answer: A
Conceptual Explanation: The pH is acidic (<7.35). The PaCO2 is high (>45), matching the
acidotic pH (Respiratory). The HCO3 is high (>26), indicating the kidneys are attempting to
compensate, but since the pH is not normal, it is ‘partially compensated.’
5. In a patient experiencing Hypovolemic Shock, which hemodynamic parameter would the
nurse expect to find?
A. Decreased Pulmonary Artery Wedge Pressure (PAWP)
B. Increased Cardiac Output (CO)
C. Decreased Systemic Vascular Resistance (SVR)
D. Decreased Pulmonary Artery Wedge Pressure (PAWP)
D. Increased Central Venous Pressure (CVP)
Answer: A
