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INSTANT PDF DOWNLOAD. Complete NUR 265 Medical-Surgical Nursing Exam Bundle – Exams 1, 2, 3, and Final. 200 tested questions (50 per exam) mirroring real Galen College exams. Includes clinically relevant scenarios, core concepts, application-level items, and verified rationales. 100% pass guarantee. NUR 265 exam bundle, Galen College of Nursing Med-Surg complete, NUR 265 exams 1-3 final, Medical-surgical nursing all exams, NUR 265 200 questions, NUR 265 tested questions, NUR 265 rationales, NUR 265 2026, Galen NUR 265, NUR 265 practice tests, Med-Surg NCLEX-style bundle, NUR 265 verified answers, NUR 265 study guide complete, Galen nursing exam pack, NUR 265 critical thinking, Med-Surg board review
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This Exam Features:
Complete NUR 265 Medical-Surgical Nursing Exam
Bundle (Exam 1, Exam 2, Exam 3 & Final), each
containing 50 Tested questions that mirror real
Galen College exams. Includes clinically relevant
scenarios, Med-Surg core concepts, application-level
items, and verified rationales to help students master the
material and pass with confidence.
Table of Contents
NUR 265 Exam 1
### 1. The RN is caring for a patient with cirrhosis, and the patient develops increasing abdominal girth with abdominal discomfort. What should the RN expect as a new order from the healthcare provider?
A. Furosemide (Lasix) B. Spironolactone C. Beta-blockers D. Albumin
Correct Answer: B. Spironolactone
Rationale: Ascites from cirrhosis often requires potassium-sparing diuretics like spironolactone to manage fluid retention by antagonizing aldosterone. This choice considers electrolyte balance and renal function, critical in MedSurg care.
### 2. The RN is caring for a patient with pancreatitis. What should the RN continue to monitor to decrease the risk of complications?
stools. Based on the patient’s symptoms, which vitamin does your patient’s liver have issues absorbing?
A. Vitamin A B. Vitamin D C. Vitamin K D. Vitamin E
Correct Answer: C. Vitamin K
Rationale: Cirrhosis impairs bile production and secretion, which is necessary for fat-soluble vitamin absorption, especially vitamin K. Vitamin K is essential for synthesis of clotting factors II, VII, IX, and X. Deficiency leads to bleeding tendencies such as ecchymosis, hemoptysis (coughing blood), and melena (dark tarry stools), indicative of coagulopathy. This aligns with advanced MedSurg expectations to recognize complications of liver dysfunction impacting hemostasis.
### 5. The RN is caring for a patient who is going to get a prosthetic (metal) valve placed. Which of the following indicates the patient understands the care for a prosthetic valve?
A. "I do not need to take medications after surgery." B. "I must wear a medical alert band that I take anticoagulants." C. "I will only take antibiotics as needed." D. "I can stop taking anticoagulants after 1 year."
Correct Answer: B. "I must wear a medical alert band that I take anticoagulants."
Rationale: Patients with metal prosthetic valves require lifelong anticoagulant therapy to prevent thromboembolism. Wearing a medical alert band informs healthcare providers of this critical information during emergencies. This reflects the need for patient education in high-risk cardiac interventions.
### 6. A patient is admitted with acute pancreatitis. Which assessment findings would be consistent with this diagnosis?
A. Gray blue color around the umbilicus (Cullen's sign) B. Abdominal tenderness C. Left upper quadrant (LUQ) pain radiating to the back D. All of the above
Correct Answer: D. All of the above
Rationale: Acute pancreatitis presents with LUQ pain that radiates to the back, abdominal tenderness, and sometimes signs of internal hemorrhage like Cullen’s sign due to peritoneal bleeding. Recognizing these manifestations is critical for early diagnosis and management of pancreatitis.
### 7. A patient with ESRD (end-stage renal disease) is utilizing peritoneal dialysis (PD). What actions must the RN take?
A. Place a mask on the patient when changing the PD catheter B. Place the patient in a semi-Fowler’s or supine position C. Give an enema prior to dialysis D. Warm the dialysate bag in a warming chamber prior to infusing E. A, B, and D only
D. Increased urine output
Correct Answer: B. Headache, changes in level of consciousness
Rationale: Disequilibrium syndrome results from rapid removal of solutes causing cerebral edema. Neurologic symptoms like headache and altered LOC are early signs and require prompt detection.
### 10. A patient arrives at the ED with complaints of angina, SOB, and diaphoresis. What are the priority RN interventions?
A. Obtain EKG within 10 minutes B. Apply oxygen C. Administer morphine, nitroglycerin, and aspirin D. Start thrombolytics within 30 minutes if STEMI E. Ensure patient goes to cath lab within 90 minutes for PCI F. Obtain intravenous access (IVF) G. All of the above
Correct Answer: G. All of the above
Rationale: Timely assessment and initiation of life-saving interventions for acute coronary syndrome (ACS) includes rapid EKG, oxygen, pain control, antiplatelet therapy, thrombolysis, or PCI, and IV access, following established clinical guidelines.
### 11. You are caring for a patient post-procedure of a pericardiocentesis to treat cardiac tamponade. Which assessment would indicate that the procedure was effective?
A. A rise in blood pressure B. An increase in heart rate C. Development of jugular venous distension D. Decreased urine output
Correct Answer: A. A rise in blood pressure
Rationale: Cardiac tamponade restricts cardiac filling and output, causing hypotension. Successful pericardiocentesis relieves pressure, improving cardiac output and blood pressure.
### 12. You are caring for a patient with pericarditis. What are the expected findings for this disease process?
A. Pericardial friction rub B. Fever C. Angina D. All of the above
Correct Answer: D. All of the above
Rationale: Pericarditis inflammation causes a characteristic friction rub, systemic febrile response, and chest pain often worsened by inspiration or lying down.
### 13. You are caring for a patient who presents to the ED with fever, chills, pallor, cardiac murmur, petechiae, and prominent splinter hemorrhages. What disease process does this patient have?
A. Less than 400 ml per day B. 1000 ml – 3000 ml per day C. UO > 5000 ml per day D. No urine output
Correct Answer: B. 1000 ml – 3000 ml per day
Rationale: The recovery phase of AKI is characterized by a diuretic phase with increased urine output as kidney function stabilizes.
### 16. The RN is caring for a patient in renal insufficiency. Which of the following signs and symptoms will be present in a patient experiencing uremia?
A. Nausea, vomiting, pleuritic pain, pericardial friction rub B. Hypertension, bradycardia C. Dry skin and alopecia D. Hyperactive reflexes
Correct Answer: A. Nausea, vomiting, pleuritic pain, pericardial friction rub
Rationale: Uremia causes systemic toxicity including GI symptoms and can cause uremic pericarditis, evident by pleuritic pain and friction rub.
### 17. You are the RN taking care of a patient that needs to go to dialysis. Which of the following actions should the RN take?
A. Assess the patient’s weight before and after dialysis B. Call the MD to see which medications to take before dialysis
C. Hold blood pressure medications and metformin before dialysis D. All of the above
Correct Answer: D. All of the above
Rationale: Monitoring fluid balance via weight, coordinating medication management, especially holding antihypertensives and metformin (which can cause lactic acidosis), are critical to safe dialysis care.
### 18. The RN is caring for a patient receiving Gentamicin. Which labs should the RN monitor?
A. Creatinine B. BUN C. Drug peak and trough levels D. All of the above
Correct Answer: D. All of the above
Rationale: Gentamicin is nephrotoxic and ototoxic; monitoring renal function and drug levels prevents toxicity while ensuring therapeutic efficacy.
### 19. The healthcare provider is considering the use of thrombolytic therapy for the patient. What is the contraindication criteria for this therapy?
A. Ischemic stroke within 3 months B. Surgery in the last 10 days
### 21. The patient is receiving beta-blocker therapy for treatment of MI. What does the RN monitor for in relation to this therapy?
A. Hypotension B. Decrease level of consciousness C. Chest discomfort D. All of the above
Correct Answer: D. All of the above
Rationale: Beta blockers decrease heart rate and cardiac output; hypotension and altered LOC may indicate poor perfusion, and chest discomfort may signal ischemia or adverse effects.
### 22. The RN is monitoring the patient who had fibrinolytics and percutaneous coronary intervention (PCI). What is the indication that the clot has lysed and the artery reperfused?
A. Sudden onset of ventricular dysrhythmias B. Bradycardia C. Hypotension D. No change in pain levels
Correct Answer: A. Sudden onset of ventricular dysrhythmias
Rationale: Reperfusion arrhythmias occur as blood flow is restored to ischemic myocardium. These rhythms often signify successful reperfusion but require close monitoring.
### 23. The patient you are taking care of has an MI. The RN anticipates which type of medication will be prescribed within 24 hours to prevent the development of heart failure?
A. Calcium channel blockers B. ACE inhibitors C. Diuretics D. Digoxin
Correct Answer: B. ACE inhibitors
Rationale: Early initiation of ACE inhibitors post-MI reduces ventricular remodeling, preserves ejection fraction, and reduces the incidence of heart failure.
### 24. The RN is contacted by the cardiac monitoring tech who says the patient is having dysrhythmias. What should the RN do next?
A. Assess for chest pain and discomfort B. Prepare to cardiovert immediately C. Administer antiarrhythmic drugs D. Ignore unless vital signs change
Correct Answer: A. Assess for chest pain and discomfort
Rationale: Clinical correlation is essential—dysrhythmias may be asymptomatic or cause ischemia. Assessing patient symptoms guides emergent response.
coughing to clear secretions, reducing the risk of postoperative pulmonary complications such as atelectasis or pneumonia.
27. Following a CABG, the patient has a body temperature of 95.8°F. What measure should be used to rewarm the patient? a) Administer IV fluids at room temperature b) Use thermal blankets c) Provide a warm bath d) Increase room temperature only
Correct Answer: b) Use thermal blankets
Rationale: Hypothermia post-cardiac surgery is common and thermal blankets provide controlled external warming, which is safer and more effective than other methods. This helps prevent complications such as coagulopathy and cardiac arrhythmias.
28. You are caring for a patient after CABG. The patient has a decrease in mediastinal drainage. Which of the following symptoms is most concerning? a) Clear lung sounds and increased BP on expiration b) Jugular venous distention (JVD) c) Mild tachycardia d) Slight hypotension
Correct Answer: b) Jugular venous distention (JVD)
Rationale: Reduced mediastinal chest tube drainage with signs including JVD suggests cardiac tamponade, a life-threatening emergency where fluid accumulation compresses the heart, impairing cardiac output.
29. The RN is coming on duty after report. Which patient should the RN see first? a) Patient with anxiety, nausea, diaphoresis, and shortness of breath b) Postoperative patient with controlled pain c) Patient ready for discharge teaching d) Patient with mild headache
Correct Answer: a) Patient with anxiety, nausea, diaphoresis, and shortness of breath
Rationale: These symptoms are classic signs of an acute myocardial infarction (MI) or cardiac event requiring immediate assessment and intervention to prevent morbidity and mortality.
30. The ED RN is assessing an 86-year-old patient with acute confusion, increased respiratory rate (36 bpm), angina, crackles and wheezing on auscultation. The RN interprets this as: a) Right sided heart failure b) Left sided heart failure c) COPD exacerbation d) Pulmonary embolism
Correct Answer: b) Left sided heart failure
Rationale: This is a realistic, measurable goal for activity tolerance during cardiac rehab. It balances functional improvement with safety and avoidance of ischemic symptoms.
33. The RN is educating the patient about outpatient care before cardiac catheterization. Which of the following indicates appropriate patient education? a) It is okay for you to stay on your Aspirin or Plavix before the procedure b) Consult with your PCP about how long you should stay off your anticoagulant c) Hold your diuretic the day of the procedure d) Take Metformin 24 hours before and after the procedure
Correct Answer: b) Consult with your PCP about how long you should stay off your anticoagulant
Rationale: Anticoagulant management varies based on indication and procedure type and must be individualized. Metformin should be held 24 hours before and 48 hours after contrast to prevent lactic acidosis, contradicting choice d. Aspirin/Plavix decisions depend on clinical scenario.
34. The patient’s EKG strip shows ventricular tachycardia (v-tach). The patient is experiencing shortness of breath, palpitations, lightheadedness, and has a weak pulse. The patient is verbal, and the rhythm has lasted more than 20 seconds. What should the RN do?
a) Prepare for immediate defibrillation b) Administer oxygen and Amiodarone c) Obtain a 12-lead EKG and monitor the patient only d) Start CPR immediately
Correct Answer: b) Administer oxygen and Amiodarone
Rationale: The patient is stable (verbal with weak pulse), so antiarrhythmic medications like Amiodarone and oxygen are indicated. Defibrillation and CPR are reserved for pulseless or unstable patients.
35. The RN receives a call from the telemonitor watcher indicating asystole. What should the RN do next?
