NUR 265 Advanced Medical-Surgical Nursing Exam 2 Study Guide 2026
|Galen College
1. A patient with heart failure has a Brain Natriuretic Peptide (BNP) level of 850
pg/mL. What is the nurse’s priority interpretation of this lab value?
A. The value is within normal limits.
B. The patient is experiencing a significant exacerbation of heart failure.
C. The patient is experiencing severe renal failure.
D. The patient has a pulmonary embolism.
Answer: B
Rationale: BNP levels over 100 pg/mL indicate heart failure; 850 pg/mL is significantly
elevated, suggesting fluid overload and ventricular stretching.
2. When assessing a patient with right-sided heart failure, which finding should
the nurse expect?
A. Crackles in the lungs
B. Frothy pink sputum
C. Jugular venous distention (JVD)
D. Orthopnea
Answer: C
Rationale: Right-sided heart failure results in systemic congestion, characterized by JVD,
peripheral edema, and hepatomegaly.
,3. A patient is admitted with a suspected Myocardial Infarction. Which lab result
is most specific to cardiac muscle damage?
A. Creatine Kinase (CK)
B. Myoglobin
C. C-Reactive Protein (CRP)
D. Troponin T or I
Answer: D
Rationale: Troponin is the most specific cardiac marker for myocardial injury and stays
elevated for 1-2 weeks.
4. The nurse is caring for a patient in hypovolemic shock. Which intravenous
fluid is most appropriate for rapid volume expansion?
A. 0.45% Sodium Chloride
B. 5% Dextrose in Water (D5W)
C. 0.9% Sodium Chloride (Normal Saline)
D. 3% Sodium Chloride
Answer: C
Rationale: Isotonic crystalloids like 0.9% NS or Lactated Ringer’s are used for rapid
volume resuscitation in shock.
5. A patient’s ECG shows a rapid, irregular rhythm with no discernible P waves.
The nurse identifies this as:
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. Sinus Bradycardia
Answer: C
Rationale: Atrial Fibrillation is characterized by a lack of P waves and an irregularly
irregular QRS rhythm.
, 6. A patient in Septic Shock has a blood pressure of 82/46 mmHg after a 3L fluid
bolus. Which medication does the nurse anticipate administering next?
A. Nitroglycerin
B. Norepinephrine
C. Furosemide
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluid
resuscitation fails to maintain MAP.
7. What is the primary goal of Positive End-Expiratory Pressure (PEEP) in a
patient with ARDS?
A. To decrease the work of breathing
B. To prevent barotrauma
C. To increase the respiratory rate
D. To keep alveoli open and improve oxygenation
Answer: D
Rationale: PEEP provides pressure at the end of expiration to prevent alveolar collapse,
improving gas exchange in ARDS.
8. A patient with a burn injury covering 40% of the body is in the emergent
phase. Which electrolyte imbalance is most likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: A
Rationale: In the emergent phase of burns, cell destruction releases potassium into the
extracellular fluid, causing hyperkalemia.
|Galen College
1. A patient with heart failure has a Brain Natriuretic Peptide (BNP) level of 850
pg/mL. What is the nurse’s priority interpretation of this lab value?
A. The value is within normal limits.
B. The patient is experiencing a significant exacerbation of heart failure.
C. The patient is experiencing severe renal failure.
D. The patient has a pulmonary embolism.
Answer: B
Rationale: BNP levels over 100 pg/mL indicate heart failure; 850 pg/mL is significantly
elevated, suggesting fluid overload and ventricular stretching.
2. When assessing a patient with right-sided heart failure, which finding should
the nurse expect?
A. Crackles in the lungs
B. Frothy pink sputum
C. Jugular venous distention (JVD)
D. Orthopnea
Answer: C
Rationale: Right-sided heart failure results in systemic congestion, characterized by JVD,
peripheral edema, and hepatomegaly.
,3. A patient is admitted with a suspected Myocardial Infarction. Which lab result
is most specific to cardiac muscle damage?
A. Creatine Kinase (CK)
B. Myoglobin
C. C-Reactive Protein (CRP)
D. Troponin T or I
Answer: D
Rationale: Troponin is the most specific cardiac marker for myocardial injury and stays
elevated for 1-2 weeks.
4. The nurse is caring for a patient in hypovolemic shock. Which intravenous
fluid is most appropriate for rapid volume expansion?
A. 0.45% Sodium Chloride
B. 5% Dextrose in Water (D5W)
C. 0.9% Sodium Chloride (Normal Saline)
D. 3% Sodium Chloride
Answer: C
Rationale: Isotonic crystalloids like 0.9% NS or Lactated Ringer’s are used for rapid
volume resuscitation in shock.
5. A patient’s ECG shows a rapid, irregular rhythm with no discernible P waves.
The nurse identifies this as:
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. Sinus Bradycardia
Answer: C
Rationale: Atrial Fibrillation is characterized by a lack of P waves and an irregularly
irregular QRS rhythm.
, 6. A patient in Septic Shock has a blood pressure of 82/46 mmHg after a 3L fluid
bolus. Which medication does the nurse anticipate administering next?
A. Nitroglycerin
B. Norepinephrine
C. Furosemide
D. Atropine
Answer: B
Rationale: Norepinephrine is the first-line vasopressor for septic shock when fluid
resuscitation fails to maintain MAP.
7. What is the primary goal of Positive End-Expiratory Pressure (PEEP) in a
patient with ARDS?
A. To decrease the work of breathing
B. To prevent barotrauma
C. To increase the respiratory rate
D. To keep alveoli open and improve oxygenation
Answer: D
Rationale: PEEP provides pressure at the end of expiration to prevent alveolar collapse,
improving gas exchange in ARDS.
8. A patient with a burn injury covering 40% of the body is in the emergent
phase. Which electrolyte imbalance is most likely?
A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypernatremia
Answer: A
Rationale: In the emergent phase of burns, cell destruction releases potassium into the
extracellular fluid, causing hyperkalemia.
