NUR 265 Advanced Medical-Surgical Nursing Exam 5 2026 |Galen
College
1. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect to find?
A. Heart rate greater than 100 beats per minute
B. Systolic blood pressure less than 90 mmHg
C. Cool, clammy, and cyanotic skin
D. Urine output less than 10 mL per hour
Answer: A
Rationale: In the compensatory stage of shock, the body’s homeostatic mechanisms (like
the sympathetic nervous system) maintain blood pressure by increasing the heart rate and
constricting peripheral vessels.
2. Which intravenous fluid is the initial choice for fluid resuscitation in a patient
with hypovolemic shock?
A. 0.45% Normal Saline
B. Lactated Ringer’s solution
C. Dextrose 5% in Water (D5W)
D. Dextrose 5% in 0.9% Normal Saline
Answer: B
Rationale: Isotonic crystalloids, such as Lactated Ringer’s or 0.9% Normal Saline, are
preferred because they expand intravascular volume without causing major fluid shifts.
,3. A patient has suffered a 40% Total Body Surface Area (TBSA) burn. Using the
Parkland formula (4mL/kg/%TBSA), calculate the total fluid needed in the first
24 hours for a patient weighing 70kg.
A. 5,600 mL
B. 2,800 mL
C. 11,200 mL
D. 14,000 mL
Answer: C
Rationale: Calculation: 4 mL x 70 kg x 40 = 11,200 mL. Half is given in the first 8 hours, and
the rest over the next 16 hours.
4. In the ‘Rule of Nines,’ what percentage of TBSA is assigned to the entire
anterior trunk (chest and abdomen)?
A. 9%
B. 36%
C. 18%
D. 4.5%
Answer: C
Rationale: The anterior trunk is 18%, and the posterior trunk is 18%, totaling 36% for the
entire torso.
5. A patient in septic shock has a Mean Arterial Pressure (MAP) of 58 mmHg
despite adequate fluid resuscitation. Which medication should the nurse
anticipate administering first?
A. Norepinephrine
B. Nitroprusside
C. Dobutamine
D. Atropine
Answer: A
, Rationale: Norepinephrine (Levophed) is the first-line vasopressor for septic shock to
maintain a MAP of at least 65 mmHg.
6. What is the primary indicator of successful fluid resuscitation in a burn
patient?
A. Urine output of 0.5 to 1.0 mL/kg/hr
B. A heart rate of 110 bpm
C. Absence of peripheral edema
D. Stable weight
Answer: A
Rationale: Hourly urine output is the most reliable indicator of organ perfusion and fluid
resuscitation adequacy in burn patients.
7. Which type of shock is characterized by bradycardia instead of tachycardia?
A. Hypovolemic shock
B. Septic shock
C. Anaphylactic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and bradycardia.
8. A patient presents with a burn that is painful, red, and has large blisters. How
should the nurse classify this burn?
A. Deep partial-thickness (Second degree)
B. Superficial (First degree)
C. Full-thickness (Third degree)
D. Deep full-thickness (Fourth degree)
Answer: A
College
1. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect to find?
A. Heart rate greater than 100 beats per minute
B. Systolic blood pressure less than 90 mmHg
C. Cool, clammy, and cyanotic skin
D. Urine output less than 10 mL per hour
Answer: A
Rationale: In the compensatory stage of shock, the body’s homeostatic mechanisms (like
the sympathetic nervous system) maintain blood pressure by increasing the heart rate and
constricting peripheral vessels.
2. Which intravenous fluid is the initial choice for fluid resuscitation in a patient
with hypovolemic shock?
A. 0.45% Normal Saline
B. Lactated Ringer’s solution
C. Dextrose 5% in Water (D5W)
D. Dextrose 5% in 0.9% Normal Saline
Answer: B
Rationale: Isotonic crystalloids, such as Lactated Ringer’s or 0.9% Normal Saline, are
preferred because they expand intravascular volume without causing major fluid shifts.
,3. A patient has suffered a 40% Total Body Surface Area (TBSA) burn. Using the
Parkland formula (4mL/kg/%TBSA), calculate the total fluid needed in the first
24 hours for a patient weighing 70kg.
A. 5,600 mL
B. 2,800 mL
C. 11,200 mL
D. 14,000 mL
Answer: C
Rationale: Calculation: 4 mL x 70 kg x 40 = 11,200 mL. Half is given in the first 8 hours, and
the rest over the next 16 hours.
4. In the ‘Rule of Nines,’ what percentage of TBSA is assigned to the entire
anterior trunk (chest and abdomen)?
A. 9%
B. 36%
C. 18%
D. 4.5%
Answer: C
Rationale: The anterior trunk is 18%, and the posterior trunk is 18%, totaling 36% for the
entire torso.
5. A patient in septic shock has a Mean Arterial Pressure (MAP) of 58 mmHg
despite adequate fluid resuscitation. Which medication should the nurse
anticipate administering first?
A. Norepinephrine
B. Nitroprusside
C. Dobutamine
D. Atropine
Answer: A
, Rationale: Norepinephrine (Levophed) is the first-line vasopressor for septic shock to
maintain a MAP of at least 65 mmHg.
6. What is the primary indicator of successful fluid resuscitation in a burn
patient?
A. Urine output of 0.5 to 1.0 mL/kg/hr
B. A heart rate of 110 bpm
C. Absence of peripheral edema
D. Stable weight
Answer: A
Rationale: Hourly urine output is the most reliable indicator of organ perfusion and fluid
resuscitation adequacy in burn patients.
7. Which type of shock is characterized by bradycardia instead of tachycardia?
A. Hypovolemic shock
B. Septic shock
C. Anaphylactic shock
D. Neurogenic shock
Answer: D
Rationale: Neurogenic shock results from the loss of sympathetic tone, leading to
vasodilation and bradycardia.
8. A patient presents with a burn that is painful, red, and has large blisters. How
should the nurse classify this burn?
A. Deep partial-thickness (Second degree)
B. Superficial (First degree)
C. Full-thickness (Third degree)
D. Deep full-thickness (Fourth degree)
Answer: A
