NUR 265 Advanced Medical-Surgical Nursing Exam Bundle 2026
|Galen College
1. Which hemodynamic parameter is the best indicator of left ventricular end-
diastolic pressure (preload)?
A. Central Venous Pressure (CVP)
B. Mean Arterial Pressure (MAP)
C. Pulmonary Artery Wedge Pressure (PAWP)
D. Systemic Vascular Resistance (SVR)
Answer: C
Rationale: PAWP reflects left atrial pressure and left ventricular end-diastolic pressure,
providing an estimate of left-sided preload.
2. A patient with Acute Kidney Injury (AKI) has a urine output of 200 mL in 24
hours. Which phase of AKI is the patient experiencing?
A. Initiation phase
B. Diuretic phase
C. Oliguric phase
D. Recovery phase
Answer: C
Rationale: The oliguric phase is characterized by a urine output of less than 400 mL per
day.
,3. What is the primary physiological benefit of Positive End-Expiratory Pressure
(PEEP) in a patient with ARDS?
A. Increasing tidal volume
B. Decreasing the work of breathing
C. Preventing alveolar collapse and improving oxygenation
D. Reducing the risk of barotrauma
Answer: C
Rationale: PEEP maintains pressure in the lungs at the end of expiration to keep alveoli
open, which improves gas exchange.
4. Which of the following signs constitutes Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and decreased level of consciousness
Answer: C
Rationale: Cushing’s Triad is a late sign of increased ICP consisting of systolic
hypertension with a wide pulse pressure, bradycardia, and irregular respiratory patterns.
5. A patient with acute pancreatitis exhibits a bluish discoloration around the
umbilicus. What is this called?
A. Cullen’s sign
B. Chvostek’s sign
C. Turner’s sign
D. Trousseau’s sign
Answer: A
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage.
, 6. In hypovolemic shock, what is the initial compensatory mechanism of the
body?
A. Decreased heart rate
B. Vasodilation
C. Activation of the sympathetic nervous system to increase heart rate
D. Increased urine output
Answer: C
Rationale: To maintain cardiac output and blood pressure, the body triggers the
sympathetic nervous system, leading to tachycardia and vasoconstriction.
7. Using the Parkland Formula, calculate the total fluid resuscitation needed in
24 hours for a 70kg patient with 40% TBSA burns.
A. 5,600 mL
B. 2,800 mL
C. 8,400 mL
D. 11,200 mL
Answer: D
Rationale: Parkland Formula: 4mL x kg x %TBSA. So, 4 x 70 x 40 = 11,200 mL.
8. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Crackles in the lungs
C. Jugular venous distention
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion and crackles.
|Galen College
1. Which hemodynamic parameter is the best indicator of left ventricular end-
diastolic pressure (preload)?
A. Central Venous Pressure (CVP)
B. Mean Arterial Pressure (MAP)
C. Pulmonary Artery Wedge Pressure (PAWP)
D. Systemic Vascular Resistance (SVR)
Answer: C
Rationale: PAWP reflects left atrial pressure and left ventricular end-diastolic pressure,
providing an estimate of left-sided preload.
2. A patient with Acute Kidney Injury (AKI) has a urine output of 200 mL in 24
hours. Which phase of AKI is the patient experiencing?
A. Initiation phase
B. Diuretic phase
C. Oliguric phase
D. Recovery phase
Answer: C
Rationale: The oliguric phase is characterized by a urine output of less than 400 mL per
day.
,3. What is the primary physiological benefit of Positive End-Expiratory Pressure
(PEEP) in a patient with ARDS?
A. Increasing tidal volume
B. Decreasing the work of breathing
C. Preventing alveolar collapse and improving oxygenation
D. Reducing the risk of barotrauma
Answer: C
Rationale: PEEP maintains pressure in the lungs at the end of expiration to keep alveoli
open, which improves gas exchange.
4. Which of the following signs constitutes Cushing’s Triad, indicating increased
intracranial pressure (ICP)?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, hypotension, and Cheyne-Stokes respirations
C. Bradycardia, hypertension with widening pulse pressure, and irregular respirations
D. Tachycardia, hypertension, and decreased level of consciousness
Answer: C
Rationale: Cushing’s Triad is a late sign of increased ICP consisting of systolic
hypertension with a wide pulse pressure, bradycardia, and irregular respiratory patterns.
5. A patient with acute pancreatitis exhibits a bluish discoloration around the
umbilicus. What is this called?
A. Cullen’s sign
B. Chvostek’s sign
C. Turner’s sign
D. Trousseau’s sign
Answer: A
Rationale: Cullen’s sign is superficial edema and bruising in the subcutaneous fatty tissue
around the umbilicus, indicating retroperitoneal hemorrhage.
, 6. In hypovolemic shock, what is the initial compensatory mechanism of the
body?
A. Decreased heart rate
B. Vasodilation
C. Activation of the sympathetic nervous system to increase heart rate
D. Increased urine output
Answer: C
Rationale: To maintain cardiac output and blood pressure, the body triggers the
sympathetic nervous system, leading to tachycardia and vasoconstriction.
7. Using the Parkland Formula, calculate the total fluid resuscitation needed in
24 hours for a 70kg patient with 40% TBSA burns.
A. 5,600 mL
B. 2,800 mL
C. 8,400 mL
D. 11,200 mL
Answer: D
Rationale: Parkland Formula: 4mL x kg x %TBSA. So, 4 x 70 x 40 = 11,200 mL.
8. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Peripheral edema
B. Crackles in the lungs
C. Jugular venous distention
D. Hepatomegaly
Answer: B
Rationale: Left-sided heart failure causes blood to back up into the pulmonary circulation,
leading to pulmonary congestion and crackles.
