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NUR 265 MEDICAL EXAM 1 – 2026
## VERSIONS 1, 2 & 3 – 300 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES
# VERSION 1 – QUESTIONS 1–100
**Question 1**
A patient with heart failure is receiving furosemide (Lasix). Which
assessment finding indicates the medication is effective?
A) Jugular venous distention (JVD) worsening
B) Weight increase of 2 kg in 24 hours
C) Clear breath sounds and decreased peripheral edema
D) Blood pressure 180/100
**Answer: C – Clear breath sounds and decreased peripheral edema**
**Rationale:** Furosemide is a loop diuretic that reduces fluid overload
in heart failure. Effectiveness is demonstrated by resolution of crackles
(clear breath sounds), reduced peripheral edema, decreased JVD, and
weight loss (not gain). Weight gain indicates fluid retention.
---
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**Question 2**
A patient with chronic obstructive pulmonary disease (COPD) has an
SpO2 of 88% on room air. The nurse administers oxygen at 2 L/min via
nasal cannula. What is the target SpO2 range for this patient?
A) 100%
B) 94-100%
C) 88-92%
D) 80-85%
**Answer: C – 88-92%**
**Rationale:** Patients with COPD (especially chronic hypercapnia)
rely on hypoxic drive for respiration. Oxygen should be titrated to
achieve an SpO2 of 88-92% to avoid suppressing respiratory drive and
causing hypercapnia (CO2 retention). Higher oxygen can lead to
respiratory acidosis.
---
**Question 3**
A patient with diabetes mellitus type 1 has a blood glucose of 450
mg/dL, urine ketones positive, and arterial pH of 7.25. The nurse
anticipates which diagnosis?
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A) Hyperosmolar hyperglycemic state (HHS)
B) Diabetic ketoacidosis (DKA)
C) Hypoglycemia
D) Lactic acidosis
**Answer: B – Diabetic ketoacidosis (DKA)**
**Rationale:** DKA is characterized by hyperglycemia (>250 mg/dL),
ketosis (positive urine/serum ketones), and metabolic acidosis (pH
<7.30). HHS occurs in type 2 diabetes, with extreme hyperglycemia
(>600 mg/dL) but no significant ketosis or acidosis.
---
**Question 4**
A patient post-operative day 1 after abdominal surgery reports sudden
chest pain, dyspnea, and hemoptysis. Vital signs: HR 120, RR 32, BP
90/60, SpO2 85% on room air. The nurse suspects:
A) Atelectasis
B) Pulmonary embolism (PE)
C) Pneumothorax
D) Wound dehiscence
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**Answer: B – Pulmonary embolism (PE)**
**Rationale:** Post-operative patients are at risk for venous
thromboembolism (VTE). Sudden onset of chest pain, dyspnea,
hemoptysis, tachycardia, tachypnea, and hypoxemia are classic for PE.
Atelectasis is more gradual; pneumothorax would have absent breath
sounds; dehiscence involves wound separation.
---
**Question 5**
A patient with cirrhosis has ascites and is receiving spironolactone. The
nurse monitors for which potential adverse effect?
A) Hyperkalemia (spironolactone is potassium-sparing)
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
**Answer: A – Hyperkalemia**
**Rationale:** Spironolactone is a potassium-sparing diuretic
(aldosterone antagonist). It can cause hyperkalemia, especially in
patients with renal impairment or those taking ACE inhibitors, ARBs, or
NUR 265 MEDICAL EXAM 1 – 2026
## VERSIONS 1, 2 & 3 – 300 PRACTICE
QUESTIONS WITH ANSWERS & RATIONALES
# VERSION 1 – QUESTIONS 1–100
**Question 1**
A patient with heart failure is receiving furosemide (Lasix). Which
assessment finding indicates the medication is effective?
A) Jugular venous distention (JVD) worsening
B) Weight increase of 2 kg in 24 hours
C) Clear breath sounds and decreased peripheral edema
D) Blood pressure 180/100
**Answer: C – Clear breath sounds and decreased peripheral edema**
**Rationale:** Furosemide is a loop diuretic that reduces fluid overload
in heart failure. Effectiveness is demonstrated by resolution of crackles
(clear breath sounds), reduced peripheral edema, decreased JVD, and
weight loss (not gain). Weight gain indicates fluid retention.
---
,2|Page
**Question 2**
A patient with chronic obstructive pulmonary disease (COPD) has an
SpO2 of 88% on room air. The nurse administers oxygen at 2 L/min via
nasal cannula. What is the target SpO2 range for this patient?
A) 100%
B) 94-100%
C) 88-92%
D) 80-85%
**Answer: C – 88-92%**
**Rationale:** Patients with COPD (especially chronic hypercapnia)
rely on hypoxic drive for respiration. Oxygen should be titrated to
achieve an SpO2 of 88-92% to avoid suppressing respiratory drive and
causing hypercapnia (CO2 retention). Higher oxygen can lead to
respiratory acidosis.
---
**Question 3**
A patient with diabetes mellitus type 1 has a blood glucose of 450
mg/dL, urine ketones positive, and arterial pH of 7.25. The nurse
anticipates which diagnosis?
,3|Page
A) Hyperosmolar hyperglycemic state (HHS)
B) Diabetic ketoacidosis (DKA)
C) Hypoglycemia
D) Lactic acidosis
**Answer: B – Diabetic ketoacidosis (DKA)**
**Rationale:** DKA is characterized by hyperglycemia (>250 mg/dL),
ketosis (positive urine/serum ketones), and metabolic acidosis (pH
<7.30). HHS occurs in type 2 diabetes, with extreme hyperglycemia
(>600 mg/dL) but no significant ketosis or acidosis.
---
**Question 4**
A patient post-operative day 1 after abdominal surgery reports sudden
chest pain, dyspnea, and hemoptysis. Vital signs: HR 120, RR 32, BP
90/60, SpO2 85% on room air. The nurse suspects:
A) Atelectasis
B) Pulmonary embolism (PE)
C) Pneumothorax
D) Wound dehiscence
, 4|Page
**Answer: B – Pulmonary embolism (PE)**
**Rationale:** Post-operative patients are at risk for venous
thromboembolism (VTE). Sudden onset of chest pain, dyspnea,
hemoptysis, tachycardia, tachypnea, and hypoxemia are classic for PE.
Atelectasis is more gradual; pneumothorax would have absent breath
sounds; dehiscence involves wound separation.
---
**Question 5**
A patient with cirrhosis has ascites and is receiving spironolactone. The
nurse monitors for which potential adverse effect?
A) Hyperkalemia (spironolactone is potassium-sparing)
B) Hypokalemia
C) Hyponatremia
D) Hypercalcemia
**Answer: A – Hyperkalemia**
**Rationale:** Spironolactone is a potassium-sparing diuretic
(aldosterone antagonist). It can cause hyperkalemia, especially in
patients with renal impairment or those taking ACE inhibitors, ARBs, or
