GALEN COLLEGE OF NURSING
NUR 265
Exam 1 - Versions 1, 2, and 3
Official Practice Exam
2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
150 180 80% N/A
Table of Contents
Section 1: Cardiovascular Disorders ........... 25 Questions (Q1-Q25)
Section 2: Respiratory Disorders ........... 25 Questions (Q26-Q50)
Section 3: Hematologic and Immune Disorders ........... 25 Questions (Q51-Q75)
Section 4: Neurological Disorders ........... 25 Questions (Q76-Q100)
Section 5: Musculoskeletal and Connective Tissue Disorders ........... 25 Questions (Q101-Q125)
Section 6: Eye, Ear, and Sensory Disorders ........... 25 Questions (Q126-Q150)
Instructions
This practice exam contains 150 multiple-choice questions divided into 6 sections covering NUR 265 Exam 1
content (Versions 1, 2, and 3). Each question has four answer choices (A through D). Select the one best answer
for each question. You have 180 minutes to complete the exam. A score of 80% or higher (120 out of 150
questions correct) is required to pass. Read each question carefully, noting the clinical scenario before selecting
your answer. Review the rationale provided after each question for learning purposes.
Disclaimer: This is a practice exam for study purposes only. It is not affiliated with or endorsed by Galen College of Nursing.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 1
, Section 1: Cardiovascular Disorders -- 2026/2027
Q1 Question 1 of 150
A 68-year-old male presents to the emergency department with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. The 12-lead ECG shows ST-segment elevation in
leads V2 through V4. The nurse should recognize these findings as indicative of which condition?
A. Acute myocardial infarction of the anterior wall
B. Unstable angina
C. Pericarditis
D. Costochondritis
Correct Answer: A
Rationale:
ST-segment elevation in leads V2-V4 indicates an acute ST-elevation myocardial infarction (STEMI) of the
anterior wall. Unstable angina does not produce ST elevation, pericarditis causes diffuse ST elevation, and
costochondritis is musculoskeletal chest pain without ECG changes.
Q2 Question 2 of 150
A patient with heart failure has a B-type natriuretic peptide level of 800 pg/mL. The nurse understands
that this value indicates which clinical situation?
A. Normal cardiac function
B. Significant heart failure with ventricular overload
C. Mild dehydration
D. Renal insufficiency only
Correct Answer: B
Rationale:
BNP levels above 400 pg/mL indicate significant heart failure. BNP is released by the ventricles in response to
increased pressure and volume overload. Normal levels are below 100 pg/mL. While renal insufficiency can
mildly elevate BNP, a level of 800 pg/mL strongly indicates heart failure.
,Q3 Question 3 of 150
A nurse is administering digoxin to a patient with heart failure and notes the patient's serum
potassium level is 3.0 mEq/L. The nurse should take which action?
A. Administer the digoxin as scheduled
B. Double the digoxin dose
C. Hold the digoxin and notify the healthcare provider about the hypokalemia
D. Administer the digoxin with a potassium supplement
Correct Answer: C
Rationale:
Hypokalemia increases the risk of digoxin toxicity because potassium competes with digoxin for binding sites
on the myocardial cells. When potassium is low, more digoxin binds, increasing its effect and toxicity risk. The
nurse should hold the medication and notify the provider for potassium replacement.
Q4 Question 4 of 150
A patient with atrial fibrillation is prescribed warfarin therapy. The nurse should teach the patient that
the target INR range for atrial fibrillation is which of the following?
A. 1.0 to 1.5
B. 5.0 to 6.0
C. 3.5 to 4.5
D. 2.0 to 3.0
Correct Answer: D
Rationale:
The target INR for patients with atrial fibrillation on warfarin therapy is 2.0 to 3.0. This range provides
adequate anticoagulation to prevent thromboembolic events while minimizing bleeding risk. An INR below 2.0
is insufficient, and an INR above 3.0 increases bleeding risk significantly.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 150
A 72-year-old patient with a history of hypertension develops sudden severe tearing chest pain that
radiates to the back. Blood pressure is 180/110 mmHg in the right arm and 130/80 mmHg in the left
arm. The nurse should suspect which life-threatening condition?
A. Aortic dissection
B. Acute myocardial infarction
C. Pulmonary embolism
D. Tension pneumothorax
Correct Answer: A
Rationale:
Sudden tearing chest pain radiating to the back with a significant blood pressure difference between arms is
the classic presentation of aortic dissection. The blood pressure discrepancy results from the dissection
involving the subclavian artery. MI causes crushing pain, PE causes pleuritic pain, and pneumothorax causes
sharp unilateral pain.
Q6 Question 6 of 150
A patient undergoes cardiac catheterization via the right femoral artery. Post-procedure, the nurse
should monitor for which most common complication at the insertion site?
A. Infection at the catheter site
B. Bleeding or hematoma formation at the femoral access site
C. Pneumothorax
D. Spinal cord compression
Correct Answer: B
Rationale:
Bleeding and hematoma formation at the femoral access site are the most common complications after
cardiac catheterization due to the large-bore needle used and the high pressure in the femoral artery. The
nurse should monitor the site frequently, check distal pulses, and ensure the patient remains on bed rest.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 4
NUR 265
Exam 1 - Versions 1, 2, and 3
Official Practice Exam
2026/2027 Edition
QUESTIONS MINUTES PASSING SCORE RECERTIFICATION
150 180 80% N/A
Table of Contents
Section 1: Cardiovascular Disorders ........... 25 Questions (Q1-Q25)
Section 2: Respiratory Disorders ........... 25 Questions (Q26-Q50)
Section 3: Hematologic and Immune Disorders ........... 25 Questions (Q51-Q75)
Section 4: Neurological Disorders ........... 25 Questions (Q76-Q100)
Section 5: Musculoskeletal and Connective Tissue Disorders ........... 25 Questions (Q101-Q125)
Section 6: Eye, Ear, and Sensory Disorders ........... 25 Questions (Q126-Q150)
Instructions
This practice exam contains 150 multiple-choice questions divided into 6 sections covering NUR 265 Exam 1
content (Versions 1, 2, and 3). Each question has four answer choices (A through D). Select the one best answer
for each question. You have 180 minutes to complete the exam. A score of 80% or higher (120 out of 150
questions correct) is required to pass. Read each question carefully, noting the clinical scenario before selecting
your answer. Review the rationale provided after each question for learning purposes.
Disclaimer: This is a practice exam for study purposes only. It is not affiliated with or endorsed by Galen College of Nursing.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 1
, Section 1: Cardiovascular Disorders -- 2026/2027
Q1 Question 1 of 150
A 68-year-old male presents to the emergency department with crushing substernal chest pain
radiating to the left arm, diaphoresis, and nausea. The 12-lead ECG shows ST-segment elevation in
leads V2 through V4. The nurse should recognize these findings as indicative of which condition?
A. Acute myocardial infarction of the anterior wall
B. Unstable angina
C. Pericarditis
D. Costochondritis
Correct Answer: A
Rationale:
ST-segment elevation in leads V2-V4 indicates an acute ST-elevation myocardial infarction (STEMI) of the
anterior wall. Unstable angina does not produce ST elevation, pericarditis causes diffuse ST elevation, and
costochondritis is musculoskeletal chest pain without ECG changes.
Q2 Question 2 of 150
A patient with heart failure has a B-type natriuretic peptide level of 800 pg/mL. The nurse understands
that this value indicates which clinical situation?
A. Normal cardiac function
B. Significant heart failure with ventricular overload
C. Mild dehydration
D. Renal insufficiency only
Correct Answer: B
Rationale:
BNP levels above 400 pg/mL indicate significant heart failure. BNP is released by the ventricles in response to
increased pressure and volume overload. Normal levels are below 100 pg/mL. While renal insufficiency can
mildly elevate BNP, a level of 800 pg/mL strongly indicates heart failure.
,Q3 Question 3 of 150
A nurse is administering digoxin to a patient with heart failure and notes the patient's serum
potassium level is 3.0 mEq/L. The nurse should take which action?
A. Administer the digoxin as scheduled
B. Double the digoxin dose
C. Hold the digoxin and notify the healthcare provider about the hypokalemia
D. Administer the digoxin with a potassium supplement
Correct Answer: C
Rationale:
Hypokalemia increases the risk of digoxin toxicity because potassium competes with digoxin for binding sites
on the myocardial cells. When potassium is low, more digoxin binds, increasing its effect and toxicity risk. The
nurse should hold the medication and notify the provider for potassium replacement.
Q4 Question 4 of 150
A patient with atrial fibrillation is prescribed warfarin therapy. The nurse should teach the patient that
the target INR range for atrial fibrillation is which of the following?
A. 1.0 to 1.5
B. 5.0 to 6.0
C. 3.5 to 4.5
D. 2.0 to 3.0
Correct Answer: D
Rationale:
The target INR for patients with atrial fibrillation on warfarin therapy is 2.0 to 3.0. This range provides
adequate anticoagulation to prevent thromboembolic events while minimizing bleeding risk. An INR below 2.0
is insufficient, and an INR above 3.0 increases bleeding risk significantly.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 3
, Q5 Question 5 of 150
A 72-year-old patient with a history of hypertension develops sudden severe tearing chest pain that
radiates to the back. Blood pressure is 180/110 mmHg in the right arm and 130/80 mmHg in the left
arm. The nurse should suspect which life-threatening condition?
A. Aortic dissection
B. Acute myocardial infarction
C. Pulmonary embolism
D. Tension pneumothorax
Correct Answer: A
Rationale:
Sudden tearing chest pain radiating to the back with a significant blood pressure difference between arms is
the classic presentation of aortic dissection. The blood pressure discrepancy results from the dissection
involving the subclavian artery. MI causes crushing pain, PE causes pleuritic pain, and pneumothorax causes
sharp unilateral pain.
Q6 Question 6 of 150
A patient undergoes cardiac catheterization via the right femoral artery. Post-procedure, the nurse
should monitor for which most common complication at the insertion site?
A. Infection at the catheter site
B. Bleeding or hematoma formation at the femoral access site
C. Pneumothorax
D. Spinal cord compression
Correct Answer: B
Rationale:
Bleeding and hematoma formation at the femoral access site are the most common complications after
cardiac catheterization due to the large-bore needle used and the high pressure in the femoral artery. The
nurse should monitor the site frequently, check distal pulses, and ensure the patient remains on bed rest.
NUR 265 Exam 1 -- 2026/2027 | Passing Score: 80% | Page 4
