NUR 265 EXAM MEDICAL SURGICAL NURSING EXAM 2 ACTUAL 2026/2027 ACCURATE EXAM APPROVED QUESTIONS AND CORRECT VERIFIED ANSWERS WITH DETAILED RATIONALES (A NEW UPDATED VERSION 2026 EDITION) |GUARANTEED PASS A+ (BRAND NEW!) FULL REVISED NUR 265 EXAM 2

NUR 265 EXAM MEDICAL SURGICAL NURSING EXAM 2
ACTUAL 2026/2027 ACCURATE EXAM APPROVED
QUESTIONS AND CORRECT VERIFIED ANSWERS WITH
DETAILED RATIONALES (A NEW UPDATED VERSION 2026
EDITION) |GUARANTEED PASS A+ (BRAND NEW!) FULL
REVISED NUR 265 EXAM 2



1. A patient with chronic heart failure is prescribed digoxin. Which finding
requires immediate nursing intervention?

 A. Apical pulse of 62 beats per minute
 B. Serum potassium level of 4.2 me/L
 C. Serum digoxin level of 2.5 ng/mL
CORRECT ANSWER – A digoxin level above 2.0 ng/mL is toxic.
Signs of toxicity include nausea, vomiting, bradycardia, and visual
disturbances. Immediate action includes holding the drug and notifying
the provider.
 D. Blood pressure of 130/80 mm Hg

2. In managing a patient with cirrhosis and ascites, which dietary
modification is most appropriate?

 A. High-protein, high-sodium diet
 B. Low-protein, low-potassium diet
 C. Low-sodium, moderate-protein diet
CORRECT ANSWER – Sodium restriction reduces fluid retention in
ascites. Moderate protein is needed to prevent muscle wasting but avoid
precipitating hepatic encephalopathy.
 D. High-carbohydrate, high-fat diet

3. A nurse assesses a patient with acute pancreatitis. Which laboratory
finding is most consistent with this diagnosis?

 A. Decreased serum glucose

, B. Serum lipase elevated to 600 U/L
CORRECT ANSWER – Lipase is more specific than amylase for
pancreatitis. Levels typically rise 3–6 times above normal (normal range
0–160 U/L) within 24 hours of onset.
 C. Decreased serum calcium
 D. Elevated hemoglobin

4. Which EKG change is characteristic of hypokalemia?

 A. Peaked T waves
 B. U waves
CORRECT ANSWER – Hypokalemia (low potassium) causes
repolarization abnormalities including U waves, flattened T waves, and
ST depression.
 C. Widened QRS complex
 D. Prolonged PR interval

5. A patient with chronic kidney disease (CKD) stage 4 is being
discharged. Which statement indicates effective teaching?

 A. “I will eat bananas daily to prevent muscle cramps.”
 B. “I will avoid NSAIDs like ibuprofen for pain.”
CORRECT ANSWER – NSAIDs reduce renal perfusion and can
accelerate CKD progression. Patients should use acetaminophen instead.
 C. “I will limit my fluid intake to 4 liters per day.”
 D. “I will take magnesium supplements for leg cramps.”

6. For a patient with diabetic ketoacidosis (DKA), which initial IV fluid is
recommended?

 A. 0.9% normal saline
CORRECT ANSWER – Normal saline restores intravascular volume
and corrects hypotension. It is the first-line fluid before transitioning to
half-normal saline once hemodynamically stable.
 B. 0.45% normal saline
 C. Dextrose 5% in water

, D. Lactated Ringer’s solution

7. A patient receiving heparin for a pulmonary embolism develops sudden
back pain and hypotension. Which action is most important?

 A. Administer protamine sulfate
 B. Obtain a complete blood count
CORRECT ANSWER – Sudden back pain and hypotension suggest
adrenal hemorrhage due to heparin-induced thrombocytopenia (HIT).
CBC confirms platelet drop.
 C. Increase heparin drip rate
 D. Place patient in Trendelenburg position

8. Which assessment finding in a patient with acute respiratory distress
syndrome (ARDS) requires immediate action?

 A. PaO2 of 65 mm Hg on FiO2 0.5
 B. Pulse oximetry 82% despite 100% non-rebreather
CORRECT ANSWER – Refractory hypoxemia is hallmark of ARDS.
This finding indicates need for intubation and mechanical ventilation
with PEEP.
 C. Respiratory rate of 22 breaths per minute
 D. Bilateral crackles on auscultation

9. A patient with liver failure has an ammonia level of 180 mcg/ld. Which
clinical manifestation is most expected?

 A. Asterisks
CORRECT ANSWER – Asterisks (liver flap) is a sign of hepatic
encephalopathy from hyperammonemia. Normal ammonia is 15–60
mcg/ld.
 B. Polyuria
 C. Hypertension
 D. Hyperreflexia

, 10. The nurse is caring for a patient with syndrome of inappropriate
antidiuretic hormone (SIADH). Which priority intervention should be
implemented?

 A. Strict fluid restriction
CORRECT ANSWER – SIADH causes water retention and
hyponatremia. Fluid restriction (usually 500–1000 mL/day) is first-line
to increase serum sodium.
 B. Administer hypertonic saline rapidly
 C. Encourage high fluid intake
 D. Place on fall precautions only

11. A patient with acute kidney injury (AKI) has a potassium level of
6.8 me/L. Which medication should the nurse prepare to administer
first?

 A. Calcium gluconate
CORRECT ANSWER – Calcium gluconate stabilizes cardiac
membranes to prevent dysrhythmias. It works within minutes but does
not lower potassium.
 B. Sodium polystyrene sulfonate (Kayexalate)
 C. Regular insulin with dextrose
 D. Furosemide

12. Which finding in a patient with hypothyroidism requires
immediate provider notification?

 A. Heart rate of 58 beats per minute
 B. Dry skin and hair loss
 C. Temperature of 95.2°F (35.1°C)
CORRECT ANSWER – Hypothermia suggests myxedema coma, a
life-threatening emergency. Other signs include bradycardia,
hypoventilation, and altered mental status.
 D. Constipation for 3 days