NUR 265/ NUR265 Exam 4– (New 2026/ 2027
Update) Advanced Concepts of Medical-
Surgical Nursing Guide| Questions & Answers |
Grade A| 100% Correct (Verified Solutions)-
Galen
Question 1
The nurse is teaching a client with a new prescription for an EpiPen. Which
statement by the client indicates correct understanding?
A) "I will store the EpiPen in my car's glove compartment for easy access."
B) "I will inject the medication into the top of my thigh, slightly to the
outside."
C) "I should wait 30 minutes after using the EpiPen before going to the
hospital."
D) "I can reuse the same EpiPen if symptoms return within an hour."
Correct ,,,answer,,,,: B. "I will inject the medication into the top of my
thigh, slightly to the outside."
Rationale: The EpiPen is designed for intramuscular injection into the
vastus lateralis (top, outer thigh) and can be administered through
clothing. Clients must carry the device with them at all times and call 911
immediately after use, as the effects are temporary .
,Question 2
A client with AIDS is admitted with a new diagnosis of cryptococcal
meningitis. Which nursing action is a priority?
A) Initiate seizure precautions with padded side rails.
B) Place the client on a pressure-relieving mattress.
C) Restrict visitors to immediate family only.
D) Administer oral antifungal medication.
Correct ,,,answer,,,,: A. Initiate seizure precautions with padded side
rails.
Rationale: Cryptococcal meningitis causes increased intracranial
pressure and central nervous system irritation, placing the patient at high
risk for seizures. Safety is the priority. Oral antifungals are typically not
used for acute meningitis; IV Amphotericin B is standard .
Question 3
The nurse is caring for a client who received a kidney transplant two
weeks ago. Which assessment finding is most indicative of potential
organ rejection?
A) Blood pressure of 172/96 mm Hg.
B) Temperature of 99.0°F (37.2°C).
C) Urine output of 100 mL/hr.
D) Serum creatinine of 1.0 mg/dL.
Correct ,,,answer,,,,: A. Blood pressure of 172/96 mm Hg.
Rationale: Hypertension is a clinical sign of kidney rejection due to fluid
retention and activation of the renin-angiotensin system. Elevated
,BUN/Creatinine, fever, and oliguria are also signs, but significantly
elevated BP is a specific correlating finding .
Question 4
The nurse has provided discharge teaching to a client with chronic
pancreatitis. Which statement indicates correct understanding?
A) "I will take my prescribed pancreatic enzymes with meals and snacks."
B) "I will eat three large meals a day and avoid snacking."
C) "I should expect my stools to become progressively frothy and foul-
smelling."
D) "I will use spices like cayenne pepper to season my food instead of
salt."
Correct ,,,answer,,,,: A. "I will take my prescribed pancreatic enzymes
with meals and snacks."
Rationale: Pancreatic enzymes (e.g., pancrelipase) must be taken with
every meal and snack to aid in the digestion of fats and proteins.
Steatorrhea (frothy/foul stools) is a sign of malabsorption that the
enzymes aim to prevent, not an expected outcome .
Question 5
A client with systemic lupus erythematosus (SLE) asks the nurse about
self-care practices. Which statement indicates a need for additional
teaching?
A) "I should inspect my skin daily for rashes."
B) "I should limit my exposure to direct sunlight to 30 continuous minutes
, each day."
C) "I should check my temperature on a regular basis."
D) "I should take my prescribed steroids in the morning."
Correct ,,,answer,,,,: B. "I should limit my exposure to direct sunlight to
30 continuous minutes each day."
Rationale: SLE is photosensitive; UV light can trigger a flare. Clients
should avoid sun exposure as much as possible, use high-SPF sunscreen,
and wear protective clothing. Even 30 minutes of direct sunlight is too
much exposure .
Question 6
A client with a pulmonary embolism (PE) develops jugular venous
distention (JVD) and syncope. Vital signs show hypotension. What is the
priority nursing action?
A) Obtain a stat 12-lead ECG.
B) Administer a 500 mL normal saline bolus.
C) Apply oxygen and call the Rapid Response Team (RRT).
D) Place the client in Trendelenburg position.
Correct ,,,answer,,,,: C. Apply oxygen and call the Rapid Response
Team (RRT).
Rationale: JVD, syncope, and hypotension indicate a massive PE causing
right heart failure and obstructive shock. This is a life-threatening
emergency requiring immediate intervention. Oxygen is the first step,
followed by emergency response .
Update) Advanced Concepts of Medical-
Surgical Nursing Guide| Questions & Answers |
Grade A| 100% Correct (Verified Solutions)-
Galen
Question 1
The nurse is teaching a client with a new prescription for an EpiPen. Which
statement by the client indicates correct understanding?
A) "I will store the EpiPen in my car's glove compartment for easy access."
B) "I will inject the medication into the top of my thigh, slightly to the
outside."
C) "I should wait 30 minutes after using the EpiPen before going to the
hospital."
D) "I can reuse the same EpiPen if symptoms return within an hour."
Correct ,,,answer,,,,: B. "I will inject the medication into the top of my
thigh, slightly to the outside."
Rationale: The EpiPen is designed for intramuscular injection into the
vastus lateralis (top, outer thigh) and can be administered through
clothing. Clients must carry the device with them at all times and call 911
immediately after use, as the effects are temporary .
,Question 2
A client with AIDS is admitted with a new diagnosis of cryptococcal
meningitis. Which nursing action is a priority?
A) Initiate seizure precautions with padded side rails.
B) Place the client on a pressure-relieving mattress.
C) Restrict visitors to immediate family only.
D) Administer oral antifungal medication.
Correct ,,,answer,,,,: A. Initiate seizure precautions with padded side
rails.
Rationale: Cryptococcal meningitis causes increased intracranial
pressure and central nervous system irritation, placing the patient at high
risk for seizures. Safety is the priority. Oral antifungals are typically not
used for acute meningitis; IV Amphotericin B is standard .
Question 3
The nurse is caring for a client who received a kidney transplant two
weeks ago. Which assessment finding is most indicative of potential
organ rejection?
A) Blood pressure of 172/96 mm Hg.
B) Temperature of 99.0°F (37.2°C).
C) Urine output of 100 mL/hr.
D) Serum creatinine of 1.0 mg/dL.
Correct ,,,answer,,,,: A. Blood pressure of 172/96 mm Hg.
Rationale: Hypertension is a clinical sign of kidney rejection due to fluid
retention and activation of the renin-angiotensin system. Elevated
,BUN/Creatinine, fever, and oliguria are also signs, but significantly
elevated BP is a specific correlating finding .
Question 4
The nurse has provided discharge teaching to a client with chronic
pancreatitis. Which statement indicates correct understanding?
A) "I will take my prescribed pancreatic enzymes with meals and snacks."
B) "I will eat three large meals a day and avoid snacking."
C) "I should expect my stools to become progressively frothy and foul-
smelling."
D) "I will use spices like cayenne pepper to season my food instead of
salt."
Correct ,,,answer,,,,: A. "I will take my prescribed pancreatic enzymes
with meals and snacks."
Rationale: Pancreatic enzymes (e.g., pancrelipase) must be taken with
every meal and snack to aid in the digestion of fats and proteins.
Steatorrhea (frothy/foul stools) is a sign of malabsorption that the
enzymes aim to prevent, not an expected outcome .
Question 5
A client with systemic lupus erythematosus (SLE) asks the nurse about
self-care practices. Which statement indicates a need for additional
teaching?
A) "I should inspect my skin daily for rashes."
B) "I should limit my exposure to direct sunlight to 30 continuous minutes
, each day."
C) "I should check my temperature on a regular basis."
D) "I should take my prescribed steroids in the morning."
Correct ,,,answer,,,,: B. "I should limit my exposure to direct sunlight to
30 continuous minutes each day."
Rationale: SLE is photosensitive; UV light can trigger a flare. Clients
should avoid sun exposure as much as possible, use high-SPF sunscreen,
and wear protective clothing. Even 30 minutes of direct sunlight is too
much exposure .
Question 6
A client with a pulmonary embolism (PE) develops jugular venous
distention (JVD) and syncope. Vital signs show hypotension. What is the
priority nursing action?
A) Obtain a stat 12-lead ECG.
B) Administer a 500 mL normal saline bolus.
C) Apply oxygen and call the Rapid Response Team (RRT).
D) Place the client in Trendelenburg position.
Correct ,,,answer,,,,: C. Apply oxygen and call the Rapid Response
Team (RRT).
Rationale: JVD, syncope, and hypotension indicate a massive PE causing
right heart failure and obstructive shock. This is a life-threatening
emergency requiring immediate intervention. Oxygen is the first step,
followed by emergency response .
