NUR 265 Practice Exam Questions with
100% Correct Answers Latest Version Top
Rated A+
Question 1
The nurse is caring for assigned clients. It would be essential for the nurse to recognize that at
greatest risk for developing obstructive shock is the client who
A. was admitted 48 hours ago with deep partial-thickness burns covering 65% of the body.
B. was admitted 12 hours ago with a spinal cord injury.
C. developed ventricular fibrillation following myocardial infarction and requires defibrillation.
D. was admitted two days ago with cardiac tamponade.
Correct Answer
D. was admitted two days ago with cardiac tamponade.
a pt with cardiac tamponade is at risk of developing obstructive shock
Page 1 of 26
,Question 2
The nurse is caring for a client who was admitted to the ED with deep fill thickness burns to the full anterior and posterior
torso/chest, and the anterior and posterior surface of both arms. The client weighs 198 pounds. What is the amount of fluid
replacement required for the first 24 hours, using the Parkland formula when calculating the fluid replacement?
A. 8640 ml
B. 12960 ml
C. 10800 ml
D. 19400 ml
Correct Answer
D. 19400 ml
Question 3
The nurse is caring for assigned clients. It would be priority for the nurse to recommend an interdisciplinary care
conference for the client who is
A. 25 years-old and recently diagnosed with a concussion and contusion following a fall onto a concrete floor
B. 35 years-old and recently diagnosed with viral meningitis caused by herpes simplex virus.
C. 55 years-old recently diagnosed with facial paralysis of cranial nerve VII (Bells palsy)
D. 50 year old and has sustained full thickness burns over 40% of the including the face and neck
Correct Answer
D. 50 year old and has sustained full thickness burns over 40% of the including the face and neck
The burn patient needs interdisciplinary care and is the appropriate referral.
Page 2 of 26
, Question 4
The nurse is caring for a client who has a urinary tract infection (UTI) and ventilator acquired pneumonia (VAP). It would
indicate that the client is in the early phase of sepsis if there is an increasein the clients A. platelet count.
B. arterial carbon dioxide (PaCO2) level.
C. serum lactate level
D. creatinine level from 0.9 mg/dL to 1.8 mg/aL.
Correct Answer
C. serum lactate level
a hallmark sign of early sepsis is increasing lactate levels
Question 5
The nurse is caring for a client who was struck by lightning and brought to the ED by a neighbor. It would be appropriate
for the nurse to initially assess the client's
A. O2 and obtain ABGs
B. HR and rhythm and obtain an EKG
C. entrance and exit sites, and obtain cardiac enzymes
D. asess HR & rhythm, obtain EKG are priorities for electrical burn pts
Correct Answer
B. HR and rhythm and obtain an EKG
assess HR and rhythm, obtain EKG are priorities for electrical burn patients
Page 3 of 26
100% Correct Answers Latest Version Top
Rated A+
Question 1
The nurse is caring for assigned clients. It would be essential for the nurse to recognize that at
greatest risk for developing obstructive shock is the client who
A. was admitted 48 hours ago with deep partial-thickness burns covering 65% of the body.
B. was admitted 12 hours ago with a spinal cord injury.
C. developed ventricular fibrillation following myocardial infarction and requires defibrillation.
D. was admitted two days ago with cardiac tamponade.
Correct Answer
D. was admitted two days ago with cardiac tamponade.
a pt with cardiac tamponade is at risk of developing obstructive shock
Page 1 of 26
,Question 2
The nurse is caring for a client who was admitted to the ED with deep fill thickness burns to the full anterior and posterior
torso/chest, and the anterior and posterior surface of both arms. The client weighs 198 pounds. What is the amount of fluid
replacement required for the first 24 hours, using the Parkland formula when calculating the fluid replacement?
A. 8640 ml
B. 12960 ml
C. 10800 ml
D. 19400 ml
Correct Answer
D. 19400 ml
Question 3
The nurse is caring for assigned clients. It would be priority for the nurse to recommend an interdisciplinary care
conference for the client who is
A. 25 years-old and recently diagnosed with a concussion and contusion following a fall onto a concrete floor
B. 35 years-old and recently diagnosed with viral meningitis caused by herpes simplex virus.
C. 55 years-old recently diagnosed with facial paralysis of cranial nerve VII (Bells palsy)
D. 50 year old and has sustained full thickness burns over 40% of the including the face and neck
Correct Answer
D. 50 year old and has sustained full thickness burns over 40% of the including the face and neck
The burn patient needs interdisciplinary care and is the appropriate referral.
Page 2 of 26
, Question 4
The nurse is caring for a client who has a urinary tract infection (UTI) and ventilator acquired pneumonia (VAP). It would
indicate that the client is in the early phase of sepsis if there is an increasein the clients A. platelet count.
B. arterial carbon dioxide (PaCO2) level.
C. serum lactate level
D. creatinine level from 0.9 mg/dL to 1.8 mg/aL.
Correct Answer
C. serum lactate level
a hallmark sign of early sepsis is increasing lactate levels
Question 5
The nurse is caring for a client who was struck by lightning and brought to the ED by a neighbor. It would be appropriate
for the nurse to initially assess the client's
A. O2 and obtain ABGs
B. HR and rhythm and obtain an EKG
C. entrance and exit sites, and obtain cardiac enzymes
D. asess HR & rhythm, obtain EKG are priorities for electrical burn pts
Correct Answer
B. HR and rhythm and obtain an EKG
assess HR and rhythm, obtain EKG are priorities for electrical burn patients
Page 3 of 26
