NUR 265
OBJECTIVE ASSESSMENT - EXAM
NUR 265 Exam 3
Medical-Surgical Nursing (2026/2027)
Galen College of Nursing
50 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders Respiratory Disorders
Gastrointestinal Disorders Endocrine & Metabolic Disorders
Renal & Urinary Disorders Critical Thinking & Prioritization
COVER PAGE - 1
NUR 265 - 2026/2027 | Passing Score: 80% | Page 1 of 1
, 1 SECTION 1 | Cardiovascular Disorders | Q1-Q10 | NUR 265 2026/2027
Q1 Question 1 of 50
Q1. A 68-year-old male is admitted with chest pain radiating to his left arm. His troponin I level is
elevated at 2.8 ng/mL, and ST-segment elevation is noted in leads V1-V4. Which nursing
intervention should be the highest priority before the patient undergoes percutaneous coronary
intervention?
A. Administer chewable aspirin 325 mg if not already given
B. Obtain a detailed family history of cardiac disease
C. Schedule a follow-up appointment with cardiology for next week
D. Teach the patient about low-sodium dietary restrictions
Correct Answer: A
Rationale:
In STEMI, aspirin administration is a time-critical intervention that reduces mortality and should be given within
minutes of arrival if not already administered by EMS. While family history and dietary teaching are important, they
are not priority actions in the acute phase.
Q2 Question 2 of 50
Q2. A 72-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg daily. Her
INR today is 4.2, and she reports dark tarry stools. What is the nurse's most appropriate
immediate action?
A. Instruct the patient to increase fluid intake and monitor at home
B. Hold the next dose of warfarin and notify the provider immediately
C. Administer vitamin K 10 mg orally and continue the warfarin
D. Recheck the INR in 24 hours before making any medication changes
Correct Answer: B
Rationale:
An INR of 4.2 with signs of gastrointestinal bleeding (dark tarry stools) indicates supratherapeutic anticoagulation
with active bleeding. The nurse must hold the warfarin and notify the provider immediately. Vitamin K is reserved
for life-threatening bleeding and requires provider orders.
NUR 265 - 2026/2027 | Passing Score: 80% | Page 2 of 1
, 1 SECTION 1 | Cardiovascular Disorders | Q1-Q10 | NUR 265 2026/2027
Q3 Question 3 of 50
Q3. A 55-year-old male post-coronary artery bypass graft (CABG) day 2 develops sudden
dyspnea, tachycardia, and a drop in blood pressure from 128/82 to 88/56 mmHg. His chest tube
output has decreased significantly. What complication should the nurse suspect first?
A. Pulmonary embolism
B. Acute graft rejection
C. Cardiac tamponade
D. Postoperative pneumonia
Correct Answer: C
Rationale:
The triad of hypotension, tachycardia, and decreased chest tube output in a post-CABG patient is classic for
cardiac tamponade due to blood accumulating in the pericardial sac. This is a surgical emergency requiring
immediate intervention. Pulmonary embolism would typically present with pleuritic chest pain and hypoxemia.
Q4 Question 4 of 50
Q4. A 60-year-old female with heart failure has a daily weight gain of 3 pounds, increased
peripheral edema, and reports sleeping on three pillows instead of one. Her furosemide dose
was recently decreased. What assessment finding would most strongly indicate the need for
immediate provider notification?
A. Mild ankle swelling that resolves with leg elevation
B. A 2-pound weight gain over the past week
C. Occasional dry cough in the morning hours
D. Crackles heard bilaterally at the lung bases
Correct Answer: D
Rationale:
Bilateral crackles at the lung bases indicate pulmonary edema, a sign of acute decompensated heart failure
requiring immediate intervention. Mild ankle swelling and a 2-pound weight gain are expected findings in chronic
heart failure, while an occasional dry cough is not an acute concern.
NUR 265 - 2026/2027 | Passing Score: 80% | Page 3 of 1
OBJECTIVE ASSESSMENT - EXAM
NUR 265 Exam 3
Medical-Surgical Nursing (2026/2027)
Galen College of Nursing
50 100% 2026/2027
QUESTIONS VERIFIED ANSWERS EDITION
TOPICS COVERED
Cardiovascular Disorders Respiratory Disorders
Gastrointestinal Disorders Endocrine & Metabolic Disorders
Renal & Urinary Disorders Critical Thinking & Prioritization
COVER PAGE - 1
NUR 265 - 2026/2027 | Passing Score: 80% | Page 1 of 1
, 1 SECTION 1 | Cardiovascular Disorders | Q1-Q10 | NUR 265 2026/2027
Q1 Question 1 of 50
Q1. A 68-year-old male is admitted with chest pain radiating to his left arm. His troponin I level is
elevated at 2.8 ng/mL, and ST-segment elevation is noted in leads V1-V4. Which nursing
intervention should be the highest priority before the patient undergoes percutaneous coronary
intervention?
A. Administer chewable aspirin 325 mg if not already given
B. Obtain a detailed family history of cardiac disease
C. Schedule a follow-up appointment with cardiology for next week
D. Teach the patient about low-sodium dietary restrictions
Correct Answer: A
Rationale:
In STEMI, aspirin administration is a time-critical intervention that reduces mortality and should be given within
minutes of arrival if not already administered by EMS. While family history and dietary teaching are important, they
are not priority actions in the acute phase.
Q2 Question 2 of 50
Q2. A 72-year-old female with a history of atrial fibrillation is prescribed warfarin 5 mg daily. Her
INR today is 4.2, and she reports dark tarry stools. What is the nurse's most appropriate
immediate action?
A. Instruct the patient to increase fluid intake and monitor at home
B. Hold the next dose of warfarin and notify the provider immediately
C. Administer vitamin K 10 mg orally and continue the warfarin
D. Recheck the INR in 24 hours before making any medication changes
Correct Answer: B
Rationale:
An INR of 4.2 with signs of gastrointestinal bleeding (dark tarry stools) indicates supratherapeutic anticoagulation
with active bleeding. The nurse must hold the warfarin and notify the provider immediately. Vitamin K is reserved
for life-threatening bleeding and requires provider orders.
NUR 265 - 2026/2027 | Passing Score: 80% | Page 2 of 1
, 1 SECTION 1 | Cardiovascular Disorders | Q1-Q10 | NUR 265 2026/2027
Q3 Question 3 of 50
Q3. A 55-year-old male post-coronary artery bypass graft (CABG) day 2 develops sudden
dyspnea, tachycardia, and a drop in blood pressure from 128/82 to 88/56 mmHg. His chest tube
output has decreased significantly. What complication should the nurse suspect first?
A. Pulmonary embolism
B. Acute graft rejection
C. Cardiac tamponade
D. Postoperative pneumonia
Correct Answer: C
Rationale:
The triad of hypotension, tachycardia, and decreased chest tube output in a post-CABG patient is classic for
cardiac tamponade due to blood accumulating in the pericardial sac. This is a surgical emergency requiring
immediate intervention. Pulmonary embolism would typically present with pleuritic chest pain and hypoxemia.
Q4 Question 4 of 50
Q4. A 60-year-old female with heart failure has a daily weight gain of 3 pounds, increased
peripheral edema, and reports sleeping on three pillows instead of one. Her furosemide dose
was recently decreased. What assessment finding would most strongly indicate the need for
immediate provider notification?
A. Mild ankle swelling that resolves with leg elevation
B. A 2-pound weight gain over the past week
C. Occasional dry cough in the morning hours
D. Crackles heard bilaterally at the lung bases
Correct Answer: D
Rationale:
Bilateral crackles at the lung bases indicate pulmonary edema, a sign of acute decompensated heart failure
requiring immediate intervention. Mild ankle swelling and a 2-pound weight gain are expected findings in chronic
heart failure, while an occasional dry cough is not an acute concern.
NUR 265 - 2026/2027 | Passing Score: 80% | Page 3 of 1
