NUR 265 Medical-Surgical Nursing – Comprehensive Practice Exam (Version 2) Galen College Style | 150 Questions | Answers & Rationales

NUR 265 Medical-Surgical Nursing –
Comprehensive Practice Exam (Version 2) Galen
College Style | 150 Questions | Answers &
Rationales


Study Tips for NUR 265 at Galen
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Focus on high-yield topics: Cardiovascular, respiratory, and endocrine
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make up ~60% of the exam
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Know your medications: MOA, side effects, nursing considerations
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N Practice prioritization: ABCs, Maslow, acute vs. chronic
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Review lab values: Potassium, sodium, glucose, INR, aPTT, creatinine
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N Use NCLEX-style questions daily
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Cardiovascular (Questions 1-20) N N




1. A client with unstable angina is receiving IV heparin. The nurse
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Nmonitors for which adverse effect?
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A. Hypertension
B. Bleeding
C. Bradycardia
D. Hyperglycemia

Answer: B. Bleeding N N


Rationale: Heparin is an anticoagulant; the primary adverse effect is
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bleeding. Monitor for bruising, hematuria, and bleeding gums.
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2. A client with heart failure is prescribed digoxin. Which finding
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Nindicates therapeutic effect?
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A. Heart rate 52 bpm N N N


B. Improved exercise tolerance and decreased dyspnea
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,C. Weight gain of 3 pounds N N N N


D. Blood pressure 90/60 mmHg
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Answer: B. Improved exercise tolerance and decreased dyspnea
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Rationale: Therapeutic effects of digoxin include increased cardiac output,
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improved symptoms, and decreased heart rate (but not bradycardia).
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3. A client with hypertension is prescribed hydrochlorothiazide.
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NWhich laboratory value should the nurse monitor?
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A. Potassium
B. Calcium
C. Glucose
D. All of the above
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Answer: D. All of the above
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Rationale: Thiazide diuretics can cause hypokalemia, hypercalcemia, and
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hyperglycemia.
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4. A client post-MI has a new murmur. Which complication does the
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nurse suspect?
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A. Pericarditis
B. Ventricular septal defect or papillary muscle rupture
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C. Heart failure N


D. Cardiogenic shock N




Answer: B. Ventricular septal defect or papillary muscle rupture
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Rationale: A new murmur after MI suggests mechanical complication such
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as VSD or mitral regurgitation from papillary muscle rupture.
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5. A client with peripheral artery disease (PAD) has a ankle-brachial
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Nindex (ABI) of 0.6. This indicates:
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A. Normal circulation N


B. Mild PAD N


C. Moderate to severe PAD N N N


D. No correlation
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,Answer: C. Moderate to severe PAD
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*Rationale: Normal ABI is 1.0-1.4. 0.5-0.8 indicates moderate to severe PAD;
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<0.5 indicates severe disease.*
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6. A client with a new onset of atrial fibrillation has a heart rate of 150
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Nbpm. What is the priority intervention?
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A. Administer warfarin N


B. Prepare for cardioversion
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C. Assess blood pressure and oxygen saturation
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D. Obtain a 12-lead ECG N N N




Answer: C. Assess blood pressure and oxygen saturation
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Rationale: Assess hemodynamic stability first. If unstable (hypotension,
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chest pain, altered mental status), immediate cardioversion is
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needed.
N




7. A client with infective endocarditis reports sudden severe left leg
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Npain, coldness, and pallor. What does the nurse suspect?
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A. Deep vein thrombosis
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B. Arterial embolizationN


C. Muscle strain N


D. Neuropathy

Answer: B. Arterial embolization
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Rationale: Vegetations from endocarditis can embolize to peripheral arteries,
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causing acute limb ischemia.
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8. A client with a permanent pacemaker has a heart rate of 50 bpm with
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Nno pacemaker spikes. What does this indicate?
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A. Normal function N


B. Failure to capture
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C. Failure to pace N N


D. Oversensing

Answer: C. Failure to pace
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Rationale: No spikes with a low heart rate indicates failure to pace. The
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pacemaker is not firing when it should.
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, 9. A client with cardiomyopathy is advised to restrict sodium. What is
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the primary reason?
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A. Prevent hypertension N


B. Reduce fluid retention and cardiac workload
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C. Improve kidney function N N


D. Prevent electrolyte imbalance
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Answer: B. Reduce fluid retention and cardiac workload
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Rationale: Sodium restriction reduces fluid retention, decreasing preload and
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cardiac workload in heart failure.
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10. A client with aortic stenosis has syncope with exertion. What is
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Nthe underlying cause?
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A. Dehydration
B. Fixed cardiac output unable to increase with activity
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C. Arrhythmia
D. Medication side effect N N




Answer: B. Fixed cardiac output unable to increase with activity
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Rationale: In aortic stenosis, the narrowed valve prevents adequate
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increase in cardiac output during exertion, causing syncope.
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11. A client with DVT is started on warfarin. The nurse teaches
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Nthat therapeutic effect takes:
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A. 1-2 hoursN


B. 24 hours
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C. 3-5 days N


D. 2 weeks
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Answer: C. 3-5 days
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*Rationale: Warfarin has a delayed onset. Heparin is used concurrently
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Nuntil INR reaches therapeutic range (usually 3-5 days).*
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12. A client with heart failure has crackles in both lungs and jugular
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Nvein distention. Which medication does the nurse anticipate?
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A. Metoprolol