NU 185 Exam 1 Medical-Surgical Nursing II (2026) Galen College
1. A nurse is assessing a client with left-sided heart failure. Which of the
following findings should the nurse expect?
A. Jugular venous distension
B. Crackles in the lungs
C. Peripheral edema
D. Abdominal distension
Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion, leading to symptoms
like crackles, dyspnea, and orthopnea. Right-sided failure causes systemic congestion such
as JVD and peripheral edema.
2. Which clinical manifestation is a late sign of hypoxia in a client with
respiratory distress?
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Tachypnea
Answer: C
Rationale: Cyanosis is a late sign of hypoxia. Restlessness, tachycardia, and tachypnea are
typically early compensatory signs of decreasing oxygen levels.
,3. A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery device is most appropriate to provide a precise concentration of
oxygen?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: A Venturi mask is the best device for clients with COPD because it provides a
specific, precise concentration of oxygen to prevent suppressing the hypoxic drive.
4. When assessing a client for Trousseau’s sign, which electrolyte imbalance is
the nurse testing for?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypermagnesemia
Answer: A
Rationale: Trousseau’s sign (carpal spasm induced by inflating a blood pressure cuff) and
Chvostek’s sign are classic indicators of hypocalcemia.
5. Which medication is considered the ‘gold standard’ for the rapid relief of
acute asthma symptoms?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
, Rationale: Albuterol is a short-acting beta2-agonist (SABA) used as a rescue inhaler for
acute bronchospasm. Salmeterol is long-acting and fluticasone is a maintenance
corticosteroid.
6. A client with a history of hypertension is prescribed an ACE inhibitor. Which
adverse effect should the nurse instruct the client to report immediately?
A. Dry cough
B. Swelling of the face or tongue
C. Increased urination
D. Metallic taste
Answer: B
Rationale: Angioedema (swelling of the face, lips, or tongue) is a life-threatening adverse
effect of ACE inhibitors. A dry cough is common but not immediately life-threatening.
7. Which laboratory value is most indicative of myocardial infarction damage?
A. Creatinine kinase (CK)
B. Brain Natriuretic Peptide (BNP)
C. Troponin I
D. C-reactive protein (CRP)
Answer: C
Rationale: Troponin I is highly specific to cardiac muscle and remains elevated for several
days following a myocardial infarction.
8. A client is diagnosed with Tuberculosis (TB). Which type of isolation
precautions must be implemented?
A. Airborne
B. Droplet
C. Contact
D. Protective environment
Answer: A
1. A nurse is assessing a client with left-sided heart failure. Which of the
following findings should the nurse expect?
A. Jugular venous distension
B. Crackles in the lungs
C. Peripheral edema
D. Abdominal distension
Answer: B
Rationale: Left-sided heart failure results in pulmonary congestion, leading to symptoms
like crackles, dyspnea, and orthopnea. Right-sided failure causes systemic congestion such
as JVD and peripheral edema.
2. Which clinical manifestation is a late sign of hypoxia in a client with
respiratory distress?
A. Restlessness
B. Tachycardia
C. Cyanosis
D. Tachypnea
Answer: C
Rationale: Cyanosis is a late sign of hypoxia. Restlessness, tachycardia, and tachypnea are
typically early compensatory signs of decreasing oxygen levels.
,3. A client is admitted with an acute exacerbation of COPD. Which oxygen
delivery device is most appropriate to provide a precise concentration of
oxygen?
A. Nasal cannula
B. Simple face mask
C. Venturi mask
D. Non-rebreather mask
Answer: C
Rationale: A Venturi mask is the best device for clients with COPD because it provides a
specific, precise concentration of oxygen to prevent suppressing the hypoxic drive.
4. When assessing a client for Trousseau’s sign, which electrolyte imbalance is
the nurse testing for?
A. Hypocalcemia
B. Hyperkalemia
C. Hyponatremia
D. Hypermagnesemia
Answer: A
Rationale: Trousseau’s sign (carpal spasm induced by inflating a blood pressure cuff) and
Chvostek’s sign are classic indicators of hypocalcemia.
5. Which medication is considered the ‘gold standard’ for the rapid relief of
acute asthma symptoms?
A. Salmeterol
B. Albuterol
C. Fluticasone
D. Montelukast
Answer: B
, Rationale: Albuterol is a short-acting beta2-agonist (SABA) used as a rescue inhaler for
acute bronchospasm. Salmeterol is long-acting and fluticasone is a maintenance
corticosteroid.
6. A client with a history of hypertension is prescribed an ACE inhibitor. Which
adverse effect should the nurse instruct the client to report immediately?
A. Dry cough
B. Swelling of the face or tongue
C. Increased urination
D. Metallic taste
Answer: B
Rationale: Angioedema (swelling of the face, lips, or tongue) is a life-threatening adverse
effect of ACE inhibitors. A dry cough is common but not immediately life-threatening.
7. Which laboratory value is most indicative of myocardial infarction damage?
A. Creatinine kinase (CK)
B. Brain Natriuretic Peptide (BNP)
C. Troponin I
D. C-reactive protein (CRP)
Answer: C
Rationale: Troponin I is highly specific to cardiac muscle and remains elevated for several
days following a myocardial infarction.
8. A client is diagnosed with Tuberculosis (TB). Which type of isolation
precautions must be implemented?
A. Airborne
B. Droplet
C. Contact
D. Protective environment
Answer: A
