NU 185 Exam 3 - Medical-Surgical Nursing II Comprehensive Study
Guide 2026 Galen College
1. A patient is admitted with a diagnosis of Atrial Fibrillation. The nurse should
be most concerned about which potential complication?
A. Peripheral edema
B. Ventricular hypertrophy
C. Hyperkalemia
D. Ischemic stroke
Answer: D
Rationale: Atrial fibrillation causes blood to pool in the atria, increasing the risk of
thrombus formation, which can lead to an embolic stroke.
2. A nurse is monitoring a patient on a ventilator. The ‘High Pressure’ alarm
begins to sound. Which of the following is a likely cause?
A. Disconnection from the ventilator
B. Endotracheal tube cuff leak
C. Patient biting the endotracheal tube
D. Extubation
Answer: C
Rationale: High-pressure alarms are triggered by increased resistance, such as biting the
tube, secretions, or kinks. Disconnections cause low-pressure alarms.
,3. Which hemodynamic parameter is the best indicator of fluid volume status in
a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Central Venous Pressure (CVP)
D. Cardiac Output (CO)
Answer: C
Rationale: CVP reflects the pressure in the right atrium and is used to estimate preload
and fluid volume status.
4. A patient with liver cirrhosis has a high ammonia level and is confused. Which
medication should the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to promote the excretion of ammonia through the stool in
patients with hepatic encephalopathy.
5. In Diabetic Ketoacidosis (DKA), the nurse would expect to see which
respiratory pattern?
A. Kussmaul respirations
B. Cheyne-Stokes respirations
C. Biot’s respirations
D. Hypoventilation
Answer: A
Rationale: Kussmaul respirations are deep, rapid breaths that the body uses to blow off
excess CO2 to compensate for metabolic acidosis.
, 6. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect?
A. Decreased heart rate
B. Cool, clammy skin
C. Increased urinary output
D. Metabolic alkalosis
Answer: B
Rationale: In the compensatory stage, blood is shunted away from the skin and kidneys to
vital organs, resulting in cool, clammy skin.
7. The nurse is caring for a patient with a chest tube. She notices ‘tidaling’ in the
water-seal chamber. What is the nurse’s best action?
A. Notify the physician immediately
B. Check the tube for kinks
C. Prepare for chest tube removal
D. Document this as a normal finding
Answer: D
Rationale: Tidaling (movement of the fluid level with respiration) is a normal finding in a
chest tube system.
8. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on PEEP.
What is the primary purpose of PEEP?
A. To decrease the work of breathing
B. To prevent alveolar collapse
C. To decrease intracranial pressure
D. To increase tidal volume
Answer: B
Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open at the end of
expiration to improve gas exchange.
Guide 2026 Galen College
1. A patient is admitted with a diagnosis of Atrial Fibrillation. The nurse should
be most concerned about which potential complication?
A. Peripheral edema
B. Ventricular hypertrophy
C. Hyperkalemia
D. Ischemic stroke
Answer: D
Rationale: Atrial fibrillation causes blood to pool in the atria, increasing the risk of
thrombus formation, which can lead to an embolic stroke.
2. A nurse is monitoring a patient on a ventilator. The ‘High Pressure’ alarm
begins to sound. Which of the following is a likely cause?
A. Disconnection from the ventilator
B. Endotracheal tube cuff leak
C. Patient biting the endotracheal tube
D. Extubation
Answer: C
Rationale: High-pressure alarms are triggered by increased resistance, such as biting the
tube, secretions, or kinks. Disconnections cause low-pressure alarms.
,3. Which hemodynamic parameter is the best indicator of fluid volume status in
a patient with hypovolemic shock?
A. Mean Arterial Pressure (MAP)
B. Systemic Vascular Resistance (SVR)
C. Central Venous Pressure (CVP)
D. Cardiac Output (CO)
Answer: C
Rationale: CVP reflects the pressure in the right atrium and is used to estimate preload
and fluid volume status.
4. A patient with liver cirrhosis has a high ammonia level and is confused. Which
medication should the nurse expect to administer?
A. Spironolactone
B. Propranolol
C. Furosemide
D. Lactulose
Answer: D
Rationale: Lactulose is used to promote the excretion of ammonia through the stool in
patients with hepatic encephalopathy.
5. In Diabetic Ketoacidosis (DKA), the nurse would expect to see which
respiratory pattern?
A. Kussmaul respirations
B. Cheyne-Stokes respirations
C. Biot’s respirations
D. Hypoventilation
Answer: A
Rationale: Kussmaul respirations are deep, rapid breaths that the body uses to blow off
excess CO2 to compensate for metabolic acidosis.
, 6. A patient is in the compensatory stage of shock. Which clinical manifestation
should the nurse expect?
A. Decreased heart rate
B. Cool, clammy skin
C. Increased urinary output
D. Metabolic alkalosis
Answer: B
Rationale: In the compensatory stage, blood is shunted away from the skin and kidneys to
vital organs, resulting in cool, clammy skin.
7. The nurse is caring for a patient with a chest tube. She notices ‘tidaling’ in the
water-seal chamber. What is the nurse’s best action?
A. Notify the physician immediately
B. Check the tube for kinks
C. Prepare for chest tube removal
D. Document this as a normal finding
Answer: D
Rationale: Tidaling (movement of the fluid level with respiration) is a normal finding in a
chest tube system.
8. A patient with Acute Respiratory Distress Syndrome (ARDS) is placed on PEEP.
What is the primary purpose of PEEP?
A. To decrease the work of breathing
B. To prevent alveolar collapse
C. To decrease intracranial pressure
D. To increase tidal volume
Answer: B
Rationale: Positive End-Expiratory Pressure (PEEP) keeps alveoli open at the end of
expiration to improve gas exchange.
