NU 185 Exam 3 | Medical-Surgical Nursing II | Galen Study Guide 2026
Galen College
1. A nurse is caring for a patient with COPD who is experiencing dyspnea. Which
breathing technique should the nurse teach to help the patient promote carbon
dioxide elimination?
A. Pursed-lip breathing
B. Deep chest breathing
C. Rapid shallow breathing
D. Holding breath for 5 seconds
Answer: A
Rationale: Pursed-lip breathing helps to maintain positive pressure in the airways and
prevents alveolar collapse, allowing for better CO2 excretion.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.32, PaCO2 50
B. pH 7.48, PaCO2 32
C. pH 7.35, HCO3 24
D. pH 7.50, HCO3 30
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and a high
PaCO2 (above 45 mmHg).
,3. A patient is diagnosed with left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatomegaly
Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion, leading to symptoms like
crackles, shortness of breath, and orthopnea.
4. When assessing a patient with right-sided heart failure, the nurse should
focus on which of the following?
A. Pulmonary edema
B. Decreased peripheral pulses
C. Pink frothy sputum
D. Systemic venous congestion
Answer: D
Rationale: Right-sided heart failure results in blood backing up into the systemic
circulation, causing JVD, edema, and ascites.
5. A nurse is monitoring a patient receiving a blood transfusion. Within 15
minutes, the patient develops fever, chills, and low back pain. What is the
priority action?
A. Stop the transfusion immediately
B. Administer acetaminophen
C. Slow the infusion rate
D. Notify the physician
Answer: A
, Rationale: These symptoms suggest a hemolytic reaction; the priority is to stop the
transfusion and disconnect the tubing to prevent further injury.
6. Which laboratory value is the most sensitive indicator of myocardial damage?
A. Troponin I
B. Myoglobin
C. Creatine kinase (CK)
D. C-reactive protein
Answer: A
Rationale: Troponin I is highly specific to cardiac muscle and is the gold standard for
diagnosing a myocardial infarction.
7. A patient with Atrial Fibrillation is at high risk for which complication?
A. Pulmonary hypertension
B. Ventricular tachycardia
C. Ischemic stroke
D. Cardiac tamponade
Answer: C
Rationale: Stasis of blood in the atria during A-fib can lead to clot formation, which may
travel to the brain causing a stroke.
8. The nurse is caring for a patient with a chest tube. Continuous bubbling is
noted in the water-seal chamber. This most likely indicates:
A. An air leak in the system
B. Normal lung re-expansion
C. The suction is set too high
D. The chest tube is occluded
Answer: A
Rationale: Intermittent bubbling is normal in some cases, but continuous bubbling in the
water-seal chamber indicates a leak in the drainage system or the pleural space.
Galen College
1. A nurse is caring for a patient with COPD who is experiencing dyspnea. Which
breathing technique should the nurse teach to help the patient promote carbon
dioxide elimination?
A. Pursed-lip breathing
B. Deep chest breathing
C. Rapid shallow breathing
D. Holding breath for 5 seconds
Answer: A
Rationale: Pursed-lip breathing helps to maintain positive pressure in the airways and
prevents alveolar collapse, allowing for better CO2 excretion.
2. Which arterial blood gas (ABG) result is most indicative of respiratory
acidosis?
A. pH 7.32, PaCO2 50
B. pH 7.48, PaCO2 32
C. pH 7.35, HCO3 24
D. pH 7.50, HCO3 30
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and a high
PaCO2 (above 45 mmHg).
,3. A patient is diagnosed with left-sided heart failure. Which clinical
manifestation should the nurse expect to find?
A. Crackles in the lungs
B. Jugular venous distention
C. Peripheral edema
D. Hepatomegaly
Answer: A
Rationale: Left-sided heart failure causes pulmonary congestion, leading to symptoms like
crackles, shortness of breath, and orthopnea.
4. When assessing a patient with right-sided heart failure, the nurse should
focus on which of the following?
A. Pulmonary edema
B. Decreased peripheral pulses
C. Pink frothy sputum
D. Systemic venous congestion
Answer: D
Rationale: Right-sided heart failure results in blood backing up into the systemic
circulation, causing JVD, edema, and ascites.
5. A nurse is monitoring a patient receiving a blood transfusion. Within 15
minutes, the patient develops fever, chills, and low back pain. What is the
priority action?
A. Stop the transfusion immediately
B. Administer acetaminophen
C. Slow the infusion rate
D. Notify the physician
Answer: A
, Rationale: These symptoms suggest a hemolytic reaction; the priority is to stop the
transfusion and disconnect the tubing to prevent further injury.
6. Which laboratory value is the most sensitive indicator of myocardial damage?
A. Troponin I
B. Myoglobin
C. Creatine kinase (CK)
D. C-reactive protein
Answer: A
Rationale: Troponin I is highly specific to cardiac muscle and is the gold standard for
diagnosing a myocardial infarction.
7. A patient with Atrial Fibrillation is at high risk for which complication?
A. Pulmonary hypertension
B. Ventricular tachycardia
C. Ischemic stroke
D. Cardiac tamponade
Answer: C
Rationale: Stasis of blood in the atria during A-fib can lead to clot formation, which may
travel to the brain causing a stroke.
8. The nurse is caring for a patient with a chest tube. Continuous bubbling is
noted in the water-seal chamber. This most likely indicates:
A. An air leak in the system
B. Normal lung re-expansion
C. The suction is set too high
D. The chest tube is occluded
Answer: A
Rationale: Intermittent bubbling is normal in some cases, but continuous bubbling in the
water-seal chamber indicates a leak in the drainage system or the pleural space.
