NU 185 Exam 3 | Medical-Surgical Nursing II | Galen Study Guide 2026
Galen College
1. A nurse is caring for a client with COPD who is experiencing dyspnea. Which
breathing technique should the nurse teach to help the client promote CO2
elimination?
A. Deep belly breathing
B. Rapid shallow breathing
C. Pursed-lip breathing
D. Holding breath for 5 seconds
Answer: C
Rationale: Pursed-lip breathing slows expiration, prevents alveolar collapse, and helps the
client better control the rate and depth of respiration, which promotes CO2 elimination.
2. When assessing a client with Left-sided Heart Failure, which clinical
manifestation should the nurse expect to find?
A. Jugular vein distention
B. Peripheral edema
C. Splenomegaly
D. Crackles in the lungs
Answer: D
Rationale: Left-sided heart failure causes pulmonary congestion, leading to symptoms like
crackles, dyspnea, and orthopnea. The other options are signs of right-sided heart failure.
,3. A client is prescribed Warfarin for Atrial Fibrillation. Which laboratory value
must the nurse monitor to evaluate the effectiveness of this medication?
A. aPTT
B. Platelet count
C. Hemoglobin
D. PT/INR
Answer: D
Rationale: Warfarin effectiveness is monitored using PT and INR. aPTT is used for heparin
monitoring.
4. A nurse is preparing to administer Digoxin to a client. Which assessment
finding would require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 12 breaths/min
C. Heart rate of 52 beats/min
D. Potassium level of 4.5 mEq/L
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60 bpm in an adult, as
it can cause further bradycardia.
5. What is the primary goal of using an Incentive Spirometer post-operatively?
A. To promote lung expansion and prevent atelectasis
B. To reduce heart rate
C. To decrease surgical site pain
D. To increase the cough reflex
Answer: A
Rationale: Incentive spirometry encourages deep breathing, which helps keep the alveoli
open and prevents lung collapse (atelectasis) and pneumonia.
, 6. A client with iron-deficiency anemia is being discharged. Which food choice
indicates the client understands the dietary instructions?
A. White bread and pasta
B. Spinach and beef liver
C. Apples and bananas
D. Milk and cheese
Answer: B
Rationale: Spinach and organ meats like beef liver are high in iron, making them excellent
choices for treating iron-deficiency anemia.
7. Which of the following is a late sign of hypoxia in an adult client?
A. Tachycardia
B. Restlessness
C. Cyanosis
D. Hypertension
Answer: C
Rationale: Restlessness and tachycardia are early signs of hypoxia. Cyanosis is a late and
critical sign of oxygen deprivation.
8. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this suggest?
A. There is an air leak in the system
B. The lung has fully re-expanded
C. The suction is set too high
D. This is a normal finding
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is expected when the client coughs or exhales.
Galen College
1. A nurse is caring for a client with COPD who is experiencing dyspnea. Which
breathing technique should the nurse teach to help the client promote CO2
elimination?
A. Deep belly breathing
B. Rapid shallow breathing
C. Pursed-lip breathing
D. Holding breath for 5 seconds
Answer: C
Rationale: Pursed-lip breathing slows expiration, prevents alveolar collapse, and helps the
client better control the rate and depth of respiration, which promotes CO2 elimination.
2. When assessing a client with Left-sided Heart Failure, which clinical
manifestation should the nurse expect to find?
A. Jugular vein distention
B. Peripheral edema
C. Splenomegaly
D. Crackles in the lungs
Answer: D
Rationale: Left-sided heart failure causes pulmonary congestion, leading to symptoms like
crackles, dyspnea, and orthopnea. The other options are signs of right-sided heart failure.
,3. A client is prescribed Warfarin for Atrial Fibrillation. Which laboratory value
must the nurse monitor to evaluate the effectiveness of this medication?
A. aPTT
B. Platelet count
C. Hemoglobin
D. PT/INR
Answer: D
Rationale: Warfarin effectiveness is monitored using PT and INR. aPTT is used for heparin
monitoring.
4. A nurse is preparing to administer Digoxin to a client. Which assessment
finding would require the nurse to withhold the medication?
A. Blood pressure of 140/90 mmHg
B. Respiratory rate of 12 breaths/min
C. Heart rate of 52 beats/min
D. Potassium level of 4.5 mEq/L
Answer: C
Rationale: Digoxin should be withheld if the apical pulse is less than 60 bpm in an adult, as
it can cause further bradycardia.
5. What is the primary goal of using an Incentive Spirometer post-operatively?
A. To promote lung expansion and prevent atelectasis
B. To reduce heart rate
C. To decrease surgical site pain
D. To increase the cough reflex
Answer: A
Rationale: Incentive spirometry encourages deep breathing, which helps keep the alveoli
open and prevents lung collapse (atelectasis) and pneumonia.
, 6. A client with iron-deficiency anemia is being discharged. Which food choice
indicates the client understands the dietary instructions?
A. White bread and pasta
B. Spinach and beef liver
C. Apples and bananas
D. Milk and cheese
Answer: B
Rationale: Spinach and organ meats like beef liver are high in iron, making them excellent
choices for treating iron-deficiency anemia.
7. Which of the following is a late sign of hypoxia in an adult client?
A. Tachycardia
B. Restlessness
C. Cyanosis
D. Hypertension
Answer: C
Rationale: Restlessness and tachycardia are early signs of hypoxia. Cyanosis is a late and
critical sign of oxygen deprivation.
8. A nurse is caring for a client with a chest tube. The nurse notes continuous
bubbling in the water-seal chamber. What does this suggest?
A. There is an air leak in the system
B. The lung has fully re-expanded
C. The suction is set too high
D. This is a normal finding
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak.
Intermittent bubbling is expected when the client coughs or exhales.
