NU 185 Exam 3: Medical-Surgical Nursing II Comprehensive Study Quiz
2026 Galen College
1. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) score
of 7. Which action is the nurse’s highest priority?
A. Assess pupil reactivity
B. Monitor intracranial pressure
C. Perform a detailed neurological exam
D. Prepare for endotracheal intubation
Answer: D
Rationale: A GCS score of 8 or less generally indicates a coma and requires immediate
airway protection via intubation.
2. Which cardiac rhythm is characterized by a ‘sawtooth’ pattern of P-waves?
A. Atrial Fibrillation
B. First-degree AV block
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: D
Rationale: Atrial flutter is classically identified by sawtooth-shaped flutter waves on the
ECG.
,3. A patient with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse expect to administer first to protect
the heart?
A. Sodium polystyrene sulfonate
B. Calcium Gluconate
C. Insulin and Glucose
D. Furosemide
Answer: B
Rationale: Calcium gluconate is administered intravenously to stabilize the myocardial cell
membrane and prevent arrhythmias in severe hyperkalemia.
4. The nurse is caring for a patient with a spinal cord injury at the T4 level. The
patient reports a sudden, severe headache and has a BP of 190/100. What is the
first action?
A. Administer PRN antihypertensives
B. Place the patient in a sitting position
C. Check for bladder distention
D. Notify the healthcare provider
Answer: B
Rationale: The symptoms suggest autonomic dysreflexia. The first priority is to sit the
patient upright to help lower blood pressure via orthostatic effect.
5. Which finding is an early sign of increased intracranial pressure (ICP)?
A. Cushing’s Triad
B. Decreased level of consciousness
C. Dilated and fixed pupils
D. Decerebrate posturing
Answer: B
, Rationale: Decreased level of consciousness (restlessness, agitation, or confusion) is the
earliest and most sensitive indicator of rising ICP.
6. During the oliguric phase of acute kidney injury (AKI), which electrolyte
imbalance is most likely?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Rationale: In the oliguric phase, the kidneys cannot excrete potassium, leading to
hyperkalemia.
7. A patient’s ECG shows a lack of P-waves and an irregularly irregular QRS
rhythm. What is the most appropriate initial intervention?
A. Assess the patient and calculate the ventricular rate
B. Administration of Amiodarone
C. Immediate defibrillation
D. Perform synchronized cardioversion
Answer: A
Rationale: The rhythm described is Atrial Fibrillation. The nurse must first assess the
patient’s stability and heart rate before initiating treatment.
8. What is the goal of administering Mannitol to a patient with a head injury?
A. To increase blood pressure
B. To prevent seizures
C. To reduce cerebral edema
D. To provide sedation
Answer: C
2026 Galen College
1. A patient with a traumatic brain injury has a Glasgow Coma Scale (GCS) score
of 7. Which action is the nurse’s highest priority?
A. Assess pupil reactivity
B. Monitor intracranial pressure
C. Perform a detailed neurological exam
D. Prepare for endotracheal intubation
Answer: D
Rationale: A GCS score of 8 or less generally indicates a coma and requires immediate
airway protection via intubation.
2. Which cardiac rhythm is characterized by a ‘sawtooth’ pattern of P-waves?
A. Atrial Fibrillation
B. First-degree AV block
C. Ventricular Tachycardia
D. Atrial Flutter
Answer: D
Rationale: Atrial flutter is classically identified by sawtooth-shaped flutter waves on the
ECG.
,3. A patient with chronic kidney disease (CKD) has a potassium level of 6.8
mEq/L. Which medication should the nurse expect to administer first to protect
the heart?
A. Sodium polystyrene sulfonate
B. Calcium Gluconate
C. Insulin and Glucose
D. Furosemide
Answer: B
Rationale: Calcium gluconate is administered intravenously to stabilize the myocardial cell
membrane and prevent arrhythmias in severe hyperkalemia.
4. The nurse is caring for a patient with a spinal cord injury at the T4 level. The
patient reports a sudden, severe headache and has a BP of 190/100. What is the
first action?
A. Administer PRN antihypertensives
B. Place the patient in a sitting position
C. Check for bladder distention
D. Notify the healthcare provider
Answer: B
Rationale: The symptoms suggest autonomic dysreflexia. The first priority is to sit the
patient upright to help lower blood pressure via orthostatic effect.
5. Which finding is an early sign of increased intracranial pressure (ICP)?
A. Cushing’s Triad
B. Decreased level of consciousness
C. Dilated and fixed pupils
D. Decerebrate posturing
Answer: B
, Rationale: Decreased level of consciousness (restlessness, agitation, or confusion) is the
earliest and most sensitive indicator of rising ICP.
6. During the oliguric phase of acute kidney injury (AKI), which electrolyte
imbalance is most likely?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Rationale: In the oliguric phase, the kidneys cannot excrete potassium, leading to
hyperkalemia.
7. A patient’s ECG shows a lack of P-waves and an irregularly irregular QRS
rhythm. What is the most appropriate initial intervention?
A. Assess the patient and calculate the ventricular rate
B. Administration of Amiodarone
C. Immediate defibrillation
D. Perform synchronized cardioversion
Answer: A
Rationale: The rhythm described is Atrial Fibrillation. The nurse must first assess the
patient’s stability and heart rate before initiating treatment.
8. What is the goal of administering Mannitol to a patient with a head injury?
A. To increase blood pressure
B. To prevent seizures
C. To reduce cerebral edema
D. To provide sedation
Answer: C
