NU 185 EXAM 1 (GALEN) NEWEST 2026/ 2027 ACTUAL
EXAM| NU185 MEDICAL-SURGICAL NURSING II
EXAM 1 REVIEW WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
A nurse is assessing a client admitted 30 minutes ago with an acute
ischemic stroke. Which assessment finding requires the nurse's
immediate intervention?
a) Blood pressure 182/96 mmHg
b) Right arm weakness
c) Sudden decrease in level of consciousness
d) Slurred speech - Correct Answer - C.
A sudden decline in LOC is the earliest and most concerning sign of
worsening cerebral perfusion or increased intracranial pressure. Airway
and neurologic deterioration take priority over expected stroke deficits.
A nurse is assessing a client with Parkinson disease. Which finding is
expected?
a) Hyperactive reflexes
b) Pill-rolling tremor at rest
c) Ascending paralysis
d) Expressive aphasia - Correct Answer -B.
Resting tremor, bradykinesia, rigidity, and shuffling gait are classic
manifestations of Parkinson disease.
pg. 1
,A client with myasthenia gravis is scheduled for breakfast. Which action
is most appropriate?
a) Administer pyridostigmine after the meal
b) Administer pyridostigmine before the meal
c) Delay medication until physical therapy
d) Hold medication if swallowing is difficult - Correct Answer - B.
Pyridostigmine should be given before meals to maximize muscle
strength needed for chewing and swallowing.
A client with Guillain-Barré syndrome reports increasing weakness that
has progressed from the legs to the chest. Which assessment has the
highest priority?
a) Skin integrity
b) Bowel sounds
c) Respiratory effort
d) Urinary output - Correct Answer - C.
Guillain-Barré syndrome can rapidly progress to respiratory muscle
paralysis, making airway and breathing the highest priority.
A client with increased intracranial pressure develops hypertension,
bradycardia, and irregular respirations. These findings indicate:
a) Neurogenic shock
b) Cushing's triad
c) Septic shock
d) Hypovolemia - Correct Answer - B.
pg. 2
,Cushing's triad is a late sign of significantly increased intracranial
pressure and possible brain herniation requiring emergency intervention.
A nurse is caring for a client who received alteplase (tPA) 45 minutes
ago for an acute ischemic stroke. Which assessment finding requires
immediate intervention?
a) Blood pressure 170/88 mmHg
b) Mild nausea
c) Sudden severe headache with unequal pupils
d) Left-sided weakness unchanged from admission - Correct Answer - C.
Sudden headache and unequal pupils suggest intracranial hemorrhage,
the most serious complication of thrombolytic therapy.
A nurse enters the room of a client actively experiencing a generalized
tonic-clonic seizure. Which action should the nurse perform first?
a) Insert a padded tongue blade
b) Protect the client's head from injury
c) Obtain blood pressure
d) Administer IV lorazepam immediately - Correct Answer - B.
The immediate priority during an active seizure is preventing injury
while maintaining the airway. Nothing should be placed in the client's
mouth.
A client with increased intracranial pressure has an ICP reading of 24
mmHg. Which provider prescription should the nurse question?
a) Elevate the head of bed to 30 degrees
b) Maintain the neck in neutral alignment
pg. 3
, c) Encourage the client to cough every 15 minutes
d) Administer mannitol as prescribed - Correct Answer - C.
Frequent coughing increases intrathoracic pressure and further elevates
intracranial pressure. The prescription should be questioned.
A client with myasthenia gravis suddenly develops severe difficulty
swallowing, excessive respiratory muscle weakness, and shallow
respirations. Which action has the highest priority?
a) Offer thickened liquids
b) Prepare for airway support
c) Reassure the client
d) Encourage coughing exercises - Correct Answer - B.
A myasthenic crisis can rapidly progress to respiratory failure. Airway
stabilization takes priority over all other interventions.
A nurse is caring for a client with a newly applied cast following an
open tibia fracture. Which assessment finding requires immediate
provider notification?
a) Mild edema around the toes
b) Warm skin distal to the cast
c) Pain rated 10/10 despite IV morphine and increasing numbness
d) Capillary refill of 2 seconds - Correct Answer - C.
Severe pain unrelieved by opioids combined with paresthesia strongly
suggests compartment syndrome, a surgical emergency.
pg. 4
EXAM| NU185 MEDICAL-SURGICAL NURSING II
EXAM 1 REVIEW WITH COMPLETE REAL EXAM
QUESTIONS AND CORRECT VERIFIED ANSWERS/
ALREADY GRADED A+ (MOST RECENT!!)
A nurse is assessing a client admitted 30 minutes ago with an acute
ischemic stroke. Which assessment finding requires the nurse's
immediate intervention?
a) Blood pressure 182/96 mmHg
b) Right arm weakness
c) Sudden decrease in level of consciousness
d) Slurred speech - Correct Answer - C.
A sudden decline in LOC is the earliest and most concerning sign of
worsening cerebral perfusion or increased intracranial pressure. Airway
and neurologic deterioration take priority over expected stroke deficits.
A nurse is assessing a client with Parkinson disease. Which finding is
expected?
a) Hyperactive reflexes
b) Pill-rolling tremor at rest
c) Ascending paralysis
d) Expressive aphasia - Correct Answer -B.
Resting tremor, bradykinesia, rigidity, and shuffling gait are classic
manifestations of Parkinson disease.
pg. 1
,A client with myasthenia gravis is scheduled for breakfast. Which action
is most appropriate?
a) Administer pyridostigmine after the meal
b) Administer pyridostigmine before the meal
c) Delay medication until physical therapy
d) Hold medication if swallowing is difficult - Correct Answer - B.
Pyridostigmine should be given before meals to maximize muscle
strength needed for chewing and swallowing.
A client with Guillain-Barré syndrome reports increasing weakness that
has progressed from the legs to the chest. Which assessment has the
highest priority?
a) Skin integrity
b) Bowel sounds
c) Respiratory effort
d) Urinary output - Correct Answer - C.
Guillain-Barré syndrome can rapidly progress to respiratory muscle
paralysis, making airway and breathing the highest priority.
A client with increased intracranial pressure develops hypertension,
bradycardia, and irregular respirations. These findings indicate:
a) Neurogenic shock
b) Cushing's triad
c) Septic shock
d) Hypovolemia - Correct Answer - B.
pg. 2
,Cushing's triad is a late sign of significantly increased intracranial
pressure and possible brain herniation requiring emergency intervention.
A nurse is caring for a client who received alteplase (tPA) 45 minutes
ago for an acute ischemic stroke. Which assessment finding requires
immediate intervention?
a) Blood pressure 170/88 mmHg
b) Mild nausea
c) Sudden severe headache with unequal pupils
d) Left-sided weakness unchanged from admission - Correct Answer - C.
Sudden headache and unequal pupils suggest intracranial hemorrhage,
the most serious complication of thrombolytic therapy.
A nurse enters the room of a client actively experiencing a generalized
tonic-clonic seizure. Which action should the nurse perform first?
a) Insert a padded tongue blade
b) Protect the client's head from injury
c) Obtain blood pressure
d) Administer IV lorazepam immediately - Correct Answer - B.
The immediate priority during an active seizure is preventing injury
while maintaining the airway. Nothing should be placed in the client's
mouth.
A client with increased intracranial pressure has an ICP reading of 24
mmHg. Which provider prescription should the nurse question?
a) Elevate the head of bed to 30 degrees
b) Maintain the neck in neutral alignment
pg. 3
, c) Encourage the client to cough every 15 minutes
d) Administer mannitol as prescribed - Correct Answer - C.
Frequent coughing increases intrathoracic pressure and further elevates
intracranial pressure. The prescription should be questioned.
A client with myasthenia gravis suddenly develops severe difficulty
swallowing, excessive respiratory muscle weakness, and shallow
respirations. Which action has the highest priority?
a) Offer thickened liquids
b) Prepare for airway support
c) Reassure the client
d) Encourage coughing exercises - Correct Answer - B.
A myasthenic crisis can rapidly progress to respiratory failure. Airway
stabilization takes priority over all other interventions.
A nurse is caring for a client with a newly applied cast following an
open tibia fracture. Which assessment finding requires immediate
provider notification?
a) Mild edema around the toes
b) Warm skin distal to the cast
c) Pain rated 10/10 despite IV morphine and increasing numbness
d) Capillary refill of 2 seconds - Correct Answer - C.
Severe pain unrelieved by opioids combined with paresthesia strongly
suggests compartment syndrome, a surgical emergency.
pg. 4
