NU 155 MEDICAL-SURGICAL NURSING I
- EXAM 3 PREP 2026 GALEN COLLEGE
1. A patient with right-sided heart failure is admitted to the medical unit. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Jugular venous distention and peripheral edema
B. Pulmonary crackles and orthopnea
C. Pink frothy sputum and dry cough
D. Decreased ejection fraction and S3 gallop
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
causing symptoms like jugular venous distention (JVD), hepatomegaly, and peripheral
edema. Options A, C, and D are characteristic of left-sided heart failure.
2. A client is diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Which
statement by the client regarding oxygen therapy indicates a need for further teaching?
A. I should use my oxygen only when I feel short of breath.
B. I will keep my oxygen flow rate at 2 liters per minute as prescribed.
C. I will avoid using oil-based moisturizers on my nose while using oxygen.
,D. I need to notify my doctor if I feel excessively sleepy or confused.
Answer: A
Conceptual Explanation: Oxygen therapy for COPD is typically prescribed for continuous
use or specific activities to maintain saturation; it should not be used PRN unless
specifically ordered that way. The ‘drive to breathe’ in COPD patients can be suppressed by
high oxygen levels, so consistent low-flow is key.
3. Which laboratory value is most specific for diagnosing a myocardial infarction (MI)?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. C-reactive protein (CRP)
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I and T are highly specific markers for cardiac muscle
injury and remain elevated longer than CK-MB, making them the gold standard for MI
diagnosis.
4. A nurse is caring for a patient in sickle cell crisis. Which intervention is the highest priority?
A. Administering broad-spectrum antibiotics
B. Providing vigorous intravenous hydration
C. Applying cold compresses to painful joints
, D. Administering iron supplements
Answer: B
Conceptual Explanation: Hydration is critical in sickle cell crisis to reduce blood viscosity
and prevent further sickling/vascular occlusion. Cold compresses should be avoided as
they cause vasoconstriction.
5. A patient with atrial fibrillation is prescribed Warfarin. The nurse should monitor which
laboratory result to ensure therapeutic dosing?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Hemoglobin and Hematocrit
Answer: C
Conceptual Explanation: INR is used to monitor the effectiveness of Warfarin. aPTT is
used for Heparin monitoring.
6. During a physical assessment, the nurse notes a patient has a ‘sawtooth’ pattern on the
EKG monitor. The patient’s heart rate is 110 bpm. The nurse identifies this rhythm as:
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
- EXAM 3 PREP 2026 GALEN COLLEGE
1. A patient with right-sided heart failure is admitted to the medical unit. Which clinical
manifestation should the nurse expect to find during the assessment?
A. Jugular venous distention and peripheral edema
B. Pulmonary crackles and orthopnea
C. Pink frothy sputum and dry cough
D. Decreased ejection fraction and S3 gallop
Answer: A
Conceptual Explanation: Right-sided heart failure leads to systemic venous congestion,
causing symptoms like jugular venous distention (JVD), hepatomegaly, and peripheral
edema. Options A, C, and D are characteristic of left-sided heart failure.
2. A client is diagnosed with Chronic Obstructive Pulmonary Disease (COPD). Which
statement by the client regarding oxygen therapy indicates a need for further teaching?
A. I should use my oxygen only when I feel short of breath.
B. I will keep my oxygen flow rate at 2 liters per minute as prescribed.
C. I will avoid using oil-based moisturizers on my nose while using oxygen.
,D. I need to notify my doctor if I feel excessively sleepy or confused.
Answer: A
Conceptual Explanation: Oxygen therapy for COPD is typically prescribed for continuous
use or specific activities to maintain saturation; it should not be used PRN unless
specifically ordered that way. The ‘drive to breathe’ in COPD patients can be suppressed by
high oxygen levels, so consistent low-flow is key.
3. Which laboratory value is most specific for diagnosing a myocardial infarction (MI)?
A. Creatine Kinase (CK-MB)
B. Myoglobin
C. C-reactive protein (CRP)
D. Troponin I
Answer: D
Conceptual Explanation: Troponin I and T are highly specific markers for cardiac muscle
injury and remain elevated longer than CK-MB, making them the gold standard for MI
diagnosis.
4. A nurse is caring for a patient in sickle cell crisis. Which intervention is the highest priority?
A. Administering broad-spectrum antibiotics
B. Providing vigorous intravenous hydration
C. Applying cold compresses to painful joints
, D. Administering iron supplements
Answer: B
Conceptual Explanation: Hydration is critical in sickle cell crisis to reduce blood viscosity
and prevent further sickling/vascular occlusion. Cold compresses should be avoided as
they cause vasoconstriction.
5. A patient with atrial fibrillation is prescribed Warfarin. The nurse should monitor which
laboratory result to ensure therapeutic dosing?
A. Activated partial thromboplastin time (aPTT)
B. Platelet count
C. International Normalized Ratio (INR)
D. Hemoglobin and Hematocrit
Answer: C
Conceptual Explanation: INR is used to monitor the effectiveness of Warfarin. aPTT is
used for Heparin monitoring.
6. During a physical assessment, the nurse notes a patient has a ‘sawtooth’ pattern on the
EKG monitor. The patient’s heart rate is 110 bpm. The nurse identifies this rhythm as:
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
