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NUR 170 MED SURG EXAM 2 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
A client with left-sided heart failure is most likely to exhibit
which finding?
A. Peripheral edema
B. Pulmonary congestion and crackles
C. Ascites
D. Jugular venous distention only
Answer: B
Rationale: Left-sided heart failure causes blood to back up into
the lungs, producing crackles, dyspnea, and orthopnea.
Question 2
Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
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Answer: B
Rationale: Troponin I is the most specific and sensitive
biomarker for myocardial injury.
Question 3
A client is receiving alteplase for an acute ischemic stroke.
Which finding requires immediate discontinuation of the
infusion?
A. New severe headache and decreased level of consciousness
B. Blood pressure 150/90 mmHg
C. Heart rate 88 bpm
D. Mild oozing at the IV site
Answer: A
Rationale: Severe headache with decreased LOC may indicate
intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy.
Question 4
Which ECG finding is most concerning for torsades de pointes?
A. Prolonged QT interval
B. Sinus bradycardia
C. Premature atrial contractions
D. First-degree AV block
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Answer: A
Rationale: Prolonged QT interval increases the risk of torsades
de pointes and sudden cardiac death.
Question 5
A client with peripheral arterial disease asks why walking causes
leg pain. Which response is best?
A. "The pain is from muscle spasms."
B. "Your muscles are not getting enough blood flow during
exercise."
C. "The pain is from nerve damage."
D. "Your veins are not working properly."
Answer: B
Rationale: Intermittent claudication is ischemic muscle pain
caused by inadequate arterial blood flow during activity.
Question 6
Which of the following is a classic sign of infective endocarditis?
A. Splinter hemorrhages and a new murmur
B. Jaundice
C. Ascites
D. Peripheral edema only
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Answer: A
Rationale: Infective endocarditis may cause splinter
hemorrhages, petechiae, Osler nodes, and a new or changing
murmur.
Question 7
A client with heart failure is prescribed furosemide. Which lab
should be monitored closely?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium only
Answer: B
Rationale: Furosemide causes potassium loss; hypokalemia can
lead to dysrhythmias.
Question 8
A client has a blood pressure of 150/90 in the right arm and
130/80 in the left arm. What does this suggest?
A. Normal variation
B. Coarctation of the aorta or subclavian artery stenosis
C. White coat hypertension
D. Aortic regurgitation
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NUR 170 MED SURG EXAM 2 – V1 & V2 Questions with Answers &
Rationales | Galen College of Nursing
VERSION 1 (Questions 1–50)
Question 1
A client with left-sided heart failure is most likely to exhibit
which finding?
A. Peripheral edema
B. Pulmonary congestion and crackles
C. Ascites
D. Jugular venous distention only
Answer: B
Rationale: Left-sided heart failure causes blood to back up into
the lungs, producing crackles, dyspnea, and orthopnea.
Question 2
Which laboratory value is most specific for myocardial
infarction?
A. CK-MB
B. Troponin I
C. Myoglobin
D. BNP
1|Page
, Page |2
Answer: B
Rationale: Troponin I is the most specific and sensitive
biomarker for myocardial injury.
Question 3
A client is receiving alteplase for an acute ischemic stroke.
Which finding requires immediate discontinuation of the
infusion?
A. New severe headache and decreased level of consciousness
B. Blood pressure 150/90 mmHg
C. Heart rate 88 bpm
D. Mild oozing at the IV site
Answer: A
Rationale: Severe headache with decreased LOC may indicate
intracranial hemorrhage, a life-threatening complication of
thrombolytic therapy.
Question 4
Which ECG finding is most concerning for torsades de pointes?
A. Prolonged QT interval
B. Sinus bradycardia
C. Premature atrial contractions
D. First-degree AV block
2|Page
, Page |3
Answer: A
Rationale: Prolonged QT interval increases the risk of torsades
de pointes and sudden cardiac death.
Question 5
A client with peripheral arterial disease asks why walking causes
leg pain. Which response is best?
A. "The pain is from muscle spasms."
B. "Your muscles are not getting enough blood flow during
exercise."
C. "The pain is from nerve damage."
D. "Your veins are not working properly."
Answer: B
Rationale: Intermittent claudication is ischemic muscle pain
caused by inadequate arterial blood flow during activity.
Question 6
Which of the following is a classic sign of infective endocarditis?
A. Splinter hemorrhages and a new murmur
B. Jaundice
C. Ascites
D. Peripheral edema only
3|Page
, Page |4
Answer: A
Rationale: Infective endocarditis may cause splinter
hemorrhages, petechiae, Osler nodes, and a new or changing
murmur.
Question 7
A client with heart failure is prescribed furosemide. Which lab
should be monitored closely?
A. Serum calcium
B. Serum potassium
C. Serum glucose
D. Serum magnesium only
Answer: B
Rationale: Furosemide causes potassium loss; hypokalemia can
lead to dysrhythmias.
Question 8
A client has a blood pressure of 150/90 in the right arm and
130/80 in the left arm. What does this suggest?
A. Normal variation
B. Coarctation of the aorta or subclavian artery stenosis
C. White coat hypertension
D. Aortic regurgitation
4|Page
