BSN Exam 2: Complex Med-Surg - Cardiac, Pulmonary,
Neuro 2026|Galen UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient is admitted with a suspected Myocardial Infarction (MI). Which
cardiac biomarker is most specific for myocardial injury and typically peaks
within 24 hours?
A. Troponin I
B. Myoglobin
C. Creatine Kinase (CK-MB)
D. C-reactive protein (CRP)
Answer: A
Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated for
several days, making them the gold standard for diagnosing MI.
2. A nurse is caring for a patient with a chest tube. Which observation in the
water-seal chamber requires immediate notification to the physician?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation (tidaling) in the water-seal chamber with respirations
C. Gentle bubbling in the suction control chamber
D. Presence of 50 mL of serosanguineous drainage in the collection chamber
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates a large air leak in the
system or from the patient, requiring immediate assessment.
,3. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. How
should the nurse interpret this finding?
A. The patient has a severe head injury and requires airway protection
B. The patient has a mild head injury
C. The patient is alert and oriented
D. The patient is in a vegetative state
Answer: A
Rationale: A GCS score of 8 or less is generally indicative of a severe head injury and
usually necessitates intubation for airway protection.
4. Which clinical manifestation is a hallmark sign of Cardiac Tamponade?
A. Widening pulse pressure
B. Flattened neck veins
C. Bradypnea and hypertension
D. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
Answer: D
Rationale: Beck’s Triad—hypotension, jugular venous distention, and muffled heart
sounds—occurs as fluid accumulates in the pericardial sac, compressing the heart.
5. A patient with ARDS is being mechanically ventilated with high PEEP. What is
a common complication the nurse must monitor for?
A. Pneumothorax due to barotrauma
B. Decreased intracranial pressure
C. Increased cardiac output
D. Respiratory alkalosis
Answer: A
Rationale: Positive End-Expiratory Pressure (PEEP) can cause barotrauma, leading to
alveoli rupture and pneumothorax.
, 6. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the priority
nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a flat, supine position
C. Call the code team
D. Assess for a full bladder or fecal impaction
Answer: D
Rationale: These are signs of Autonomic Dysreflexia. The priority is to sit the patient up
and then identify and remove the noxious stimulus, most commonly a full bladder.
7. In the interpretation of ABGs, a pH of 7.28, PaCO2 of 55, and HCO3 of 26
indicates:
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH is acidic (<7.35) and the PaCO2 is high (>45), while the bicarbonate is
normal, indicating respiratory acidosis.
8. Which rhythm is characterized by a ‘sawtooth’ pattern on the ECG strip?
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. First-degree AV block
Answer: A
Rationale: Atrial flutter is known for its distinct saw-toothed F-waves resulting from a
rapid atrial reentrant circuit.
Neuro 2026|Galen UPDATED ACTUAL Questions and
CORRECT Answers
1. A patient is admitted with a suspected Myocardial Infarction (MI). Which
cardiac biomarker is most specific for myocardial injury and typically peaks
within 24 hours?
A. Troponin I
B. Myoglobin
C. Creatine Kinase (CK-MB)
D. C-reactive protein (CRP)
Answer: A
Rationale: Troponin I and T are highly specific to cardiac muscle and remain elevated for
several days, making them the gold standard for diagnosing MI.
2. A nurse is caring for a patient with a chest tube. Which observation in the
water-seal chamber requires immediate notification to the physician?
A. Continuous bubbling in the water-seal chamber
B. Fluctuation (tidaling) in the water-seal chamber with respirations
C. Gentle bubbling in the suction control chamber
D. Presence of 50 mL of serosanguineous drainage in the collection chamber
Answer: A
Rationale: Continuous bubbling in the water-seal chamber indicates a large air leak in the
system or from the patient, requiring immediate assessment.
,3. A patient with a head injury has a Glasgow Coma Scale (GCS) score of 7. How
should the nurse interpret this finding?
A. The patient has a severe head injury and requires airway protection
B. The patient has a mild head injury
C. The patient is alert and oriented
D. The patient is in a vegetative state
Answer: A
Rationale: A GCS score of 8 or less is generally indicative of a severe head injury and
usually necessitates intubation for airway protection.
4. Which clinical manifestation is a hallmark sign of Cardiac Tamponade?
A. Widening pulse pressure
B. Flattened neck veins
C. Bradypnea and hypertension
D. Beck’s Triad (Muffled heart sounds, JVD, Hypotension)
Answer: D
Rationale: Beck’s Triad—hypotension, jugular venous distention, and muffled heart
sounds—occurs as fluid accumulates in the pericardial sac, compressing the heart.
5. A patient with ARDS is being mechanically ventilated with high PEEP. What is
a common complication the nurse must monitor for?
A. Pneumothorax due to barotrauma
B. Decreased intracranial pressure
C. Increased cardiac output
D. Respiratory alkalosis
Answer: A
Rationale: Positive End-Expiratory Pressure (PEEP) can cause barotrauma, leading to
alveoli rupture and pneumothorax.
, 6. A patient with a T6 spinal cord injury reports a sudden, severe headache and
is found to have a blood pressure of 190/100 mmHg. What is the priority
nursing action?
A. Administer an antihypertensive medication
B. Place the patient in a flat, supine position
C. Call the code team
D. Assess for a full bladder or fecal impaction
Answer: D
Rationale: These are signs of Autonomic Dysreflexia. The priority is to sit the patient up
and then identify and remove the noxious stimulus, most commonly a full bladder.
7. In the interpretation of ABGs, a pH of 7.28, PaCO2 of 55, and HCO3 of 26
indicates:
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH is acidic (<7.35) and the PaCO2 is high (>45), while the bicarbonate is
normal, indicating respiratory acidosis.
8. Which rhythm is characterized by a ‘sawtooth’ pattern on the ECG strip?
A. Atrial Flutter
B. Ventricular Tachycardia
C. Atrial Fibrillation
D. First-degree AV block
Answer: A
Rationale: Atrial flutter is known for its distinct saw-toothed F-waves resulting from a
rapid atrial reentrant circuit.
