NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 3
UPDATE
50 Multiple-Choice Questions
Complete Answers with Detailed Rationales
Aligned with Medical-Surgical Nursing Standards
Galen College | NU 185 | Medical-Surgical Nursing II
Cardiac • Respiratory • Endocrine • GI • Renal • Neurological • Perioperative
For academic study and exam review • Verify with current course materials
,NU 185 | Review 3 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical topics of NU 185
Medical-Surgical Nursing II. Each item is followed by the correct answer and an expanded rationale that explains the
underlying pathophysiology or nursing priority, why the correct option is preferred, and why the distractors are incorrect.
Topics span cardiovascular, respiratory, endocrine, gastrointestinal, renal, neurological, and perioperative care. Study tip:
Attempt each question before reading the answer. Then carefully review the detailed rationale and relate the concepts to
clinical practice.
Topic Index (Selected High-Yield Areas)
• Heart failure (left vs right), ACS, arrhythmias, hypertension management
• COPD, asthma, pneumonia, respiratory failure, ABG interpretation
• Diabetes mellitus, thyroid disorders, adrenal crises and emergencies
• GI bleeding, pancreatitis, liver disease, bowel obstruction priorities
• Acute kidney injury, CKD, fluid & electrolyte imbalances
• Stroke, increased ICP, seizures, neurological assessment
• Perioperative care, post-op complications, pain management
• Infection, sepsis, shock states, and priority nursing interventions
Page 2
, NU 185 | Review 3 | 2026/2027 UPDATE
Question 1
A patient with suspected Thyroid Storm presents with a temperature of 104.5°F (40.3°C) and a heart rate of 144 bpm.
Which intervention should the nurse prioritize first?
A. Administering prescribed Propylthiouracil (PTU)
B. Obtaining a STAT thyroid panel (T3, T4, TSH)
C. Applying cooling blankets and ice packs
D. Initiating intravenous Propranolol
Answer: D
Rationale
In Thyroid Storm, beta-blockers like Propranolol are the priority to mitigate the life-threatening effects of sympathetic
overstimulation, such as tachycardia and potential heart failure, before tackling hormone production.
Question 2
A client is admitted with Diabetic Ketoacidosis (DKA). The nurse notes the following laboratory values: Glucose 550
mg/dL, pH 7.20, and Potassium 3.2 mEq/L. Which action is the highest priority?
A. Start a regular insulin drip at 0.1 units/kg/hr
B. Initiate a bolus of Normal Saline
C. Administer sodium bicarbonate to correct acidosis
D. Administer IV potassium replacement
Answer: D
Rationale
Insulin will shift potassium into the cells, further lowering serum levels. If the potassium is already low (3.2 mEq/L), it must be
corrected before or concurrent with insulin to prevent fatal arrhythmias. Understanding this concept is essential for safe clinical
decision-making. Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link
assessment data to the primary disease process and anticipated complications.
Question 3
Which clinical manifestation distinguishes Hyperosmolar Hyperglycemic Syndrome (HHS) from Diabetic Ketoacidosis
(DKA)?
A. Blood glucose levels exceeding 400 mg/dL
B. Severe dehydration and hypotension
C. Absence of significant ketosis
D. Presence of Altered Mental Status
Answer: C
Rationale
Unlike DKA, HHS patients usually have enough endogenous insulin to prevent lipolysis and subsequent ketone formation,
though glucose levels are often much higher in HHS. Understanding this concept is essential for safe clinical decision-making.
Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link assessment data to
the primary disease process and anticipated complications.
Page 3
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 3
UPDATE
50 Multiple-Choice Questions
Complete Answers with Detailed Rationales
Aligned with Medical-Surgical Nursing Standards
Galen College | NU 185 | Medical-Surgical Nursing II
Cardiac • Respiratory • Endocrine • GI • Renal • Neurological • Perioperative
For academic study and exam review • Verify with current course materials
,NU 185 | Review 3 | 2026/2027 UPDATE
How to Use This Review
This comprehensive exam review contains high-yield multiple-choice questions covering the core clinical topics of NU 185
Medical-Surgical Nursing II. Each item is followed by the correct answer and an expanded rationale that explains the
underlying pathophysiology or nursing priority, why the correct option is preferred, and why the distractors are incorrect.
Topics span cardiovascular, respiratory, endocrine, gastrointestinal, renal, neurological, and perioperative care. Study tip:
Attempt each question before reading the answer. Then carefully review the detailed rationale and relate the concepts to
clinical practice.
Topic Index (Selected High-Yield Areas)
• Heart failure (left vs right), ACS, arrhythmias, hypertension management
• COPD, asthma, pneumonia, respiratory failure, ABG interpretation
• Diabetes mellitus, thyroid disorders, adrenal crises and emergencies
• GI bleeding, pancreatitis, liver disease, bowel obstruction priorities
• Acute kidney injury, CKD, fluid & electrolyte imbalances
• Stroke, increased ICP, seizures, neurological assessment
• Perioperative care, post-op complications, pain management
• Infection, sepsis, shock states, and priority nursing interventions
Page 2
, NU 185 | Review 3 | 2026/2027 UPDATE
Question 1
A patient with suspected Thyroid Storm presents with a temperature of 104.5°F (40.3°C) and a heart rate of 144 bpm.
Which intervention should the nurse prioritize first?
A. Administering prescribed Propylthiouracil (PTU)
B. Obtaining a STAT thyroid panel (T3, T4, TSH)
C. Applying cooling blankets and ice packs
D. Initiating intravenous Propranolol
Answer: D
Rationale
In Thyroid Storm, beta-blockers like Propranolol are the priority to mitigate the life-threatening effects of sympathetic
overstimulation, such as tachycardia and potential heart failure, before tackling hormone production.
Question 2
A client is admitted with Diabetic Ketoacidosis (DKA). The nurse notes the following laboratory values: Glucose 550
mg/dL, pH 7.20, and Potassium 3.2 mEq/L. Which action is the highest priority?
A. Start a regular insulin drip at 0.1 units/kg/hr
B. Initiate a bolus of Normal Saline
C. Administer sodium bicarbonate to correct acidosis
D. Administer IV potassium replacement
Answer: D
Rationale
Insulin will shift potassium into the cells, further lowering serum levels. If the potassium is already low (3.2 mEq/L), it must be
corrected before or concurrent with insulin to prevent fatal arrhythmias. Understanding this concept is essential for safe clinical
decision-making. Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link
assessment data to the primary disease process and anticipated complications.
Question 3
Which clinical manifestation distinguishes Hyperosmolar Hyperglycemic Syndrome (HHS) from Diabetic Ketoacidosis
(DKA)?
A. Blood glucose levels exceeding 400 mg/dL
B. Severe dehydration and hypotension
C. Absence of significant ketosis
D. Presence of Altered Mental Status
Answer: C
Rationale
Unlike DKA, HHS patients usually have enough endogenous insulin to prevent lipolysis and subsequent ketone formation,
though glucose levels are often much higher in HHS. Understanding this concept is essential for safe clinical decision-making.
Incorrect choices often reflect common misconceptions about pathophysiology or prioritization. Always link assessment data to
the primary disease process and anticipated complications.
Page 3
