NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 4
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 4 | 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 4 | 2026/2027 UPDATE
Question 1
A patient with a history of COPD is admitted with an acute exacerbation. The ABG results are: pH 7.30, PaCO2 55,
HCO3 28, and PaO2 60. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale
The pH is low (acidosis), the PaCO2 is high (respiratory component), and the HCO3 is slightly elevated (compensatory). This
indicates respiratory acidosis. 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 2
When caring for a patient with a chest tube, the nurse notes continuous bubbling in the water seal chamber. What is the
priority nursing action?
A. Document this as a normal finding.
B. Clamp the tube immediately near the insertion site.
C. Increase the suction to 20 cm H2O.
D. Check the system for an air leak.
Answer: D
Rationale
Continuous bubbling in the water seal chamber indicates an air leak in the system or the patient’s pleural space, requiring
investigation. 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 4
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 4 | 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 4 | 2026/2027 UPDATE
Question 1
A patient with a history of COPD is admitted with an acute exacerbation. The ABG results are: pH 7.30, PaCO2 55,
HCO3 28, and PaO2 60. Which acid-base imbalance is the patient experiencing?
A. Respiratory Acidosis
B. Metabolic Acidosis
C. Metabolic Alkalosis
D. Respiratory Alkalosis
Answer: A
Rationale
The pH is low (acidosis), the PaCO2 is high (respiratory component), and the HCO3 is slightly elevated (compensatory). This
indicates respiratory acidosis. 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 2
When caring for a patient with a chest tube, the nurse notes continuous bubbling in the water seal chamber. What is the
priority nursing action?
A. Document this as a normal finding.
B. Clamp the tube immediately near the insertion site.
C. Increase the suction to 20 cm H2O.
D. Check the system for an air leak.
Answer: D
Rationale
Continuous bubbling in the water seal chamber indicates an air leak in the system or the patient’s pleural space, requiring
investigation. 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
