NU 185
MEDICAL-SURGICAL NURSING II
Medical-Surgical Nursing II Review 9
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 9 | 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 9 | 2026/2027 UPDATE
Question 1
A patient is admitted with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which clinical condition most
likely accounts for these arterial blood gas (ABG) results?
A. Prolonged hyperventilation due to a panic attack
B. Excessive ingestion of sodium bicarbonate for heartburn
C. Severe diabetic ketoacidosis with Kussmaul respirations
D. Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
Answer: D
Rationale
A pH of 7.28 is acidic. A PaCO2 of 52 is high (respiratory), and the HCO3 is normal, indicating uncompensated respiratory
acidosis. COPD leads to CO2 retention, fitting this profile. 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
A patient with a history of heart failure is experiencing sudden shortness of breath, pink frothy sputum, and a heart rate
of 120 bpm. What is the priority nursing intervention?
A. Administering a prescribed bolus of IV Normal Saline
B. Obtaining a 12-lead EKG to check for myocardial infarction
C. Positioning the patient in high-Fowler’s position with legs dependent
D. Preparing the patient for immediate synchronized cardioversion
Answer: C
Rationale
Pink frothy sputum is a classic sign of pulmonary edema. High-Fowler’s position with legs dependent helps decrease venous
return to the heart (preload) and improves oxygenation. 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 9
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 9 | 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 9 | 2026/2027 UPDATE
Question 1
A patient is admitted with a pH of 7.28, PaCO2 of 52 mmHg, and HCO3 of 26 mEq/L. Which clinical condition most
likely accounts for these arterial blood gas (ABG) results?
A. Prolonged hyperventilation due to a panic attack
B. Excessive ingestion of sodium bicarbonate for heartburn
C. Severe diabetic ketoacidosis with Kussmaul respirations
D. Acute exacerbation of Chronic Obstructive Pulmonary Disease (COPD)
Answer: D
Rationale
A pH of 7.28 is acidic. A PaCO2 of 52 is high (respiratory), and the HCO3 is normal, indicating uncompensated respiratory
acidosis. COPD leads to CO2 retention, fitting this profile. 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
A patient with a history of heart failure is experiencing sudden shortness of breath, pink frothy sputum, and a heart rate
of 120 bpm. What is the priority nursing intervention?
A. Administering a prescribed bolus of IV Normal Saline
B. Obtaining a 12-lead EKG to check for myocardial infarction
C. Positioning the patient in high-Fowler’s position with legs dependent
D. Preparing the patient for immediate synchronized cardioversion
Answer: C
Rationale
Pink frothy sputum is a classic sign of pulmonary edema. High-Fowler’s position with legs dependent helps decrease venous
return to the heart (preload) and improves oxygenation. 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
