NU 185
MEDICAL-SURGICAL NURSING II
Exam 4 Comprehensive Study Guide
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 | Exam 4 Study Guide | 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 | Exam 4 Study Guide | 2026/2027 UPDATE
Question 1
A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL and arterial blood gas results showing a
pH of 7.25. Which assessment finding is most characteristic of this condition?
A. Severe peripheral edema and hypertension
B. Hyperventilation with Kussmaul respirations
C. Neurological tremors and bradycardia
D. Profuse diaphoresis and moist skin
Answer: B
Rationale
Kussmaul respirations are deep, rapid breaths that occur in Diabetic Ketoacidosis (DKA) as the body attempts to compensate
for metabolic acidosis by blowing off carbon dioxide. 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 nurse is caring for a patient who underwent a Transurethral Resection of the Prostate (TURP) and has a continuous
bladder irrigation (CBI) system in place. The nurse notices the drainage has become bright red with numerous clots.
What is the priority nursing action?
A. Notify the surgeon immediately for suspected arterial bleeding
B. Increase the flow rate of the irrigation solution
C. Decrease the flow rate to prevent bladder spasms
D. Administer an oral anticoagulant as prescribed
Answer: B
Rationale
Bright red drainage with clots indicates active bleeding. The nurse should increase the CBI flow rate to flush the clots and
prevent bladder obstruction; if the drainage does not clear, the provider should be notified. 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
Exam 4 Comprehensive Study Guide
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 | Exam 4 Study Guide | 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 | Exam 4 Study Guide | 2026/2027 UPDATE
Question 1
A patient with Type 1 Diabetes is admitted with a blood glucose of 550 mg/dL and arterial blood gas results showing a
pH of 7.25. Which assessment finding is most characteristic of this condition?
A. Severe peripheral edema and hypertension
B. Hyperventilation with Kussmaul respirations
C. Neurological tremors and bradycardia
D. Profuse diaphoresis and moist skin
Answer: B
Rationale
Kussmaul respirations are deep, rapid breaths that occur in Diabetic Ketoacidosis (DKA) as the body attempts to compensate
for metabolic acidosis by blowing off carbon dioxide. 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 nurse is caring for a patient who underwent a Transurethral Resection of the Prostate (TURP) and has a continuous
bladder irrigation (CBI) system in place. The nurse notices the drainage has become bright red with numerous clots.
What is the priority nursing action?
A. Notify the surgeon immediately for suspected arterial bleeding
B. Increase the flow rate of the irrigation solution
C. Decrease the flow rate to prevent bladder spasms
D. Administer an oral anticoagulant as prescribed
Answer: B
Rationale
Bright red drainage with clots indicates active bleeding. The nurse should increase the CBI flow rate to flush the clots and
prevent bladder obstruction; if the drainage does not clear, the provider should be notified. 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
