NU 185
MEDICAL-SURGICAL NURSING II
Exam 3 Comprehensive Review
UPDATE
51 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 3 Review | 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 3 Review | 2026/2027 UPDATE
Question 1
A patient with Type 1 Diabetes presents to the ER with Kussmaul respirations, fruity breath odor, and a blood glucose of
550 mg/dL. Which lab value is most consistent with a diagnosis of Diabetic Ketoacidosis (DKA)?
A. pH 7.48, Bicarbonate 28 mEq/L
B. pH 7.25, Bicarbonate 12 mEq/L
C. Serum Osmolality 350 mOsm/kg
D. Negative urine ketones
Answer: B
Rationale
DKA is characterized by metabolic acidosis (pH < 7.30, Bicarbonate < 18 mEq/L) and the presence of ketones. High serum
osmolality is more indicative of 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.
Question 2
A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which nursing intervention is a
priority for this patient?
A. Encourage fluid intake to 3L/day
B. Initiate fluid restriction of 800-1000 mL/day
C. Administer Vasopressin as ordered
D. Monitor for hypernatremia
Answer: B
Rationale
SIADH involves excessive ADH, leading to water retention and dilutional hyponatremia. Fluid restriction is the primary
treatment. Administering vasopressin would worsen the condition. 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 3 Comprehensive Review
UPDATE
51 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 3 Review | 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 3 Review | 2026/2027 UPDATE
Question 1
A patient with Type 1 Diabetes presents to the ER with Kussmaul respirations, fruity breath odor, and a blood glucose of
550 mg/dL. Which lab value is most consistent with a diagnosis of Diabetic Ketoacidosis (DKA)?
A. pH 7.48, Bicarbonate 28 mEq/L
B. pH 7.25, Bicarbonate 12 mEq/L
C. Serum Osmolality 350 mOsm/kg
D. Negative urine ketones
Answer: B
Rationale
DKA is characterized by metabolic acidosis (pH < 7.30, Bicarbonate < 18 mEq/L) and the presence of ketones. High serum
osmolality is more indicative of 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.
Question 2
A patient is diagnosed with Syndrome of Inappropriate Antidiuretic Hormone (SIADH). Which nursing intervention is a
priority for this patient?
A. Encourage fluid intake to 3L/day
B. Initiate fluid restriction of 800-1000 mL/day
C. Administer Vasopressin as ordered
D. Monitor for hypernatremia
Answer: B
Rationale
SIADH involves excessive ADH, leading to water retention and dilutional hyponatremia. Fluid restriction is the primary
treatment. Administering vasopressin would worsen the condition. 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
