NU 185
Medical-Surgical Nursing II - Exam
4 (Critical Care & Complex Systems)
Exam 4 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Medical-Surgical Nursing II - Exam 4 (Critical Care & Complex Systems) 2026/2027
UPDATED – Galen
1. A patient in the ICU has a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg. Which
clinical finding should the nurse anticipate?
A. Flattened neck veins and dry mucous membranes
B. Peripheral vasodilation and warm extremities
C. Bilateral crackles and dyspnea
D. Increased urinary output and bradycardia
Answer: C
Rationale: Normal PAWP is 6-12 mmHg. An elevation to 22 mmHg indicates left-sided
heart failure or fluid volume overload, leading to pulmonary congestion and crackles.
2. A nurse is caring for a patient in the compensatory stage of shock. Which physiological
response is characteristic of this stage?
A. Decreased heart rate to conserve myocardial oxygen
B. Metabolic alkalosis due to rapid respirations
C. Activation of the renin-angiotensin-aldosterone system
D. Increased capillary permeability and edema
, Answer: C
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
the RAAS and sympathetic nervous system activation to maintain blood pressure and
perfusion.
3. A patient with a spinal cord injury at T3 presents with a blood pressure of 190/100 mmHg,
a severe headache, and flushing above the level of injury. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Place the patient in a supine position
C. Check the patient’s bladder for distension
D. Prepare for immediate endotracheal intubation
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the stimulus, often a full bladder or impacted bowel, while sitting the patient upright.
4. Which arterial blood gas (ABG) result is most indicative of early Acute Respiratory Distress
Syndrome (ARDS)?
A. pH 7.48, PaCO2 30, PaO2 58
B. pH 7.30, PaCO2 55, PaO2 60
C. pH 7.35, PaCO2 40, PaO2 95
D. pH 7.25, PaCO2 60, PaO2 50
Medical-Surgical Nursing II - Exam
4 (Critical Care & Complex Systems)
Exam 4 • Practice Questions & Rationales
UPDATE
Actual Questions & Verified Answers
with Detailed Clinical Rationales
Practice Questions with Rationales
Galen College of Nursing
NU 185
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NU 185 Medical-Surgical Nursing II - Exam 4 (Critical Care & Complex Systems) 2026/2027
UPDATED – Galen
1. A patient in the ICU has a Pulmonary Artery Wedge Pressure (PAWP) of 22 mmHg. Which
clinical finding should the nurse anticipate?
A. Flattened neck veins and dry mucous membranes
B. Peripheral vasodilation and warm extremities
C. Bilateral crackles and dyspnea
D. Increased urinary output and bradycardia
Answer: C
Rationale: Normal PAWP is 6-12 mmHg. An elevation to 22 mmHg indicates left-sided
heart failure or fluid volume overload, leading to pulmonary congestion and crackles.
2. A nurse is caring for a patient in the compensatory stage of shock. Which physiological
response is characteristic of this stage?
A. Decreased heart rate to conserve myocardial oxygen
B. Metabolic alkalosis due to rapid respirations
C. Activation of the renin-angiotensin-aldosterone system
D. Increased capillary permeability and edema
, Answer: C
Rationale: In the compensatory stage, the body attempts to maintain homeostasis through
the RAAS and sympathetic nervous system activation to maintain blood pressure and
perfusion.
3. A patient with a spinal cord injury at T3 presents with a blood pressure of 190/100 mmHg,
a severe headache, and flushing above the level of injury. What is the priority nursing action?
A. Administer an IV bolus of normal saline
B. Place the patient in a supine position
C. Check the patient’s bladder for distension
D. Prepare for immediate endotracheal intubation
Answer: C
Rationale: These are signs of autonomic dysreflexia. The priority is to identify and remove
the stimulus, often a full bladder or impacted bowel, while sitting the patient upright.
4. Which arterial blood gas (ABG) result is most indicative of early Acute Respiratory Distress
Syndrome (ARDS)?
A. pH 7.48, PaCO2 30, PaO2 58
B. pH 7.30, PaCO2 55, PaO2 60
C. pH 7.35, PaCO2 40, PaO2 95
D. pH 7.25, PaCO2 60, PaO2 50
