NU 185
Medical-Surgical Nursing II Exam
4 Comprehensive Study Guide
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 Comprehensive Study Guide 2026/2027 UPDATE –
Galen
1. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering first to stabilize the cardiac
membrane?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Rationale: In severe hyperkalemia, calcium gluconate is the priority to stabilize the
myocardium and prevent life-threatening arrhythmias, although it does not lower the
potassium level itself.
2. An adult patient presents with burns to the entire right arm, the entire right leg, and the
anterior chest. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA)
affected?
A. 27%
B. 45%
, C. 36%
D. 54%
Answer: B
Rationale: Rule of Nines: Entire arm (9%) + Entire leg (18%) + Anterior chest (18%) =
45%.
3. The nurse is monitoring a patient with a traumatic brain injury. Which assessment finding
is most indicative of Cushing’s Triad?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, widening pulse pressure, and irregular respirations
C. Hypotension, muffled heart sounds, and JVD
D. Headache, nuchal rigidity, and photophobia
Answer: B
Rationale: Cushing’s Triad (bradycardia, hypertension with widening pulse pressure, and
irregular breathing) is a late sign of increased intracranial pressure.
4. A patient with a head injury develops polyuria (up to 500 mL/hr) and a urine specific
gravity of 1.002. Which condition does the nurse suspect?
A. Diabetes Insipidus (DI)
B. Diabetes Mellitus Type 1
C. Acute Kidney Injury
Medical-Surgical Nursing II Exam
4 Comprehensive Study Guide
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 Comprehensive Study Guide 2026/2027 UPDATE –
Galen
1. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which medication should the nurse anticipate administering first to stabilize the cardiac
membrane?
A. Sodium polystyrene sulfonate
B. Regular insulin and D50W
C. Calcium gluconate
D. Furosemide
Answer: C
Rationale: In severe hyperkalemia, calcium gluconate is the priority to stabilize the
myocardium and prevent life-threatening arrhythmias, although it does not lower the
potassium level itself.
2. An adult patient presents with burns to the entire right arm, the entire right leg, and the
anterior chest. Using the Rule of Nines, what is the estimated Total Body Surface Area (TBSA)
affected?
A. 27%
B. 45%
, C. 36%
D. 54%
Answer: B
Rationale: Rule of Nines: Entire arm (9%) + Entire leg (18%) + Anterior chest (18%) =
45%.
3. The nurse is monitoring a patient with a traumatic brain injury. Which assessment finding
is most indicative of Cushing’s Triad?
A. Tachycardia, hypotension, and tachypnea
B. Bradycardia, widening pulse pressure, and irregular respirations
C. Hypotension, muffled heart sounds, and JVD
D. Headache, nuchal rigidity, and photophobia
Answer: B
Rationale: Cushing’s Triad (bradycardia, hypertension with widening pulse pressure, and
irregular breathing) is a late sign of increased intracranial pressure.
4. A patient with a head injury develops polyuria (up to 500 mL/hr) and a urine specific
gravity of 1.002. Which condition does the nurse suspect?
A. Diabetes Insipidus (DI)
B. Diabetes Mellitus Type 1
C. Acute Kidney Injury
