NUR 170
Medical-Surgical Nursing 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
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical-Surgical Nursing Exam 4 Comprehensive Study Guide 2026/2027 UPDATE –
Galen
1. A nurse is caring for a patient who develops atrial fibrillation with a rapid ventricular
response. The patient’s blood pressure is 88/50 mmHg and they are reporting chest pain.
Which intervention should the nurse anticipate first?
A. Administration of a beta-blocker intravenously
B. Synchronized cardioversion
C. Immediate defibrillation at 200 Joules
D. Performing a carotid sinus massage
Answer: B
Rationale: For a patient with symptomatic or unstable tachycardia (hypotension and chest
pain), synchronized cardioversion is the immediate priority. Defibrillation is used for
pulseless rhythms like V-fib.
2. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which EKG change is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
, D. Shortened PR interval
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves and widened QRS
complexes. U waves are seen in hypokalemia.
3. A nurse is interpreting ABG results for a patient with severe COPD: pH 7.31, PaCO2 58
mmHg, HCO3 32 mEq/L. How should the nurse document these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: C
Rationale: The pH is low (acidosis), PaCO2 is high (respiratory cause), and HCO3 is high
(compensatory response). Since the pH is not back to normal, it is partially compensated.
4. A patient is admitted with a Suspected Myocardial Infarction. The provider orders
Morphine, Oxygen, Nitroglycerin, and Aspirin (MONA). In which order should these be
prioritized based on standard emergency protocol?
A. Nitroglycerin, Morphine, Oxygen, Aspirin
B. Morphine, Oxygen, Aspirin, Nitroglycerin
C. Aspirin, Nitroglycerin, Oxygen, Morphine
Medical-Surgical Nursing 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
NUR 170
✓ 100% Verified Answers
✓ Complete Rationales Included
Exam (elaborations)
Instant PDF Download • Ready for Study
,NUR 170 Medical-Surgical Nursing Exam 4 Comprehensive Study Guide 2026/2027 UPDATE –
Galen
1. A nurse is caring for a patient who develops atrial fibrillation with a rapid ventricular
response. The patient’s blood pressure is 88/50 mmHg and they are reporting chest pain.
Which intervention should the nurse anticipate first?
A. Administration of a beta-blocker intravenously
B. Synchronized cardioversion
C. Immediate defibrillation at 200 Joules
D. Performing a carotid sinus massage
Answer: B
Rationale: For a patient with symptomatic or unstable tachycardia (hypotension and chest
pain), synchronized cardioversion is the immediate priority. Defibrillation is used for
pulseless rhythms like V-fib.
2. A patient with chronic kidney disease (CKD) has a serum potassium level of 6.8 mEq/L.
Which EKG change is the nurse most likely to observe?
A. Tall, peaked T waves
B. ST-segment depression
C. Prominent U waves
, D. Shortened PR interval
Answer: A
Rationale: Hyperkalemia (K+ > 5.0) typically causes tall, peaked T waves and widened QRS
complexes. U waves are seen in hypokalemia.
3. A nurse is interpreting ABG results for a patient with severe COPD: pH 7.31, PaCO2 58
mmHg, HCO3 32 mEq/L. How should the nurse document these findings?
A. Uncompensated respiratory acidosis
B. Fully compensated metabolic alkalosis
C. Partially compensated respiratory acidosis
D. Partially compensated metabolic acidosis
Answer: C
Rationale: The pH is low (acidosis), PaCO2 is high (respiratory cause), and HCO3 is high
(compensatory response). Since the pH is not back to normal, it is partially compensated.
4. A patient is admitted with a Suspected Myocardial Infarction. The provider orders
Morphine, Oxygen, Nitroglycerin, and Aspirin (MONA). In which order should these be
prioritized based on standard emergency protocol?
A. Nitroglycerin, Morphine, Oxygen, Aspirin
B. Morphine, Oxygen, Aspirin, Nitroglycerin
C. Aspirin, Nitroglycerin, Oxygen, Morphine
