NU 185 Medical-Surgical Nursing 2 Comprehensive Studyguide
2026/2027 | Complete Questions And Answers (Verified
Answers) | Nu 185 Medical-Surgical Nursing 2 Comprehensive
Exam Prep | Comprehensive Exam Guide 2026&2027
1. A client with acute pulmonary edema is experiencing severe dyspnea and has an oxygen
saturation of 82% on room air. Which nursing action should be performed first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Encourage oral fluids
D. Obtain a 12-lead ECG
Answer: B
Placing the client upright improves lung expansion and decreases venous return, while
supplemental oxygen addresses the immediate life-threatening hypoxemia.
2. A client with chronic heart failure reports gaining 2.5 kg over the past three days. Which
finding most directly explains this weight gain?
A. Increased muscle mass
B. Reduced metabolic rate
C. Fluid retention
D. Decreased appetite
Answer: C
Rapid weight gain in heart failure is most commonly caused by retained fluid. Daily weights
are therefore an important indicator of changing fluid status.
3. A client taking furosemide for heart failure has a potassium level of 2.9 mEq/L. Which
assessment finding should the nurse anticipate?
A. Muscle weakness and dysrhythmias
B. Facial flushing and hypertension
C. Hyperactive bowel sounds
D. Increased deep tendon reflexes
Answer: A
Furosemide can cause potassium loss. Significant hypokalemia can produce muscle weakness
and potentially dangerous cardiac dysrhythmias.
4. A client with left-sided heart failure develops crackles, severe dyspnea, and pink frothy
sputum. Which condition should the nurse suspect?
A. Pulmonary embolism
,B. Pleural effusion
C. Acute pulmonary edema
D. Pneumothorax
Answer: C
Pulmonary edema results from fluid accumulation in the alveoli and commonly presents with
severe dyspnea, crackles, and pink frothy sputum.
5. A client receiving digoxin has an apical pulse of 52/min before the scheduled dose. What
should the nurse do?
A. Administer the medication with food
B. Give half the prescribed dose
C. Recheck the pulse after ambulation
D. Withhold the dose and notify the provider
Answer: D
Digoxin can decrease the heart rate. An adult apical pulse below 60/min is generally a reason
to withhold the dose and seek further evaluation.
6. Which assessment finding is most characteristic of right-sided heart failure?
A. Peripheral edema
B. Pink frothy sputum
C. Severe pulmonary crackles
D. Orthopnea
Answer: A
Right-sided heart failure causes systemic venous congestion, commonly producing dependent
edema, jugular venous distention, hepatomegaly, and weight gain.
7. A client with stable angina reports chest discomfort after climbing stairs that resolves
after resting. How should the nurse interpret this finding?
A. It indicates complete coronary artery occlusion
B. It is consistent with predictable myocardial oxygen demand
C. It indicates an acute myocardial infarction
D. It is characteristic of pericarditis
Answer: B
Stable angina typically occurs with exertion when myocardial oxygen demand increases and
improves with rest or prescribed antianginal therapy.
8. A client arrives in the emergency department reporting crushing substernal chest pain
radiating to the left arm. Which action has the highest priority?
,A. Ask about the client's family history
B. Encourage the client to walk to the radiology department
C. Obtain immediate cardiac assessment and a 12-lead ECG
D. Provide a full dietary history
Answer: C
Acute coronary syndrome requires rapid assessment. A 12-lead ECG helps identify myocardial
ischemia or infarction and guides urgent treatment.
9. A client taking sublingual nitroglycerin for angina reports dizziness after taking the
medication. Which explanation is most appropriate?
A. Nitroglycerin can cause vasodilation and a temporary drop in blood pressure
B. Nitroglycerin causes severe sodium retention
C. Nitroglycerin directly increases blood glucose
D. Nitroglycerin causes bronchoconstriction
Answer: A
Nitroglycerin causes vasodilation, which can lower blood pressure and produce dizziness,
particularly when the client changes position quickly.
10. A client with an acute myocardial infarction suddenly develops ventricular fibrillation
and becomes unresponsive. Which intervention is the priority?
A. Obtain a urine specimen
B. Begin chest physiotherapy
C. Administer oral aspirin
D. Initiate CPR and prepare for immediate defibrillation
Answer: D
Ventricular fibrillation is a pulseless, life-threatening rhythm. Immediate CPR and
defibrillation are essential for survival.
11. A client with atrial fibrillation is prescribed warfarin. Which laboratory value is most
important for monitoring therapeutic effect?
A. Serum sodium
B. INR
C. Serum calcium
D. Hemoglobin A1c
Answer: B
Warfarin therapy is monitored using the international normalized ratio (INR), which measures
the anticoagulant effect and helps guide dosing.
, 12. A client with deep vein thrombosis suddenly develops dyspnea, pleuritic chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Pulmonary embolism
B. Heart failure
C. Pneumonia
D. Pericarditis
Answer: A
A thrombus can dislodge and travel to the pulmonary circulation, causing a potentially fatal
pulmonary embolism characterized by sudden respiratory and cardiovascular changes.
13. Which intervention is appropriate for a client with suspected deep vein thrombosis?
A. Massage the affected leg
B. Encourage vigorous exercise
C. Keep the affected extremity elevated as prescribed and avoid massage
D. Apply continuous pressure directly over the thrombus
Answer: C
Massaging a limb with suspected DVT may dislodge the thrombus. Appropriate management
includes prescribed anticoagulation, activity recommendations, and measures that reduce
venous stasis.
14. A client with hypertension is prescribed an ACE inhibitor. Which laboratory value
should the nurse monitor particularly closely?
A. Potassium
B. Chloride
C. Phosphate
D. Albumin
Answer: A
ACE inhibitors can increase serum potassium, particularly in clients with renal impairment or
those taking other medications that increase potassium.
15. A client taking lisinopril reports swelling of the lips and tongue. What is the nurse's
priority response?
A. Encourage increased oral fluids
B. Hold the medication and obtain emergency assistance
C. Administer the next dose with food
D. Reassure the client that this is expected
Answer: B
2026/2027 | Complete Questions And Answers (Verified
Answers) | Nu 185 Medical-Surgical Nursing 2 Comprehensive
Exam Prep | Comprehensive Exam Guide 2026&2027
1. A client with acute pulmonary edema is experiencing severe dyspnea and has an oxygen
saturation of 82% on room air. Which nursing action should be performed first?
A. Obtain the client's daily weight
B. Place the client in high-Fowler's position and administer prescribed oxygen
C. Encourage oral fluids
D. Obtain a 12-lead ECG
Answer: B
Placing the client upright improves lung expansion and decreases venous return, while
supplemental oxygen addresses the immediate life-threatening hypoxemia.
2. A client with chronic heart failure reports gaining 2.5 kg over the past three days. Which
finding most directly explains this weight gain?
A. Increased muscle mass
B. Reduced metabolic rate
C. Fluid retention
D. Decreased appetite
Answer: C
Rapid weight gain in heart failure is most commonly caused by retained fluid. Daily weights
are therefore an important indicator of changing fluid status.
3. A client taking furosemide for heart failure has a potassium level of 2.9 mEq/L. Which
assessment finding should the nurse anticipate?
A. Muscle weakness and dysrhythmias
B. Facial flushing and hypertension
C. Hyperactive bowel sounds
D. Increased deep tendon reflexes
Answer: A
Furosemide can cause potassium loss. Significant hypokalemia can produce muscle weakness
and potentially dangerous cardiac dysrhythmias.
4. A client with left-sided heart failure develops crackles, severe dyspnea, and pink frothy
sputum. Which condition should the nurse suspect?
A. Pulmonary embolism
,B. Pleural effusion
C. Acute pulmonary edema
D. Pneumothorax
Answer: C
Pulmonary edema results from fluid accumulation in the alveoli and commonly presents with
severe dyspnea, crackles, and pink frothy sputum.
5. A client receiving digoxin has an apical pulse of 52/min before the scheduled dose. What
should the nurse do?
A. Administer the medication with food
B. Give half the prescribed dose
C. Recheck the pulse after ambulation
D. Withhold the dose and notify the provider
Answer: D
Digoxin can decrease the heart rate. An adult apical pulse below 60/min is generally a reason
to withhold the dose and seek further evaluation.
6. Which assessment finding is most characteristic of right-sided heart failure?
A. Peripheral edema
B. Pink frothy sputum
C. Severe pulmonary crackles
D. Orthopnea
Answer: A
Right-sided heart failure causes systemic venous congestion, commonly producing dependent
edema, jugular venous distention, hepatomegaly, and weight gain.
7. A client with stable angina reports chest discomfort after climbing stairs that resolves
after resting. How should the nurse interpret this finding?
A. It indicates complete coronary artery occlusion
B. It is consistent with predictable myocardial oxygen demand
C. It indicates an acute myocardial infarction
D. It is characteristic of pericarditis
Answer: B
Stable angina typically occurs with exertion when myocardial oxygen demand increases and
improves with rest or prescribed antianginal therapy.
8. A client arrives in the emergency department reporting crushing substernal chest pain
radiating to the left arm. Which action has the highest priority?
,A. Ask about the client's family history
B. Encourage the client to walk to the radiology department
C. Obtain immediate cardiac assessment and a 12-lead ECG
D. Provide a full dietary history
Answer: C
Acute coronary syndrome requires rapid assessment. A 12-lead ECG helps identify myocardial
ischemia or infarction and guides urgent treatment.
9. A client taking sublingual nitroglycerin for angina reports dizziness after taking the
medication. Which explanation is most appropriate?
A. Nitroglycerin can cause vasodilation and a temporary drop in blood pressure
B. Nitroglycerin causes severe sodium retention
C. Nitroglycerin directly increases blood glucose
D. Nitroglycerin causes bronchoconstriction
Answer: A
Nitroglycerin causes vasodilation, which can lower blood pressure and produce dizziness,
particularly when the client changes position quickly.
10. A client with an acute myocardial infarction suddenly develops ventricular fibrillation
and becomes unresponsive. Which intervention is the priority?
A. Obtain a urine specimen
B. Begin chest physiotherapy
C. Administer oral aspirin
D. Initiate CPR and prepare for immediate defibrillation
Answer: D
Ventricular fibrillation is a pulseless, life-threatening rhythm. Immediate CPR and
defibrillation are essential for survival.
11. A client with atrial fibrillation is prescribed warfarin. Which laboratory value is most
important for monitoring therapeutic effect?
A. Serum sodium
B. INR
C. Serum calcium
D. Hemoglobin A1c
Answer: B
Warfarin therapy is monitored using the international normalized ratio (INR), which measures
the anticoagulant effect and helps guide dosing.
, 12. A client with deep vein thrombosis suddenly develops dyspnea, pleuritic chest pain, and
tachycardia. Which complication should the nurse suspect?
A. Pulmonary embolism
B. Heart failure
C. Pneumonia
D. Pericarditis
Answer: A
A thrombus can dislodge and travel to the pulmonary circulation, causing a potentially fatal
pulmonary embolism characterized by sudden respiratory and cardiovascular changes.
13. Which intervention is appropriate for a client with suspected deep vein thrombosis?
A. Massage the affected leg
B. Encourage vigorous exercise
C. Keep the affected extremity elevated as prescribed and avoid massage
D. Apply continuous pressure directly over the thrombus
Answer: C
Massaging a limb with suspected DVT may dislodge the thrombus. Appropriate management
includes prescribed anticoagulation, activity recommendations, and measures that reduce
venous stasis.
14. A client with hypertension is prescribed an ACE inhibitor. Which laboratory value
should the nurse monitor particularly closely?
A. Potassium
B. Chloride
C. Phosphate
D. Albumin
Answer: A
ACE inhibitors can increase serum potassium, particularly in clients with renal impairment or
those taking other medications that increase potassium.
15. A client taking lisinopril reports swelling of the lips and tongue. What is the nurse's
priority response?
A. Encourage increased oral fluids
B. Hold the medication and obtain emergency assistance
C. Administer the next dose with food
D. Reassure the client that this is expected
Answer: B
