STUDY REVIEW
M E D I C A L- S U R G I C A L N U R S I N G I - E X A M 4 R E V I E W
NU 155 / NU 155 - Exam 4 Review
Medical-Surgical Nursing I Study Guide -
Complete
Exam Review & Study Guide
50 QUESTIONS FULL RATIONALES ANSWER KEY INCLUDED
50 5 100%
Q U ES T IO N S S EC T IO N S R AT IO N A L ES
WHAT THIS COVERS
01 Lower Respiratory Disorders & Oxygenation
02 Cardiovascular & Perfusion Nursing Care
03 Hematologic & Immunologic Disorders
04 Musculoskeletal & Mobility Nursing
05 Skin Integrity, Wound Care & Nutrition
AB OUT T H I S S T UDY G UI DE
Fifty original practice questions with detailed rationales for independent course review.
Every scenario, option, and rationale was newly written for this document and accuracy-checked.
Topics follow the publicly documented NU 155 medical-surgical curriculum at Galen College of Nursing.
Independent and unofficial: not affiliated with, endorsed by, or sourced from any institution, and not a record of any administered
examination.
PA S S I N G S C O R E LEVEL F O R M AT
75% - 38/50 Correct RN - Application & Analysis PDF - 50 Items + Key
EXAM REVIEW STU D Y AID Page 1
, SECTION 01 - LOWER RESPIRATORY DISORDERS & OXYGENATION
Q1. A client admitted with community-acquired pneumonia has a respiratory rate of 26, coarse crackles, and
a weak cough with thick secretions. Which nursing interventions form the priority airway-clearance plan?
A. Encourage fluids, teach deep breathing and coughing with splinting, and use incentive spirometry while
positioning semi-Fowler
B. Restrict fluids to reduce secretions and schedule chest physiotherapy only after meals
C. Place the client flat to promote venous return and suppress the cough reflex
D. Suction the client routinely every 30 minutes whether or not secretions are present
Correct Answer: A
Rationale: Pneumonia nursing centers on mobilizing secretions and improving gas exchange: hydration thins mucus,
deep breathing with coughing and incentive spirometry expand alveoli and clear airways, and upright positioning
improves ventilation. Routine suctioning traumatizes mucosa and is reserved for clients who cannot clear secretions
independently.
Q2. A client starting treatment for active tuberculosis asks why so many pills are required and why the nurse
watches him take them. Which teaching set is accurate?
A. Multiple drugs prevent resistance, therapy lasts months, and direct observation supports completion of
the full regimen
B. One drug would suffice if taken perfectly, and observed therapy is only for clients who cannot read
C. The pills can be stopped once the sputum converts and the cough resolves
D. Pyridoxine is given to prevent the orange discoloration caused by rifampin
Correct Answer: A
Rationale: Multidrug therapy with RIPE agents prevents the emergence of resistant organisms, treatment continues for
six months or longer despite symptom improvement, and directly observed therapy is the standard support that ensures
completion. Stopping at sputum conversion invites relapse and resistance, and pyridoxine prevents isoniazid neuropathy
rather than rifampin effects.
Q3. A charge nurse is matching isolation precautions to clients: one with active pulmonary tuberculosis, one
with pertussis, and one with Clostridioides difficile infection. Which assignments are correct?
A. Contact for all three because organisms transmit on hands and equipment
B. Droplet for tuberculosis, airborne for pertussis, and standard for C. difficile
C. Airborne for tuberculosis, droplet for pertussis, and contact for C. difficile
D. Airborne for all three because all organisms travel on dust particles
Correct Answer: C
Rationale: Tuberculosis spreads on droplet nuclei requiring airborne precautions with an N95 respirator, pertussis
transmits in larger respiratory droplets requiring droplet precautions with a surgical mask, and C. difficile spreads by
spore contact requiring contact precautions with soap-and-water hand hygiene. Matching organism to route is the core of
transmission-based precautions.
EXAM REVIEW STUDY AID Page 2
, Q4. A client with COPD requires oxygen and is at risk for carbon dioxide retention, while a trauma client in
the emergency department is severely hypoxic with inadequate spontaneous breathing and needs the
highest possible oxygen concentration. Which delivery devices best match each client?
A. Simple face mask for both, adjusted by adding liters of flow
B. Nonrebreather for the COPD client and nasal cannula for the trauma client
C. Venturi mask for precise titrated oxygen in the COPD client, and nonrebreather mask for the critically
hypoxic trauma client
D. Nasal cannula for both clients because all devices deliver equivalent concentrations
Correct Answer: C
Rationale: The Venturi mask entrains room air to deliver a precisely known fraction of inspired oxygen, the safest
choice when suppressing respiratory drive is a concern, while a nonrebreather reservoir delivers the highest practical
concentration for acute severe hypoxemia. Device selection is driven by the precision or concentration needed, and
cannulas and simple masks cannot meet either extreme.
Q5. A client with bronchiectasis is scheduled for postural drainage and percussion twice daily. Which
scheduling instruction should the nurse emphasize?
A. Schedule sessions immediately after meals to use the increased mucus production
B. Schedule sessions before meals or at least an hour and a half after eating to avoid nausea and vomiting
C. Perform drainage only at bedtime and never during daylight hours
D. Hold all sessions on days when the client feels unusually well
Correct Answer: B
Rationale: Position changes and percussion of dependent lobes commonly provoke coughing and gagging, so sessions
are timed before meals or well after eating to prevent aspiration and vomiting. Symptom-free days still require treatment
because bronchiectasis clearance is chronic and preventive, not symptom-triggered.
Q6. A postoperative client returns from abdominal surgery with an incentive spirometer at the bedside. Which
teaching demonstrates correct use?
A. Blow out forcefully into the device to inflate the piston as far as possible
B. Inhale and exhale rapidly through the device for one full minute each hour to mobilize secretions
C. Use the device only when pain medication is due so discomfort does not interfere
D. Exhale normally, seal lips around the mouthpiece, inhale slowly and deeply, hold the breath briefly, and
repeat about ten times hourly while awake
Correct Answer: D
Rationale: Incentive spirometry mimics a sustained maximal inspiration: slow deep inhalation, an inspiratory hold that
stents alveoli open, and frequent repetition while awake to prevent and treat atelectasis. It is an inhaled maneuver, not a
blowing one, and spacing use around analgesia rather than timing it optimally limits effectiveness.
EXAM REVIEW STUDY AID Page 3
M E D I C A L- S U R G I C A L N U R S I N G I - E X A M 4 R E V I E W
NU 155 / NU 155 - Exam 4 Review
Medical-Surgical Nursing I Study Guide -
Complete
Exam Review & Study Guide
50 QUESTIONS FULL RATIONALES ANSWER KEY INCLUDED
50 5 100%
Q U ES T IO N S S EC T IO N S R AT IO N A L ES
WHAT THIS COVERS
01 Lower Respiratory Disorders & Oxygenation
02 Cardiovascular & Perfusion Nursing Care
03 Hematologic & Immunologic Disorders
04 Musculoskeletal & Mobility Nursing
05 Skin Integrity, Wound Care & Nutrition
AB OUT T H I S S T UDY G UI DE
Fifty original practice questions with detailed rationales for independent course review.
Every scenario, option, and rationale was newly written for this document and accuracy-checked.
Topics follow the publicly documented NU 155 medical-surgical curriculum at Galen College of Nursing.
Independent and unofficial: not affiliated with, endorsed by, or sourced from any institution, and not a record of any administered
examination.
PA S S I N G S C O R E LEVEL F O R M AT
75% - 38/50 Correct RN - Application & Analysis PDF - 50 Items + Key
EXAM REVIEW STU D Y AID Page 1
, SECTION 01 - LOWER RESPIRATORY DISORDERS & OXYGENATION
Q1. A client admitted with community-acquired pneumonia has a respiratory rate of 26, coarse crackles, and
a weak cough with thick secretions. Which nursing interventions form the priority airway-clearance plan?
A. Encourage fluids, teach deep breathing and coughing with splinting, and use incentive spirometry while
positioning semi-Fowler
B. Restrict fluids to reduce secretions and schedule chest physiotherapy only after meals
C. Place the client flat to promote venous return and suppress the cough reflex
D. Suction the client routinely every 30 minutes whether or not secretions are present
Correct Answer: A
Rationale: Pneumonia nursing centers on mobilizing secretions and improving gas exchange: hydration thins mucus,
deep breathing with coughing and incentive spirometry expand alveoli and clear airways, and upright positioning
improves ventilation. Routine suctioning traumatizes mucosa and is reserved for clients who cannot clear secretions
independently.
Q2. A client starting treatment for active tuberculosis asks why so many pills are required and why the nurse
watches him take them. Which teaching set is accurate?
A. Multiple drugs prevent resistance, therapy lasts months, and direct observation supports completion of
the full regimen
B. One drug would suffice if taken perfectly, and observed therapy is only for clients who cannot read
C. The pills can be stopped once the sputum converts and the cough resolves
D. Pyridoxine is given to prevent the orange discoloration caused by rifampin
Correct Answer: A
Rationale: Multidrug therapy with RIPE agents prevents the emergence of resistant organisms, treatment continues for
six months or longer despite symptom improvement, and directly observed therapy is the standard support that ensures
completion. Stopping at sputum conversion invites relapse and resistance, and pyridoxine prevents isoniazid neuropathy
rather than rifampin effects.
Q3. A charge nurse is matching isolation precautions to clients: one with active pulmonary tuberculosis, one
with pertussis, and one with Clostridioides difficile infection. Which assignments are correct?
A. Contact for all three because organisms transmit on hands and equipment
B. Droplet for tuberculosis, airborne for pertussis, and standard for C. difficile
C. Airborne for tuberculosis, droplet for pertussis, and contact for C. difficile
D. Airborne for all three because all organisms travel on dust particles
Correct Answer: C
Rationale: Tuberculosis spreads on droplet nuclei requiring airborne precautions with an N95 respirator, pertussis
transmits in larger respiratory droplets requiring droplet precautions with a surgical mask, and C. difficile spreads by
spore contact requiring contact precautions with soap-and-water hand hygiene. Matching organism to route is the core of
transmission-based precautions.
EXAM REVIEW STUDY AID Page 2
, Q4. A client with COPD requires oxygen and is at risk for carbon dioxide retention, while a trauma client in
the emergency department is severely hypoxic with inadequate spontaneous breathing and needs the
highest possible oxygen concentration. Which delivery devices best match each client?
A. Simple face mask for both, adjusted by adding liters of flow
B. Nonrebreather for the COPD client and nasal cannula for the trauma client
C. Venturi mask for precise titrated oxygen in the COPD client, and nonrebreather mask for the critically
hypoxic trauma client
D. Nasal cannula for both clients because all devices deliver equivalent concentrations
Correct Answer: C
Rationale: The Venturi mask entrains room air to deliver a precisely known fraction of inspired oxygen, the safest
choice when suppressing respiratory drive is a concern, while a nonrebreather reservoir delivers the highest practical
concentration for acute severe hypoxemia. Device selection is driven by the precision or concentration needed, and
cannulas and simple masks cannot meet either extreme.
Q5. A client with bronchiectasis is scheduled for postural drainage and percussion twice daily. Which
scheduling instruction should the nurse emphasize?
A. Schedule sessions immediately after meals to use the increased mucus production
B. Schedule sessions before meals or at least an hour and a half after eating to avoid nausea and vomiting
C. Perform drainage only at bedtime and never during daylight hours
D. Hold all sessions on days when the client feels unusually well
Correct Answer: B
Rationale: Position changes and percussion of dependent lobes commonly provoke coughing and gagging, so sessions
are timed before meals or well after eating to prevent aspiration and vomiting. Symptom-free days still require treatment
because bronchiectasis clearance is chronic and preventive, not symptom-triggered.
Q6. A postoperative client returns from abdominal surgery with an incentive spirometer at the bedside. Which
teaching demonstrates correct use?
A. Blow out forcefully into the device to inflate the piston as far as possible
B. Inhale and exhale rapidly through the device for one full minute each hour to mobilize secretions
C. Use the device only when pain medication is due so discomfort does not interfere
D. Exhale normally, seal lips around the mouthpiece, inhale slowly and deeply, hold the breath briefly, and
repeat about ten times hourly while awake
Correct Answer: D
Rationale: Incentive spirometry mimics a sustained maximal inspiration: slow deep inhalation, an inspiratory hold that
stents alveoli open, and frequent repetition while awake to prevent and treat atelectasis. It is an inhaled maneuver, not a
blowing one, and spacing use around analgesia rather than timing it optimally limits effectiveness.
EXAM REVIEW STUDY AID Page 3
