,NU 189 Medical-Surgical Nursing II
Exam Prep — Comprehensive Review +
Practice MCQs — Galen College of
Nursing 2025/2026
1. The nurse is caring for a patient with acute pericarditis. Which position should the nurse encourage to
relieve the patient's chest pain?
A. Supine with legs elevated
B. Sitting upright and leaning forward
C. Left lateral recumbent
D. Trendelenburg
Correct Answer: B. Sitting upright and leaning forward
Rationale: Leaning forward reduces pressure on the inflamed pericardium, relieving pain in acute pericarditis.
Supine positioning worsens pain, and lateral or Trendelenburg positions do not provide the same relief .
2. The nurse is teaching a patient with angina about sublingual nitroglycerin. Which statement by the patient
indicates correct understanding?
A. "I should swallow the tablet with water."
B. "I can take up to three doses, 5 minutes apart, and call 911 if pain persists."
C. "I can take as many doses as I need."
D. "I should take nitroglycerin only if my blood pressure is high."
,Correct Answer: B. "I can take up to three doses, 5 minutes apart, and call 911 if pain persists."
Rationale: Standard guidelines recommend up to three doses at 5-minute intervals. If pain is unrelieved,
emergency services must be activated. Swallowing the tablet prevents rapid absorption, and unlimited dosing
is unsafe .
3. Which cardiac biomarker is the most specific indicator of myocardial injury?
A. C-reactive protein
B. B-type natriuretic peptide
C. Troponin
D. Creatine kinase-MB
Correct Answer: C. Troponin
Rationale: Troponin is the most specific and sensitive cardiac biomarker for myocardial injury. It rises within 3–
4 hours of infarction and remains elevated for up to 10–14 days. BNP indicates heart failure, and CK-MB is less
specific .
4. The nurse observes fluctuation of the water level in the water seal chamber with each respiration in a
patient with a chest tube. Which action is required?
A. Clamp the chest tube immediately
B. Notify the health care provider
C. Continue to monitor; this is a normal finding
D. Prepare for chest tube removal
, Correct Answer: C. Continue to monitor; this is a normal finding
Rationale: Tidaling (fluctuation of the water level with breathing) indicates that the chest tube is patent and
the system is functioning properly. No intervention is needed .
5. A patient with a chest tube suddenly becomes disconnected from the drainage system. What is the priority
nursing action?
A. Clamp the chest tube immediately
B. Place the end of the chest tube in a container of sterile water
C. Reconnect the tube to the drainage system and tape it
D. Notify the provider and prepare for a new chest tube insertion
Correct Answer: B. Place the end of the chest tube in a container of sterile water
Rationale: Placing the disconnected end under sterile water creates an underwater seal, preventing air from
entering the pleural space and causing a tension pneumothorax .
6. A patient with cirrhosis is assessed for hand flapping when the wrists are extended. This finding is known as:
A. Asterixis
B. Fasciculations
C. Myoclonus
D. Tremor at rest
Exam Prep — Comprehensive Review +
Practice MCQs — Galen College of
Nursing 2025/2026
1. The nurse is caring for a patient with acute pericarditis. Which position should the nurse encourage to
relieve the patient's chest pain?
A. Supine with legs elevated
B. Sitting upright and leaning forward
C. Left lateral recumbent
D. Trendelenburg
Correct Answer: B. Sitting upright and leaning forward
Rationale: Leaning forward reduces pressure on the inflamed pericardium, relieving pain in acute pericarditis.
Supine positioning worsens pain, and lateral or Trendelenburg positions do not provide the same relief .
2. The nurse is teaching a patient with angina about sublingual nitroglycerin. Which statement by the patient
indicates correct understanding?
A. "I should swallow the tablet with water."
B. "I can take up to three doses, 5 minutes apart, and call 911 if pain persists."
C. "I can take as many doses as I need."
D. "I should take nitroglycerin only if my blood pressure is high."
,Correct Answer: B. "I can take up to three doses, 5 minutes apart, and call 911 if pain persists."
Rationale: Standard guidelines recommend up to three doses at 5-minute intervals. If pain is unrelieved,
emergency services must be activated. Swallowing the tablet prevents rapid absorption, and unlimited dosing
is unsafe .
3. Which cardiac biomarker is the most specific indicator of myocardial injury?
A. C-reactive protein
B. B-type natriuretic peptide
C. Troponin
D. Creatine kinase-MB
Correct Answer: C. Troponin
Rationale: Troponin is the most specific and sensitive cardiac biomarker for myocardial injury. It rises within 3–
4 hours of infarction and remains elevated for up to 10–14 days. BNP indicates heart failure, and CK-MB is less
specific .
4. The nurse observes fluctuation of the water level in the water seal chamber with each respiration in a
patient with a chest tube. Which action is required?
A. Clamp the chest tube immediately
B. Notify the health care provider
C. Continue to monitor; this is a normal finding
D. Prepare for chest tube removal
, Correct Answer: C. Continue to monitor; this is a normal finding
Rationale: Tidaling (fluctuation of the water level with breathing) indicates that the chest tube is patent and
the system is functioning properly. No intervention is needed .
5. A patient with a chest tube suddenly becomes disconnected from the drainage system. What is the priority
nursing action?
A. Clamp the chest tube immediately
B. Place the end of the chest tube in a container of sterile water
C. Reconnect the tube to the drainage system and tape it
D. Notify the provider and prepare for a new chest tube insertion
Correct Answer: B. Place the end of the chest tube in a container of sterile water
Rationale: Placing the disconnected end under sterile water creates an underwater seal, preventing air from
entering the pleural space and causing a tension pneumothorax .
6. A patient with cirrhosis is assessed for hand flapping when the wrists are extended. This finding is known as:
A. Asterixis
B. Fasciculations
C. Myoclonus
D. Tremor at rest
