NU 185
EXAM 2
NCLEX Style Questions w/ Rationales
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
This document contains NCLEX-style
Exam questions tailored to the NU 185
course at Galen College of Nursing
It covers core topics assessed in the
course and reflects the actual exam format
and question style.
, Each question is followed by a correct answer and rationale
to support exam preparation.
Which layer of the heart is responsible for the forceful contractions that pump blood throughout
the body?
A. Epicardium
B. Myocardium
C. Endocardium
D. Pericardium
Correct Answer: B. Myocardium
Rationale: The myocardium is the thick muscular middle layer responsible for the heart's contractions
and pumping action.
Which of the following correctly describes the flow of oxygenated blood?
A. Right atrium → right ventricle → pulmonary artery
B. Pulmonary veins → left atrium → left ventricle
C. Superior vena cava → right atrium → right ventricle
D. Left ventricle → right atrium → lungs
Correct Answer: B. Pulmonary veins → left atrium → left ventricle
Rationale: Oxygenated blood returns from the lungs through the pulmonary veins to the left atrium, then
moves to the left ventricle before being pumped to the rest of the body.
Which vessel type is responsible for gas exchange at the tissue level?
A. Arteries
B. Veins
C. Capillaries
D. Venules
Correct Answer: C. Capillaries
Rationale: Capillaries are the smallest blood vessels where oxygen and carbon dioxide exchange occurs
between blood and tissues.
Which vessel carries deoxygenated blood away from the heart?
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Inferior vena cava
Correct Answer: B. Pulmonary artery
Rationale: The pulmonary artery is the only artery that carries deoxygenated blood, transporting it from
the right ventricle to the lungs for oxygenation.
, A nurse is assessing a client with decreased tissue perfusion. Which finding would support this
diagnosis?
A. Warm, pink skin
B. Bounding peripheral pulses
C. Capillary refill less than 2 seconds
D. Cool extremities and weak pulses
Correct Answer: D. Cool extremities and weak pulses
Rationale: Decreased perfusion results in poor blood flow to extremities, leading to cool skin and weak
pulses.
A patient arrives at the emergency department with chest pain that began 6 hours ago. Which
cardiac marker is most specific for diagnosing myocardial infarction (MI)?
A. Myoglobin
B. Creatinine Kinase (CK)
C. Troponin
D. B-type Natriuretic Peptide (BNP)
Correct Answer: C. Troponin
Rationale: Troponin is the gold standard for diagnosing myocardial infarction because of its high
specificity to cardiac muscle and long elevation time after injury.
A patient presents with shortness of breath, fatigue, and peripheral edema. Which lab value would
best support a diagnosis of heart failure?
A. Troponin: 0.2 ng/ml
B. BNP: 450 pg/ml
C. Myoglobin: 80 ng/ml
D. CK: 0.2 ng/ml
Correct Answer: B. BNP: 450 pg/ml
Rationale: BNP is elevated in response to ventricular stretch and fluid overload, which are common in
heart failure. A level above 100 pg/ml is indicative of heart failure.
A patient's CK level is 0.5 ng/ml. What does this most likely indicate?
A. Normal result
B. Early myocardial infarction
C. Severe heart failure
D. Non-cardiac muscle injury
Correct Answer: D. Non-cardiac muscle injury
Rationale: While CK may increase with cardiac injury, it is not cardiac-specific and can also rise with
skeletal muscle damage.
Which statement about myoglobin is most accurate?
A. It is highly specific to cardiac tissue
B. It rises late after myocardial injury
EXAM 2
NCLEX Style Questions w/ Rationales
Medical-Surgical Nursing II
Galen College of Nursing
This Document Description:
This document contains NCLEX-style
Exam questions tailored to the NU 185
course at Galen College of Nursing
It covers core topics assessed in the
course and reflects the actual exam format
and question style.
, Each question is followed by a correct answer and rationale
to support exam preparation.
Which layer of the heart is responsible for the forceful contractions that pump blood throughout
the body?
A. Epicardium
B. Myocardium
C. Endocardium
D. Pericardium
Correct Answer: B. Myocardium
Rationale: The myocardium is the thick muscular middle layer responsible for the heart's contractions
and pumping action.
Which of the following correctly describes the flow of oxygenated blood?
A. Right atrium → right ventricle → pulmonary artery
B. Pulmonary veins → left atrium → left ventricle
C. Superior vena cava → right atrium → right ventricle
D. Left ventricle → right atrium → lungs
Correct Answer: B. Pulmonary veins → left atrium → left ventricle
Rationale: Oxygenated blood returns from the lungs through the pulmonary veins to the left atrium, then
moves to the left ventricle before being pumped to the rest of the body.
Which vessel type is responsible for gas exchange at the tissue level?
A. Arteries
B. Veins
C. Capillaries
D. Venules
Correct Answer: C. Capillaries
Rationale: Capillaries are the smallest blood vessels where oxygen and carbon dioxide exchange occurs
between blood and tissues.
Which vessel carries deoxygenated blood away from the heart?
A. Aorta
B. Pulmonary artery
C. Pulmonary vein
D. Inferior vena cava
Correct Answer: B. Pulmonary artery
Rationale: The pulmonary artery is the only artery that carries deoxygenated blood, transporting it from
the right ventricle to the lungs for oxygenation.
, A nurse is assessing a client with decreased tissue perfusion. Which finding would support this
diagnosis?
A. Warm, pink skin
B. Bounding peripheral pulses
C. Capillary refill less than 2 seconds
D. Cool extremities and weak pulses
Correct Answer: D. Cool extremities and weak pulses
Rationale: Decreased perfusion results in poor blood flow to extremities, leading to cool skin and weak
pulses.
A patient arrives at the emergency department with chest pain that began 6 hours ago. Which
cardiac marker is most specific for diagnosing myocardial infarction (MI)?
A. Myoglobin
B. Creatinine Kinase (CK)
C. Troponin
D. B-type Natriuretic Peptide (BNP)
Correct Answer: C. Troponin
Rationale: Troponin is the gold standard for diagnosing myocardial infarction because of its high
specificity to cardiac muscle and long elevation time after injury.
A patient presents with shortness of breath, fatigue, and peripheral edema. Which lab value would
best support a diagnosis of heart failure?
A. Troponin: 0.2 ng/ml
B. BNP: 450 pg/ml
C. Myoglobin: 80 ng/ml
D. CK: 0.2 ng/ml
Correct Answer: B. BNP: 450 pg/ml
Rationale: BNP is elevated in response to ventricular stretch and fluid overload, which are common in
heart failure. A level above 100 pg/ml is indicative of heart failure.
A patient's CK level is 0.5 ng/ml. What does this most likely indicate?
A. Normal result
B. Early myocardial infarction
C. Severe heart failure
D. Non-cardiac muscle injury
Correct Answer: D. Non-cardiac muscle injury
Rationale: While CK may increase with cardiac injury, it is not cardiac-specific and can also rise with
skeletal muscle damage.
Which statement about myoglobin is most accurate?
A. It is highly specific to cardiac tissue
B. It rises late after myocardial injury
