NUR 265 Med-Surg Exam 2 High-Yield Questions 2026 Galen College
1. A client presents with a pH of 7.25, PCO2 of 50 mmHg, and HCO3 of 24 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A high PCO2 (above 45) indicates the cause
is respiratory.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in the lungs
B. Frothy pink sputum
C. Peripheral edema
D. Paroxysmal nocturnal dyspnea
Answer: C
Rationale: Right-sided heart failure leads to systemic congestion, causing peripheral
edema and jugular venous distention.
,3. A nurse is caring for a patient with a chest tube. What should the nurse do if
the chest tube becomes accidentally dislodged?
A. Reinsert the tube immediately
B. Cover the site with a clean paper towel
C. Clamp the remaining tubing
D. Apply an occlusive dressing taped on three sides
Answer: D
Rationale: A three-sided occlusive dressing allows air to escape but prevents air from
entering the pleural space, preventing a tension pneumothorax.
4. What is the priority nursing action for a client experiencing an acute asthma
attack?
A. Administer a short-acting beta-agonist (SABA)
B. Obtain a chest X-ray
C. Administer a long-acting beta-agonist
D. Teach deep breathing exercises
Answer: A
Rationale: SABAs like Albuterol are rescue medications used for immediate
bronchodilation during an attack.
5. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.5
mEq/L. Which medication should the nurse anticipate?
A. Spironolactone
B. Furosemide
C. Magnesium Sulfate
D. Sodium Polystyrene Sulfonate
Answer: D
Rationale: Sodium Polystyrene Sulfonate (Kayexalate) helps remove potassium from the
body through the stool.
, 6. In the ‘Rule of Nines’ for burns, what percentage is assigned to the entire
anterior torso?
A. 9%
B. 36%
C. 18%
D. 4.5%
Answer: C
Rationale: The anterior torso (chest and abdomen) accounts for 18% of the total body
surface area.
7. Which EKG finding is most indicative of myocardial infarction (MI)?
A. ST-segment elevation
B. PR interval prolongation
C. Widened QRS complex
D. Inverted P wave
Answer: A
Rationale: ST-segment elevation (STEMI) indicates acute myocardial injury and is a
hallmark of MI.
8. What is the primary goal of treatment for a client in hypovolemic shock?
A. Administering vasopressors
B. Increasing urinary output
C. Restoring fluid volume
D. Decreasing heart rate
Answer: C
Rationale: The priority in hypovolemic shock is replacing lost fluid volume to restore
perfusion.
1. A client presents with a pH of 7.25, PCO2 of 50 mmHg, and HCO3 of 24 mEq/L.
Which acid-base imbalance is occurring?
A. Metabolic Acidosis
B. Metabolic Alkalosis
C. Respiratory Acidosis
D. Respiratory Alkalosis
Answer: C
Rationale: A pH below 7.35 indicates acidosis. A high PCO2 (above 45) indicates the cause
is respiratory.
2. Which clinical manifestation is most characteristic of right-sided heart failure?
A. Crackles in the lungs
B. Frothy pink sputum
C. Peripheral edema
D. Paroxysmal nocturnal dyspnea
Answer: C
Rationale: Right-sided heart failure leads to systemic congestion, causing peripheral
edema and jugular venous distention.
,3. A nurse is caring for a patient with a chest tube. What should the nurse do if
the chest tube becomes accidentally dislodged?
A. Reinsert the tube immediately
B. Cover the site with a clean paper towel
C. Clamp the remaining tubing
D. Apply an occlusive dressing taped on three sides
Answer: D
Rationale: A three-sided occlusive dressing allows air to escape but prevents air from
entering the pleural space, preventing a tension pneumothorax.
4. What is the priority nursing action for a client experiencing an acute asthma
attack?
A. Administer a short-acting beta-agonist (SABA)
B. Obtain a chest X-ray
C. Administer a long-acting beta-agonist
D. Teach deep breathing exercises
Answer: A
Rationale: SABAs like Albuterol are rescue medications used for immediate
bronchodilation during an attack.
5. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.5
mEq/L. Which medication should the nurse anticipate?
A. Spironolactone
B. Furosemide
C. Magnesium Sulfate
D. Sodium Polystyrene Sulfonate
Answer: D
Rationale: Sodium Polystyrene Sulfonate (Kayexalate) helps remove potassium from the
body through the stool.
, 6. In the ‘Rule of Nines’ for burns, what percentage is assigned to the entire
anterior torso?
A. 9%
B. 36%
C. 18%
D. 4.5%
Answer: C
Rationale: The anterior torso (chest and abdomen) accounts for 18% of the total body
surface area.
7. Which EKG finding is most indicative of myocardial infarction (MI)?
A. ST-segment elevation
B. PR interval prolongation
C. Widened QRS complex
D. Inverted P wave
Answer: A
Rationale: ST-segment elevation (STEMI) indicates acute myocardial injury and is a
hallmark of MI.
8. What is the primary goal of treatment for a client in hypovolemic shock?
A. Administering vasopressors
B. Increasing urinary output
C. Restoring fluid volume
D. Decreasing heart rate
Answer: C
Rationale: The priority in hypovolemic shock is replacing lost fluid volume to restore
perfusion.
