NU 185 Exam 2 Medical-Surgical Nursing II Practice 2026 Galen
College
1. A patient presents with dyspnea, crackles in the lungs, and an S3 gallop.
Which condition is most likely?
A. Right-sided heart failure
B. Left-sided heart failure
C. Peripheral vascular disease
D. Deep vein thrombosis
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles,
dyspnea, and extra heart sounds like S3.
2. Which arterial blood gas (ABG) result is indicative of respiratory acidosis?
A. pH 7.32, PaCO2 50 mmHg
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.30, HCO3 18 mEq/L
D. pH 7.50, HCO3 30 mEq/L
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and an elevated
PaCO2 (above 45 mmHg).
,3. A patient taking Digoxin reports seeing yellow-green halos around lights.
What is the nurse’s priority action?
A. Administer the next dose
B. Encourage intake of potassium-rich foods
C. Check the patient’s blood pressure
D. Assess for signs of toxicity and notify the provider
Answer: D
Rationale: Visual disturbances such as yellow-green halos are a classic sign of Digoxin
toxicity.
4. When assessing a patient with a history of COPD, the nurse notes a barrel
chest. This is caused by:
A. Hypertrophy of the heart
B. Chronic inflammation of the bronchial tubes
C. Air trapping and hyperinflation of the lungs
D. Decreased lung compliance
Answer: C
Rationale: In COPD, air trapping leads to a permanent increase in the anteroposterior
diameter of the chest, known as a barrel chest.
5. Which laboratory value is the most important to monitor for a patient
receiving Heparin?
A. PT/INR
B. Platelet count
C. Hemoglobin
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: aPTT is used to monitor the effectiveness and safety of unfractionated Heparin
therapy.
, 6. A patient with diabetes mellitus is found unconscious and clammy. What is
the immediate nursing action?
A. Administer 1 unit of regular insulin
B. Offer 4 ounces of orange juice
C. Call the family
D. Check blood glucose and prepare Glucagon or D50
Answer: D
Rationale: For an unconscious patient showing signs of hypoglycemia (clammy skin), the
nurse must provide quick glucose source via IV or injection.
7. A patient is diagnosed with Peripheral Artery Disease (PAD). What is a
common clinical manifestation?
A. Intermittent claudication
B. Varicose veins
C. Warm, flushed skin
D. Dependent edema
Answer: A
Rationale: Intermittent claudication is muscle pain occurring during exercise and
disappearing at rest, caused by arterial insufficiency.
8. What is the priority assessment for a patient in the immediate post-operative
phase?
A. Airway patency
B. Urine output
C. Pain level
D. Bowel sounds
Answer: A
Rationale: Airway, Breathing, and Circulation (ABCs) always take priority in post-
operative care.
College
1. A patient presents with dyspnea, crackles in the lungs, and an S3 gallop.
Which condition is most likely?
A. Right-sided heart failure
B. Left-sided heart failure
C. Peripheral vascular disease
D. Deep vein thrombosis
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in crackles,
dyspnea, and extra heart sounds like S3.
2. Which arterial blood gas (ABG) result is indicative of respiratory acidosis?
A. pH 7.32, PaCO2 50 mmHg
B. pH 7.48, PaCO2 30 mmHg
C. pH 7.30, HCO3 18 mEq/L
D. pH 7.50, HCO3 30 mEq/L
Answer: A
Rationale: Respiratory acidosis is characterized by a low pH (below 7.35) and an elevated
PaCO2 (above 45 mmHg).
,3. A patient taking Digoxin reports seeing yellow-green halos around lights.
What is the nurse’s priority action?
A. Administer the next dose
B. Encourage intake of potassium-rich foods
C. Check the patient’s blood pressure
D. Assess for signs of toxicity and notify the provider
Answer: D
Rationale: Visual disturbances such as yellow-green halos are a classic sign of Digoxin
toxicity.
4. When assessing a patient with a history of COPD, the nurse notes a barrel
chest. This is caused by:
A. Hypertrophy of the heart
B. Chronic inflammation of the bronchial tubes
C. Air trapping and hyperinflation of the lungs
D. Decreased lung compliance
Answer: C
Rationale: In COPD, air trapping leads to a permanent increase in the anteroposterior
diameter of the chest, known as a barrel chest.
5. Which laboratory value is the most important to monitor for a patient
receiving Heparin?
A. PT/INR
B. Platelet count
C. Hemoglobin
D. Activated partial thromboplastin time (aPTT)
Answer: D
Rationale: aPTT is used to monitor the effectiveness and safety of unfractionated Heparin
therapy.
, 6. A patient with diabetes mellitus is found unconscious and clammy. What is
the immediate nursing action?
A. Administer 1 unit of regular insulin
B. Offer 4 ounces of orange juice
C. Call the family
D. Check blood glucose and prepare Glucagon or D50
Answer: D
Rationale: For an unconscious patient showing signs of hypoglycemia (clammy skin), the
nurse must provide quick glucose source via IV or injection.
7. A patient is diagnosed with Peripheral Artery Disease (PAD). What is a
common clinical manifestation?
A. Intermittent claudication
B. Varicose veins
C. Warm, flushed skin
D. Dependent edema
Answer: A
Rationale: Intermittent claudication is muscle pain occurring during exercise and
disappearing at rest, caused by arterial insufficiency.
8. What is the priority assessment for a patient in the immediate post-operative
phase?
A. Airway patency
B. Urine output
C. Pain level
D. Bowel sounds
Answer: A
Rationale: Airway, Breathing, and Circulation (ABCs) always take priority in post-
operative care.
