NU 185 Exam 2 Medical-Surgical Nursing II 2026 Galen College
1. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Hepatic engorgement
C. Peripheral edema
D. Crackles in the lung bases
Answer: D
Rationale: Left-sided heart failure leads to pulmonary congestion, causing fluid to back up
into the lungs, which manifests as crackles, dyspnea, and orthopnea.
2. A nurse is preparing to administer Digoxin to a patient. Which action should
the nurse take first?
A. Assess the apical pulse for one full minute
B. Check the patient’s potassium level
C. Administer the medication with food
D. Monitor the patient’s blood pressure
Answer: A
Rationale: Digoxin decreases the heart rate; the apical pulse must be checked for 1 minute
and held if it is less than 60 bpm in adults.
,3. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Alkalosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Respiratory Acidosis
Answer: D
Rationale: A low pH (< 7.35) indicates acidosis, and an elevated PaCO2 (> 45 mmHg) with
a normal HCO3 indicates the cause is respiratory.
4. What is the primary goal of therapy for a patient in the acute phase of a Sickle
Cell Crisis?
A. Increasing physical activity
B. Restricting fluid intake
C. Administering iron supplements
D. Pain management and hydration
Answer: D
Rationale: Treatment for sickle cell crisis focuses on ‘HOP’: Hydration, Oxygenation, and
Pain relief to prevent further sickling and tissue ischemia.
5. Which medication is the preferred antidote for Heparin toxicity?
A. Vitamin K
B. Calcium Gluconate
C. Glucagon
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the specific antidote used to reverse the effects of heparin
in cases of overdose or hemorrhage.
, 6. A patient with a chest tube has continuous bubbling in the water-seal
chamber. What does this indicate?
A. The system is functioning normally
B. The lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is too high
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the drainage system.
7. Which laboratory marker is the most specific for diagnosing a Myocardial
Infarction (MI)?
A. CK-MB
B. Troponin I
C. Myoglobin
D. C-reactive protein
Answer: B
Rationale: Troponins are highly specific to cardiac muscle and remain elevated longer
than other markers, making them the gold standard for MI diagnosis.
8. Which assessment finding would the nurse expect in a patient with Peripheral
Artery Disease (PAD)?
A. Painless ulcers on the ankles
B. Warm, reddish-brown skin on the legs
C. Intermittent claudication
D. Significant edema in the lower extremities
Answer: C
Rationale: Intermittent claudication, or muscle pain during exercise that is relieved by
rest, is a classic symptom of PAD due to ischemia.
1. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Hepatic engorgement
C. Peripheral edema
D. Crackles in the lung bases
Answer: D
Rationale: Left-sided heart failure leads to pulmonary congestion, causing fluid to back up
into the lungs, which manifests as crackles, dyspnea, and orthopnea.
2. A nurse is preparing to administer Digoxin to a patient. Which action should
the nurse take first?
A. Assess the apical pulse for one full minute
B. Check the patient’s potassium level
C. Administer the medication with food
D. Monitor the patient’s blood pressure
Answer: A
Rationale: Digoxin decreases the heart rate; the apical pulse must be checked for 1 minute
and held if it is less than 60 bpm in adults.
,3. A patient’s ABG results are: pH 7.30, PaCO2 55 mmHg, and HCO3 24 mEq/L.
How should the nurse interpret these results?
A. Metabolic Alkalosis
B. Respiratory Alkalosis
C. Metabolic Acidosis
D. Respiratory Acidosis
Answer: D
Rationale: A low pH (< 7.35) indicates acidosis, and an elevated PaCO2 (> 45 mmHg) with
a normal HCO3 indicates the cause is respiratory.
4. What is the primary goal of therapy for a patient in the acute phase of a Sickle
Cell Crisis?
A. Increasing physical activity
B. Restricting fluid intake
C. Administering iron supplements
D. Pain management and hydration
Answer: D
Rationale: Treatment for sickle cell crisis focuses on ‘HOP’: Hydration, Oxygenation, and
Pain relief to prevent further sickling and tissue ischemia.
5. Which medication is the preferred antidote for Heparin toxicity?
A. Vitamin K
B. Calcium Gluconate
C. Glucagon
D. Protamine Sulfate
Answer: D
Rationale: Protamine sulfate is the specific antidote used to reverse the effects of heparin
in cases of overdose or hemorrhage.
, 6. A patient with a chest tube has continuous bubbling in the water-seal
chamber. What does this indicate?
A. The system is functioning normally
B. The lung has fully re-expanded
C. There is an air leak in the system
D. The suction pressure is too high
Answer: C
Rationale: Continuous bubbling in the water-seal chamber indicates an air leak between
the patient and the drainage system.
7. Which laboratory marker is the most specific for diagnosing a Myocardial
Infarction (MI)?
A. CK-MB
B. Troponin I
C. Myoglobin
D. C-reactive protein
Answer: B
Rationale: Troponins are highly specific to cardiac muscle and remain elevated longer
than other markers, making them the gold standard for MI diagnosis.
8. Which assessment finding would the nurse expect in a patient with Peripheral
Artery Disease (PAD)?
A. Painless ulcers on the ankles
B. Warm, reddish-brown skin on the legs
C. Intermittent claudication
D. Significant edema in the lower extremities
Answer: C
Rationale: Intermittent claudication, or muscle pain during exercise that is relieved by
rest, is a classic symptom of PAD due to ischemia.
