NU 185 Exam 3 | Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A patient is diagnosed with Atrial Fibrillation. The nurse understands the
primary goal of treatment is to prevent which complication?
A. Ischemic stroke
B. Pulmonary edema
C. Cardiac tamponade
D. Ventricular fibrillation
Answer: A
Rationale: In atrial fibrillation, blood pools in the atria due to ineffective contraction,
leading to the formation of thrombi that can embolize to the brain, causing a stroke.
2. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Crackles in the lung bases
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, causing fluid to leak into
the alveoli, resulting in crackles, dyspnea, and orthopnea.
,3. A nurse is assessing a patient for Digoxin toxicity. Which finding should the
nurse report immediately?
A. Increased appetite
B. Yellow-green visual halos
C. Heart rate of 82 bpm
D. Constipation
Answer: B
Rationale: Visual disturbances, such as blurred vision or yellow-green halos, are classic
signs of Digoxin toxicity, along with nausea and bradycardia.
4. On an EKG strip, which component represents atrial depolarization?
A. ST segment
B. QRS complex
C. T wave
D. P wave
Answer: D
Rationale: The P wave represents the electrical impulse starting in the SA node and
spreading through the atria (atrial depolarization).
5. A patient with a history of DVT suddenly develops sharp chest pain and
shortness of breath. Which condition should the nurse suspect?
A. Pulmonary embolism
B. Myocardial infarction
C. Pneumothorax
D. Pleural effusion
Answer: A
Rationale: Sudden onset of dyspnea and pleuritic chest pain in a patient with DVT risk is
highly suggestive of a pulmonary embolism.
, 6. What is the primary nursing intervention for a patient in the oliguric phase of
Acute Kidney Injury (AKI)?
A. Encourage fluid intake up to 3000 mL/day
B. Monitor for fluid volume overload
C. Administer potassium supplements
D. Provide a high-protein diet
Answer: B
Rationale: During the oliguric phase, urine output drops significantly, putting the patient
at risk for fluid volume excess, hypertension, and edema.
7. A patient’s potassium level is 6.5 mEq/L. Which EKG change is the nurse most
likely to see?
A. Prominent U waves
B. Prolonged QT interval
C. Flat ST segment
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia typically causes tall, peaked T waves, widening of the QRS, and
loss of the P wave as levels increase.
8. An ABG shows pH 7.30, PaCO2 52, and HCO3 24. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH is low (<7.35) and the PaCO2 is high (>45), indicating a respiratory
cause for the acidosis.
College
1. A patient is diagnosed with Atrial Fibrillation. The nurse understands the
primary goal of treatment is to prevent which complication?
A. Ischemic stroke
B. Pulmonary edema
C. Cardiac tamponade
D. Ventricular fibrillation
Answer: A
Rationale: In atrial fibrillation, blood pools in the atria due to ineffective contraction,
leading to the formation of thrombi that can embolize to the brain, causing a stroke.
2. Which clinical manifestation is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Crackles in the lung bases
C. Peripheral edema
D. Hepatosplenomegaly
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, causing fluid to leak into
the alveoli, resulting in crackles, dyspnea, and orthopnea.
,3. A nurse is assessing a patient for Digoxin toxicity. Which finding should the
nurse report immediately?
A. Increased appetite
B. Yellow-green visual halos
C. Heart rate of 82 bpm
D. Constipation
Answer: B
Rationale: Visual disturbances, such as blurred vision or yellow-green halos, are classic
signs of Digoxin toxicity, along with nausea and bradycardia.
4. On an EKG strip, which component represents atrial depolarization?
A. ST segment
B. QRS complex
C. T wave
D. P wave
Answer: D
Rationale: The P wave represents the electrical impulse starting in the SA node and
spreading through the atria (atrial depolarization).
5. A patient with a history of DVT suddenly develops sharp chest pain and
shortness of breath. Which condition should the nurse suspect?
A. Pulmonary embolism
B. Myocardial infarction
C. Pneumothorax
D. Pleural effusion
Answer: A
Rationale: Sudden onset of dyspnea and pleuritic chest pain in a patient with DVT risk is
highly suggestive of a pulmonary embolism.
, 6. What is the primary nursing intervention for a patient in the oliguric phase of
Acute Kidney Injury (AKI)?
A. Encourage fluid intake up to 3000 mL/day
B. Monitor for fluid volume overload
C. Administer potassium supplements
D. Provide a high-protein diet
Answer: B
Rationale: During the oliguric phase, urine output drops significantly, putting the patient
at risk for fluid volume excess, hypertension, and edema.
7. A patient’s potassium level is 6.5 mEq/L. Which EKG change is the nurse most
likely to see?
A. Prominent U waves
B. Prolonged QT interval
C. Flat ST segment
D. Tall, peaked T waves
Answer: D
Rationale: Hyperkalemia typically causes tall, peaked T waves, widening of the QRS, and
loss of the P wave as levels increase.
8. An ABG shows pH 7.30, PaCO2 52, and HCO3 24. How should the nurse
interpret these results?
A. Metabolic Acidosis
B. Respiratory Alkalosis
C. Respiratory Acidosis
D. Metabolic Alkalosis
Answer: C
Rationale: The pH is low (<7.35) and the PaCO2 is high (>45), indicating a respiratory
cause for the acidosis.
