NU 185 Exam 3: Medical-Surgical Nursing II Study Guide 2026 Galen
College
1. A patient with heart failure is prescribed Digoxin. Which clinical finding
should the nurse prioritize as a sign of Digoxin toxicity?
A. Increased urine output
B. Visual disturbances like yellow halos
C. Fine crackles in the lungs
D. Hypertension
Answer: B
Rationale: Visual disturbances, such as yellow-green halos, along with nausea and
bradycardia, are classic signs of Digoxin toxicity.
2. Which assessment finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Dyspnea and crackles
C. Dependent edema
D. Hepatosplenomegaly
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in respiratory
symptoms like dyspnea and crackles.
,3. A patient is admitted with suspected Acute Respiratory Distress Syndrome
(ARDS). Which arterial blood gas (ABG) result is common in the early stages?
A. Metabolic acidosis due to renal failure
B. Respiratory alkalosis due to hyperventilation
C. Respiratory acidosis from CO2 retention
D. Metabolic alkalosis from vomiting
Answer: B
Rationale: Early ARDS often presents with tachypnea and hyperventilation, leading to
respiratory alkalosis before respiratory failure progresses.
4. When caring for a patient with a chest tube, the nurse notes ‘tidaling’ in the
water seal chamber. What does this indicate?
A. A significant air leak is present
B. The lung has fully re-expanded
C. The system is functioning normally
D. The suction is turned up too high
Answer: C
Rationale: Tidaling (the rise and fall of water with respiration) is a normal finding
indicating that the chest tube system is patent.
5. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.5
mEq/L. Which medication should the nurse anticipate administering first?
A. Furosemide
B. Sodium Polystyrene Sulfonate
C. Spironolactone
D. Calcium Gluconate
Answer: D
Rationale: Calcium Gluconate is administered first in severe hyperkalemia to stabilize the
myocardium and prevent dysrhythmias.
, 6. In the oliguric phase of Acute Kidney Injury (AKI), the nurse should monitor
for which electrolyte imbalance?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Rationale: Reduced urine output in the oliguric phase leads to the retention of potassium,
resulting in hyperkalemia.
7. Which neurological assessment finding is part of Cushing’s Triad, indicating
increased intracranial pressure (ICP)?
A. Tachycardia
B. Widened pulse pressure
C. Hypotension
D. Tachypnea
Answer: B
Rationale: Cushing’s Triad consists of bradycardia, hypertension with a widened pulse
pressure, and irregular respirations.
8. A patient is diagnosed with an Ischemic Stroke. What is the standard
timeframe for administering Alteplase (tPA) from the onset of symptoms?
A. 6 hours
B. 24 hours
C. 12 hours
D. 3 to 4.5 hours
Answer: D
Rationale: Alteplase should generally be administered within 3 to 4.5 hours of symptom
onset for eligible patients with ischemic stroke.
College
1. A patient with heart failure is prescribed Digoxin. Which clinical finding
should the nurse prioritize as a sign of Digoxin toxicity?
A. Increased urine output
B. Visual disturbances like yellow halos
C. Fine crackles in the lungs
D. Hypertension
Answer: B
Rationale: Visual disturbances, such as yellow-green halos, along with nausea and
bradycardia, are classic signs of Digoxin toxicity.
2. Which assessment finding is most characteristic of left-sided heart failure?
A. Jugular venous distention
B. Dyspnea and crackles
C. Dependent edema
D. Hepatosplenomegaly
Answer: B
Rationale: Left-sided heart failure leads to pulmonary congestion, resulting in respiratory
symptoms like dyspnea and crackles.
,3. A patient is admitted with suspected Acute Respiratory Distress Syndrome
(ARDS). Which arterial blood gas (ABG) result is common in the early stages?
A. Metabolic acidosis due to renal failure
B. Respiratory alkalosis due to hyperventilation
C. Respiratory acidosis from CO2 retention
D. Metabolic alkalosis from vomiting
Answer: B
Rationale: Early ARDS often presents with tachypnea and hyperventilation, leading to
respiratory alkalosis before respiratory failure progresses.
4. When caring for a patient with a chest tube, the nurse notes ‘tidaling’ in the
water seal chamber. What does this indicate?
A. A significant air leak is present
B. The lung has fully re-expanded
C. The system is functioning normally
D. The suction is turned up too high
Answer: C
Rationale: Tidaling (the rise and fall of water with respiration) is a normal finding
indicating that the chest tube system is patent.
5. A patient with Chronic Kidney Disease (CKD) has a potassium level of 6.5
mEq/L. Which medication should the nurse anticipate administering first?
A. Furosemide
B. Sodium Polystyrene Sulfonate
C. Spironolactone
D. Calcium Gluconate
Answer: D
Rationale: Calcium Gluconate is administered first in severe hyperkalemia to stabilize the
myocardium and prevent dysrhythmias.
, 6. In the oliguric phase of Acute Kidney Injury (AKI), the nurse should monitor
for which electrolyte imbalance?
A. Hypokalemia
B. Hypernatremia
C. Hyperkalemia
D. Hypophosphatemia
Answer: C
Rationale: Reduced urine output in the oliguric phase leads to the retention of potassium,
resulting in hyperkalemia.
7. Which neurological assessment finding is part of Cushing’s Triad, indicating
increased intracranial pressure (ICP)?
A. Tachycardia
B. Widened pulse pressure
C. Hypotension
D. Tachypnea
Answer: B
Rationale: Cushing’s Triad consists of bradycardia, hypertension with a widened pulse
pressure, and irregular respirations.
8. A patient is diagnosed with an Ischemic Stroke. What is the standard
timeframe for administering Alteplase (tPA) from the onset of symptoms?
A. 6 hours
B. 24 hours
C. 12 hours
D. 3 to 4.5 hours
Answer: D
Rationale: Alteplase should generally be administered within 3 to 4.5 hours of symptom
onset for eligible patients with ischemic stroke.
