NU 155 MEDICAL-SURGICAL NURSING I - EXAM 3 PREP GALEN
COLLEGE - (60) UP-TO-DATE ACTUAL EXAM QUESTIONS AND 100%
ACCURATE SOLUTIONS | VERIFIED ANSWERS - INSTANT PDF
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Examiner/Administrator: Galen College of Nursing
CANDIDATE ASSESSMENT BOOKLET
Candidate Name: Candidate ID:
___________________________ ___________________________
Examination Date: Campus/Testing Center:
_________________________ __________________
Course Code: NU 155 Examination Version: A
Candidate Instructions
This assessment is designed to evaluate the student nurse’s understanding of
foundational medical-surgical nursing concepts commonly covered in Nursing I
coursework. The examination focuses on clinical judgment, prioritization, patient
safety, pharmacological principles, fluid and electrolyte balance, perioperative care,
respiratory disorders, cardiovascular alterations, endocrine dysfunction, and
gastrointestinal nursing management. Students are expected to apply nursing
knowledge using evidence-based reasoning and safe clinical decision-making in a
variety of patient-care scenarios representative of entry-level nursing practice.
Candidates are allotted 120 minutes to complete approximately 60 multiple-choice
questions. Read each question carefully before selecting the best response. Only one
answer is correct for each item unless otherwise stated. Clinical scenarios may
require prioritization using frameworks such as ABCs, Maslow’s hierarchy, and
nursing process principles. Calculators are permitted only if approved by faculty.
No external materials, notes, or electronic devices are permitted during testing.
Core Competency Domains
• Foundations of Medical-Surgical Nursing
• Fluid, Electrolyte, and Acid-Base Balance
• Respiratory System Disorders
• Cardiovascular and Peripheral Vascular Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Disorders
, • Perioperative Nursing Care
• Infection Prevention and Patient Safety
• Pharmacological Nursing Interventions
• Clinical Judgment and Prioritization
This examination is an original educational simulation independently developed for
exam preparation purposes. It is inspired by the structure and rigor commonly
associated with undergraduate medical-surgical nursing assessments but does not
reproduce or disclose any proprietary institutional examination materials.
Q1. A nurse is caring for a postoperative patient 8 hours after abdominal surgery. The
patient suddenly becomes restless, reports dyspnea, and has an oxygen saturation of
86% on room air. Which nursing action should the nurse perform first?
A. Notify the healthcare provider immediately
B. Encourage the patient to use the incentive spirometer
C. Apply supplemental oxygen and assess breath sounds
D. Administer prescribed IV opioid analgesics
Correct Answer: C. Apply supplemental oxygen and assess breath sounds
Explanation: The nurse should first address airway and breathing concerns
according to ABC priorities. Applying oxygen immediately improves oxygenation
while assessment helps identify the cause, such as atelectasis or pulmonary embolism.
Option A is important but occurs after immediate stabilization. Option B may help
prevent atelectasis but is not the priority during acute hypoxia. Option D could
worsen respiratory depression and should not be prioritized in a hypoxic patient.
Q2. A patient with heart failure has gained 4 pounds in 48 hours and reports
increasing ankle edema. Which finding is most concerning to the nurse?
A. Blood pressure 138/86 mm Hg
B. Fine crackles in bilateral lung bases
C. Urine output of 1,200 mL/day
D. Heart rate of 88 beats/minute
Correct Answer: B. Fine crackles in bilateral lung bases
Explanation: Crackles indicate pulmonary fluid accumulation and worsening left-
sided heart failure. Rapid weight gain and edema suggest fluid retention progressing
,toward pulmonary congestion. Option A is mildly elevated but less urgent. Option C is
within acceptable range. Option D is normal and not immediately concerning.
Q3. A nurse is reviewing arterial blood gas results for a patient with severe vomiting:
pH 7.49, PaCO2 47 mm Hg, HCO3 34 mEq/L. How should the nurse interpret these
findings?
A. Respiratory acidosis with compensation
B. Metabolic alkalosis with partial compensation
C. Respiratory alkalosis with compensation
D. Metabolic acidosis without compensation
Correct Answer: B. Metabolic alkalosis with partial compensation
Explanation: The elevated pH indicates alkalosis. Increased bicarbonate confirms
metabolic origin, and elevated PaCO2 reflects respiratory compensation. Vomiting
causes loss of gastric acid, leading to metabolic alkalosis. Option A is incorrect
because respiratory acidosis would have low pH. Option C is inconsistent with
elevated bicarbonate. Option D contradicts the alkalotic pH.
Q4. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 6 L/min via nasal cannula. The patient becomes increasingly somnolent.
Which action should the nurse take?
A. Increase oxygen flow rate immediately
B. Discontinue oxygen therapy
C. Assess respiratory status and oxygen saturation
D. Place the patient in Trendelenburg position
Correct Answer: C. Assess respiratory status and oxygen saturation
Explanation: COPD patients are at risk for carbon dioxide retention when
receiving excessive oxygen. The nurse should assess respiratory function and
oxygenation before changing therapy. Option A may worsen hypercapnia. Option B
could cause severe hypoxemia. Option D does not improve ventilation and may
worsen breathing difficulty.
Q5. A nurse is caring for a patient receiving furosemide. Which laboratory value
requires immediate intervention?
, A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.1 mg/dL
D. Glucose 108 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Explanation: Furosemide is a loop diuretic that can cause hypokalemia, placing
the patient at risk for dysrhythmias and muscle weakness. Potassium below 3.5 mEq/L
is abnormal, and 2.9 mEq/L is critically low. The remaining values are within normal
limits.
Q6. A nurse is teaching a patient newly diagnosed with type 2 diabetes mellitus.
Which statement by the patient indicates understanding of proper foot care?
A. “I will soak my feet in hot water every night.”
B. “I should trim my toenails very short.”
C. “I will inspect my feet daily for cuts or redness.”
D. “I can walk barefoot inside my home safely.”
Correct Answer: C. “I will inspect my feet daily for cuts or redness.”
Explanation: Daily foot inspection helps detect injuries early because diabetic
neuropathy reduces sensation. Option A increases burn risk. Option B may cause skin
injury. Option D increases risk of unnoticed trauma.
Q7. A patient with a nasogastric tube connected to suction reports nausea and
abdominal distention. Which nursing action is most appropriate?
A. Irrigate the tube according to protocol
B. Remove the nasogastric tube immediately
C. Place the patient in a supine position
D. Increase oral fluid intake
Correct Answer: A. Irrigate the tube according to protocol
Explanation: Nausea and distention may indicate tube obstruction. Irrigation
restores patency and decompression. Option B requires provider prescription and is
premature. Option C may worsen aspiration risk. Option D is contraindicated if
bowel obstruction is suspected.
COLLEGE - (60) UP-TO-DATE ACTUAL EXAM QUESTIONS AND 100%
ACCURATE SOLUTIONS | VERIFIED ANSWERS - INSTANT PDF
DOWNLOAD
Examiner/Administrator: Galen College of Nursing
CANDIDATE ASSESSMENT BOOKLET
Candidate Name: Candidate ID:
___________________________ ___________________________
Examination Date: Campus/Testing Center:
_________________________ __________________
Course Code: NU 155 Examination Version: A
Candidate Instructions
This assessment is designed to evaluate the student nurse’s understanding of
foundational medical-surgical nursing concepts commonly covered in Nursing I
coursework. The examination focuses on clinical judgment, prioritization, patient
safety, pharmacological principles, fluid and electrolyte balance, perioperative care,
respiratory disorders, cardiovascular alterations, endocrine dysfunction, and
gastrointestinal nursing management. Students are expected to apply nursing
knowledge using evidence-based reasoning and safe clinical decision-making in a
variety of patient-care scenarios representative of entry-level nursing practice.
Candidates are allotted 120 minutes to complete approximately 60 multiple-choice
questions. Read each question carefully before selecting the best response. Only one
answer is correct for each item unless otherwise stated. Clinical scenarios may
require prioritization using frameworks such as ABCs, Maslow’s hierarchy, and
nursing process principles. Calculators are permitted only if approved by faculty.
No external materials, notes, or electronic devices are permitted during testing.
Core Competency Domains
• Foundations of Medical-Surgical Nursing
• Fluid, Electrolyte, and Acid-Base Balance
• Respiratory System Disorders
• Cardiovascular and Peripheral Vascular Disorders
• Endocrine and Metabolic Disorders
• Gastrointestinal and Hepatic Disorders
, • Perioperative Nursing Care
• Infection Prevention and Patient Safety
• Pharmacological Nursing Interventions
• Clinical Judgment and Prioritization
This examination is an original educational simulation independently developed for
exam preparation purposes. It is inspired by the structure and rigor commonly
associated with undergraduate medical-surgical nursing assessments but does not
reproduce or disclose any proprietary institutional examination materials.
Q1. A nurse is caring for a postoperative patient 8 hours after abdominal surgery. The
patient suddenly becomes restless, reports dyspnea, and has an oxygen saturation of
86% on room air. Which nursing action should the nurse perform first?
A. Notify the healthcare provider immediately
B. Encourage the patient to use the incentive spirometer
C. Apply supplemental oxygen and assess breath sounds
D. Administer prescribed IV opioid analgesics
Correct Answer: C. Apply supplemental oxygen and assess breath sounds
Explanation: The nurse should first address airway and breathing concerns
according to ABC priorities. Applying oxygen immediately improves oxygenation
while assessment helps identify the cause, such as atelectasis or pulmonary embolism.
Option A is important but occurs after immediate stabilization. Option B may help
prevent atelectasis but is not the priority during acute hypoxia. Option D could
worsen respiratory depression and should not be prioritized in a hypoxic patient.
Q2. A patient with heart failure has gained 4 pounds in 48 hours and reports
increasing ankle edema. Which finding is most concerning to the nurse?
A. Blood pressure 138/86 mm Hg
B. Fine crackles in bilateral lung bases
C. Urine output of 1,200 mL/day
D. Heart rate of 88 beats/minute
Correct Answer: B. Fine crackles in bilateral lung bases
Explanation: Crackles indicate pulmonary fluid accumulation and worsening left-
sided heart failure. Rapid weight gain and edema suggest fluid retention progressing
,toward pulmonary congestion. Option A is mildly elevated but less urgent. Option C is
within acceptable range. Option D is normal and not immediately concerning.
Q3. A nurse is reviewing arterial blood gas results for a patient with severe vomiting:
pH 7.49, PaCO2 47 mm Hg, HCO3 34 mEq/L. How should the nurse interpret these
findings?
A. Respiratory acidosis with compensation
B. Metabolic alkalosis with partial compensation
C. Respiratory alkalosis with compensation
D. Metabolic acidosis without compensation
Correct Answer: B. Metabolic alkalosis with partial compensation
Explanation: The elevated pH indicates alkalosis. Increased bicarbonate confirms
metabolic origin, and elevated PaCO2 reflects respiratory compensation. Vomiting
causes loss of gastric acid, leading to metabolic alkalosis. Option A is incorrect
because respiratory acidosis would have low pH. Option C is inconsistent with
elevated bicarbonate. Option D contradicts the alkalotic pH.
Q4. A patient with chronic obstructive pulmonary disease (COPD) is receiving
oxygen at 6 L/min via nasal cannula. The patient becomes increasingly somnolent.
Which action should the nurse take?
A. Increase oxygen flow rate immediately
B. Discontinue oxygen therapy
C. Assess respiratory status and oxygen saturation
D. Place the patient in Trendelenburg position
Correct Answer: C. Assess respiratory status and oxygen saturation
Explanation: COPD patients are at risk for carbon dioxide retention when
receiving excessive oxygen. The nurse should assess respiratory function and
oxygenation before changing therapy. Option A may worsen hypercapnia. Option B
could cause severe hypoxemia. Option D does not improve ventilation and may
worsen breathing difficulty.
Q5. A nurse is caring for a patient receiving furosemide. Which laboratory value
requires immediate intervention?
, A. Sodium 138 mEq/L
B. Potassium 2.9 mEq/L
C. Calcium 9.1 mg/dL
D. Glucose 108 mg/dL
Correct Answer: B. Potassium 2.9 mEq/L
Explanation: Furosemide is a loop diuretic that can cause hypokalemia, placing
the patient at risk for dysrhythmias and muscle weakness. Potassium below 3.5 mEq/L
is abnormal, and 2.9 mEq/L is critically low. The remaining values are within normal
limits.
Q6. A nurse is teaching a patient newly diagnosed with type 2 diabetes mellitus.
Which statement by the patient indicates understanding of proper foot care?
A. “I will soak my feet in hot water every night.”
B. “I should trim my toenails very short.”
C. “I will inspect my feet daily for cuts or redness.”
D. “I can walk barefoot inside my home safely.”
Correct Answer: C. “I will inspect my feet daily for cuts or redness.”
Explanation: Daily foot inspection helps detect injuries early because diabetic
neuropathy reduces sensation. Option A increases burn risk. Option B may cause skin
injury. Option D increases risk of unnoticed trauma.
Q7. A patient with a nasogastric tube connected to suction reports nausea and
abdominal distention. Which nursing action is most appropriate?
A. Irrigate the tube according to protocol
B. Remove the nasogastric tube immediately
C. Place the patient in a supine position
D. Increase oral fluid intake
Correct Answer: A. Irrigate the tube according to protocol
Explanation: Nausea and distention may indicate tube obstruction. Irrigation
restores patency and decompression. Option B requires provider prescription and is
premature. Option C may worsen aspiration risk. Option D is contraindicated if
bowel obstruction is suspected.
