NU 155 / NU155 Medical-Surgical Nursing I Exam 2
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Respiratory Disorders (Questions 1–12)
Q1: A patient with COPD is prescribed home oxygen therapy. The nurse teaches the
patient that the goal oxygen saturation is:
A. 98–100%
B. 88–92%
C. 95–100%
D. 85–88%
Correct Answer: B
Rationale: In COPD patients with chronic hypercapnia, the goal SpO₂ is 88–92% to
maintain the hypoxic drive for breathing; excessive oxygen can suppress the
respiratory drive, worsen hypercapnia, and precipitate respiratory acidosis.
Q2: A patient with asthma is experiencing an acute exacerbation with wheezing,
dyspnea, and a respiratory rate of 28. The nurse administers albuterol via nebulizer.
The primary mechanism of action of albuterol is:
A. Anticholinergic bronchodilation
,B. Beta-2 adrenergic agonist causing bronchial smooth muscle relaxation
C. Mast cell stabilization
D. Leukotriene receptor antagonism
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist that binds to beta-2
receptors on bronchial smooth muscle, causing rapid bronchodilation and relieving
acute bronchospasm within minutes.
Q3: A patient with a pneumothorax has a chest tube inserted. The nurse observes
continuous bubbling in the water seal chamber. The nurse recognizes this as:
A. Normal functioning of the chest tube
B. An air leak that requires assessment of the tubing connections and patient
condition
C. Evidence of fluid accumulation
D. An indication to clamp the chest tube
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which may be from the patient (bronchopleural fistula) or the system (loose
connections); the nurse must assess tubing connections, patient respiratory status,
and notify the provider if the leak is from the patient.
Q4: A patient with pneumonia has a productive cough with rust-colored sputum,
fever of 102°F, and consolidation on chest X-ray. The nurse suspects:
A. Viral pneumonia
,B. Streptococcus pneumoniae (pneumococcal) pneumonia
C. Fungal pneumonia
D. Aspiration pneumonia
Correct Answer: B
Rationale: Rust-colored sputum, lobar consolidation, and acute febrile illness are
classic for pneumococcal pneumonia caused by Streptococcus pneumoniae, the
most common bacterial cause of community-acquired pneumonia.
Q5: A patient with pulmonary embolism (PE) presents with sudden-onset dyspnea,
tachypnea, pleuritic chest pain, and tachycardia. The nurse understands that the
primary treatment for hemodynamically unstable PE is:
A. Oral anticoagulation alone
B. Systemic thrombolysis or embolectomy
C. Observation without intervention
D. Bronchodilator therapy
Correct Answer: B
Rationale: Massive PE with hemodynamic instability (hypotension, shock) requires
emergent systemic thrombolysis or surgical/embolectomy to restore pulmonary
perfusion and right ventricular function, as anticoagulation alone is insufficient in
this life-threatening presentation.
Q6: A patient with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. The nurse understands that the recommended ventilator strategy
includes:
, A. High tidal volumes (12–15 mL/kg)
B. Low tidal volumes (6 mL/kg predicted body weight) with adequate PEEP
C. No PEEP to prevent barotrauma
D. High respiratory rates with low pressures
Correct Answer: B
Rationale: Lung-protective ventilation in ARDS uses low tidal volumes (6 mL/kg
predicted body weight) and adequate PEEP to prevent alveolar collapse, reduce
ventilator-induced lung injury, and improve oxygenation while minimizing barotrauma
and volutrauma.
Q7: A patient with a chest tube has the tube accidentally dislodged from the chest
wall. The nurse's immediate action is to:
A. Reinsert the tube
B. Apply an occlusive dressing taped on three sides and notify the provider
immediately
C. Leave the site open to air
D. Submerge the tube in water
Correct Answer: B
Rationale: An occlusive dressing taped on three sides creates a flutter valve that
allows air to escape during exhalation but prevents air entry during inhalation,
reducing the risk of tension pneumothorax while awaiting provider intervention.
Q8: A patient with obstructive sleep apnea (OSA) is prescribed continuous positive
airway pressure (CPAP). The nurse teaches that CPAP works by:
Practice Test Actual 2025/2026 with Detailed
Rationales | 100% Verified | Pass Guaranteed – A+
Graded
SECTION 1: Respiratory Disorders (Questions 1–12)
Q1: A patient with COPD is prescribed home oxygen therapy. The nurse teaches the
patient that the goal oxygen saturation is:
A. 98–100%
B. 88–92%
C. 95–100%
D. 85–88%
Correct Answer: B
Rationale: In COPD patients with chronic hypercapnia, the goal SpO₂ is 88–92% to
maintain the hypoxic drive for breathing; excessive oxygen can suppress the
respiratory drive, worsen hypercapnia, and precipitate respiratory acidosis.
Q2: A patient with asthma is experiencing an acute exacerbation with wheezing,
dyspnea, and a respiratory rate of 28. The nurse administers albuterol via nebulizer.
The primary mechanism of action of albuterol is:
A. Anticholinergic bronchodilation
,B. Beta-2 adrenergic agonist causing bronchial smooth muscle relaxation
C. Mast cell stabilization
D. Leukotriene receptor antagonism
Correct Answer: B
Rationale: Albuterol is a short-acting beta-2 adrenergic agonist that binds to beta-2
receptors on bronchial smooth muscle, causing rapid bronchodilation and relieving
acute bronchospasm within minutes.
Q3: A patient with a pneumothorax has a chest tube inserted. The nurse observes
continuous bubbling in the water seal chamber. The nurse recognizes this as:
A. Normal functioning of the chest tube
B. An air leak that requires assessment of the tubing connections and patient
condition
C. Evidence of fluid accumulation
D. An indication to clamp the chest tube
Correct Answer: B
Rationale: Continuous bubbling in the water seal chamber indicates an air leak,
which may be from the patient (bronchopleural fistula) or the system (loose
connections); the nurse must assess tubing connections, patient respiratory status,
and notify the provider if the leak is from the patient.
Q4: A patient with pneumonia has a productive cough with rust-colored sputum,
fever of 102°F, and consolidation on chest X-ray. The nurse suspects:
A. Viral pneumonia
,B. Streptococcus pneumoniae (pneumococcal) pneumonia
C. Fungal pneumonia
D. Aspiration pneumonia
Correct Answer: B
Rationale: Rust-colored sputum, lobar consolidation, and acute febrile illness are
classic for pneumococcal pneumonia caused by Streptococcus pneumoniae, the
most common bacterial cause of community-acquired pneumonia.
Q5: A patient with pulmonary embolism (PE) presents with sudden-onset dyspnea,
tachypnea, pleuritic chest pain, and tachycardia. The nurse understands that the
primary treatment for hemodynamically unstable PE is:
A. Oral anticoagulation alone
B. Systemic thrombolysis or embolectomy
C. Observation without intervention
D. Bronchodilator therapy
Correct Answer: B
Rationale: Massive PE with hemodynamic instability (hypotension, shock) requires
emergent systemic thrombolysis or surgical/embolectomy to restore pulmonary
perfusion and right ventricular function, as anticoagulation alone is insufficient in
this life-threatening presentation.
Q6: A patient with acute respiratory distress syndrome (ARDS) is on mechanical
ventilation. The nurse understands that the recommended ventilator strategy
includes:
, A. High tidal volumes (12–15 mL/kg)
B. Low tidal volumes (6 mL/kg predicted body weight) with adequate PEEP
C. No PEEP to prevent barotrauma
D. High respiratory rates with low pressures
Correct Answer: B
Rationale: Lung-protective ventilation in ARDS uses low tidal volumes (6 mL/kg
predicted body weight) and adequate PEEP to prevent alveolar collapse, reduce
ventilator-induced lung injury, and improve oxygenation while minimizing barotrauma
and volutrauma.
Q7: A patient with a chest tube has the tube accidentally dislodged from the chest
wall. The nurse's immediate action is to:
A. Reinsert the tube
B. Apply an occlusive dressing taped on three sides and notify the provider
immediately
C. Leave the site open to air
D. Submerge the tube in water
Correct Answer: B
Rationale: An occlusive dressing taped on three sides creates a flutter valve that
allows air to escape during exhalation but prevents air entry during inhalation,
reducing the risk of tension pneumothorax while awaiting provider intervention.
Q8: A patient with obstructive sleep apnea (OSA) is prescribed continuous positive
airway pressure (CPAP). The nurse teaches that CPAP works by:
