NU 192 Exam 2 V1 | NU 192 Medical-
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 2) | Galen
1. A patient is admitted to the ICU with Acute Respiratory Distress Syndrome (ARDS). Which
of the following clinical findings are characteristic of the early stages of ARDS? (Select All That
Apply)
A. Dyspnea and tachypnea
B. Refractory hypoxemia
C. Diffuse crackles upon auscultation
D. Respiratory alkalosis on initial ABG
E. White-out appearance on chest X-ray
F. Bradycardia
Correct Answer: A, B, D
Explanation: Early ARDS is often characterized by rapid breathing and difficulty catching
one’s breath despite oxygen supplementation. Refractory hypoxemia is a hallmark sign
where the partial pressure of oxygen remains low even with high FiO2 levels. Initial blood
gas analysis usually shows respiratory alkalosis due to the patient’s hyperventilation in an
attempt to maintain oxygenation.
,2. A nurse is monitoring a patient with a Central Venous Pressure (CVP) line. The current
reading is 1 cm H2O. Which intervention should the nurse anticipate?
A. Administration of a loop diuretic
B. Fluid bolus of 0.9% Normal Saline
C. Decreasing the IV infusion rate
D. Initiation of a vasodilator
Correct Answer: B
Explanation: A CVP of 1 cm H2O is significantly below the normal range of 2 to 8 mmHg,
indicating hypovolemia or fluid volume deficit. To restore adequate preload and cardiac
output, the nurse should anticipate the provider ordering a fluid bolus. Monitoring the
patient’s response to fluid resuscitation is critical to preventing organ hypoperfusion.
3. Which cardiac rhythm is characterized by a lack of P waves, an irregularly irregular
ventricular response, and a high risk for thromboembolism?
A. Atrial Flutter
B. Atrial Fibrillation
C. Sinus Bradycardia
D. Ventricular Tachycardia
Correct Answer: B
,Explanation: Atrial fibrillation (AFib) occurs when the atria quiver instead of contracting
effectively, leading to blood stasis in the auricles. This stasis creates a significant risk for
the formation of mural thrombi, which can embolize and cause a stroke. Anticoagulation
therapy is a standard of care for patients with persistent AFib to mitigate this risk.
4. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which medications are expected in the acute management of this condition? (Select All That
Apply)
A. IV Regular Insulin and Dextrose 50%
B. Oral Spironolactone
C. IV Calcium Gluconate
D. Sodium Polystyrene Sulfonate (Kayexalate)
E. Lisinopril
F. Albuterol nebulizer
Correct Answer: A, C, D, F
Explanation: Hyperkalemia management involves stabilizing the cardiac membrane with
Calcium Gluconate and shifting potassium into cells using insulin and albuterol. Kayexalate
works by exchanging sodium for potassium in the gut to facilitate the actual removal of
potassium from the body. Medications like Spironolactone and Lisinopril should be avoided
because they can further increase potassium levels in CKD patients.
, 5. A patient with an anterior wall Myocardial Infarction (MI) is at highest risk for which of the
following complications?
A. Bradycardia
B. Heart Failure
C. Atrioventricular block
D. Tricuspid regurgitation
Correct Answer: B
Explanation: An anterior wall MI typically involves the left ventricle, which is the primary
pumping chamber of the heart. Damage to this area frequently leads to reduced ejection
fraction and subsequent heart failure or cardiogenic shock. Nurses must closely monitor
for pulmonary edema and decreased cardiac output in these patients.
6. During the emergent phase of a 40% Total Body Surface Area (TBSA) burn, which
laboratory abnormality is most expected?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Decreased Hematocrit
Correct Answer: A
Surgical Nursing II-B | NCLEX (NGN) Q&A
with Rationale (NU192 Exam 2) | Galen
1. A patient is admitted to the ICU with Acute Respiratory Distress Syndrome (ARDS). Which
of the following clinical findings are characteristic of the early stages of ARDS? (Select All That
Apply)
A. Dyspnea and tachypnea
B. Refractory hypoxemia
C. Diffuse crackles upon auscultation
D. Respiratory alkalosis on initial ABG
E. White-out appearance on chest X-ray
F. Bradycardia
Correct Answer: A, B, D
Explanation: Early ARDS is often characterized by rapid breathing and difficulty catching
one’s breath despite oxygen supplementation. Refractory hypoxemia is a hallmark sign
where the partial pressure of oxygen remains low even with high FiO2 levels. Initial blood
gas analysis usually shows respiratory alkalosis due to the patient’s hyperventilation in an
attempt to maintain oxygenation.
,2. A nurse is monitoring a patient with a Central Venous Pressure (CVP) line. The current
reading is 1 cm H2O. Which intervention should the nurse anticipate?
A. Administration of a loop diuretic
B. Fluid bolus of 0.9% Normal Saline
C. Decreasing the IV infusion rate
D. Initiation of a vasodilator
Correct Answer: B
Explanation: A CVP of 1 cm H2O is significantly below the normal range of 2 to 8 mmHg,
indicating hypovolemia or fluid volume deficit. To restore adequate preload and cardiac
output, the nurse should anticipate the provider ordering a fluid bolus. Monitoring the
patient’s response to fluid resuscitation is critical to preventing organ hypoperfusion.
3. Which cardiac rhythm is characterized by a lack of P waves, an irregularly irregular
ventricular response, and a high risk for thromboembolism?
A. Atrial Flutter
B. Atrial Fibrillation
C. Sinus Bradycardia
D. Ventricular Tachycardia
Correct Answer: B
,Explanation: Atrial fibrillation (AFib) occurs when the atria quiver instead of contracting
effectively, leading to blood stasis in the auricles. This stasis creates a significant risk for
the formation of mural thrombi, which can embolize and cause a stroke. Anticoagulation
therapy is a standard of care for patients with persistent AFib to mitigate this risk.
4. A patient with Chronic Kidney Disease (CKD) presents with a potassium level of 6.8 mEq/L.
Which medications are expected in the acute management of this condition? (Select All That
Apply)
A. IV Regular Insulin and Dextrose 50%
B. Oral Spironolactone
C. IV Calcium Gluconate
D. Sodium Polystyrene Sulfonate (Kayexalate)
E. Lisinopril
F. Albuterol nebulizer
Correct Answer: A, C, D, F
Explanation: Hyperkalemia management involves stabilizing the cardiac membrane with
Calcium Gluconate and shifting potassium into cells using insulin and albuterol. Kayexalate
works by exchanging sodium for potassium in the gut to facilitate the actual removal of
potassium from the body. Medications like Spironolactone and Lisinopril should be avoided
because they can further increase potassium levels in CKD patients.
, 5. A patient with an anterior wall Myocardial Infarction (MI) is at highest risk for which of the
following complications?
A. Bradycardia
B. Heart Failure
C. Atrioventricular block
D. Tricuspid regurgitation
Correct Answer: B
Explanation: An anterior wall MI typically involves the left ventricle, which is the primary
pumping chamber of the heart. Damage to this area frequently leads to reduced ejection
fraction and subsequent heart failure or cardiogenic shock. Nurses must closely monitor
for pulmonary edema and decreased cardiac output in these patients.
6. During the emergent phase of a 40% Total Body Surface Area (TBSA) burn, which
laboratory abnormality is most expected?
A. Hyperkalemia
B. Hypernatremia
C. Hypokalemia
D. Decreased Hematocrit
Correct Answer: A
