NU185 MEDICAL-SURGICAL NURSING II – EXAM 3 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED|GALEN COLLEGE

1|Page



NU185 MEDICAL-SURGICAL NURSING II –
EXAM 3 2026 ALL QUESTIONS AND CORRECT
DETAILED ANSWERS WITH RATIONALES
ALREADY A GRADED WITH EXPERT
FEEDBACK |NEW AND REVISED|GALEN
COLLEGE

1. A nurse is assessing a client who has a traumatic brain injury
(TBI) and notes a Glasgow Coma Scale (GCS) score of 8. Which of
the following actions should the nurse take first?
 A) Notify the provider
 B) Assess the client's vital signs
 C) Ensure a patent airway
 D) Prepare for intubation
Rationale: A GCS score of 8 or less indicates a severe brain
injury and requires immediate intervention to protect the airway.
Ensuring a patent airway is the priority, followed by breathing
and circulation (ABCs).
2. A nurse is caring for a client who is 24 hours post-craniotomy.
Which of the following findings should the nurse report to the
provider immediately?
 A) Blood pressure of 130/80 mm Hg
 B) Heart rate of 88 beats per minute
 C) Urine output of 60 mL/hr
 D) Clear drainage from the nose or ears
Rationale: Clear drainage from the nose or ears after a

,2|Page


craniotomy may indicate a cerebrospinal fluid (CSF) leak, which
increases the risk of meningitis. This should be reported
immediately. CSF leakage can be tested for glucose (positive in
CSF).
3. A nurse is providing teaching to a client who has a new diagnosis
of epilepsy and a prescription for phenytoin. Which of the following
statements by the client indicates a need for further teaching?
 A) "I will take my medication at the same time every day."
 B) "I will avoid drinking alcohol while taking this medication."
 C) "I will stop taking my medication once my seizures are
controlled."
 D) "I will notify my provider if I experience any new symptoms."
Rationale: Antiepileptic medications must be taken consistently
and should not be stopped abruptly, as this can precipitate status
epilepticus. Clients should be taught to take medications as
prescribed and not to discontinue without provider guidance.
4. A nurse is assessing a client who has Parkinson's disease. Which
of the following findings should the nurse expect?
 A) Resting tremors and bradykinesia
 B) Nuchal rigidity and photophobia
 C) Muscle weakness and atrophy
 D) Chorea and athetosis
Rationale: Parkinson's disease is characterized by resting
tremors, bradykinesia (slow movement), rigidity, and postural
instability. Nuchal rigidity and photophobia are signs of
meningitis. Muscle weakness and atrophy may indicate muscular
dystrophy or ALS. Chorea and athetosis are seen in Huntington's
disease.

,3|Page


5. A nurse is providing teaching to a client who has a new diagnosis
of multiple sclerosis (MS). Which of the following statements by the
client indicates an understanding of the teaching?
 A) "I will avoid taking hot showers to prevent exacerbation of
symptoms."
 B) "I will increase my intake of high-fat foods."
 C) "I will stop taking my medications once my symptoms resolve."
 D) "I will rest frequently and conserve energy."
Rationale: Clients with MS should avoid overheating (hot
showers, hot weather) as it can exacerbate symptoms (Uhthoff's
phenomenon). Energy conservation and rest are important.
Medications should not be discontinued without provider
guidance.
6. A nurse is assessing a client who has a stroke (cerebrovascular
accident). Which of the following findings should the nurse identify
as a sign of right-sided hemispheric stroke?
 A) Aphasia
 B) Right-sided weakness
 C) Left-sided neglect
 D) Impaired reading ability
Rationale: Right-sided hemispheric stroke typically causes left-
sided motor deficits, left-sided neglect, and spatial-perceptual
deficits. Aphasia and impaired reading ability are associated with
left-sided hemispheric stroke. Right-sided weakness would be
associated with left-sided hemispheric stroke.
7. A nurse is caring for a client who is receiving alteplase (tissue
plasminogen activator) for an acute ischemic stroke. Which of the

, 4|Page


following assessment findings should the nurse monitor for as a
priority?
 A) Hypotension
 B) Bleeding
 C) Tachycardia
 D) Hyperglycemia
Rationale: Alteplase is a thrombolytic agent that can cause
bleeding, including intracranial hemorrhage. The nurse should
monitor the client for signs of bleeding (e.g., changes in level of
consciousness, headache, bleeding gums). Blood pressure should
be monitored but bleeding is the priority.
8. A nurse is assessing a client who has a herniated lumbar disc.
Which of the following findings should the nurse expect?
 A) Pain that radiates down the leg (sciatica)
 B) Pain that worsens with rest
 C) Pain that is relieved by coughing
 D) Pain that radiates down the leg (sciatica)
Rationale: Herniated lumbar disc often causes radicular pain
that radiates down the leg (sciatica) due to nerve root
compression. Pain typically worsens with activity and
coughing/sneezing (increased intrathecal pressure).
9. A nurse is providing postoperative teaching to a client who has
had a total hip arthroplasty. Which of the following instructions
should the nurse include?
 A) Cross legs at the ankles when sitting
 B) Avoid crossing legs and maintain abduction
 C) Flex the hip beyond 90 degrees when sitting