NU185 MEDICAL-SURGICAL NURSING II EXAM 1 PREP 2026 ALL QUESTIONS AND CORRECT DETAILED ANSWERS WITH RATIONALES ALREADY A GRADED WITH EXPERT FEEDBACK |NEW AND REVISED |GALEN COLLEGE

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

1. A nurse is caring for a client who has a serum potassium level of
5.8 mEq/L. Which of the following findings should the nurse expect?
 A) Hypotension and weak pulses
 B) Cardiac dysrhythmias and muscle weakness
 C) Muscle cramps and abdominal cramping
 D) Thirst and dry mucous membranes
Rationale: A serum potassium level of 5.8 mEq/L indicates
hyperkalemia. Hyperkalemia can cause cardiac dysrhythmias
(such as peaked T-waves on ECG) and muscle weakness.
Hypotension and weak pulses are associated with hypokalemia or
hypovolemia. Muscle cramps and abdominal cramping are
associated with hypokalemia. Thirst and dry mucous membranes
are associated with hypernatremia.
2. A nurse is preparing to administer a blood transfusion to a client.
Which of the following actions should the nurse take first?
 A) Obtain the client's vital signs
 B) Verify the blood product with another licensed nurse
 C) Verify the provider's prescription for the blood transfusion

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 D) Initiate a large-bore IV line for the transfusion
Rationale: The nurse should first verify the provider's
prescription for the blood transfusion, including the type and
amount of blood product. This ensures the correct product is
being administered. Vital signs, verification with another nurse,
and IV access are important but should follow the verification of
the prescription.
3. A nurse is providing teaching to a client about a low-sodium diet.
Which of the following foods should the nurse recommend?
 A) Canned vegetable soup
 B) Processed cheese slices
 C) Fresh fruits and vegetables
 D) Pickled vegetables
Rationale: Fresh fruits and vegetables are naturally low in
sodium and are recommended on a low-sodium diet. Canned
soups, processed cheeses, and pickled vegetables are high in
sodium.
4. A nurse is assessing a client who has a sodium level of 150 mEq/L.
Which of the following findings should the nurse expect?
 A) Hypotension and weak pulses
 B) Thirst and dry mucous membranes
 C) Muscle cramps and abdominal cramping
 D) Lethargy and confusion
Rationale: A sodium level of 150 mEq/L indicates
hypernatremia. Thirst and dry mucous membranes are classic
signs due to cellular dehydration. Lethargy and confusion can
occur with severe hypernatremia but are not the primary early
signs.

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5. A nurse is caring for a client who is postoperative and reports
pain at a level of 8 on a 0-to-10 pain scale. Which of the following
actions should the nurse take first?
 A) Administer the prescribed PRN analgesic
 B) Reposition the client to improve comfort
 C) Assess the client's vital signs and pain characteristics
 D) Notify the provider of the client's pain level
Rationale: The nursing process begins with assessment. Before
intervening, the nurse should perform a focused pain
assessment, including location, quality, intensity, and
characteristics, as well as checking vital signs to ensure safe
medication administration.
6. A nurse is preparing to insert a nasogastric (NG) tube for gastric
decompression. Which of the following positions should the nurse
place the client in to facilitate the procedure?
 A) Supine with the head of the bed flat
 B) High Fowler's position with the head tilted slightly forward
 C) Semi-Fowler's position with the head tilted backward
 D) Prone position with the head turned to the side
Rationale: High Fowler's position with the head tilted slightly
forward aligns the natural curvature of the airway and
esophagus, facilitating passage of the NG tube and reducing the
risk of aspiration.
7. A nurse is caring for a client who is receiving continuous enteral
feedings through a nasogastric tube. Which of the following actions
should the nurse take to prevent aspiration?
 A) Flush the tube with 30 mL of water every 2 hours

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 B) Administer the feeding as a bolus rather than continuous
 C) Keep the head of the bed elevated at least 15 degrees
 D) Keep the head of the bed elevated at least 30 degrees
Rationale: Keeping the head of the bed elevated at least 30
degrees (and ideally 30-45 degrees) during continuous enteral
feedings reduces the risk of aspiration by preventing reflux of
gastric contents.
8. A nurse is assessing a client's oxygen saturation using a pulse
oximeter. Which of the following factors can cause a false low
reading?
 A) The client's hemoglobin level is elevated
 B) The client has poor peripheral perfusion
 C) The client's body temperature is elevated
 D) The client is receiving supplemental oxygen
Rationale: Poor peripheral perfusion, such as in hypothermia,
shock, or vasoconstriction, can cause a false low pulse oximetry
reading because the device cannot detect adequate blood flow.
Supplemental oxygen can cause a false high reading.
9. A nurse is preparing to administer an intramuscular (IM)
injection using the ventrogluteal site. Which of the following actions
should the nurse take to locate the site?
 A) Place the heel of the hand on the greater trochanter with the
thumb pointing toward the iliac crest
 B) Place the heel of the hand on the greater trochanter with the
thumb pointing toward the anterior superior iliac spine
 C) Place the palm of the hand on the iliac crest with the fingers
pointing toward the knee